Nund Rebecca L, Scarinci Nerina A, Cartmill Bena, Ward Elizabeth C, Kuipers Pim, Porceddu Sandro V
a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , QLD , Australia .
b Centre for Functioning and Health Research, Metro South Hospital and Health Services District, Queensland Health , Buranda , QLD , Australia .
Disabil Rehabil. 2016;38(5):462-71. doi: 10.3109/09638288.2015.1046563. Epub 2015 May 18.
Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC.
Twelve carers of people with dysphagia following HNC participated in individual semi-structured, in-depth interviews. Categories and sub-categories identified from the qualitative analysis were mapped to the ICF using the established linking rules.
The majority of the categories and sub-categories from the qualitative analysis were successfully linked to the ICF with most linking to the Activities and Participation component. A number of contextual factors were also identified as impacting on the functioning of carers.
The ICF can be successfully used to describe the third-party disability in carers of people with dysphagia following HNC management. This information could be used by clinicians, researchers and policy makers to help establish evidence-based guidelines that include carers in the assessment and management of dysphagia associated with HNC.
Clinical levels of distress and reduced quality of life have been associated with caring for a person with dysphagia following head and neck cancer. The flow-on effects of dysphagia experienced by a carer or close family member can be understood as a third-party disability, which impacts on their functioning, activities and participation in the context of the environment and personal factors. Using the ICF to describe the indirect effects of dysphagia on the carer may help to guide the assessment and support of this population, and advocate for the inclusion of the concerns of the carer in dysphagia management.
第三方残疾涉及个人损伤对其家庭成员或重要他人的功能和能力产生的影响。随着研究表明头颈癌（HNC）后吞咽困难对护理者具有广泛影响，本研究旨在确定国际功能、残疾和健康分类（ICF）中描述HNC后吞咽困难患者护理者的第三方残疾的领域和类别。
12名HNC后吞咽困难患者的护理者参与了个体半结构化深度访谈。使用既定的链接规则将定性分析确定的类别和子类别映射到ICF。
定性分析中的大多数类别和子类别成功链接到ICF，其中大部分链接到活动与参与部分。还确定了一些影响护理者的背景因素。
ICF可成功用于描述HNC治疗后吞咽困难患者护理者的第三方残疾。临床医生、研究人员和政策制定者可利用这些信息，帮助制定基于证据的指南，将护理者纳入与HNC相关的吞咽困难评估和管理中。
临床痛苦水平和生活质量下降与照顾头颈癌后吞咽困难患者有关。护理者或亲密家庭成员经历的吞咽困难的连带影响可被理解为第三方残疾，这会影响他们在环境和个人因素背景下的功能、活动和参与。使用ICF描述吞咽困难对护理者的间接影响，可能有助于指导对这一人群的评估和支持，并倡导在吞咽困难管理中纳入护理者的关切。
