Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-AS PRISM, Tampa, FL, USA.
Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA.
Support Care Cancer. 2024 Mar 27;32(4):254. doi: 10.1007/s00520-024-08424-3.
Patients with head and neck cancer (HNC) experience significant symptom burden from combination chemotherapy and radiation (chemoradiation) that affects acute and long-term health-related quality of life (HRQOL). However, psychosocial impacts of HNC symptom burden are not well understood. This study examined psychosocial consequences of treatment-related symptom burden from the perspectives of survivors of HNC and HNC healthcare providers.
This was a cross-sectional, mixed-method study conducted at an NCI-designated comprehensive cancer center. Participants (N = 33) were survivors of HNC who completed a full course of chemoradiation (n = 20) and HNC healthcare providers (n = 13). Participants completed electronic surveys and semi-structured interviews.
Survivors were M = 61 years old (SD = 9) and predominantly male (75%), White (90%), non-Hispanic (100%), and diagnosed with oropharynx cancer (70%). Providers were mostly female (62%), White (46%) or Asian (31%), and non-Hispanic (85%) and included physicians, registered nurses, an advanced practice nurse practitioner, a registered dietician, and a speech-language pathologist. Three qualitative themes emerged: (1) shock, shame, and self-consciousness, (2) diminished relationship satisfaction, and (3) lack of confidence at work. A subset of survivors (20%) reported clinically low social wellbeing, and more than one-third of survivors (35%) reported clinically significant fatigue, depression, anxiety, and cognitive dysfunction.
Survivors of HNC and HNC providers described how treatment-related symptom burden impacts psychosocial identity processes related to body image, patient-caregiver relationships, and professional work. Results can inform the development of supportive interventions to assist survivors and caregivers with navigating the psychosocial challenges of HNC treatment and survivorship.
头颈部癌症（HNC）患者在接受联合化疗和放疗（放化疗）治疗时会经历严重的症状负担，这会影响其急性和长期的健康相关生活质量（HRQOL）。然而，HNC 症状负担的心理社会影响尚不清楚。本研究从 HNC 幸存者和 HNC 医疗保健提供者的角度探讨了与治疗相关的症状负担的心理社会后果。
这是一项在 NCI 指定的综合癌症中心进行的横断面、混合方法研究。参与者（N=33）包括完成全疗程放化疗的 HNC 幸存者（n=20）和 HNC 医疗保健提供者（n=13）。参与者完成了电子调查和半结构化访谈。
幸存者的平均年龄为 61 岁（标准差=9），主要为男性（75%）、白人（90%）、非西班牙裔（100%），诊断为口咽癌（70%）。提供者主要为女性（62%）、白人（46%）或亚洲人（31%），非西班牙裔（85%），包括医生、注册护士、高级实践护士从业者、注册营养师和言语语言病理学家。出现了三个定性主题：（1）震惊、羞耻和自我意识，（2）关系满意度降低，以及（3）工作缺乏信心。有一部分幸存者（20%）报告社会幸福感较低，超过三分之一的幸存者（35%）报告有明显的疲劳、抑郁、焦虑和认知功能障碍。
HNC 幸存者和 HNC 提供者描述了与治疗相关的症状负担如何影响与身体形象、医患关系和专业工作相关的心理社会认同过程。研究结果可为开发支持性干预措施提供信息，以帮助幸存者和护理人员应对 HNC 治疗和生存所带来的心理社会挑战。
