Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer Effects of psychosocial intervention on quality of life in patients with head and neck cancer. Psychosocial effects of a skin camouflage program in female survivors with head and neck cancer: A randomized controlled trial Long-term effect of a nurse-led psychosocial intervention on health-related quality of life in patients with head and neck cancer: a randomised controlled trial Psychological distress in head and neck cancer patients 7-11 years after curative treatment. One-year effect of a nurse-led psychosocial intervention on depressive symptoms in patients with head and neck cancer: a randomized controlled trial. A general critical appraisal tool: an evaluation of construct validity. Teaching head and neck cancer patients coping strategies: results of a feasibility study. Development and pilot testing of a psychoeducational intervention for oral cancer patients. Research paper: Impact on Quality of Life of a Telemedicine System Supporting Head and Neck Cancer Patients: A Controlled Trial During the Postoperative Period at Home A Tailored Smoking, Alcohol, and Depression Intervention for Head and Neck Cancer Patients Impact of a telehealth intervention on quality of life and symptom distress in patients with head and neck cancer. Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors Long-term health-related quality of life in survivors of head and neck cancer. Results of a feasibility study for a psycho-educational intervention in head and neck cancer. Individualised mindfulness‐based stress reduction for head and neck cancer patients undergoing radiotherapy of curative intent: a descriptive pilot study Comparison of Two Types of Meditation on Patients' Psychosocial Responses During Radiation Therapy for Head and Neck Cancer. Comparison of psychosocial outcomes in head and neck cancer patients receiving a coping strategies intervention and control subjects receiving no intervention. Reliability analysis for a proposed critical appraisal tool demonstrated value for diverse research designs. Prospective evaluation of health-related quality of life in long-term oral and oropharyngeal cancer survivors and the perceived need for supportive care. P02.170. Mindfulness-based stress reduction (MBSR) for breast cancer: a systematic review of randomized-controlled trials An investigation of the effect of tailored information on symptoms of anxiety and depression in Head and Neck cancer patients.
Background The incidence of head and neck cancer is increasing slightly . Head and neck cancer but also it ’s necessary and often successful treatment may affect general domains of health-related quality of life and provoke a variety of adverse symptoms and side effects , both during and after treatment . The objective of this study was to compare a person-centred care intervention in terms of health-related quality of life , disease-specific symptoms or problems , with traditional care as a control group for patients with head and neck cancer . Methods In this r and omized controlled trial ,  person – centred-care intervention and traditional care ( control ) groups comprised 54 and 42 patients , respectively . Outcome measures used were : the EORTC QLQ-C30 and the EORTC QLQ-C35 . Both groups answered the question naires at baseline and after 4 , 10 , 18 and 52 weeks from start of treatment . The question naires ’ scores were compared between groups by using independent sample s test and non-parametric test for continuous variables . For categorical data , Fisher ’s exact test was used . Longitudinal data were analysed using generalized linear models for normally distributed repeated measures data . Results At baseline , the intervention and control groups were comparable in terms of medical and sociodemographic variables , clinical characteristics , health-related quality of life and disease-specific symptoms or problems . At all the follow-up points , even during the worst period for the patients , the person-centred-care group consistently reported better scores than the control group . The differences were numerically but not always statistically significant . When testing longitudinal data , statistically significant results were found for head and neck cancer-specific problems , swallowing ( p = 0.014 ) , social eating ( p = 0.048 ) and feeling ill ( p = 0.021 ) . Conclusions The results from this study suggest that adopting the person-centred-care concept practice d here could be a way to improve function and wellbeing in patients with head and neck cancer . Trial registration The study was retrospectively registered in 2016 - 12 - 05 in Clinical Trials gov . “ Can a Person-centred-care Intervention Improve Health-related Quality of Life in Patients With Head and Neck Cancer ” registration number : NCT02982746 Goals of the work Patients with head and neck cancer have complex needs that affect many basic functions of life and contribute to substantial psychosocial problems . The aim of this study was to evaluate the effectiveness of a problem-focused intervention for patients with psychosocial dysfunction who had completed treatment for head and neck cancer . Patients and methods Using a quasi-experimental design , 54 participants who were above pre-determined cutoff points for psychosocial dysfunction ( hospital and depression scale , work and