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Dysphagia

, Volume 29, Issue 6, pp 692–703 | Cite as

Application of the International Classification of Functioning, Disability and Health (ICF) to People with Dysphagia Following Non-surgical Head and Neck Cancer Management

  • Rebecca L. NundEmail author
  • Nerina A. Scarinci
  • Bena Cartmill
  • Elizabeth C. Ward
  • Pim Kuipers
  • Sandro V. Porceddu
Original Article

Abstract

The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 individuals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the diverse impact of dysphagia associated with HNC on the individual, can be used to guide more holistic assessment and management for this population.

Keywords

Deglutition Deglutition disorders ICF Head and neck cancer Radiotherapy 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Babin E, Sigston E, Hitier M, Dehesdin D, Marie JP, Choussy O. Quality of life in head and neck cancers patients: predictive factors, functional and psychosocial outcome. Eur Arch Otorhinolaryngol. 2008;265(3):265–70. doi: 10.1007/s00405-007-0561-0.PubMedCrossRefGoogle Scholar
  2. 2.
    Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ, Kaasa S. Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. Acta Oncol. 1994;33(8):879–85.PubMedCrossRefGoogle Scholar
  3. 3.
    de Graeff A, de Leeuw JRJ, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA. A prospective study on quality of life of patients with cancer of the oral cavity or oropharynx treated with surgery with or without radiotherapy. Oral Oncol. 1999;35(1):27–32.PubMedCrossRefGoogle Scholar
  4. 4.
    Hunter KU, Schipper M, Feng FY, Lyden T, Haxer M, Murdoch-Kinch C-A, Cornwall B, Lee CSY, Chepeha DB, Eisbruch A. Toxicities affecting quality of life after chemo-IMRT of oropharyngeal cancer: prospective study of patient-reported, observer-rated, and objective outcomes. Int J Radiat Oncol Biol Phys. 2013;85(4):935–40. doi: 10.1016/j.ijrobp.2012.08.030.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Frowen JJ, Perry AR. Swallowing outcomes after radiotherapy for head and neck cancer: a systematic review. Head Neck. 2006;28(10):932–44. doi: 10.1002/hed.20438.PubMedCrossRefGoogle Scholar
  6. 6.
    Wall LR, Cartmill B, Ward EC, Hill AJ. Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia. 2013;28(4):481–493. doi: 10.1007/s00455-013-9491-8.
  7. 7.
    Tschiesner UM, Rogers SN, Harréus U, Berghaus A, Cieza A. Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review. Eur Arch Otorhinolaryngol. 2008;265(6):627–37. doi: 10.1007/s00405-008-0641-9.PubMedCrossRefGoogle Scholar
  8. 8.
    Cartmill B, Cornwell P, Ward EC, Davidson W, Porceddu SV. A prospective investigation of swallowing, nutrition, and patient-rated functional impact following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer. Dysphagia. 2012;27(1):32–45. doi: 10.1007/s00455-011-9333-5.PubMedCrossRefGoogle Scholar
  9. 9.
    Barringer DA, Hutcheson KA, Sturgis EM, Kies MS, Lewin JS. Effect of induction chemotherapy on speech and swallowing function in patients with oral tongue cancer. Head Neck. 2009;31(5):611–7. doi: 10.1002/hed.20989.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Hughes PJ, Scott PM, Kew J, Cheung DM, Leung SF, Ahuja AT, van Hasselt CA. Dysphagia in treated nasopharyngeal cancer. Head Neck. 2000;22(4):393–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Jensen K, Lambertsen K, Torkov P, Dahl M, Bonde Jensen A, Grau C. Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer. Acta Oncol. 2007;46(8):1159–68. doi: 10.1080/02841860701491041.PubMedCrossRefGoogle Scholar
  12. 12.
    World Health Organization. International classification of functioning, disability and health. Geneva: World Health Organization; 2001.Google Scholar
  13. 13.
    Tschiesner UM. Changing the perspective: current trends in the assessment of functional outcome in patients with head and neck cancer. Curr Oncol Rep. 2011;13(2):126–31. doi: 10.1007/s11912-011-0156-1.PubMedCrossRefGoogle Scholar
  14. 14.
    Tschiesner UM, Linseisen E, Coenen M, Rogers SN, Harreus U, Berghaus A, Cieza A. Evaluating sequelae after head and neck cancer from the patient perspective with the help of the International Classification of Functioning, Disability and Health. Eur Arch Otorhinolaryngol. 2009;266(3):425–36. doi: 10.1007/s00405-008-0764-z.PubMedCrossRefGoogle Scholar
  15. 15.
