Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation.

OBJECTIVE:: The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI-H&N) in a consecutive series of Brazilian patients. METHOD:: This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI-H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian Portuguese version of the PCI. Use, feasibility and acceptability of the PCI were tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian Portuguese version of the PCI and a Brazilian Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio-emotional composite scores from the UW-QOL and the PCI were analyzed. RESULTS:: Twenty (20) patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analyzed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste, and fear of adverse events. The three specialists most selected by the patients for further consultation were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. CONCLUSION:: The translation and cultural adaptation of the PCI into Brazilian Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use among the Brazilian head and neck cancer population.

Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation / Inventário de Preocupações dos Pacientes com câncer de cabeça e pescoço: adaptação cultural brasileira

Summary Objective: The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI-H&N) in a consecutive series of Brazilian patients. Method: This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI-H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian Portuguese version of the PCI. Use, feasibility and acceptability of the PCI were tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian Portuguese version of the PCI and a Brazilian Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio-emotional composite scores from the UW-QOL and the PCI were analyzed. Results: Twenty (20) patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analyzed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste, and fear of adverse events. The three specialists most selected by the patients for further consultation were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. Conclusion: The translation and cultural adaptation of the PCI into Brazilian Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use among the Brazilian head and neck cancer population.

Resumo Objetivo: O objetivo deste estudo foi traduzir, adaptar culturalmente e avaliar o Inventário de Preocupações dos Pacientes - Cabeça e Pescoço (IPP-CP) em uma série consecutiva de pacientes brasileiros. Método: Este estudo incluiu pacientes adultos tratados por câncer do trato aerodigestivo superior (TADS). A tradução e a adaptação cultural do IPP-CP seguiram diretrizes internacionalmente aceitas e incluíram uma amostra piloto de pacientes que completaram a primeira versão em português do IPP-CP. O uso, a viabilidade e a aceitabilidade do IPP-CP foram testados posteriormente, em uma série consecutiva de pacientes com câncer do TADS que completaram a versão final em português do PCI e uma versão em português do questionário de qualidade de vida da Universidade de Washington (UW-QOL). As associações entre os escores físicos e socioemocionais do UW-QOL e do IPP foram analisadas. Resultados: Vinte pacientes participaram da pesquisa piloto (processo de adaptação cultural e tradução), e 84 pacientes foram analisados no estudo de validação cultural. As questões mais selecionadas foram: medo de o câncer voltar, boca seca, mastigação/comer, fala/voz/ser compreendido, deglutição, saúde dental/dentes, ansiedade, fadiga/cansaço, paladar e medo de eventos adversos. Os três especialistas mais selecionados foram fonoaudiólogo, dentista e psicólogo. Relações estatisticamente significativas entre IPP e UW-QOL foram encontradas. Conclusão: A tradução e a adaptação cultural do IPP para o português foram bem-sucedidas, e os resultados demonstram a viabilidade e a utilidade da ferramenta, tornando-a valiosa para uso na população brasileira com câncer de CP.

Vocal handicap and quality of life after treatment of advanced squamous carcinoma of the larynx and/or hypopharynx.

OBJECTIVE/HYPOTHESIS: To evaluate and correlate voice-specific quality of life (QOL) and health-related QOL (HR-QOL) after treatment for advanced cancer of the larynx and/or hypopharynx. STUDY DESIGN: Cross-sectional study. METHODS: Patients submitted to partial laryngectomy (PL), salvage PL (sPL), concomitant radiotherapy and chemotherapy (RT+Chemo), total laryngectomy (TL), salvage TL (sTL), total pharyngolaryngectomy (TP) and salvage total pharyngolaryngectomy (sTP). The following questionnaires were used: (1) Voice Handicap Index (VHI) and (2) University of Washington Quality of Life Questionnaire (UW-QOL; version 4). RESULTS: Eighty-four patients participated in the study. All the patients PL (10), sPL (1), and RT+Chemo (24) communicated by laryngeal voice. Of the 49 patients submitted to total removal of the larynx, 30 communicated with alaryngeal phonation, the major part being tracheoesophageal prosthesis (17). The worst subscale of VHI for the total patient group was functional (mean=13.15), and the value of the total score was 31. Patients submitted to PL, RT+Chemo, and TL presented slight handicap (medians of 27, 14, and 21.5, respectively). Patients treated with sTL, TP, and sTP presented moderate handicap (medians of 45, 37.5, and 31.5, respectively). HR-QOL was considered between good and excellent for 78.6% of the patients, and poor for 21.4%. The correlation between voice-specific QOL and HR-QOL was significant (P=0.0001). CONCLUSION: Patients treated for advanced cancer of the larynx/hypopharynx present slight to moderate voice handicap and good/excellent HR-QOL. Stricter analysis of both the VHI and UW-QOL data suggests that more attention be given to the vocal handicap of the individual patient.

Avaliação eletromiográfica de superfície e nasofibroscópica da deglutição em pacientes submetidos à tireoidectomia e seu impacto na qualidade de vida / Electromyographic assessment of surface and nasofibroscopy of swallowing in patients undergoing thyroidectomy and its impact on quality of life

Apesar das potenciais complicações e sequelas das tireoidectomia serem muito comentadas na literatura, não encontramos estudos que abordassem as alterações de deglutição e suas associações com a qualidade de vida dos indivíduos tireoidectomizados, especialmente de modo prospectivo e instrumental, com o uso da eletromiografia de superfície e da avaliação endoscópica da deglutição. O objetivo deste estudo foi avaliar os resultados funcionais e de qualidade de vida relacionados à deglutição em pacientes submetidos à tireoidectomia. Metodologia: Foi realizado um estudo prospectivo com 120 pacientes submetidos à cirurgia de tireóide (parcial ou total) pelo Departamento de Cirurgia de Cabeça e Pescoço do Hospital A.C.Camargo. Os pacientes responderam a dois questionários: o MD Anderson Dysphagia Inventory – MDADI, que avalia os efeitos da disfagia na qualidade de vida e o de sintomas de vias aéreas superiores após tireoidectomia e duas avaliações instrumentais da deglutição: a eletromiografia de superfície e a nasolaringoscopia da deglutição. A deglutição foi avaliada com três diferentes consistências (liquida, liquido-pastosa e pastosa) com volume de 5ml em ambos os exames. Todas as avaliações foram realizadas nos períodos pré e pós-operatório recente e tardio. Resultados: Foram realizadas 1204 avaliações (301 nasofibroscopias da deglutição, 301 eletromiografias de superfície da deglutição e 602 aplicações dos questionários de qualidade de vida e de sintomas de vias aéreas superiores). Houve predominio do sexo feminino, com idade mediana de 47 anos. A maior parte dos casos foi submetida a tireoidectomia total e apresentou diagnóstico histológico de carcinoma papilífero. No pós-operatório recente (1mês) foram identificados 21 (17,5%) pacientes com imobilidade (parcial ou total) de pregas vocais. Após 1 ano, 6 (5%) pacientes mantiveram a nasolaringoscopia alterada...