social adjustment scale ) were given the opportunity to self-select into either the experimental group for the psychosocial intervention programme which was delivered in an individualised format , with bibliotherapy as an adjunct , or the control group for usual care . Main results Analysis of covariance results 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 ) for the experimental group , all of which were sustained into the 3-month follow-up period . No such improvements were evident for the control group . Conclusions This study suggests that head and neck cancer patients with post-treatment psychosocial dysfunction  can benefit from a problem-focused psychosocial intervention . Such evidence can inform practice , policy and future research , aim ed at improving post-treatment quality of life for patients with head and neck cancer BACKGROUND A longitudinal , prospect i ve , case-control study evaluated if a psychosocial support program improved health-related quality of life ( HRQL ) in head and neck ( H&N ) cancer patients . METHODS One hundred forty-four H&N cancer patients were included : 52 study patients and 92 controls . The study group met the support team repeatedly throughout the first year after diagnosis . HRQL was assessed three times during the first year and after 3 years using the EORTC QLQ-C30 , EORTC QLQ-H&N35 , and HADS . RESULTS A few statistically significant differences were found , all favoring the controls . Controls reported better global quality of life after 1 year and felt less ill after 3 years . Depression and treatment-related side effects were prevalent in both groups . CONCLUSIONS Our psychosocial support program did not improve HRQL in H&N cancer patients . Its effectiveness may be improved by evaluating and actively integrating HRQL assessment s during the program , thereby enabling rapid and adequate symptomatic treatment and /or psychologic intervention OBJECTIVE The purpose of this study was to evaluate the effects of a skin camouflage program on disfigurement , self-esteem , social interaction , and body image in female head and neck cancer ( HNC ) survivors . METHODS A prospect i ve , repeated- measures , r and omized controlled therapeutic intervention design was used . A total of 66 participants were r and omly assigned to each group , with 32 in the experimental group and 34 in the control group . The experimental group received a 4-session skin camouflage program , and the control group received routine care . Patients were assessed at 3 time points : baseline assessment ( T0 ) and then at 1 , 2 , and 3 months ( T1 , T2 , and T3 , respectively ) after participating in the skin camouflage program . RESULTS Patients in the experimental group had significantly less facial disfigurement , depression , fear of social interaction , and anxiety regarding social interaction compared with those in the control group . Participants in both groups had significantly lower levels of facial disfigurement , depression , fear of social interaction , anxiety of social interaction , and body image at the final posttest assessment than at the pretest assessment . There were no differences between the groups and within groups with respect to self-esteem . CONCLUSIONS The 3-month skin camouflage program effectively improved facial disfigurement , fear of social interaction , anxiety of social interaction , and body image of female HNC survivors . A survival care plan should include a skin camouflage program to improve body image perception and decrease anxiety after treatment of HNC Background : Head and neck cancer ( HNC ) patients are prone to have a poor health-related quality of life after cancer treatment . This study investigated the effect of the nurse counselling and after intervention ( NUCAI ) on the health-related quality of life and depressive symptoms of HNC patients between 12 and 24 months after cancer treatment . Methods : Two hundred and five HNC patients were r and omly allocated to NUCAI ( N=103 ) or usual care ( N=102 ) . The 12-month nurse-led NUCAI is problem-focused and patient-driven and aims to help HNC patients manage with the physical , psychological and social consequences of their disease and its treatment . Health-related quality of life was evaluated with the EORTC QLQ-C30 and QLQ H&N35 . Depressive symptoms were evaluated with the CES-D. Results : At 12 months the intervention group showed a significant ( P<0.05 ) improvement in emotional and physical functioning , pain , swallowing , social contact , mouth opening and depressive symptoms . At 18 months , global quality of life , role and emotional functioning , pain , swallowing , mouth opening and depressive symptoms were significantly better in the intervention group than in the control group , and at 24 months emotional functioning and fatigue were significantly better in the intervention group . Conclusion : The NUCAI effectively improved several domains of health-related quality of life and depressive symptoms in HNC patients and would seem a promising intervention for implementation in daily clinical practice Long-term survivors of head and neck cancer may suffer from psychological distress and reduced quality of life because of late side-effects of the treatment . In a follow-up study of patients r and omised to two different radiation fractionating regimens , 204 patients filled in a mailed question naire 7 - 11 years after treatment . The question naire consisted of the General Health Question naire , 20-item version ( GHQ-20 ) , and the EORTC Core Quality of Life Question naire ( EORTC QLQ-C30 ) . There were no differences in psychological distress between patients receiving conventional radiotherapy  and those receiving a slightly hypofractionated regimen .  