31 results found
Brady GC, Goodrich J, Roe JWG, 2020, Using experience-based co-design to improve the pre-treatment care pathway for people diagnosed with head and neck cancer., Support Care Cancer, Vol: 28, Pages: 739-745
BACKGROUND: Recent studies have highlighted that people diagnosed with head and neck cancer (HNC) have complex information needs. They are subject to multiple clinical appointments with numerous healthcare professionals in preparation for their treatment. Speech and language therapists (SLTs) are core members of the HNC multidisciplinary team, providing assessment, prehabilitation and counselling regarding potential treatment effects on the critical functions, including swallowing and communication. We believed the purpose of the pre-treatment speech-language therapy (SLT) consultation within this pathway is not well understood by patients. Whilst the benefits of prophylactic swallowing exercise prescriptions continue to be explored, adherence is a frequently cited challenge in clinical trials. We sought to enhance pre-treatment dysphagia services for patients with head and neck cancer (HNC) undergoing chemoradiation. METHODS: A participatory action research approach called experience-based co-design (EBCD) was undertaken at a tertiary cancer hospital in the UK. People who had previous radical radiation treatment for head and neck cancer and staff members within the head and neck unit were recruited to take part in in-depth, one-to-one interviews about their experiences of the pre-treatment SLT head and neck radiation clinic. Patient interviews were video-recorded, analysed and edited down to a 30 min 'trigger' film. At a subsequent patient feedback event, the film was shown and an 'emotional mapping' exercise was undertaken. Through facilitated discussion, patient priorities for change were agreed and recorded. At a staff feedback event, key themes from the staff interviews were discussed and priority areas for change identified. The project culminated in a joint patient and staff event where the film was viewed, experiences shared and joint priorities for change agreed. Task and finish groups were developed to implement these changes. RESULTS: Seven patients
Clunie G, Roe J, Alexander C, et al., Voice and swallowing outcomes following airway reconstruction in adults: a systematic review, The Laryngoscope, ISSN: 0023-852X
Objectives: Laryngotracheal stenosis is a rare condition characterized by upper airway narrowing. Reconstructive surgical treatment aims to manage the area of stenosis to improve dyspnea and can impact on voice and swallowing function. This article critically evaluates the literature about voice and swallowing outcomes in adults with laryngotracheal stenosis who undergo reconstructive surgery.Study Design: Systematic review.Methods: Six databases were searched for articles referring to voice and swallowing outcome measures following reconstruction procedures in adults with laryngotracheal stenosis. Screening was completed using predefined inclusion/exclusion criteria. Results: A total of 143 abstracts were reviewed, with 67 articles selected for full text review. 20 studies met the inclusion criteria. Data extraction was completed with The Strengthening Reporting of Observational Studies in Epidemiology checklist with Oxford Centre for Evidence-Based Medicine Level of Evidence used to indicate quality. Risk of bias was assessed using the Risk of Bias Assessment Tool for Non-Randomized Studies. All studies scored a high risk of bias in at least one of the domains. Selection and timing of outcome measures was heterogenous and there was limited information provided about rationale or reliability.Conclusion: The literature acknowledges the importance of voice and swallowing outcomes following airway reconstruction. Studies show correlation between reconstructive surgery and deterioration in vocal function; there is no consistent data about swallowing outcomes. The lack of a core outcome measures set for adults with laryngotracheal stenosis limits the findings of this review. Further research is needed to establish clear criteria for robust and clinically relevant outcome measurement.
Nund RL, Brown B, Ward EC, et al., 2019, What Are We Really Measuring? A Content Comparison of Swallowing Outcome Measures for Head and Neck Cancer Based on the International Classification of Functioning, Disability and Health (ICF), DYSPHAGIA, Vol: 34, Pages: 575-591, ISSN: 0179-051X
Patterson J, Toft K, McAuley F, et al., 2019, Feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing following prophylactic swallowing rehabilitation in head and neck cancer, CLINICAL OTOLARYNGOLOGY, Vol: 44, Pages: 549-556, ISSN: 1749-4478
Brady GC, Roe JWG, O' Brien M, et al., 2018, An investigation of the prevalence of swallowing difficulties and impact on quality of life in patients with advanced lung cancer, SUPPORTIVE CARE IN CANCER, Vol: 26, Pages: 515-519, ISSN: 0941-4355
Brady G, Roe J, 2018, Dysphagia associated with head and neck cancer, Clinical Cases in Dysphagia, Pages: 66-83, ISBN: 9781138087545
© 2019 selection and editorial matter, Margaret Walshe and Maggie-Lee Huckabee; individual chapters, the contributors. This clinical case considers the complexities of management of dysphagia following treatment for head and neck cancer (HNC). The chapter explores the side effects of radical treatments, including surgery and chemoradiotherapy (CRT), on the patient’s swallowing function and the management options available to clinicians. It includes the perspective of a person coping with dysphagia after radical surgery and adjuvant CRT for HNC. Surgery and/or CRT are the mainstay treatment for HNC. One of the most common and profound effects of HNC and its treatment are the acute and long-term difficulties with eating and drinking. The nature and severity of dysphagia for the HNC patient are both complex and have the potential to change over time, depending on the treatments received. Patients should be informed of the potential acute and longer-term risk for dysphagia and therefore be empowered to monitor symptoms, access support and play an active role in their rehabilitation.
