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BACKGROUND: Quality of life (QoL) is influenced in head and neck cancer (HNC) patients by a set of factors related to diagnosis, treatment and tumor impacts. The aim of this study was to evaluate the Quality of Life (QoL) changes in Head and Neck cancer (HNC) patients during treatment (radiotherapy and/or chemoradiotherapy). METHODS: QoL was evaluated prospectively in 63 HNC patients during radiotherapy and/or chemoradiotherapy at three moments: before or at beginning (T0), in the middle (T1 ~ four weeks) and immediately at the end (T2 ~ eight weeks) of treatment. The differences between the scores at different time points was verified using Friedman's non-parametric test. Negative changes between time points were evaluated, with differences (delta) of ±10 points being considered to be clinically significant. RESULTS: The total mean age was 59.1 ± 9.5y, and 82.5% were male. The oral cavity and larynx were more frequent tumors. The functional score for 'role' was decreased at time points T1 and T2 as compared to T0, while an improvement in scores was observed for cognitive function. Several physical symptoms also worsened over time, such as: fatigue, nausea and vomiting, dry mouth and sticky saliva, swallowing and skin symptoms, senses and teeth problems. A high frequency of altered and clinically meaningful values were observed for most of domains, ranging from 6 to 74%. CONCLUSIONS: The QoL became worse at approximately one month after treatment beginning in HNC patients, and this remained until the end of therapy. Protocols directing to early nutritional counseling and management of symptoms of nutritional impact are important to improve clinical outcomes. This is part of preventive actions aiming to make the exhausting treatment process less traumatic and easier to complete.

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OBJECTIVE: To evaluate an educational program based on the principles of self-management with a conventional educational program through quality of life, anxiety and depression instruments within 12 months of starting cancer treatment. METHOD: An experimental, randomized, controlled study conducted with head and neck cancer patients treated at a university hospital in the city of São Paulo, Brazil. Patients were randomly divided into two groups: the control group submitted to the conventional educational plan, and the experimental group submitted to the educational plan for self-management. Descriptive and analytical statistics were used for the analyzes using the t-test, Fischer's exact test and Repeated Measures ANOVA. RESULTS: Twenty (20) patients were selected. Most participants were male, in advanced stages of disease and undergoing three therapeutic modalities. The control group showed a gradual decrease in quality of life scores during treatment, while the experimental group progressively increased. The correlation was significant between the presence of anxiety and depression symptoms and poor quality of life. Patients in the control group had a significant worsening in social/family well-being (P = 0.02) and the prevalence of additional head and neck cancer-related additional concerns (P = 0.01), while the experimental group had reduced anxiety symptoms (P = 0.001) and improved emotional well-being (P = 0.01). CONCLUSION: The educational intervention based on building self-management skills favored quality of life and reduced anxiety and depression. Brazilian Registry of Clinical Trials (RBR 2q53ct).

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The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.

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OBJECTIVES: To investigate associations between religiosity, spirituality and quality of life (QoL) in patients with visible sequelae due to head and neck cancer surgery. SUBJECT AND METHODS: Cross-sectional study in 202 patients in a cancer hospital in Brazil. Psychosocial, demographic and clinical conditions were collected through interviews, clinical examinations and from the medical records. The outcome was QoL, measured by the Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) and the University of Washington QoL Questionnaire for patients with head and neck cancer (UW-QOL). The explanatory variables were religiosity (Duke University Religiosity Index-DUREL) and spirituality (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-FACIT-Sp12). Pearson's correlation and linear regression were used for data analysis. RESULTS: Religiosity and spirituality were associated with both measures of the patients' QoL. After adjustment, higher scores of QoL (FACT-HN and UW-QOL) were found in patients with higher levels of religiosity and of spirituality. Other significant covariates were gender (male), those living with their families, with sequelae not involving the cervical region, longer post-surgical time and who had no chemotherapy or radiation. CONCLUSION: Religiosity and spirituality were associated with the patients' QoL, regardless of their sociodemographic and cancer-related clinical conditions and behaviours.

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OBJECTIVE: The present cross-sectional study evaluated the quality of life of patients treated with 3-D conformal radiotherapy for cancer of the mouth, oropharynx, hypopharynx, or larynx and investigated possible associations with clinical and sociodemographic variables using multivariate analysis. METHODS: The sample was composed of 90 patients who had completed treatment at least 3 months earlier. Data were collected from April 2016 to May 2017. The patients were clinically evaluated with regard to stimulated salivary flow, trismus, and radiation caries. Sociodemographic data and data related to the disease (stage, location of primary tumor, and radiation dose) were collected from the patient charts. Quality of life was assessed using the Brazilian version of the University of Washington Quality of Life (UW-QOL) questionnaire. Poisson logistic regression was performed to determine the mean ratio and test associations with the clinical and sociodemographic variables. RESULTS: The mean total of the UW-QOL was 814.88 (± 224.58). Patient age, staging of cancer, hyposalivation, and trismus were associated with quality of life. Patients with tumors in the advanced stage, those with hyposalivation and those with trismus respectively had 11% (CI 0.80-0.98), 12% (CI 0.79-0.99), and 15% (CI 0.77-0.94) lower UW-QOL scores, indicating poorer quality of life. CONCLUSION: Survivors of head and neck cancer experience a negative impact on quality of life associated with trismus, hyposalivation, advanced stage tumors, and a younger patient age. The present findings underscore the importance of a specific approach focused on these aspects to ensure better quality of life in the long term.

