Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Population
2.3. Data Collection
2.4. Routine Care
2.5. Nurse-Led Consultation
2.6. Data Collection
2.7. Statistical Analysis
2.8. Ethics
3. Results
3.1. Participant Demographic and Clinical Characteristics
3.2. Nurse-Led Consultations
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Routine Care | NLC | p-Value |
---|---|---|---|
Age (mean, SD) | 63.7 (11.0) | 63.5 (12.0) | 0.62 |
Gender N (%) Male Female | 55 (76.4) 17 (23.6) | 47 (75.8) 15 (24.2) | 0.93 |
Marital status N (%) | 0.39 | ||
Married | 39 (54.2) | 29 (46.7) | |
Not married | 33 (45.8) | 33 (53.2) | |
Alcohol N (%) consumption | 0.50 | ||
Yes | 33 (45.8) | 32 (51.6) | |
No | 39 (54.2) | 30 (48.4) | |
Smoking N (%) | |||
Yes | 26 (36.1) | 14 (22.6) | 0.08 |
No | 46 (63.9) | 48 (77.4) | |
Weight before radiotherapy (kg), mean (SD) | 72.6 (13.9) | 71.7 (14.9) | 0.29 |
Pre-existing conditions N (%) | <0.0001 | ||
Yes | 64 (88.9) | 39 (62.9) | |
No | 8 (11.1) | 23 (37.1) | |
Pre-existing oncological conditions N (%) | <0.000 | ||
Yes | 21 (29.2) | 20 (32.3) | |
No | 51 (70.8) | 42 (67.7) | |
Cancer recurrence N (%) | 0.04 | ||
Yes | 7 (9.7) | 14 (22.6) | |
No | 65 (90.3) | 48 (77.4) | |
Cancer location N (%) | <0.000 | ||
Oropharynx | 27 (37.5) | 33 (53.2) | |
Oral cavity | 15 (20.8) | 1 (1.6) | |
Nasopharynx | 2 (2.8) | 4 (6.4) | |
Larynx | 11 (15.3) | 3 (4.8) | |
Hypopharynx | 11 (15.3) | 3 (4.8) | |
Salivary glands | 4 (5.6) | 8 (12.9) | |
Nasal cavity | 0 (0.0) | 7 (11.3) | |
Thyroid | 2 (2.8) | 1 (1.6) | |
Stage N (%) | 0.14 | ||
I | 3 (4.2) | 4 (6.4) | |
II | 9 (12.5) | 9 (14.5) | |
III | 17 (23.6) | 13 (20.9 | |
IV | 42 (58.3) | 29 (46.7) | |
Unknown | 1 (1.4) | 7 (11.3) | |
Treatment type N (%) | 0.38 | ||
Radiotherapy only | 6 (8.3) | 8 (12.9) | |
Radiotherapy and other | 66 (91.6) | 54 (87.1) | |
Radiotherapy sessions (mean, SD) | 32.2 (1.4) | 32.5 (1.3) | 0.29 |
Radiation dose (Gy, mean SD) | 63.6 (6.8) | 64.4 (6.7) | 0.68 |
Radiotherapy interruption | 0.68 | ||
Yes | 12 (16.7) | 12 (19.3) | |
No | 60 (83.3) | 50 (80.6) | |
Tube placement during radiotherapy | 0.02 | ||
Yes | 29 (59.7) | 14 (77.4) | |
No | 43 (40.3) | 48 (22.6) | |
Hospitalization during radiotherapy | 0.37 | ||
Yes | 12 (16.7) | 7 (11.3) | |
No | 60 (83.3) | 55 (88.7) | |
Total | 72 (100.0) | 62 (100.0) |
Consultations | T0 N = 63 | T1 N = 63 | T2 N = 41 * | |
---|---|---|---|---|
Variables | Interventions | n (%) | n (%) | n (%) |
Nutrition | Screening | 63 (100) | 62 (98.4) | 40 (97.6) |
Education | 37 (58.7) | 11 (17.5) | 12 (29.3) | |
Coordination | 19 (30.2) | 13 (20.6) | 9 (22.0) | |
Smoking | Screening | 61 (96.8) | 59 (93.7) | 34 (83.0) |
Education | 10 (15.9) | 6 (9.5) | 0 | |
Coordination | 4 (6.4) | 1 (1.6) | 0 | |