Clunie GM, Kinshuck AJ, Sandhu GS, et al., 2017, Voice and swallowing outcomes for adults undergoing reconstructive surgery for laryngotracheal stenosis, CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, Vol: 25, Pages: 195-199, ISSN: 1068-9508
Purpose of review Adult laryngotracheal stenosis is a rare, multifactorial condition which carries a significant physical and psychosocial burden. Surgical approaches have developed in recent years, however, voice and swallowing function can be affected prior to treatment, in the immediate postoperative phase, and as an ongoing consequence of the condition and surgical intervention. In this study we discuss: the nature of the problem; surgical interventions to address airway disorders; optimal patterns of care to maximize voice and swallowing outcomes.Recent findings Studies in this field are limited and focused on surgical outcomes and airway status with voice and swallowing a secondary consideration. Retrospective studies of swallowing have focused on factors such as the duration of dysphagia symptoms following airway surgery and made comparisons between type of surgery, use of stent, and length of swallowing problems. The literature suggests that patients are likely to return to their preoperative diet. There has been a focus on voice outcomes following cricotracheal resection which results in a postoperative decrease in the fundamental frequency. However, study comparisons are limited by the use of inconsistent outcome measures (for both voice and swallowing) which are often not validated, with heterogeneous groups and varying surgical techniques.Summary The limited literature suggests that swallowing function is more likely to recover to presurgical status than voice function. Further prospective studies incorporating consistent instrumental, clinician, and patient-reported outcome measurement are required to understand the nature and extent of dysphagia and dysphonia resulting from this condition and its treatment.
Hutcheson KA, Barrow MP, Barringer DA, et al., 2017, Dynamic Imaging Grade of Swallowing Toxicity (DIGEST): Scale Development and Validation, CANCER, Vol: 123, Pages: 62-70, ISSN: 0008-543X
Gujral DM, Long M, Roe JWG, et al., 2017, Standardisation of Target Volume Delineation for Carotid-sparing Intensity-modulated Radiotherapy in Early Glottis Cancer, CLINICAL ONCOLOGY, Vol: 29, Pages: 42-50, ISSN: 0936-6555
Petkar I, Rooney K, Roe JWG, et al., 2016, DARS: a phase III randomised multicentre study of dysphagia- optimised intensity-modulated radiotherapy (Do-IMRT) versus standard intensity- modulated radiotherapy (S-IMRT) in head and neck cancer, BMC CANCER, Vol: 16, ISSN: 1471-2407
Wells M, King E, Toft K, et al., 2016, Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer-the SiP study protocol, Pilot and Feasibility Studies, Vol: 2, ISSN: 2055-5784
BACKGROUND: Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. METHODS/DESIGN: This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. DISCUSSION: This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallow
Patterson JM, Brady GC, Roe JWG, 2016, Research into the prevention and rehabilitation of dysphagia in head and neck cancer: a UK perspective, CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, Vol: 24, Pages: 208-214, ISSN: 1068-9508
Roe JWG, Carding PN, Drinnan MJ, et al., 2016, Swallowing performance and tube feeding status in patients treated with parotid-sparing intensity-modulated radiotherapy for head and neck cancer, HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol: 38, Pages: E1436-E1444, ISSN: 1043-3074
Goldsmith TA, Roe JWG, 2015, Human papilloma virus-related oropharyngeal cancer: opportunities and challenges in dysphagia management, CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, Vol: 23, Pages: 185-190, ISSN: 1068-9508
Brady GC, Carding PN, Bhosle J, et al., 2015, Contemporary management of voice and swallowing disorders in patients with advanced lung cancer, CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, Vol: 23, Pages: 191-196, ISSN: 1068-9508
Roe JWG, Drinnan MJ, Carding PN, et al., 2014, Patient-reported outcomes following parotid-sparing intensity-modulated radiotherapy for head and neck cancer. How important is dysphagia?, ORAL ONCOLOGY, Vol: 50, Pages: 1182-1187, ISSN: 1368-8375