    Tschiesner UM, Chen A, Funk G, Yueh B, Rogers SN. Shortfalls in international, multidisciplinary outcome data collection following head and neck cancer: does the ICF Core Set for HNC provide a common solution? Oral Oncol. 2009;45(10):849–55. doi: 10.1016/j.oraloncology.2009.04.003.PubMedCrossRefGoogle Scholar
  16. 16.
    Threats T. Use of the ICF in dysphagia management. Semin Speech Lang. 2007;28(4):323–33. doi: 10.1055/s-2007-986529.PubMedCrossRefGoogle Scholar
  17. 17.
    Tschiesner UM, Cieza A, Rogers SN, Piccirillo J, Funk G, Stucki G, Berghaus A. Developing core sets for patients with head and neck cancer based on the International Classification of Functioning, Disability and Health (ICF). Eur Arch Otorhinolaryngol. 2007;264(10):1215–22. doi: 10.1007/s00405-007-0335-8.PubMedCrossRefGoogle Scholar
  18. 18.
    Tschiesner UM, Rogers SN, Dietz A, Yueh B, Cieza A. Development of ICF core sets for head and neck cancer. Head Neck. 2010;32(2):210–20. doi: 10.1002/hed.21172.PubMedGoogle Scholar
  19. 19.
    Hutcheson KA, Lewin JS. Functional outcomes after chemoradiotherapy of laryngeal and pharyngeal cancers. Curr Oncol Rep. 2012;14(2):158–65. doi: 10.1007/s11912-012-0216-1.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Roe JWG, Carding PN, Dwivedi RC, Kazi RA, Rhys-Evans PH, Harrington KJ, Nutting CM. Swallowing outcomes following Intensity Modulated Radiation Therapy (IMRT) for head and neck cancer: a systematic review. Oral Oncol. 2010;46(10):727–33. doi: 10.1016/j.oraloncology.2010.07.012.PubMedCrossRefGoogle Scholar
  21. 21.
    Campbell BH, Spinelli K, Marbella AM, Myers KB, Kuhn JC, Layde PM. Aspiration, weight loss, and quality of life in head and neck cancer survivors. Arch Otolaryngol Head Neck Surg. 2004;130(9):1100–3. doi: 10.1001/archotol.130.9.1100.PubMedCrossRefGoogle Scholar
  22. 22.
    Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Bhamidipati PV, Karlsson U, Nguyen PD, Alfieri A, Nguyen LM, Lemanski C, Chan W, Rose S, Sallah S. Aspiration rate following chemoradiation for head and neck cancer: an underreported occurrence. Radiother Oncol. 2006;80(3):302–6. doi: 10.1016/j.radonc.2006.07.031.PubMedCrossRefGoogle Scholar
  23. 23.
    van den Berg MGA, Rütten H, Rasmussen-Conrad EL, Knuijt S, Takes RP, van Herpen CML, Wanten GJA, Kaanders JHAM, Merkx MAW. Nutritional status, food intake, and dysphagia in long-term survivors with head and neck cancer treated with chemoradiotherapy: a cross-sectional study. Head Neck. 2014;36:60–65. doi: 10.1002/hed.23265.
  24. 24.
    Cartmill B, Cornwell P, Ward EC, Davidson W, Porceddu SV. Long-term functional outcomes and patient perspective following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer. Dysphagia. 2012;27(4):481–90. doi: 10.1007/s00455-012-9394-0.PubMedCrossRefGoogle Scholar
  25. 25.
    Larsson M, Hedelin B, Athlin E. Lived experiences of eating problems for patients with head and neck cancer during radiotherapy. J Clin Nurs. 2003;12(4):562–70.PubMedCrossRefGoogle Scholar
  26. 26.
    Larsson M, Hedelin B, Athlin E. Needing a hand to hold: lived experiences during the trajectory of care for patients with head and neck cancer treated with radiotherapy. Cancer Nurs. 2007;30(4):324–34. doi: 10.1097/01.NCC.0000281722.56996.07.PubMedCrossRefGoogle Scholar
  27. 27.
    McQuestion M, Fitch M, Howell D. The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Euro J Oncol Nurs. 2011;15(2):145–51. doi: 10.1016/j.ejon.2010.07.006.CrossRefGoogle Scholar
  28. 28.
    Ottosson S, Laurell G, Olsson C. The experience of food, eating and meals following radiotherapy for head and neck cancer: a qualitative study. J Clin Nurs. 2013;22(7–8):1034–43.PubMedCrossRefGoogle Scholar
  29. 29.
    Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV. The lived experience of dysphagia following non-surgical treatment for head and neck cancer. Int J Speech Lang Pathol. 2014;16(3):282–289. doi: 10.3109/17549507.2013.861869.
  30. 30.
    Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV. Survivors’ experiences of dysphagia-related services following head and neck cancer: implications for clinical practice. Int J Lang Commun Disord. 2014;49(3):354–363. doi: 10.1111/1460-6984.12071.
  31. 31.
    Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage Publications; 2002.Google Scholar
  32. 32.
    Sandelowski M. Whatever happened to qualitative description? Res Nurs Heal. 2000;23(4):334–40.CrossRefGoogle Scholar
  33. 33.