A high prevalence of psychological distress was found in both treatment groups ( 30 % of ' cases ' according to the GHQ-20 ) , especially in patients with impaired cognitive or social function , or with pain . Clinicians need to be aware of this morbidity , and their ability to detect patients with psychological problems needs to be improved . The GHQ-20 can facilitate the communication process in a clinical setting . With an increased awareness of these problems and by using valid instruments for identification of patients at risk , the clinicians may intervene and help the patients to reduce their psychological distress BACKGROUND Many patients with head and neck cancer ( HNC ) experience depressive symptoms after treatment . This r and omized controlled trial investigated the effects of a psychosocial nurse counseling and after intervention ( NUCAI ) versus usual care on the depressive and HNC-related physical symptoms of patients with HNC at 1 year after diagnosis . METHODS A total of 205 patients with HNC were r and omly assigned to either intervention ( n = 103 ) or usual care ( n = 102 ) , with stratification for gender and tumor stage . The NUCAI , which consisted of six bimonthly 45-minute counseling sessions , was a problem-focused intervention aim ed at helping patients to manage the physical , psychological , and social consequences of HNC and its treatment . It was nurse-led and offered in combination with regular medical follow-up visits at the University Medical Center Utrecht , the Netherl and s. Depressive symptoms at 1 year after diagnosis were the primary outcome . Analyses were performed on an intention-to-treat basis for the total sample and for a predefined subgroup of patients with raised levels of depressive symptoms ( Center for Epidemiologic Studies -Depression score ≥ 12 ; n = 91 ) at baseline using mixed-effect models . RESULTS One year after HNC treatment , levels of depressive symptoms were significantly lower in the intervention group than in the control group in the total sample and in the subgroup of patients with raised levels of depressive symptoms . CONCLUSION The NUCAI was feasible and effective in reducing depressive symptoms in patients with HNC 1 year after HNC treatment , and especially in patients with raised levels of depressive symptoms . The results of this study need to be confirmed in future studies before the NUCAI can be used in daily clinical practice BACKGROUND Many critical appraisal tools ( CATs ) exist for which there is little or no information on development of the CAT , evaluation of validity , or testing reliability . The proposed CAT was developed based on a number of other CATs , general research methods theory , and reporting guidelines but requires further study to determine its effectiveness . OBJECTIVES To establish a scoring system and to evaluate the construct validity of the proposed critical appraisal tool before undertaking reliability testing . METHODS Data obtained from this exploratory study along with information on the design of the proposed CAT were combined to evaluate construct validity using the St and ards for educational and psychological testing which consist of five types of evidence : test content , response process , internal structure , relations to other variables , and consequences of testing . To obtain data for internal structure and relations to other variables , the proposed CAT was analysed against five alternative CATs . A r and om sample of 10 papers from six different research design s across the range of health related research were selected , giving a total sample size of 60 papers . RESULTS In all research design s , the proposed CAT had significant ( p<0.05 , two-tailed ) weak to moderate positive correlations ( Kendall 's τ 0.33 - 0.55 ) with the alternative CATs , except in the Preamble category . There were significant moderate to strong positive correlations in the quasi-experimental ( τ 0.70 - 1.00 ) , descriptive/exploratory/observational ( τ 0.72 - 1.00 ) , qualitative ( τ 0.74 - 0.81 ) , and systematic review ( τ 0.62 - 0.82 ) design s and to a lesser extent in the true experimental ( τ 0.68 - 0.70 ) design . There were no significant correlations in the single system research design s. CONCLUSIONS Based on the results obtained , the theory on which the proposed CAT was design ed , and the objective of the proposed CAT there was enough evidence to show that inferences made from scores obtained from the proposed CAT should be sound To test the feasibility of providing a psycho-educational intervention for people with head and neck ( H&N ) cancer . A prospect i ve non-r and omized design was used . Subjects were patients with H&N cancer . They were offered the Nucare coping strategies program in one of three formats : small group and one-to-one formats with therapists ; and a home format , with material for home use , without a therapist . Outcomes measures ( quality of life ( QOL ) and anxiety and depression ) were collected at baseline and following the intervention . Analyses were performed using non-parametric statistics . Of 128 people invited to participate , 66 agreed , 59 completed the intervention and 50 had outcomes data . Following the intervention , there were significant improvements in physical and social functioning and global QOL , and reduced fatigue , sleep disturbance and depressive symptoms . These data suggest that the intervention may have some beneficial effects , although an appropriately design ed study is required to confirm this OBJECTIVE Oral cancer elicits considerable distress in both the pre and post-treatment periods . This paper details the development , validation and pilot-testing of a psychoeducational intervention for oral cancer patients . METHOD An educational booklet covering information about oral cancer and its treatment and effective coping strategies was developed by a multi-disciplinary team . It was evaluated by patient focus groups and content/educational experts , delivered to subjects in pre and post-operative presentations by a health educator , and pilot-tested in a r and omized controlled trial versus st and ard care . RESULTS Pilot data from 19 subjects ( 10 psychoeducation , nine st and ard care )  indicates that the intervention is feasible and highly acceptable . At follow-up the intervention group showed a gain in knowledge , less body image disturbance , lower anxiety and a trend toward higher wellbeing . CONCLUSION This program , which is currently being evaluated in a larger RCT with extended follow-up , should prove useful in reducing the psychosocial burden of oral cancer and its treatment OBJECTIVES Telemedicine applications carry the potential to enhance the quality of life of patients , but studies evaluating telemedicine applications are still scarce . The evidence regarding the effectiveness of telemedicine is limited and not yet conclusive . This study investigated whether telemedicine could be beneficial to the quality of life of cancer patients . DESIGN AND MEASUREMENTS Between 1999 and 2002 , we conducted a prospect i ve controlled trial evaluating the effects of a telemedicine application on the quality of life of patients with cancer involving the head and neck , using quality of life question naires that covered 22 quality of life parameters . All patients had undergone surgery for head and neck cancer at the Erasmus MC , a tertiary university hospital in The Netherl and s. Patients in the intervention group were given access to an electronic health information support system for a period of six weeks , starting at discharge from the hospital . RESULTS In total , we included 145 patients in the control group and 39 in the intervention group . At 6 weeks , the end of the intervention , the intervention group had significantly improved QoL in 5 of the 22 studied parameters . Only one of these five quality of life parameters remained significantly different at 12 weeks . CONCLUSIONS This study adds to the sparse evidence that telemedicine may be beneficial for the quality of life of cancer patients Background : Smoking , alcohol use , and depression are interrelated and highly prevalent in patients with head and neck cancer , adversely affecting quality of life and survival . Smoking , alcohol , and depression share common treatments , such as cognitive behavioral therapy and antidepressants . Consequently , we developed and tested a tailored smoking , alcohol , and depression intervention for patients with head and neck cancer . Methods : Patients with head and neck cancer with at least one of these disorders were recruited from the University of Michigan and three Veterans Affairs medical centers . Subjects were r and omized to usual care or nurse-administered intervention consisting of cognitive behavioral therapy and medications . Data collected included smoking , alcohol use , and depressive symptoms at baseline and at 6 months . Results : The mean age was 57 years . Most participants were male ( 84 % ) and White ( 90 % ) . About half ( 52 % ) were married , 46 % had a high school education or less , and 52 % were recruited from Veterans Affairs sites . The sample was fairly evenly distributed across three major head and neck cancer sites and over half ( 61 % ) had stage III/IV cancers . Significant differences in 6-month smoking cessation rates were noted with 47 % quitting in the intervention compared with 31 % in usual care ( P < 0.05 ) . Alcohol and depression rates improved in both groups , with no significant differences in 6-month depression and alcohol outcomes . Conclusion : Treating comorbid smoking , problem drinking , and depression may increase smoking cessation rates above that of usual care and may be more practical than treating these disorders separately . ( Cancer Epidemiol Biomarkers Prev 2006;15(11):2203–8 BACKGROUND Patients undergoing treatment for head and neck cancer commonly experience signicant changes in quality of life ( QoL ) and levels of symptom distress . It is not known if a telehealth intervention would mitigate these changes . OBJECTIVE To evaluate the impact of a telehealth intervention on QoL and symptom burden in patients undergoing initial treatment for head and neck cancers . METHODS A r and omized clinical trial comparing the impact on QoL and symptom distress of telehealth intervention and st and ard care was conducted with 80 patients ( 45 treatment , 35 control ) who had been diagnosed with head or neck cancer and were receiving 1 or more treatment modalities . Treatment group participants responded daily to symptom management algorithms using a simple telehealth messaging device .  