Pain | Screening | 44 (69.8) | 41 (65.1) | 26 (63.4) |
Education | 3 (4.8) | 16 (25.4) | 11 (26.8) | |
Coordination | 4 (6.3) | 0 | 1 (2.4) | |
Oral cavity status | Screening | 60 (95.2) | 59 (93.7) | NA |
Education | 60 (95.2) | 46 (73.0) | NA | |
Coordination | 0 | 0 | NA | |
Swallowing/chewing capacity | Screening | 57 (90.5) | 51(81.0) | NA |
Education | 0 | 0 | NA | |
Coordination | 6 (9.5) | 3 (4.8) | NA |
Variables | T0 N = 62 | T1 N = 62 | T2 N = 41 | ||||
---|---|---|---|---|---|---|---|
n (%) | MED (IQR) | n (%) | MED (IQR) | n (%) | MED (IQR) | ||
Nutrition | |||||||
Weight | Screening | 62 (100) | 62 (98.4) | 40 (97.6) | |||
Kg | 70 (19.9) | 67.2 (17.4) | 67.4 (14.8) | ||||
Kondrup a | Screening | 57 (90.5) | 2.0 (1.0) | NA | NA | NA | NA |
Kondrup ≥ 3 | 13 (20.6) | 3.0 (1.0) | |||||
Smoking | Screening | 61 (96.8) | 59 (93.7) | 34 (83.0) | |||
Status | Non-smoker | 46 (73.0) | 48 (76.2) | 32 (78.1) | |||
Smoker | 15 (23.8) | 11 (17.5) | 2 (4.9) | ||||
Attitude b | Ambivalent | 5 (33.0) | 3 (27.0) | 1 (50.0) | |||
Motivated | 7 (47.0) | 4 (36.0) | 1 (50.0) | ||||
Consumption | Screening | 11(73.0) | 10 (91.0) | 2 (100) | |||
n/day c | 20 (21) | 10.0 (10) | 25 (10) | ||||
Pain | Screening | 44 (69.8) | 41 (65.1) | 26 (63.4) | |||
Score EVA d | 0 (3.0) | 2.0 (4.0) | 3.0 (5.0) | ||||
Oral status | Screening | 60 (95.2) | 59 (93.7) | NA | NA | ||
Score OAG e | 1.5 (3.0) | 3.0 (3.0) | |||||
Swallowing/chewing capacity (dysphagia) | Screening | 57 (90.5) | 51 (81.0) | NA | NA | ||
Absence | 45 (71.4) | 38 (60.3) | |||||
Presence | 5 (7.9) | 9 (14.3) | |||||
Dysphagia associated with other symptoms f | 7 (11.1) | 4 (6.4) |
MDASI-HN Dimensions | T1 (3rd–4th Week) | T2 (5th–6th Week) | ||||||
---|---|---|---|---|---|---|---|---|
Mean (RC) | Mean (NLC) | Mean Difference (95% CI) | p-Value | Mean (RC) | Mean (NLC) | Mean Difference (95% CI) | p-Value | |
Core symptoms | ||||||||
Pain | 3.4 | 3.0 | 0.40 (−1.35–0.53) | 0.39 | 4.5 | 4.0 | −0.49 (−1.45–0.46) | 0.31 |
Fatigue | 3.8 | 3.8 | −0.01 (−0.84–0.82) | 0.98 | 4.9 | 4.6 | −0.30 (−1.13–0.52) | 0.47 |
Nausea | 1.4 | 1.5 | 0.11 (0.66–0.88) | 0.77 | 2.0 | 2.0 | −0.02 (−0.94–0.89) | 0.96 |
Disturbed sleep | 2.3 | 2.7 | 0.37 (−0.55–1.29) | 0.43 | 2.5 | 2.8 | 0.24 (−0.63–1.12) | 0.58 |
Being distressed (worried) | 2.7 | 2.9 | 0.18 (−0.72–1.09) | 0.69 | 2.8 | 2.9 | 0.13 (−0.78–1.04) | 0.77 |
Shortness of breath | 1.9 | 1.9 | 0.06 (−0.75–0.88) | 0.87 | 2.0 | 1.9 | −0.09 (−0.90–0.70) | 0.81 |
Difficulty remembering | 2.7 | 2.9 | 0.18 (−0.72–1.09) | 0.69 | 2.8 | 2.9 | 0.13 (−0.78–1.04) | 0.77 |
Lack of appetite | 3.1 | 2.7 | −0.36 (−1.37–0.64) | 0.47 | 4.3 | 3.7 | −0.60 (−1.64–0.43) | 0.25 |
Drowsiness | 2.3 | 2.2 | −0.07 (−0.84–0.70) | 0.85 | 3.2 | 2.9 | −0.24 (−1.17–0.68) | 0.60 |
