Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study

Elisabeth Hansson, Eric Carlström, Lars-Eric Olsson, Jan Nyman, Ingalill Koinberg, Elisabeth Hansson, Eric Carlström, Lars-Eric Olsson, Jan Nyman, Ingalill Koinberg

Abstract

Background: The incidence of head and neck cancer is increasing slightly. Head and neck cancer but also it's necessary and often successful treatment may affect general domains of health-related quality of life and provoke a variety of adverse symptoms and side effects, both during and after treatment. The objective of this study was to compare a person-centred care intervention in terms of health-related quality of life, disease-specific symptoms or problems, with traditional care as a control group for patients with head and neck cancer.

Methods: In this randomized controlled trial, person-centred-care intervention and traditional care (control) groups comprised 54 and 42 patients, respectively. Outcome measures used were: the EORTC QLQ-C30 and the EORTC QLQ-C35. Both groups answered the questionnaires at baseline and after 4, 10, 18 and 52 weeks from start of treatment. The questionnaires' scores were compared between groups by using independent samples test and non-parametric test for continuous variables. For categorical data, Fisher's exact test was used. Longitudinal data were analysed using generalized linear models for normally distributed repeated measures data.

Results: At baseline, the intervention and control groups were comparable in terms of medical and sociodemographic variables, clinical characteristics, health-related quality of life and disease-specific symptoms or problems. At all the follow-up points, even during the worst period for the patients, the person-centred-care group consistently reported better scores than the control group. The differences were numerically but not always statistically significant. When testing longitudinal data, statistically significant results were found for head and neck cancer-specific problems, swallowing (p = 0.014), social eating (p = 0.048) and feeling ill (p = 0.021).

Conclusions: The results from this study suggest that adopting the person-centred-care concept practiced here could be a way to improve function and wellbeing in patients with head and neck cancer.

Trial registration: The study was retrospectively registered in 2016-12-05 in Clinical Trials gov. "Can a Person-centred-care Intervention Improve Health-related Quality of Life in Patients With Head and Neck Cancer" registration number: NCT02982746.

Figures

Fig. 1
Fig. 1
CONSORT DIAGRAM, flow chart of the participants in the gPCC—G and the CG
Fig. 2
Fig. 2
Mean values and standard deviation (SD) of the Global Health status and Role Function (QLQ-30) sub-scores at the five the measurement points, for both groups
Fig. 3
Fig. 3
Mean values and standard deviation (SD) of the Swallowing, Social eating and Felt ill (QLQ-35) sub-scores at the five measurement points, for both groups

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