A pilot study of the effectiveness of a pre-operative supportive care education and counselling intervention for patients undergoing major head and neck cancer surgery — ASN Events
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  3. A pilot study of the effectiveness of a pre-operative supportive care education and counselling intervention for patients undergoing major head and neck cancer surgery

A pilot study of the effectiveness of a pre-operative supportive care education and counselling intervention for patients undergoing major head and neck cancer surgery (#820)

Penny Chapman 1 , Sarah McDonald 1 , Laurelle Stalker 1 , Andrew Badcoe 1 , Carrie Lethborg 1 , John Santamaria 1 , Bernard Lyons 1
  1. St Vincent's Hospital, Fitzroy, Vic, Australia

BACKGROUND: Surgical treatment of head and neck cancer is complex, and recovery involves significant physiological, functional, social and psychological challenges. Patient education, information and counselling are critical components of supportive care during the recovery period.1 Anecdotal evidence suggests that patients may adjust better to these challenges when education and counselling is initiated pre-operatively by a multidisciplinary team.

AIM: To assess the effectiveness of a semi-structured, multidisciplinary Pre-operative Supportive Care Education and Counselling Intervention (PSC-ECI) for patients undergoing major head and neck cancer.

METHODS: 60 eligible surgical patients were recruited and randomly assigned to a control (n=30) or intervention (n=30) group. The intervention group received the PSC-ECI via a tandem meeting with a speech pathologist, nurse coordinator or social worker.  The control group received standard care. For both, pre- and post- measures of psychosocial distress were obtained using a Distress Thermometer2. Qualitative feedback was obtained via a 6 week post surgery questionnaire.

RESULTS: 40 complete data sets were obtained - 20 from control and 20 from the intervention group. Post-operative distress scores were 1 point lower in the intervention group compared to the control. A majority of the intervention group valued the PSC-ECI. The semi-structured, multidisciplinary approach was highly valued overall. 19% of the control and 24% of the intervention group reported not being prepared for surgery. A diversity of post-operative adjustment issues and supports were reported across both groups. 

SIGNIFICANCE: Despite ambiguity in the results, semi-structured pre-operative education and counselling appears to somewhat reduce adjustment issues encountered post surgery. Findings have confirmed the value of the PSC-ECI in preparing patients for recovery challenges and optimising longer term adjustment. They have substantially informed clinical practice and prompted ongoing multidisciplinary pre-operative interventions following the pilot. A larger study involving the PSC-ECI is likely to help clarify ambiguous findings, identify its beneficial components for specific patient sub-groups of head and neck cancer patients, and further target its delivery.

  1. Ziegler L, Newell R, Stafford N & Lewin R. (1998) A literature review of head and neck cancer patients information needs, experiences and views regarding decision-making. European Journal of Cancer Care 13, 119-126
  2. Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher H & Holland JC (1998) Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer 82, 1904–1908