Computerized monitoring of patient-reported speech and swallowing problems in head and neck cancer patients in clinical practice

• DOI: 10.1007/s00520-012-1422-y
• Publication Date: 2012-03-06T08:21:17Z
• Authors: Ingrid C. Cnossen; Remco de Bree; Rico N. P. M. Rinkel; Simone E. J. Eere...; Derek H. F. Rietveld; Patricia Doornaert; Jan Buter; Johannes A. Lange...; C. René Leemans; Irma M. Verdonck-...
• Keywords: Quality of life; REHABILITATION; Adult; Male; SDG 16 - Peace; IMPACT; HOSPITAL ANXIETY; DYSPHAGIA; Speech Disorders; Emotional well-being; 03 medical and health sciences; DISTRESS; 0302 clinical medicine; SDG 3 - Good Health and Well-being; QUALITY-OF-LIFE; RADIATION-THERAPY; Surveys and Questionnaires; Outcome Assessment, Health Care; Ambulatory Care; Humans; Diagnosis, Computer-Assisted; Prospective Studies; Head and neck cancer; Aged; Patient-reported speech and swallowing problems; Aged, 80 and over; Psychiatric Status Rating Scales; E-health; Middle Aged; Justice and Strong Institutions; 3. Good health; DEPRESSION SCALE; Oncology; Head and Neck Neoplasms; ONCOLOGY PRACTICE; Quality of Life; Feasibility Studies; Original Article; Female; Deglutition Disorders; Stress, Psychological; RADIOTHERAPY; Follow-Up Studies

The purpose of this study is to evaluate computerized monitoring of speech and swallowing outcomes and its impact on quality of life (QoL) and emotional well-being in head and neck cancer patients in an outpatient clinic.Sixty-seven patients, treated by single or multimodality treatment, completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires and the Hospital Anxiety and Depression Scale in an outpatient clinic, using a touch screen computer system (OncoQuest), at baseline (at time of diagnosis) and first follow-up (1 month after end of treatment).Tumor sites included oral cavity (n = 12), oropharynx (n = 18), hypopharynx (n = 8), and larynx (n = 29). Tumor stage included carcinoma in situ (n = 3), stage I (n = 21), stage II (n = 7), stage III (n = 15), and IV (n = 21). No speech or swallowing problems at baseline or follow-up were noted in 23 % (speech) and 41 % (swallowing) of patients. Twenty-one percent (speech) and 19 % (swallowing) had problems at baseline and returned to normal scores at follow-up, while 16 % (speech) and 19 % (swallowing) had normal scores at baseline and developed problems at follow-up. Forty percent (speech) and 21 % (swallowing) had persistent problems from baseline to follow-up. At baseline, speech problems were significantly related to tumor site and emotional distress. At baseline and follow-up, swallowing problems were significantly related to QoL and emotional distress. At follow-up, speech problems were significantly related to QoL, emotional distress, and swallowing problems.Monitoring speech and swallowing problems through OncoQuest in an outpatient clinic is feasible. Many patients report speech and swallowing problems, negatively affecting their QoL and emotional well-being.