    Cieza A, Brockow T, Ewert T, Amman E, Kollerits B, Chatterji S, Ustün TB, Stucki G. Linking health-status measurements to the international classification of functioning, disability and health. J Rehabil Med. 2002;34(5):205–10.PubMedCrossRefGoogle Scholar
  34. 34.
    Cieza A, Geyh S, Chatterji S, Kostanjsek N, Üstün B, Stucki G. ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37(4):212–8. doi: 10.1080/16501970510040263.PubMedCrossRefGoogle Scholar
  35. 35.
    Perry A, Skeat J. Australian therapy outcome measures (AusTOMs) for speech pathology. Melbourne: La Trobe University; 2004.Google Scholar
  36. 36.
    McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, Bricker DE. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17(2):97–114. doi: 10.1007/s00455-001-0109-1.PubMedCrossRefGoogle Scholar
  37. 37.
    O’Halloran R, Larkins B. The ICF Activities and Participation related to speech-language pathology. Int J Speech Lang Pathol. 2008;10(1–2):18–26. doi: 10.1080/14417040701772620.CrossRefGoogle Scholar
  38. 38.
    Cousins N, MacAulay F, Lang H, MacGillivray S, Wells M. A systematic review of interventions for eating and drinking problems following treatment for head and neck cancer suggests a need to look beyond swallowing and trismus. Oral Oncol. 2013;49(5):387–400. doi: 10.1016/j.oraloncology.2012.12.002.PubMedCrossRefGoogle Scholar
  39. 39.
    Locher JL, Robinson CO, Bailey FA, Carroll WR, Heimburger DC, Saif MW, Tajeu G, Ritchie CS. Disruptions in the organization of meal preparation and consumption among older cancer patients and their family caregivers. Psycho Oncol. 2009;19(9):967–74. doi: 10.1002/pon.1656.CrossRefGoogle Scholar
  40. 40.
    Howe TJ. The ICF contextual factors related to speech-language pathology. Int J Speech Lang Pathol. 2008;10(1–2):27–37. doi: 10.1080/14417040701774824.CrossRefGoogle Scholar
  41. 41.
    Patterson JM, Rapley T, Carding PN, Wilson JA, McColl E. Head and neck cancer and dysphagia; caring for carers. Psycho Oncol. 2013;22:1815–20. doi: 10.1002/pon.3226.CrossRefGoogle Scholar
  42. 42.
    Mayre-Chilton KM, Talwar BP, Goff LM. Different experiences and perspectives between head and neck cancer patients and their care-givers on their daily impact of a gastrostomy tube. J Hum Nutr Dietetics. 2011;24(5):449–59. doi: 10.1111/j.1365-277X.2011.01165.x.CrossRefGoogle Scholar
  43. 43.
    Penner JL, McClement S, Lobchuk M, Daeninck P. Family members experiences caring for patients with advanced head and neck cancer receiving tube feeding: a descriptive phenomenological study. J Pain Symptom Manag. 2012;44(4):563–71. doi: 10.1016/j.jpainsymman.2011.10.016.CrossRefGoogle Scholar
  44. 44.
    Scarinci N, Worrall L, Hickson L. The ICF and third-party disability: its application to spouses of older people with hearing impairment. Disabil Rehabil. 2009;31(25):2088–100. doi: 10.3109/09638280902927028.PubMedCrossRefGoogle Scholar
  45. 45.
    Grawburg M, Howe TJ, Worrall L, Scarinci N. Describing the impact of aphasia on close family members using the ICF framework. Disabil Rehabil. 2013;1–12. doi: 10.3109/09638288.2013.834984.
  46. 46.
    DeRenzo E. Ethical considerations in dysphagia research and treatment: Secular and scared. In: Sonies BC, editor. Dysphagia: a continuum of care. Gaithersburg: Aspen Publishers; 1997. p. 91–106.Google Scholar
  47. 47.
    Meiselman HL. Dimensions of the meal. J Foodserv. 2008;19(1):13–21. doi: 10.1111/j.1745-4506.2008.00076.x.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rebecca L. Nund
    • 1
    • 2
    Email author
  • Nerina A. Scarinci
    • 1
  • Bena Cartmill
    • 2
    • 3
  • Elizabeth C. Ward
    • 2
    • 4
  • Pim Kuipers
    • 2
    • 5
  • Sandro V. Porceddu
    • 6
    • 7
  1. 1.Division of Speech Pathology, School of Health and Rehabilitation SciencesThe University of QueenslandSt LuciaAustralia
  2. 2.Centre for Functioning and Health Research, Metro South Hospital and Health Services DistrictQueensland HealthBurandaAustralia
  3. 3.Speech Pathology DepartmentPrincess Alexandra HospitalWoolloongabbaAustralia
  4. 4.School of Health and Rehabilitation SciencesThe University of QueenslandSt LuciaAustralia
  5. 5.Population and Social Health Research Program, Griffith Health InstituteGriffith UniversityLoganAustralia
  6. 6.School of MedicineThe University of QueenslandHerstonAustralia
  7. 7.Radiation Oncology DepartmentPrincess Alexandra HospitalWoolloongabbaAustralia

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