Role of Psychosocial Factors on Communicative Participation among Survivors of Head and Neck Cancer

Abstract

Objective The purpose of this study was to examine the unique contribution of psychosocial factors, including perceived social support, depression, and resilience to communicative participation, among adult survivors of head and neck cancer (HNC). Study Design Cross-sectional. Setting University-based laboratory and speech clinic. Subjects and Methods Adult survivors of HNC who were at least 2 years posttreatment for HNC completed patient-reported outcome measures, including those related to communicative participation and psychosocial function. Multiple linear regression analysis was conducted to predict communicative participation. Self-rated speech severity, cognitive function, laryngectomy status, and time since diagnosis were entered first as a block of variables (block 1), and psychosocial factors were entered second (block 2). Results Eighty-eight adults who were on average 12.2 years post-HNC diagnosis participated. The final regression model predicted 58.2% of the variance in communicative participation (full model R = 0.58, P < .001). Self-rated speech severity, cognitive function, laryngectomy status, and time since diagnosis together significantly predicted 46.1% of the variance in block 1. Perceived social support, depression, resilience, and interactions significantly and uniquely predicted 12.1% of the additional variance in block 2. Conclusion For clinicians, psychosocial factors such as perceived depression warrant consideration when counseling patients with HNC about communication outcomes and when designing future studies related to rehabilitation.

The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults

“…Other self-reported variables including cognitive symptoms, depression, perceived social support, and resilience are also significantly associated with communicative participation. 73,77,78 These findings support the premise that communicative participation is affected by multiple non-speech impairments as well as environmental and personal factors in HNCA survivors, as well as in other populations.…”

Communicative Participation and Quality of Life in Pretreatment Oral and Oropharyngeal Head and Neck Cancer

“…The CPIB measures the impact of HNC on communication in everyday settings, or “communicative participation.” Items in the CPIB were developed on the basis of a literature review 8 and qualitative studies 13 , 14 . The CPIB was subsequently validated in several large‐scale psychometric studies across a number of clinical populations, including HNC, 12,15,16 and has been used to investigate relationships between communicative participation and other HNC outcomes such as speech intelligibility 17 and depression 18 , 19 . One advantage of the CPIB is that it is able to capture communication difficulties, regardless of whether deficits are related to speech, voice, or other contributing factors.…”

Social participation in head and neck cancer survivors with swallowing disorder: World Health Organization Disability Assessment Schedule 2.0 study

“…The effect of cancer location on social participation gained attention in recent researches; however, the relationship could not be made. 29,30 Our study showed that HNC survivors' social participation decreased in the order of oral cavity cancer, pharyngeal cancer (β = 3.4 ± 1.39), and laryngeal cancer (β = 9.2 ± 3.80) after considering all variables. A possible explanation for the poor social participation in laryngeal cancer with swallowing impairment could also be associated with the laryngectomy 31,32 and the use of a voice prosthesis.…”