| Patients with head and neck cancer often have to deal with side-effects of initial treatment (surgery, radiotherapy, chemoradiation, or a combination), and the considerable threat to self-image, confidence, and identity may be difficult to cope with and can be a cause of psychosocial problems. A recent study at our department revealed that some aspects of health related quality of life are predictive of overall and disease specific survival, independently from sociodemographic and clinical predictive parameters. Emotional functioning after treatment appeared to be one of the predictors of survival. To obtain insight in psychological distress, 41 patient-spouse pairs completed the Hospital Anxiety and Depression Scale (HADS). A clinical level of distress was noted in 27% of the patients and 20% of the spouses. Distress in patients was related to the presence of a feeding tube, speech and swallowing problems, less social contacts, a passive style of coping, and non-expression of emotions. Distress in spouses was related to the presence of a feeding tube in patients, a passive coping style, less vitality, and a disrupted daily life schedule due to caregiving. A pilot study on psychological intervention in close cooperation with the Ingeborg Douwes Center revealed that group intervention can be beneficial in both patients and spouses. Systematic routine screening of health related quality of life and psychological distress and referral to intervention may be beneficial. At our department, touch screen computer-assisted data collection including the EORTC-QLQ C30 and H&N35 and the HADS appeared to be feasible and is used for clinical and scientific documentation. Current research is focussing on efficacy of intervention regarding HRQOL and psychological distress. |
