Survivors’ experiences of dysphagia‐related services following head and neck cancer: Implications for clinical practice

Abstract

The interviews revealed the need for both greater access to services and a desire for services which address the multitude of issues faced by people with dysphagia following HNC in the post-treatment period. Speech and language therapists managing this caseload need to ensure post-treatment services are available and address not only the physical but also the emotional and psychosocial changes impacting people with dysphagia in order to assist them to adjust to, and live successfully with dysphagia. Further research should be conducted to support the development of innovative services and to highlight dysphagia-related survivorship issues to governing bodies/policy makers.

Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes

“…Overall, both patients and clinicians reported higher satisfaction with the TMOC, and perceived it to be more efficient than the SMOC. Access to consistent high‐quality care has been identified as a priority by head and neck cancer survivors . Although patients perceived both service delivery models to be effective, the live consultative nature of the TMOC enabled them to actively participate in their healthcare management.…”

“…Speech pathologists are integral members of the head and neck cancer team and specialize in the assessment, management, and rehabilitation of swallowing and communication disorders. Because of the complex nature of these deficits, expertise in a wide range of specialist clinical tasks is required to provide prompt and accurate intervention that minimizes medical complications and optimizes functional outcomes …”

“…However, not all speech pathologists have the knowledge and skills required to manage this population independently. Hence, ongoing clinical support is generally provided to the local speech pathologist by the specialist clinician from the cancer center and/or the patient travels back to the specialist service for direct intervention . Issues with this current model are that telephone and email contact relies solely on verbal/written reports, which are difficult to validate and risk omissions or the misinterpretation of clinical information.…”

Patient-reported outcomes following parotid-sparing intensity-modulated radiotherapy for head and neck cancer. How important is dysphagia?

“…This has important therapeutic value in both the preparation and management of the patient throughout the rehabilitation process. Recent qualitative studies have highlighted the impact of dysphagia following non-surgical treatment for HNC and the importance of a patient-centred approach to swallowing rehabilitation that addresses not only the impairment, but also the persisting emotional and psychosocial consequences of dysphagia [17,22].…”

Optimising nutrition support in patients with head and neck cancer

“…Moroney et al (2017) reported continual improvement of toxicities post-treatment, however, the first measurement was at two weeks and so it is unknown what occurs during that initial acute period post-treatment. It has been identified as a time when patients feel most vulnerable as they are "entering the unknown", with the post-treatment period described as "probably the worst part" in a recent qualitative study (Nund et al, 2014). Thus a more intensive review period in the first two weeks post-treatment could be trialled.…”