Unmet needs and relationship challenges of head and neck cancer patients and their spouses

Abstract

In head and neck cancer (HNC), couple-based interventions may be useful for facilitating treatment completion, patient rehabilitation, and improving both partners’ quality of life (QOL). With the goal of identifying targets for future interventions, we conducted a qualitative study to understand patient and spouse unmet needs and relationship challenges during curative radiotherapy for HNC. Semi-structured interviews were conducted with 6 HNC patients (83% male) and 6 spouses (83% female) within 6 months of completing treatment. Interviews were audiotaped and transcribed using Grounded Theory Analysis. Patients and spouses identified several unmet needs including better preparation regarding the severity of physical side effects, a clearer timeline for recovery, and strategies for dealing with their own and each other’s emotional reactions. Caregiver unmet needs included balancing competing roles/responsibilities, making time for self-care, and finding effective strategies for encouraging patient self-care. Eighty-three percent of spouses and all patients reported increased conflict during treatment. Other relationship challenges included changes in intimacy and social/leisure activities. Findings suggest that couple-based interventions that emphasize the importance of managing physical and psychological symptoms through the regular practice of self-care routines may be beneficial for both patients and spouses. Likewise, programs that teach spouses ways to effectively motivate and encourage patient self-care may help to minimize conflict and help couples navigate HNC treatment and recovery together as a team.

Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature

“…Study characteristics (n = 23) are reported in Table 1. Sample sizes ranged from 6 30,40 to 910 39 dyads. Four studies 37‐40 (17.4%) included patients with various cancer types, whereas 19 (82.6%) studies narrowed their sample by recruiting patients with either a specific cancer type 5,10,30‐36,41,43‐47,49,50 or in one case, a few specific types 42 .…”

“…Four studies 37‐40 (17.4%) included patients with various cancer types, whereas 19 (82.6%) studies narrowed their sample by recruiting patients with either a specific cancer type 5,10,30‐36,41,43‐47,49,50 or in one case, a few specific types 42 . There were 12 cross‐sectional observational, 5,10,30,32,34,35,39‐42,44‐46,48 6 longitudinal, 5,31,36,39,43,49 2 mixed methods, 30,47 2 qualitative, 33,40 and 1 retrospective study 50 . Fifteen studies (65.2%) were conducted in the United States, 5,10,30,32‐34,39‐47 while 8 (34.8%) were international.…”

“…The authors identified several common drawbacks. Only four studies 30,37,39,42 (17.4%) recruited their sample of dyads within a single relationship‐type (spousal or partnered). The other 19 studies included dyads of various relationship types.…”

New frontiers in couple-based interventions in cancer care: refining the prescription for spousal communication

“…Cancer also challenges couples' established communication patterns, roles and responsibilities [10,11]. Whereas some individuals report that cancer brought them closer together, others experience adjustment and communication challenges that fuel interpersonal conflict and can even lead to divorce [12][13][14].…”

In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment

“…Historically a relatively neglected condition, the past decade has seen increasing research interest on head and neck patients (Patterson et al, 2015) and carers (Badr et al, 2016;Balfe et al, 2016a;Balfe et al, 2016b;Balfe et al, 2016c;Balfe et al, 2016d;Balfe et al, 2016e;Hanly et al, 2016). Areas of the head and neck experience continue to be overlooked, however.…”