QoL was evaluated by the Functional Assessment of Cancer Therapy-Head and Neck Scale ( FACTHN ) and symptom burden by the Memorial Symptom Assessment Scale ( MSAS ) . Control group participants completed assessment s while they received routine care . RESULTS In the posttreatment phase , the telehealth participants had signicantly better scores than the controls for physical well-being ( 20.6 vs 17.0 , P = .02 ) and trial outcome index ( 59.9 vs. 50.2 , P = .04 ) on the FACT-HN , and total scores on the MSAS ( 0.9 vs. 1.2 , P = .04 ) . LIMITATIONS The moderate sample size of 80 patients limits the power to measure more subtle impacts of the intervention . CONCLUSIONS Using telehealth to provide support to patients with head and neck cancer during the acute phase of treatment improved some aspects of posttreatment QoL and symptom burden The primary aim was to determine the efficacy of the Distress Thermometer ( DT ) in screening for anxiety and mood problems against the University of Washington Quality of Life , version 4 ( UWQOL ) . Secondary aims were to evaluate the association between demographic , clinical and health-related QOL variables with significant distress . Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospect ively recruited . Both DT and UWQOL were completed pre-consultation . Receiver operating characteristic ( ROC ) curve analyses of DT score for anxiety dysfunction yielded an area under the curve ( AUC ) of 0.877 , with a sensitivity of 84 % ( 43/51 ) and specificity of 76 % ( 159/210 ) for a DT cut-off of ≥4 ; with a corresponding AUC of 0.825 for mood with sensitivity 78 % ( 28/36 ) and specificity 71 % ( 159/225 ) . Treatment with radiotherapy and a longer consultation time were associated with significant distress ( DT ≥4 ) . Significant distress was also reported in two third of those reporting less than “ Good ” overall QOL . Distress levels were particularly associated with poor Social – Emotional function , more so than the association seen with poor physical function . DT is a reasonable screening tool for distress in the HNC population . The DT cut-off score ≥4 was effective in identifying those with significant distress . Significant distress is associated in survivors with poor health-related quality of life , those who received radiotherapy and patients who have longer consultation times in clinic OBJECTIVE To examine health-related quality of life ( HRQOL ) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores . DESIGN Prospect i ve , observational outcomes study . SETTING Tertiary care institution . PATIENTS A total of 337 patients diagnosed as having head and neck carcinoma between January 1995 and December 2004 , who enrolled in the Outcomes Assessment Project and survived at least 5 years . INTERVENTIONS While participating in the longitudinal Outcomes Assessment Project , patients filled out surveys measuring HRQOL at numerous points in time . MAIN OUTCOME MEASURES Outcomes included 5-year scores in eating , speech , aesthetics , social disruption , physical and mental health , depressive symptoms , and overall quality of life ( QOL ) . In addition to analyzing patients ' 5-year HRQOL outcomes , multivariate analyses were performed to determine which patient , clinical , treatment , and 1-year HRQOL factors independently predicted these 5-year outcomes . RESULTS Overall , the cohort 's long-term general health was similar to that to age-matched norms from the general population . But over 50 % of these survivors had problems eating , 28.5 % reported depressive symptoms , and 17.3 % reported substantial pain . At long-term follow-up , 13.6 % continued to smoke , and 38.9 % used alcohol . Multivariate analyses demonstrated that 1-year pain and diet were the strongest independent predictors of 5-year HRQOL outcomes . CONCLUSIONS Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems that these survivors face . Early interventions addressing eating issues , swallowing problems , and pain management will be a crucial component in improving this patient population 's long-term QOL , especially in those who are functioning poorly 1 year after diagnosis BACKGROUND With survival rates for people with head and neck ( H&N ) cancers static during the past 30 years and the enormous burden of psychosocial impacts they suffer well documented , the testing of psychosocial interventions in this group is a priority . OBJECTIVE To test the feasibility of providing a psycho-educational intervention for people with H&N cancer . METHODOLOGY A prospect i ve non-r and omised design was used . Subjects were patients with H&N cancer . They were offered the Nucare coping strategies program in one of three formats : small group and one-to-one formats with therapists ; and a home format , with material for home use , without a therapist . Outcomes measures ( quality of life ( QOL ) and anxiety and depression ) were collected at baseline and following the intervention . Analyses were performed using non-parametric statistics . RESULTS Of 128 people invited to participate , 66 agreed , 59 completed the intervention and 50 had outcomes data . Following the intervention , there were significant improvements in physical and social functioning and global QOL , and reduced fatigue , sleep disturbance and depressive symptoms . CONCLUSIONS These data suggest that the intervention is desired by the target group , feasible to deliver after cancer therapy and may have some beneficial effects , although an appropriately design ed study is required to confirm this People with head and neck cancer ( HNC ) experience elevated symptom toxicity and co-morbidity as a result of treatment , which is associated with poorer psychosocial and quality -of-life ( QoL ) outcomes . This Phase I study examined whether an individualised mindfulness-based stress reduction ( IMBSR ) programme could be successfully used with HNC patients undergoing curative treatment . Primary aims were to explore feasibility , compliance , acceptability and fidelity . Secondary aims were to determine whether ( 1 ) participation in the intervention was associated with changes in post-intervention mindfulness and ( 2 ) post-intervention mindfulness was associated with post-intervention distress and QoL.  Nineteen HNC patients participated in a seven-session IMBSR programme with pre- and post-test outcome measures of psychological distress , depression , anxiety and QoL. Primary aims were assessed by therapists or participants . Mindfulness , distress and QoL were assessed using self-report question naires at pre- and post-intervention . Longer time spent meditating daily was associated with higher post-intervention mindfulness . After controlling for pre-intervention mindfulness , there was an association between higher post-intervention mindfulness and lower psychological distress and higher total , social and emotional QoL. This study offers important preliminary evidence than an IMBSR intervention can be administered to HNC patients during active cancer treatment . A r and omised controlled trial is warranted to confirm these findings OBJECTIVES Radiation treatment for head and neck cancer introduces adaptive dem and s and subjects patients to significant and unique psychosocial challenges . There is growing evidence that meditation is useful in lessening anxiety and depression in cancer patients . This study compared the effects of two types of meditation training on the psychological responses of patients with head and neck cancer during radiation therapy .  DESIGN R and omized clinical trial . SETTING Smilow Cancer Hospital at Yale New Haven . PATIENTS A total of 29 patients with head and neck cancers were recruited and 28 patients were followed during their radiation therapy over 12 weeks . INTERVENTIONS Depending on their group assignment , patients were taught one of two st and ardized meditations : meditation with a coach or self-meditation with a CD . OUTCOME MEASURES Patient psychosocial responses were defined as anxiety , depression , and emotional distress and were measured by the Hospital and Anxiety Depression Scale ( HADS ) and the Emotional Distress Thermometer . Measures were self-reported and collected by the nurse manager at baseline and 6 and 12 weeks during the patient 's scheduled weekly visit . RESULTS No significant mean differences were found between the two meditation groups on all three outcomes : anxiety , depression , and emotional distress . Patients in both the meditation with a coach and self-meditation with a CD groups reported less distress from baseline and at 6 and 12 weeks , as evidence d by the HADS anxiety scale . CONCLUSIONS This study demonstrated two equally effective meditation techniques that can be implemented with patients experiencing high stress during radiation treatments in any health care setting to decrease patient anxiety , depression , and emotional distress . The data established self-meditation with a CD as a more cost-effective alternative to meditation with a coach , which requires intensive training and time commitment for patients This feasibility study aim ed at comparing psychosocial outcomes in head and neck cancer patients receiving the Nucare program  with a group of control subjects receiving no intervention .  A prospect i ve , nonr and omized study design was used . The Nucare program , a short-term psychoeducational coping strategies intervention , was the test intervention . Control subjects were matched to intervention subjects by cancer stage and time since cancer diagnosis . Outcomes were quality of life and depressive symptoms evaluated at baseline and 3 to 4 months later . One hundred thirty-eight subjects were recruited , and outcome data were available on 101 subjects . At outcome evaluation , compared with their baseline scores , the intervention group had improved physical and social functioning , global quality of life , fatigue , sleep disturbance , and depressive symptoms ; the control group showed no changes in quality of life or depressive symptoms . The results suggest that the Nucare program may improve quality of life and reduce depressive symptoms in head and neck cancer patients OBJECTIVE To examine the reliability of scores obtained from a proposed critical appraisal tool ( CAT ) . STUDY DESIGN AND SETTING Based on a r and om sample of 24 health-related research papers , the scores from the proposed CAT were examined