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Exploring the Acceptability of Behavioral Swallowing Interventions for Head and Neck Cancer Patients During Radiotherapy: A Qualitative Study of Patients' Experience.
Manduchi, Beatrice; Fitch, Margaret I; Ringash, Jolie G; Howell, Doris; Hutcheson, Katherine A; Martino, Rosemary.
Affiliation
  • Manduchi B; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. beatrice.manduchi@mail.utoronto.ca.
  • Fitch MI; Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada. beatrice.manduchi@mail.utoronto.ca.
  • Ringash JG; The Swallowing Lab, University of Toronto, Toronto, ON, Canada. beatrice.manduchi@mail.utoronto.ca.
  • Howell D; Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
  • Hutcheson KA; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
  • Martino R; Department of Otolaryngology- Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
Dysphagia ; 2023 Nov 22.
Article in En | MEDLINE | ID: mdl-37991659
ABSTRACT
The PRO-ACTIVE randomized clinical trial offers 3 swallowing therapies to Head and Neck Cancer (HNC) patients during radiotherapy namely reactive, proactive low- ("EAT-RT" only), and high-intensity ("EAT-RT + exercises"). Understanding the perceived acceptability of these interventions is important to inform eventual implementation into clinical practice. This study explored patients' perspectives using qualitative methodology. At 2 Canadian PRO-ACTIVE trial sites, 24 trial participants were recruited for individual semi-structured interviews, representing each of the 3 trial arms. Data collection and thematic analysis were guided by the Theoretical Framework of Acceptability (TFA). Member checking was conducted through follow-up focus groups. Seven themes were derived reflecting the TFA constructs. Overall, regardless of trial arm, patients reported a positive experience with therapy. Patients identified benefits of EAT-RT therapy, reporting that it provided meaningful feedback on diet progress and supported goal setting for oral intake. Patients who received proactive therapies valued the opportunity to set expectations early, build mealtime routine iteratively over time, and have an extended engagement with the SLP. Regardless of trial arm, patients agreed proactive therapy aligned with what they think is best and that therapy intensity should accommodate individual needs. This study identified the value to HNC patients of receiving swallowing interventions during RT and setting realistic expectations around swallowing. Compared to reactive care, proactive therapies were perceived helpful in consolidating habits early, establishing realistic expectations around swallowing and building an extended rapport with the SLP. These findings will inform the implementation of proactive versus reactive swallowing therapies in clinical practice.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Dysphagia Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country: Canadá

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Dysphagia Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country: Canadá