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- Hammerlid, E, et al.
(författare)
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A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients
- 1999
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 80:5-6, s. 766-774
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Tidskriftsartikel (refereegranskat)abstract
- A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment.
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| 2. |
- Bjordal, K, et al.
(författare)
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- 1999
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Ingår i: Journal of Clinical Oncology. - 1527-7755. ; 17:3, s. 1008-1019
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.
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| 3. |
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| 4. |
- Hammerlid, Eva, 1957, et al.
(författare)
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A prospective study of quality of life in head and neck cancer patients. Part I: At diagnosis
- 2001
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Ingår i: Laryngoscope. - : Wiley. - 0023-852X. ; 111:4 Pt 1, s. 669-680
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: A Swedish and Norwegian study was designed to examine health-related quality of life (HQL) in patients with head and neck cancer (head and neck) at diagnosis and during treatment and rehabilitation. The overall aim was to examine the impact on HQL at diagnosis depending on tumor location, stage, sex, and age (part I) and to describe HQL longitudinally and determine for which patients and during which period HQL deteriorated most (part II), This article presents the results at diagnosis. Method Patients with head and neck cancer at five hospitals in Sweden and Norway were consecutively requested to participate, They were asked to answer the EORTC QLQ-C30 and QLQ-H&N35 (the European Organization for Research and Treatment of Cancer, Core 30 questionnaire and head and neck cancer module) repeatedly during I year. A total of 357 patients (mean age, 63 y; 72% males) were included, Results: Patients with different tumor locations all had their special problems at diagnosis, for example, those with tumors in the larynx with communication, those with oral tumors with pain, and those with pharyngeal tumors with nutrition and pain. The patients with hypopharyngeal cancer reported the worst HQL. Stage appeared to have the strongest impact on HQL. Patients with a more advanced tumor stage reported significantly worse HQL scores for 24 of 32 variables reflecting functioning or problems. The females scored worse than the males for some areas, in particular, emotional functioning. The older patients scored significantly better for emotional and social functioning than patients <65 years but worse for physical functioning and various symptoms. The traditional way of grouping the tumor locations into oral, pharyngeal, laryngeal, and "other" tumors (salivary gland, sinus and nose, and unknown primary) was tested from a HQL point of view and found to be consistent. Conclusions: The chosen questionnaires differentiated between different sites of head and neck cancer at diagnosis. Tumor stage had the most powerful impact on HQL score.
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| 6. |
- Jordhoy, M S, et al.
(författare)
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A palliative-care intervention and death at home: a cluster randomised trial
- 2000
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Ingår i: The Lancet. - 1474-547X. ; 356:9233, s. 888-893
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Palliative Medicine Unit at University Hospital of Trondheim, Norway, started an intervention programme that aims to enable patients to spend more time at home and die there if they prefer. Close cooperation was needed with the community health-care professionals, who acted as the principal formal caregivers, and a multidisciplinary consultant team coordinated the care. We did a cluster randomised trial to assess the intervention's effectiveness compared with conventional care METHODS: Community health-care districts in and around Trondheim, Norway, were defined as the clusters to be randomised. We enrolled 434 patients (235 assigned intervention and 199 conventional care [controls]) in these districts who had incurable malignant disease and an expected survival of 2-9 months. Main outcomes were place of death and time spent in institutions in the last month of life. FINDINGS: 395 patients died. Of these, more intervention patients than controls died at home (54 [25%] vs 26 [15%], p<0.05). The time spent at home was not significantly increased, although intervention patients spent a smaller proportion of time in nursing homes in the last month of life than did controls (7.2 vs 14.6%, p<0.05). Hospital use was similar in the two groups. INTERPRETATION: The palliative-care intervention enabled more patients to die at home. More resources for care in the home (palliative care training and staff) and an increased focus on use of nursing homes would be necessary, however, to increase time at home and reduce hospital admissions.
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| 8. |
- Sahlstrand Johnson, Pernilla, et al.
(författare)
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IN VITRO STUDIES AND SAFETY ASSESSMENT OF DOPPLER ULTRASOUND AS A DIAGNOSTIC TOOL IN RHINOSINUSITIS
- 2010
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Ingår i: Ultrasound in Medicine and Biology. - : Elsevier BV. - 0301-5629. ; 36:12, s. 2123-2131
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Tidskriftsartikel (refereegranskat)abstract
- We have previously proposed the use of Doppler ultrasound to noninvasively stage a sinus infection. In this study, we first investigated the acoustic properties of nonpurulent and mucopurulent sinus secretions. The density, viscosity, speed of sound and attenuation of 18 samples of sinus fluid were examined. We then assessed the safety of the method by determining the temperature increase when ultrasound is transmitted through a bone sample of the same thickness as the anterior wall of the maxillary sinus. As a measure of the probability to generate acoustic streaming, we determined the ratio of sound attenuation over the viscosity of the sinus fluid and compared this with the value obtained from acoustic streaming measurements on a model system. The results indicated that detectable levels of acoustic streaming can be generated in serous sinus fluid, which has a low viscosity, but is very unlikely in mucopurulent secretions. The attenuation of the mucopurulent sinus fluid was 10 times higher than that of the serous cyst fluid, but the viscosity of the mucopurulent secretion was a thousand times higher than that of serous fluid. The safety experiments gave a temperature increase of the bone of
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