Paleri V, Roe JWG, Strojan P, et al., 2014, Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: An evidence-based review, HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol: 36, Pages: 431-443, ISSN: 1043-3074
Leslie P, Sandsund C, Roe J, 2014, Researching the rehabilitation needs of patients with life-limiting disease: Challenges and opportunities, Progress in Palliative Care, Vol: 22, Pages: 313-318, ISSN: 0969-9260
© W. S. Maney & Son Ltd 2014. People with life-limiting disease are among the most vulnerable groups accessing healthcare. Given this vulnerability, polarized views have been expressed in the literature regarding such individuals’ involvement in research studies. This is further compounded when the research is focused on rehabilitation, the concept of which is often misunderstood by patients, carers, and medical professionals. A number of factors can affect how we conduct research to elicit the needs of people with life-limiting disease, including social, historical, and cultural influences. Despite advances in palliative care research, challenges remain for those working across the specialism. In this review, we discuss the challenges of conducting rehabilitation research in this distinct clinical specialism and important considerations when involving patients and carers. We highlight the opportunities for understanding patient rehabilitation needs through mixed methods research design for studies involving those undergoing potentially complex rehabilitation interventions across settings.Note: People with life-limiting disease will be referred to as ‘patients’ in the context of their being involved with the healthcare system and receiving care from a clinician.
Dwivedi RC, St Rose S, Roe JWG, et al., 2012, Validation of the sydney swallow questionnaire (SSQ) in a cohort of head and neck cancer patients, Dysphagia, Vol: 27, ISSN: 0179-051X
Roe JWG, Carding PN, Rhys-Evans PH, et al., 2012, Assessment and management of dysphagia in patients with head and neck cancer who receive radiotherapy in the United Kingdom - A web-based survey, ORAL ONCOLOGY, Vol: 48, Pages: 343-348, ISSN: 1368-8375
Roe JW, Carding PN, Dwivedi RC, et al., 2011, Swallowing outcomes following intensity modulated radiation therapy (IMRT) for head and neck cancer - A systematic review, Dysphagia, Vol: 26, ISSN: 0179-051X
Roe JWG, Ashforth KM, 2011, Prophylactic swallowing exercises for patients receiving radiotherapy for head and neck cancer, CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, Vol: 19, Pages: 144-149, ISSN: 1068-9508
Dwivedi RC, Rose SS, Roe JWG, et al., 2011, FIRST REPORT ON THE RELIABILITY AND VALIDITY OF SPEECH HANDICAP INDEX IN NATIVE ENGLISH-SPEAKING PATIENTS WITH HEAD AND NECK CANCER, HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, Vol: 33, Pages: 341-348, ISSN: 1043-3074
Roe JWG, Carding PN, Dwivedi RC, et al., 2010, Swallowing outcomes following Intensity Modulated Radiation Therapy (IMRT) for head & neck cancer - A systematic review, ORAL ONCOLOGY, Vol: 46, Pages: 727-733, ISSN: 1368-8375
Roe JWG, Leslie P, 2010, Beginning of the end? Ending the therapeutic relationship in palliative care, INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, Vol: 12, Pages: 304-308, ISSN: 1754-9507
Dwivedi RC, Roe JWG, Kazi RA, et al., 2010, Outcome Assessment in Oral and Oropharyngeal Cancers, JOURNAL OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, Vol: 39, Pages: 215-215, ISSN: 1916-0216
Dwivedi RC, St Rose S, Roe JWG, et al., 2010, Validation of the Sydney Swallow Questionnaire (SSQ) in a cohort of head and neck cancer patients, ORAL ONCOLOGY, Vol: 46, Pages: E10-E14, ISSN: 1368-8375
Huins C, Lobeck E, Roe J, 2009, Unilateral vocal cord paralysis in patients with lung cancer, European Journal of Palliative Care, Vol: 16, Pages: 214-217, ISSN: 1352-2779
Roe JW, Leslie P, Drinnan MJ, 2007, Oropharyngeal dysphagia: The experience of patients with non-head and neck cancers receiving specialist palliative care, PALLIATIVE MEDICINE, Vol: 21, Pages: 567-574, ISSN: 0269-2163
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