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- Hammerlid, Eva, 1957, et al.
(författare)
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Quality-of-life effects of psychosocial intervention in patients with head and neck cancer.
- 1999
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Ingår i: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. - 0194-5998. ; 120:4, s. 507-16
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Tidskriftsartikel (refereegranskat)abstract
- METHODS: Two studies of psychosocial interventions in head and neck cancer patients at different stages of their disease were performed. We explored the feasibility and effectiveness of different approaches, offered for the first time to this population. The first study concerned long-term group psychological therapy for patients with newly diagnosed head and neck cancer. Quality of life was measured longitudinally for 1 year and compared with that of a control group. The second study comprised a short-term psychoeducational program 1 year after treatment for head and neck cancer. Quality-of-life assessments were made repeatedly from diagnosis until 1 month after the intervention. RESULTS: Thirteen patients started the psychological group therapy, and 8 of them completed both the intervention and evaluation procedure. The quality of life of the therapy group improved more than that of a control group in most areas measured during the study year, in particular psychiatric morbidity, social functioning, emotional functioning, and global quality of life. The results indicate benefits from the therapy, although the therapy group scored worse than the control group at diagnosis. Most of the variables representing functioning and symptoms improved after the 1-week psychoeducational program, especially items reflecting "trouble eating" and "problems enjoying your meals." Patients' judgments of the intervention quality indicated satisfaction with all separate elements, mostly education, about cancer and the opportunity to socialize with the other guests. CONCLUSION: These pilot studies suggest that head and neck cancer patients can benefit from different psychosocial interventions. Quality-of-life questionnaires were well accepted and sensitive to changes during the studies. Thus our early findings seem promising and would justify confirmation in larger studies.
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- Stalfors, Joacim, 1966, et al.
(författare)
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A cost analysis of participation via personal attendance versus telemedicine at a head and neck oncology multidisciplinary team meeting
- 2005
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Ingår i: JOURNAL OF TELEMEDICINE AND TELECARE. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 11:4, s. 205-210
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Tidskriftsartikel (refereegranskat)abstract
- Multidisciplinary team (MDT) meetings are used for establishing diagnosis, for tumour, node, metastasis (TNM) classification and for treatment in head and neck tumour patients in the western region of Sweden. Because of the distances, telemedicine was introduced to link the regional hospital to two of the three district general hospitals (DGHs). We evaluated the costs of presenting patients face to face (FTF) versus via telemedicine. Cost analyses were based on questionnaires completed by patients presented at the MDT meeting. A total of 39 patients were included in the FTF group and 45 patients in the telemedicine group. The cost analysis showed that FTF presentation cost SEK 2267 versus SEK 2036 by telemedicine (difference not significant). The small difference was explained by the fact that the responsible physician accompanied only six of 39 patients when presented FTF, but when presented via telemedicine the DGH physician always participated. A sensitivity analysis revealed that if the responsible physician always accompanied his/her patient for presentation FTF, the cost would be SEK 5366 per patient. This study shows that costs may be saved by carrying out MDT meetings by means of telemedicine instead of FTF.
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- Stalfors, Joacim, 1966, et al.
(författare)
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Haptic palpation of head and neck cancer patients--implication for education and telemedicine.
- 2001
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Ingår i: Studies in health technology and informatics. - 0926-9630. ; 81, s. 471-4
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Tidskriftsartikel (refereegranskat)abstract
- Malignancy in the head and neck area is a disease that often gives high morbidity in functions like speech, eating, breathing and cosmetics. To ensure a treatment of high clinical standard these patients are presented for a multidisciplinary tumor-team at Sahlgren University hospital. The team usually involves ENT-surgeons (Ear, Nose and Throat), oncologists, radiologists, pathologists, plastic surgeon, general surgeon and oral surgeons. The aim of the presentation is to classificate the tumor and suggests a treatment. The patients presented are from the whole western region of Sweden, and therefore some patients have to travel long distances. To minimize travel telemedicine was introduced 1998 with success [1]. One concern, when presenting a patient with telemedicine, has been the lack of possibility to palpate the tumor and the tissue surrounding it. To address this problem a 3D model of the tumor visualizes the region and possibly allows haptic palpation. Based on a series of high resolution CT/MR scans, a model of the region around the patients tumor is created. Haptic properties are added to the skin and subcutaneous structures (including the tumor) of the model. Initially, the haptic tuning is done by an examining physician, but in the final telemedical application, the aim is to develop a sensory device for this purpose (e.g. a position sensitive glove, such as Virtual Technologies, Inc. CyberGlove [2] and a graded system for setting firmness of the tissue). The model with its haptic properties can then be examined visually and haptically, the latter using a haptic device such as the SensAble PHANToM [3]. The present system uses a 3D model in VRML format based on reconstructed structures in the ROI (which includes the jawbones, the vertebra, the throat, major muscles and the skin) from high resolution CT. Haptic properties are added using MAGMA 2.5 (ReachIn Technologies AB, Sweden) [4]. Haptic force feedback is provided using a PHANToM Desktop (SensAble Technologies Inc) [3]. Visual feedback can be either monoscopic or stereoscopic (StereoGraphic CrystalEyes) [5]. The system will be used for concept testing and for evaluating possible limitations and/or the need for a modified examination protocol. Once a reliable set of parameters has been generated (using both professionals and medical students at various levels), the remote components will be added.
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| 8. |
- Westin, Tomas, 1955, et al.
(författare)
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Tumour boards/multidisciplinary head and neck cancer meetings: are they of value to patients, treating staff or a political additional drain on healthcare resources?
- 2008
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Ingår i: Current opinion in otolaryngology & head and neck surgery. - 1531-6998. ; 16:2, s. 103-7
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE OF REVIEW: This article reviews the literature on the management of head and neck cancer using multidisciplinary team meetings as well as addressing the question of whether or not this organization is of benefit to the patients and treating staff and if it is cost efficient. RECENT FINDINGS: The multidisciplinary team has developed because of the complexity of clinical workup and treatment of head and neck cancer for which no single physician can claim to master all the training and skills necessary to treat the patients. The multidisciplinary team ensures that the professional efforts are coordinated and timely, thus ensuring the best results for patients. The multidisciplinary team usually involves a centralization of care with specialization, which benefits the outcome of treatment as well as enabling the development of clinical pathways to minimize complications, and improving on cost effectiveness. SUMMARY: The multidisciplinary team has become more and more an integral part of the clinical pathway for a patient with head and neck cancer in many European countries. This is cost effective and benefits patient outcomes.
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