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OBJECTIVE: To evaluate the psychometric properties of the Brazilian version of the Shame and Stigma Scale (SSS) in a sample of patients with head and neck cancers (HNC). METHODS: This is a validation study carried out in a Brazilian cancer hospital. Patients over 18 years old who knew about their HNC diagnosis were consecutively recruited, answering the SSS, the Functional Assessment of Cancer Therapy (General and Head and Neck supplement) questionnaire, and the University of Washington Quality of Life Questionnaire. Internal consistency, test-retest procedure, convergent validity, and responsiveness analysis were the psychometric properties evaluated. RESULTS: A total of 122 HNC patients were included. The SSS showed appropriate internal consistency (alphas ranging from 0.71 to 0.86), test-retest reliability (higher than 0.92 with exception of the "Regret domain"), and convergent validity. The responsiveness analysis with 38 patients was able to discriminate the scores before and after prosthetic procedures. SIGNIFICANCE OF THE RESULTS: The Brazilian Portuguese version of the SSS may be considered a valid and reliable instrument for the evaluation of Brazilian patients with HNC. Future SSS validation studies are welcome in other developing countries in order to make cancer health providers aware of these negative feelings in their HNC patients.

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Abstract The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.

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Abstract The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.

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OBJECTIVE: to identify the frequency of fatigue and domains affected in patients with head and neck cancer undergoing radiation therapy, at the beginning, middle and end of treatment. METHOD: longitudinal and prospective study of quasi-experimental design, involving 60 patients with head and neck cancer. It should be highlighted that this article will address only the data of the Control Group. The dependent variables were collected through interview, using the revised Piper Fatigue Scale, which is a multidimensional instrument that assesses global, behavioral, affective and sensory/psychological domains. Data analysis was based on absolute and relative frequencies. RESULTS: there was a predominance of males, age group between 41-60 years, low level of education and in regular use of alcohol and cigarettes. All domains in the fatigue scale had their scores increased, presenting median values of greater magnitude in Time 2 and Time 3, when compared to the Time 1 values, indicating an increase in fatigue levels during radiation therapy. CONCLUSION: fatigue increased in the course of the radiation therapy, having all domains affected. Therefore, its evaluation throughout the treatment is important, as fatigue is a common and debilitating symptom on cancer patients.

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Objective: The study's purpose has been to summarize the knowledge about primary studies that investigated radiotherapy experiences from the perspective of head and neck cancer patients. Methods: It is an integrative literature review. Results: The final sample consisted of 13 studies that were published from 1998 to 2015. Through the studies thematic analysis were identified four major themes, as follows: "physical consequences of radiotherapy", "psychological and emotional repercussions of radiotherapy", "lack of information about the treatment and posture of the health professional regarding the treatment adverse effects" and "support networks". Conclusion: The studies showed that the radiotherapy treatment had important negative repercussions in the patients' life regarding the reactions and readjustments, and also the roles played family wise, all due to the treatment. There was also an important knowledge gap on the subject, then demonstrating the need for new studies with a qualitative approach, aiming to better understand this experience, therefore, producing care improvement

Objetivo: Sintetizar o conhecimento de estudos primários que investigaram a experiência da radioterapia, na perspectiva do paciente com câncer de cabeça e pescoço. Método: Revisão integrativa da literatura. Resultados: Amostra final composta por 13 estudos publicados entre 1998 a 2015. Pela análise temática dos estudos foram identificados quatro temas maiores: "repercussões físicas da radioterapia", "repercussões psicológicas e emocionais da radioterapia", "falta de informação sobre o tratamento e a postura do profissional de saúde perante os efeitos adversos do tratamento" e "redes de apoio". Conclusão: Os estudos evidenciaram que o tratamento radioterápico trouxe repercussões negativas importantes na vida dos pacientes frente às reações e rearranjos na vida e nos papéis desempenhados dentro da família, decorrentes do tratamento. Verificou-se também uma lacuna importante de conhecimento sobre a temática, demonstrando a necessidade de novos estudos, com abordagem qualitativa, para melhor compreensão desta experiência, refletindo em aprimoramento da assistência

Objetivo: Sintetizar el conocimiento de estudios primarios que investigaron la experiencia de la radioterapia, en la perspectiva del paciente con cáncer de cabeza y cuello. Método: Revisión integrativa de la literatura. Resultados: La muestra final consistió en 13 estudios publicados entre 1998 y 2015. En el análisis temático de los estudios se identificaron cuatro temas más grandes: "repercusiones físicas de la radioterapia", "repercusiones psicológicas y emocionales de la radioterapia", "falta de información sobre el tratamiento y la la postura del profesional de la salud ante los efectos adversos del tratamiento y las redes de apoyo. Conclusión: Los estudios evidenciaron que el tratamiento radioterápico trajo repercusiones negativas importantes en la vida de los pacientes frente a las reacciones y reajustes en la vida y en los papeles desempeñados dentro de la familia, derivados del tratamiento. Se verificó también una laguna importante de conocimiento sobre la temática, demostrando la necesidad de nuevos estudios, con abordaje cualitativo, para una mejor comprensión de esta experiencia, reflejando en el perfeccionamiento de la asistencia

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