Head and Neck Cancer (HNC) treatment can result in functional limitations like dysphagia, dysarthria, cancer-related fatigue and psychosocial problems such as altered body image, anxiety and depression. An integrated Head and Neck Rehabilitation program (HNR) is a unique tailored program for HNC patients developed to restore patients’ functioning and to optimize Health related quality of Life (HRQoL) and societal participation.
This project aims to assess the effectiveness of this HNR program as a whole, as well as to gain (more) evidence for interventions (to be) applied in in the modular tailored HNR program. Main goal is to improve access to and optimize rehabilitation and survivorship care for Head and Neck cancer (HNC) patients in the Netherlands.
In an observational prospective study, feasibility and impact of HNR on HRQoL was assessed. Results show HNR has a positive impact on HRQoL. It might accelerate recovery and may have added value compared to mono-disciplinary usual care. A controlled design is recommended, though gathered not ethical because HNR is reimbursed as part of Basic care within Dutch health insurance. Hence, in a multicenter analysis (cost-) effectiveness of HNR will be compared with mono-disciplinary Usual Supportive Care in six Dutch HNC centers.
To improve access to rehabilitation and survivorship care for HNC patients, assessment of rehabilitation needs should be integrated in the multidisciplinary HNC pathway. To do so it is necessary to get an overview of the organization and availability of HNC rehabilitation care during/after treatment in the Netherlands. Therefore, an online survey was set up to evaluate to what extent the Dutch cancer rehabilitation guideline is implemented in all HNC centers and subsequently what barriers and facilitators can be identified.
HNR is set up based on the best available evidence, there are, however, rehabilitation interventions that have not yet been investigated sufficiently, like exercise during HNC treatment. Therefore, a mixed methods study is performed to establish feasibility of an exercise intervention during chemo radiation treatment for advanced HNC.
HNR is based on ICF-WHO framework to improve outcome measurement of rehabilitation at both individual and population level. Assessment of participation is relevant and development of PROM´s focusing on participation is required. A multicenter research project will be conducted to translate and validate a communication participation questionnaire for HNC patients with speech difficulties.