Pre-Treatment Information on Dysphagia: Exploring the Views of Head and Neck Cancer Patients

• Sally Brockbank, BSc(Hons),Nicholas Miller, PhD,Sarah Owen, BSc(Hons)
,
• Joanne M. Patterson, PhD

Abstract 

Context

Swallowing difficulties (dysphagia) are a common acute and chronic side effect of head and neck cancer treatment. Dysphagia is associated with medical concerns such as malnutrition and pulmonary health as well as quality of life outcomes. Providing information on the likely changes to swallowing is an important component of pre-treatment preparation. There is little research providing the patients’ perspective in this area.

Objectives

This is a qualitative study to describe patients’ views on pre-treatment information regarding changes to eating, drinking and swallowing following chemoradiotherapy treatment for head and neck cancer.

Methods

A purposive sample of 24 head and neck cancer patients with a range of post-treatment dysphagia severity, up to two years following chemoradiotherapy, was selected to participate in focus groups or semi-structured interviews. Thematic analysis was conducted by two researchers and results were verified with three participants.

Results

Half of the participants presented with mild dysphagia, with the remainder having moderate to severe dysphagia.

Mean age was 59 years, mean time post-treatment was 10 months.

Data were grouped into three main themes and subthemes: expectations about treatment outcomes and whether information correlated with pre-treatment information; presentation of information, including the format and delivery; and the difficulties with absorption and retention of information.

Conclusion

Patients require information on the impact and prognosis for their swallowing ability.

There was a general preference for verbal information, from someone knowledgeable about dysphagia. However, there are also individual preferences for the manner and pace at which this information is delivered.

Further research is indicated to explore ways of providing information that is individually tailored to patients’ needs and preferences.

Key Words: Head and neck cancer, swallowing, dysphagia, pre-treatment, qualitative