Evaluation of a nursing aftercare intervention for patients with head and neck cancer treated with chemoradiation

Abstract

Background: Head and neck cancer (HNC) patients treated with chemoradiation have to rediscover their life after recovering from severe side-effects and build-up self-confidence. To assist patients in this, an aftercare intervention to support patients' self-management was implemented. This study aimed to evaluate the feasibility and first effects. Method(s): HNC patients treated in the Erasmus MC between November 2015 and November 2016 were included in the intervention group (n=39). They received a nurse-led intervention using the Self-Management Web (SMW) while patients of the historical control group received standard care. TheSMW contains 14 areas of life on physical, psychological and social themes and was used to set priorities, define goals and make action plans for the future. Patients completed questionnaires on quality of life, self-management behaviour, self-efficacy and quality of care. Additionally, individual interviews were performed to gain insight into patients' experiences with the aftercare intervention. Result(s): Patients in the intervention group showed a significant reduction in anxiety and an increase in self-efficacy. The differences between the extent to which the nurse paid attention to the topics compared to the importance patients attached to these were small. They need more attention to knowledge about their disease, emotional and spiritual well-being and self-care; patients in the control group indicated that they wanted more attention on all topics. No significant differences were found in quality of life and self-management behaviour between both groups. In the interviews, patients highly appreciated the opportunity to discuss a broad range of topics and recommended it for standard practice. Conclusion(s): HNC patients experience a significant reduction in anxiety and increased levels of self-efficacy after our aftercare self-management intervention. The topics of theSMW represent a complete overview while the solution-focused approach encourages patients to set goals for their recovery progress.