using intraclass correlation coefficients ( ICCs ) , generalizability theory , and participants ' feedback . RESULTS The ICC for all research papers was 0.83 ( consistency ) and 0.74 ( absolute agreement ) for four participants . For individual research design s , the highest ICC ( consistency ) was for qualitative research ( 0.91 ) and the lowest was for descriptive , exploratory and observational research ( 0.64 ) . The G study showed a moderate research design effect ( 32 % ) for scores averaged across all papers . The research design effect was mainly in the Sampling , Results , and Discussion categories ( 44 % , 36 % , and 34 % , respectively ) . The scores for research design s showed a majority paper effect for each ( 53 - 70 % ) , with small to moderate rater or paper × rater interaction effects ( 0 - 27 % ) . CONCLUSIONS Possible reasons for the research design effect were that the participants were unfamiliar with some of the research design s and that papers were not matched to participants ' expertise . Even so , the proposed CAT showed great promise as a tool that can be used across a wide range of research design PURPOSE To evaluate long-term changes in health related quality of life ( HRQOL ) in oral/oropharyngeal cancer survivors and their need for and use of supportive care . METHODS Between 1999 and 2001 , 80 advanced oral or oropharyngeal cancer patients treated with free-flap reconstruction and postoperative radiotherapy were included in a prospect i ve study of whom 27 patients were long-term survivors ( mean 9.2 years , range 8 - 11 years ) . The HRQOL of 26 patients ( response rate 96 % ) was assessed with the EORTC QLQ-C30 and QLQ-H&N35 question naires at four points in time : pretreatment ( baseline ) , and at 6 months , 12 months ( short term ) and 8 - 11 years ( long-term ) follow up . A study specific question naire was developed to evaluate the need for and use of supportive care ( allied health services , peer contact , psychosocial care , and complementary care ) and was completed at the period of treatment and at long-term follow up . RESULTS A number of HRQOL domains worsened significantly ( p < 0.01 ) in the long-term : emotional functioning , social functioning , swallowing , speech , taste/smell , dry mouth , sticky saliva and coughing assessed by the mixed effects statistical model . At time of treatment , the need for supportive care was the highest for a dental hygienist ( 77 % ) , a physical therapist ( 73 % ) , a speech therapist ( 42 % ) , a dietician ( 38 % ) , and a special diet ( 62 % ) . At long-term follow up , the need for supportive care was limited to a dental hygienist ( 46 % ) and a physical therapist ( 23 % ) . Only small differences were observed between the perceived need for and actual use of supportive care . CONCLUSION A range of HRQOL domains in head and neck cancer survivors were deteriorated in the long-term compared to baseline and to the first year after treatment . At time of treatment and less frequently at long-term follow up , patients reported needing and using a variety of supportive care services Methods MEDLINE , PsychInfo , EMBASE , CAMBASE , and the Cochrane Library were screened through October 2011 . R and omized controlled trials ( RCTs ) comparing MBSR to controls  were analyzed . Risk of bias was assessed using the Cochrane risk of bias tool . For each outcome , st and ardized mean differences ( SMD ) and 95 % confidence intervals ( CI ) were calculated , if at least 2 studies assessing this outcome were available . As a measure of heterogeneity , I was calculated OBJECTIVE To investigate if tailored information provision decreases symptoms of anxiety and depression in late stage Head and Neck ( H&N ) cancer patients . METHODS This non-r and omized , controlled trial was conducted with stage III or IV H&N cancer patients . Subjects were recruited at two academic health centers in Montreal . At the test center , subjects received the Multimode Comprehensive Tailored Information Package ( MCTIP ) , while at the control center , they received normal information provision . Participants were evaluated using the Hospital Anxiety and Depression Scale ( HADS ) at baseline and 3 and 6 month later . Data were analyzed using descriptive statistics then T tests and chi square tests to compare group differences and finally mixed model analysis to test differences in outcome variables . RESULTS A total of 103 subjects were recruited and of them 96 ( 47 tests and 49 controls ) participants completed baseline , 3 and 6 month evaluations . The test group experienced lower levels of anxiety ( p = 0.001 ) and depression ( p = 0.089 ) than the control group . CONCLUSION The subjects receiving tailored information had lower levels of anxiety than their counterparts . In addition , depression showed a reduction in the expected direction in the test group . PRACTICE IMPLICATION S Our results need to be further confirmed using a r and omized approach in different sample s but they suggest benefits for stage III and IV H&N cancer patients receiving tailored , multi-modal information concerning their cancer
Aim The purpose of this systematic review is to identify psychological interventions that have been effective at improving quality of life and reducing psychological distress ( depression and anxiety ) in patients with head and neck cancer .