Heather M Starmer1, Noel Ayoub1, Cynthia Byward2, Jennifer Kizner3, Quynh Le4, Wendy Hara4, F Christopher Holsinger1. 1. Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California. 2. Department of Communication Sciences and Disorders, California State University-East Bay, Hayward, California. 3. Department of Head and Neck Oncology, Stanford Hospitals and Clinics, Palo Alto, California. 4. Department of Radiation Oncology, Stanford University, Palo Alto, California, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: The objective of this study was to evaluate the impact of developing an integrated head and neck cancer speech and swallowing rehabilitation program on physician/team focus on functional outcomes. STUDY DESIGN: Prospective cross-sectional design. METHODS: Surveys regarding physician behavior and patient satisfaction with speech and swallowing were administered in an academic oncology practice prior to and 1 year following establishment of a dedicated head and neck speech and swallowing rehabilitation program. Participants included new and established head and neck cancer patients recruited consecutively. The primary outcome was physician behavior regarding speech and swallowing outcomes (as measured by discussion of function, providing suggestions regarding function, and referral to speech-language pathology services). RESULTS: A total of 199 surveys were returned at the first time point and 271 at the second. Demographic variables were comparable between the two groups. The later cohort was more likely to report team discussion and suggestions regarding speech and swallowing function than the former (P < .001, 95% confidence interval [CI]: -0.775 to -0.265; P < .001, 95% CI: -0.928 to -0.035, respectively). Although there was no significant difference between the groups in regard to satisfaction with speech (P = .07), more favorable satisfaction with swallowing was reported by the later cohort (P = .028, 95% CI: -0.531 to -0.029). CONCLUSIONS: Integration of speech and swallowing rehabilitation into head and neck cancer programs is associated with increased physician focus on functional outcomes and greater patient satisfaction in regard to swallowing function. We advocate for standard integration of such services into the multidisciplinary head and neck cancer care team. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2578-2581, 2017.
OBJECTIVES/HYPOTHESIS: The objective of this study was to evaluate the impact of developing an integrated head and neck cancer speech and swallowing rehabilitation program on physician/team focus on functional outcomes. STUDY DESIGN: Prospective cross-sectional design. METHODS: Surveys regarding physician behavior and patient satisfaction with speech and swallowing were administered in an academic oncology practice prior to and 1 year following establishment of a dedicated head and neck speech and swallowing rehabilitation program. Participants included new and established head and neck cancerpatients recruited consecutively. The primary outcome was physician behavior regarding speech and swallowing outcomes (as measured by discussion of function, providing suggestions regarding function, and referral to speech-language pathology services). RESULTS: A total of 199 surveys were returned at the first time point and 271 at the second. Demographic variables were comparable between the two groups. The later cohort was more likely to report team discussion and suggestions regarding speech and swallowing function than the former (P < .001, 95% confidence interval [CI]: -0.775 to -0.265; P < .001, 95% CI: -0.928 to -0.035, respectively). Although there was no significant difference between the groups in regard to satisfaction with speech (P = .07), more favorable satisfaction with swallowing was reported by the later cohort (P = .028, 95% CI: -0.531 to -0.029). CONCLUSIONS: Integration of speech and swallowing rehabilitation into head and neck cancer programs is associated with increased physician focus on functional outcomes and greater patient satisfaction in regard to swallowing function. We advocate for standard integration of such services into the multidisciplinary head and neck cancer care team. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2578-2581, 2017.
Authors: Gaurav S Ajmani; Cheryl C Nocon; Bruce E Brockstein; Nicholas P Campbell; Amy B Kelly; Jamie Allison; Mihir K Bhayani Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-06-01 Impact factor: 6.223