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. 2024 May;281(5):2575-2585.
doi: 10.1007/s00405-024-08488-1. Epub 2024 Feb 7.

Organization of head and neck cancer rehabilitation care: a national survey among healthcare professionals in Dutch head and neck cancer centers

Ellen Passchier  1   2 , Ann-Jean C C Beck  1   3 , Martijn M Stuiver  1   3   2   4 , Valesca P Retèl  3   5 , Arash Navran  6 , Wim H van Harten  3   5 , Michiel W M van den Brekel  7   8   9 , Lisette van der Molen  1 ; Dutch Head, Neck Society
Affiliations

Organization of head and neck cancer rehabilitation care: a national survey among healthcare professionals in Dutch head and neck cancer centers

Ellen Passchier et al. Eur Arch Otorhinolaryngol. 2024 May.

Abstract

Purpose: Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries.

Methods: An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers.

Results: Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation.

Conclusion: Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways.

Keywords: Barriers and facilitators; Head and neck cancer; Rehabilitation; Survey; Survivorship care; The Netherlands.

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Conflict of interest statement

The study had no funding and there are no conflicts to declare.

Figures

Fig. 1
Fig. 1
Structure and content of the survey. Survey respondents: The representative of the team was a chairman of the DHNS (head and neck surgeon, radiotherapist), nurse specialist or PM&R physician. If available, a representative of the rehabilitation team answered items related to the discipline. The representative of the Financial Department comprised of an manager or employee of the department. aBased on recommendations guideline cancer rehabilitation. bBarriers and facilitators were based on domains of Institute of Medicine (IOM). PM&R, physical medicine and rehabilitation; QoL, quality of life; DHNS, Dutch Head and Neck Society
Fig. 2
Fig. 2
Barriers and facilitators plotted per category Clinician-related, Patient-related, and Organizational and plotted per item. Each plot displays (axis %) the barriers or facilitators reported by the respondents
See this image and copyright information in PMC

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References

    1. IKNL kankerregistratie. 2023. https://iknl.nl/kankersoorten/hoofd-halskanker/registratie/incidentie.
    1. Parke SC, Langelier DM, Cheng JT, Kline-Quiroz C, Stubblefield MD. State of rehabilitation research in the head and neck cancer population: functional impact vs impairment-focused outcomes. Curr Oncol Rep. 2022;24(4):517–532. doi: 10.1007/s11912-022-01227-x. - DOI - PubMed
    1. Passchier E, Stuiver MM, van der Molen L, Kerkhof SIC, van den Brekel MWM, Hilgers FJM. Feasibility and impact of a dedicated multidisciplinary rehabilitation program on health-related quality of life in advanced head and neck cancer patients. Eur Arch Otorhinolaryngol. 2016;273(6):1577–1587. doi: 10.1007/s00405-015-3648-z. - DOI - PubMed
    1. Eades M, Murphy J, Carney S, Amdouni S, Lemoignan J, Jelowicki M, Nadler M, Chasen M, Gagnon B. Effect of an interdisciplinary rehabilitation program on quality of life in patients with head and neck cancer: review of clinical experience. Head Neck. 2013;35(3):343–349. doi: 10.1002/hed.22972. - DOI - PubMed
    1. Ringash J, Bernstein LJ, Devins G, Dunphy C, Giuliani M, Martino R, McEwen S. Head and neck cancer survivorship: learning the needs, meeting the needs. Semin Radiat Oncol. 2018;28(1):64–74. doi: 10.1016/j.semradonc.2017.08.008. - DOI - PubMed