Dry mouth | 4.7 | 4.3 | 0.23 (−1.27–0.81) | 0.45 | 5.1 | 4.9 | −0.23 (−1.27–0.81) | 0.66 |
Sadness | 2.5 | 2.9 | 0.41 (−0.58–1.39) | 0.41 | 2.7 | 2.9 | 0.18 (−0.84–1.20) | 0.72 |
Vomiting | 0.6 | 0.7 | 0.02 (−0.55–0.61) | 0.92 | 1.5 | 1.0 | −0.43 (−1.25–0.38) | 0.29 |
Numbness/tingling | 1.1 | 1.5 | 0.42 (−0.24–1.10) | 0.21 | 1.7 | 1.8 | 0.12 (−0.75–1.00) | 0.77 |
Head and neck symptoms | ||||||||
Mucus | 3.5 | 3.7 | 0.21 (−0.78–1.21) | 0.67 | 4.4 | 4.6 | 0.27 (−0.68–1.22) | 0.57 |
Difficulty with swallowing/chewing | 4.4 | 3.8 | −0.57 (−1.61–0.46) | 0.28 | 5.3 | 4.6 | −0.63 (−1.69–0.42) | 0.24 |
Coughing/choking | 1.7 | 1.6 | 0.32 (−1.30–0.65) | 0.86 | 1.6 | 1.7 | −0.32 (−1.30–0.65) | 0.51 |
Difficulty with voice/speech | 3.1 | 3.2 | 0.07 (−0.86–1.02) | 0.87 | 3.9 | 3.9 | −0.02 (−1.05–1.01) | 0.96 |
Burning/rash | 2.5 | 2.3 | 0.52 (−1.56–0.50 | 0.31 | 4.4 | 3.9 | −0.52 (−1.56–0.50) | 0.31 |
Constipation | 1.8 | 2.2 | 0.37 (−0.58–1.33) | 0.63 | 2.7 | 2.4 | −0.24 (−1.25–0.77) | 0.63 |
Problem with tasting food | 4.0 | 3.7 | −0.37 (−1.55–0.79) | 0.53 | 5.8 | 5.1 | −0.64 (−1.83–0.54) | 0.28 |
Mouth/throat sores | 3.4 | 3.5 | 0.11 (−0.97–1.20) | 0.83 | 4.4 | 4.3 | −0.03 (−1.13–1.06) | 0.94 |
Problem with teeth or gums | 2.3 | 3.0 | 0.69 (−0.27–1.67) | 0.16 | 2.8 | 3.0 | 0.20 (−0.80–1.21) | 0.69 |
Interference symptoms | ||||||||
General activity | 3.4 | 3.4 | 0.07 (−0.88–1.03) | 0.87 | 4.0 | 4.1 | 0.09 (−0.88–1.07) | 0.84 |
Mood | 2.9 | 3.3 | 0.36 (−0.61–1.33) | 0.46 | 3.5 | 3.3 | 0.36 (−0.61–1.33) | 0.46 |
Work | 3.8 | 3.4 | −0.46 (−1.58–0.64) | 0.41 | 3.7 | 4.0 | 0.35 (−0.72–1.42) | 0.52 |
Relationships with others | 2.4 | 2.3 | −0.12 (−0.98–0.73) | 0.77 | 2.8 | 2.7 | −0.11 (−0.98–0.75) | 0.79 |
Walking | 2.2 | 2.1 | −0.17 (−1.09–0.75) | 0.71 | 2.7 | 1.7 | −0.96 (−1.85–0.08) | 0.03 |
Joy of living | 2.6 | 3.5 | 0.93 (−0.08–1.95) | 0.07 | 2.6 | 3.3 | 0.66 (−0.35–1.67) | 0.20 |
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Luta, X.; Colomer-Lahiguera, S.; Martins Cardoso, R.J.; Hof, F.; Savoie, M.; Schuler, C.; Wicht, J.; Fucina, N.; Debarge, P.; Ninane, F.; et al. Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data. Cancers 2022, 14, 1227. https://doi.org/10.3390/cancers14051227
Luta X, Colomer-Lahiguera S, Martins Cardoso RJ, Hof F, Savoie M, Schuler C, Wicht J, Fucina N, Debarge P, Ninane F, et al. Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data. Cancers. 2022; 14(5):1227. https://doi.org/10.3390/cancers14051227
Chicago/Turabian StyleLuta, Xhyljeta, Sara Colomer-Lahiguera, Rodrigo Jose Martins Cardoso, Frank Hof, Manon Savoie, Cosette Schuler, Justine Wicht, Nadia Fucina, Patricia Debarge, Françoise Ninane, and et al. 2022. "Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data" Cancers 14, no. 5: 1227. https://doi.org/10.3390/cancers14051227