An investigation into the adherence to daily, preventative swallowing exercises in head and neck cancer patients with radiotherapy or concurrent chemoradiotherapy-induced dysphagia
Cardiff Metropolitan University
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Background: Previous studies have indicated positive correlations between adherence to prophylactic swallowing exercises for head and neck cancer patients and an improvement in swallow function post-treatment. However, adherence to such exercises within this cohort is generally low. The systematic documentation of the experiences of these patients regarding swallowing exercises and the subsequent reasons for non-adherence is yet to be explored. Methods: An online survey was distributed to five online head and neck cancer specific support groups/forums. 29 out of the 78 initial participants were eligible to complete the questionnaire. Participants were split into two groups: those who were provided with exercises by a speech and language therapist and those who sought out exercises themselves. Participants supplied information regarding their motivation to complete exercises, specific details of the type and intensity of the exercise regime, and their overall impression of the exercises. Participants were also asked to provide classifying information regarding their age bracket, gender, TNM staging, country of residence, and level of education. Results: Factors that reportedly encouraged motivation included carrying out a regime low in response costs such as increased time and effort, having information regarding the purpose and long-term benefits of the exercises, having access to support and information, and having belief in the efficacy and self-efficacy of the exercises. Technology was reported as a prominent source of information and mode of therapy within this cohort. Adherence was decreased by factors such as a lack of immediate evidence of efficacy, increased concomitant side-effects of treatment, and a lack of information regarding the purpose of the exercises from health professionals. Conclusions: Motivation as a whole appears much lower in participants who are provided with exercises compared to those who seek out exercises themselves. Further research is needed to explore the factors discussed in this study within a wider participant sample; to identify possible patterns pertaining to classifying factors such as age, or intensity/type of regimes prescribed by speech and language therapists compared to self-prescribed regimes. Head and neck cancer patients may benefit from strategies discussed in this study, such as electronic sources of information and goal setting to optimize adherence.
B.Sc. (Hons) Speech and Language Therapy
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