Rehabilitering og symptom belastning ved mundhulecancer. Litteraturstudie

Transkript

1 Rehabilitering og symptom belastning ved mundhulecancer Litteraturstudie

2 Overblik Review/oversigtsartikel Metode/litteratur Resultater

3 Review/oversigtsartikel Early and late physical and psychosocial effects of primary surgery in patients with oral and oropharyngeal cancers: a systematic review Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology (OOOO Journal) In Press 28. januar 2016

4 Søgestrategi Engelske artikler publiceret ml januar 2004 og januar 2014 Patienter med orale cancere Primært kirurgisk behandlede Artiklerne undersøger fysisk og psykisk velbefindende hos patienter

5 Søgeord Oral cancer Rehabilitation Surgery Anxiety Body image Depression Dysphagia Eating Psychosocial Speec Swallow Nurse

6 Litteratursøgning

7 Symptomer Smerter Ernæring/evne til at spise Dysphagi Trismus Stemme/tale Dysfiguration/udseende Socialt liv Psykisk påvirkning

8 Tidsfaktorer Pre-op Discharge 1mo 3 mo 6 mo 12 mo 18 mo 5 yrs 9 yrs Pain Nutrition/ inability to eat Dysphagia Trismus Voice/speech Disfigurement Social life Emotional distress

9 Gensidig/indbyrdes påvirkning (Interrelatedness) Smerter Dysfagi Emotionel påvirket

10 Symptombyrde Talrige symptomer Symptomernes alvorlighed Symptomernes påvirkning af patienten = symptom byrde Kilde: Cleeland CS. Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr.

11 Konklusion Patienter med orale cancere er påvirket af deres sygdom og behandling både tidligt og sent i forløbet Mange forskellige faktorer har indflydelse på dette Har en stor symptombyrde Behov for rehabilitering for at lette og forebygge symptomer og sekvælæ

12 Fremtidig forskning Flere undersøgelser skal afdække hvordan man bedst kan støtte patienterne med deres komplekse fysiske, psykiske og sociale behov Skræddersyede programmer, baseret på systematiske reviews, der kan sørge for den bedste genoptræning i relation til f.eks. dysfagi, ernæring, trismus Studier der viser den bedste måde at undervise og inddrage patienter i fysisk genoptræning og psykosocial støtte, f.eks. individuel støtte, større eller mindre grupper, samtaler, klasseundervisning Udvikling af evidensbaserede guidelines for rehabilitering af patienter der er kirurgisk behandlet for oral cancere

13 Referencer Yang Z, et al Quality of life of patients with tongue cancer 1 year after surgery. J Oral Maxillofac Surg. 2010;68(9): doi: /j.joms Rieger J, et al Journal of Psychosocial Social Perception of Speech in Individuals with Oropharyngeal Reconstruction. 2008;(August 2012): Van den Brink JL, et al Quality of life during the first 3 months following discharge after surgery for head and neck cancer: prospective evaluation. J Otolaryngol. 2006;35: Handschel J, et al. Psychological aspects affect quality of life in patients with oral squamous cell carcinomas. Psychooncology. 2013;22(3): Biazevic et al. Immediate impact of primary surgery on health-related quality of life of hospitalized patients with oral and oropharyngeal cancer. J Oral Maxillofac Surg. 2008;66(7): Shepherd KL, et al. Prospective evaluation of quality of life in patients with oral and oropharyngeal cancer: from diagnosis to three months post-treatment. Oral Oncol. 2004;40(7): Chen S-C, et al- Orofacial pain and predictors in oral squamous cell carcinoma patients receiving treatment. Oral Oncol. 2011;47(2): Oskam IM, et al. Prospective evaluation of health-related quality of life in long-term oral and oropharyngeal cancer survivors and the perceived need for supportive care. Oral Oncol. 2013;49(5): Jager-Wittenaar H, et al.critical weight loss in head and neck cancer--prevalence and risk factors at diagnosis: an explorative study.support Care Cancer. 2007;15(9): Hu T-W et al. A qualitative study of the experience of oral cancer among Taiwanese men. Int J Nurs Pract. 2009;15(4):

14 Referencer Smith GI, et al. Measures of health-related quality of life and functional status in survivors of oral cavity cancer who have had defects reconstructed with radial forearm free flaps. BrJ Oral Maxillofac Surg. 2006;44(3): Jenewein J, et al Quality of life and dyadic adjustment in oral cancer patients and their female partners. Eur J Cancer Care (Engl). 2008;17(2): Roing M, et al.the uncanny mouth - a phenomenological approach to oral cancer. Patient Educ Couns. 2007;67(3): Kamstra JI, et al. Oral symptoms and functional outcome related to oral and oropharyngeal cancer. Support Care Cancer. 2011;19(9): Chen S-C. Life experiences of Taiwanese oral cancer patients during the postoperative period. Scand J Caring Sci. 2012;26(1): O Brien K, et al. An exploration of the perceived changes in intimacy of patients relationships following head and neck cancer. J Clin Nurs. 2012;21(17-18): Roing M, et al. Making new meanings of being in the world after treatment for oral cancer. Qual Health Res. 2009;19(8): Fingeret MC, et al. Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer. 2010;(March): Humphris GM, et al. The association of cigarette smoking and anxiety, depression and fears of recurrence in patients following treatment of oral and oropharyngeal malignancy. Eur J Cancer Care (Engl). 2004;13(4): Yamauchi T, et al. Risk factors for postoperative dysphagia in oral cancer. Bull Tokyo Dent Coll. 2012;53(2):67-74.

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