6.2.1 Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer (376)

Cherith Semple, Clinical Nurse Specialist - Head and Neck Cancer, Cancer Services, South Eastern Trust NI, Belfast, Northern Ireland, United Kingdom Co authors: Lynn Dunwoody, George Kernohan & Eilis McCaughan cherith.semple@setrust.hscni.net

Abstract:

Patients who have completed treatment for head and neck cancer report a high level of physical and psychological dysfunction, indicating a need for post-treatment psychosocial intervention. These post-treatment challenges are not isolated to one discrete or unitary aspect of life, but span across many domains, contributing to the holism of individuals’ post-treatment experience. A problem-focused psychosocial intervention programme was developed targeting eight specific post-treatment problems, which included, anxiety, depression, eating and drinking difficulties, speech problems, fatigue, altered appearance, financial concerns and smoking cessation.

The intervention was delivered in an individualised format, with bibliotherapy as an adjunct following the screening of 129 patients for psychosocial difficulties. The intervention for patients with psychosocial difficulties was evaluated using a quasi-experimental design (n= 54), recording 1-week and 3-month post-intervention data. The change in mean outcome scores between the experimental and control group on standardised measures (HADS, WASA and UWQOLv4) were assessed using ANCOVA. The statistical findings demonstrated a reduction in psychological distress (anxiety, p = 0.001; depression, p=0.005), improving social functioning (p=0.048) and quality of life scores (p = < 0.05); which were sustained over time for the experimental group. A patient satisfaction survey was also conducted at 1-week post-intervention and reported that participants were generally very satisfied with the psychosocial intervention.

This study provides tentative evidence that patients with psychosocial dysfunction following treatment for head and neck cancer benefit from a problem-focused psychosocial intervention. Such evidence is essential to inform practice, policy and future research, aimed at improving post-treatment quality of life.

Recommended reading list:

  • Humphris GM, Ozakinci G. (2006) Psychological responses and support needs of patients following head and neck cancer International Journal of Surgery 4, 37 – 44
  • National Institute for Clinical Excellence (2004) Guidance on Cancer Services: Improving outcomes in head and neck cancer – The Manual. London: National Institute for Clinical Excellence
  • Semple CJ, Sullivan K, Dunwoody L, Kernohan WG. (2004) Psychosocial interventions for patients with head and neck cancer: past, present and future. Cancer Nursing. 27 (6) 434 - 441

Source of Funding: UK - Health Service (Local)

Amount in Funding: 100,001 - 500,000

Biography:

Completed BSc (Hons) Nursing at the University of Ulster in 1995. Appointed Macmillan Clinical Nurse Specialist (CNS) in Head and Neck Oncology in 1999. From 2002 - 2005 full-time doctoral studies after being awarded a three year Research and Development Fellowship from the R&D Office in Northern Ireland. Currently, working as Macmillan CNS in Head and Neck Oncology with protected research time. Research interests include quality of life issues for patients with head and neck cancer, and more specifically, information needs, post-treatment psychosocial intervention and support needs of parents with young children who have been diagnosed with head and neck cancer.