Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy

Laurelie R. Wall, Bena Cartmill, Elizabeth C. Ward, Anne J. Hill, Elizabeth Isenring, Sandro V. Porceddu

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Purpose: Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model. Methods: Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated. Results: An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 % reporting swallowing and/or nutritional issues. Distress was reported by 27 % of patients and 30 % of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 % of the time but only 10 % of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both. Conclusions: Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.

Original languageEnglish
Pages (from-to)1227-1234
Number of pages8
JournalSupportive Care in Cancer
Volume24
Issue number3
DOIs
Publication statusPublished - 1 Mar 2016

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Speech-Language Pathology
Dietetics
Head and Neck Neoplasms
Caregivers
Radiotherapy
Deglutition
Radiation Oncology
Information Storage and Retrieval
Deglutition Disorders
Comorbidity
Appointments and Schedules
Joints
Drug Therapy

Cite this

@article{e0d08b11a6144fab90e6e6dc72ec8f3f,
title = "Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy",
abstract = "Purpose: Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model. Methods: Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated. Results: An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 {\%} reporting swallowing and/or nutritional issues. Distress was reported by 27 {\%} of patients and 30 {\%} of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 {\%} of the time but only 10 {\%} of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both. Conclusions: Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.",
author = "Wall, {Laurelie R.} and Bena Cartmill and Ward, {Elizabeth C.} and Hill, {Anne J.} and Elizabeth Isenring and Porceddu, {Sandro V.}",
year = "2016",
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Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy. / Wall, Laurelie R.; Cartmill, Bena; Ward, Elizabeth C.; Hill, Anne J.; Isenring, Elizabeth; Porceddu, Sandro V.

In: Supportive Care in Cancer, Vol. 24, No. 3, 01.03.2016, p. 1227-1234.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Evaluation of a weekly speech pathology/dietetic service model for providing supportive care intervention to head and neck cancer patients and their carers during (chemo)radiotherapy

AU - Wall, Laurelie R.

AU - Cartmill, Bena

AU - Ward, Elizabeth C.

AU - Hill, Anne J.

AU - Isenring, Elizabeth

AU - Porceddu, Sandro V.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose: Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model. Methods: Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated. Results: An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 % reporting swallowing and/or nutritional issues. Distress was reported by 27 % of patients and 30 % of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 % of the time but only 10 % of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both. Conclusions: Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.

AB - Purpose: Dysphagia is a common and debilitating side effect for head and neck cancer (HNC) patients undergoing radiotherapy (RT) with or without chemotherapy ([C]RT) and is associated with nutritional and emotional comorbidities. Emotional sequelae and distress are also known to affect carers of HNC patients. A weekly, joint speech pathology/dietetic (SP/DN) service-delivery model has been employed to manage swallowing/nutritional and associated emotional issues during (C)RT. This study aimed to conduct a service evaluation of the weekly SP/DN clinical model. Methods: Cross-sectional sampling of core service metrics and perceptions of key stakeholders (70 HNC patients, 30 carers, and 10 clinicians) were collated from the Metro South Radiation Oncology Service in Brisbane, Australia. Data from each source was examined separately and then triangulated. Results: An average of 28 patients (SD = 5.54) attended SP/DN appointments per week, with 58 % reporting swallowing and/or nutritional issues. Distress was reported by 27 % of patients and 30 % of carers. Clinicians felt able to adequately identify and manage swallowing and nutrition 90 % of the time but only 10 % of the time for distress. Seventy-six percent of scheduled SP/DN sessions were perceived as necessary by either patients, clinicians or both. Conclusions: Findings demonstrated a third of patients and their carers had a high level of distress during HNC [C]RT, supporting need for the provision of a weekly SP/DN service in a select cohort. However, the routine weekly SP/DN assessment model for all patients undergoing HNC treatment demonstrates the potential for over-servicing. Alternative service-delivery models warrant further evaluation.

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U2 - 10.1007/s00520-015-2912-5

DO - 10.1007/s00520-015-2912-5

M3 - Article

VL - 24

SP - 1227

EP - 1234

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 3

ER -