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The head and neck symptom checklist©: an instrument to evaluate nutrition impact symptoms effect on energy intake and weight loss

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Abstract

Purpose

This study aimed to validate the Head and Neck Patient Symptom Checklist© (HNSC©) by tracing the prevalence and interference with eating of nutrition impact symptoms (NIS) over time and by examining relationships among NIS included in the HNSC, energy intake, and weight loss.

Methods

Height, weight, 3-day diet records, and HNSC© were obtained at baseline, posttreatment, and 2.5 month follow-up for 52 treatment–naive head and neck cancer (HNC) patients. Relationships among energy intake, weight loss, age, sex, treatment, tumor stage, and NIS were evaluated using general estimating equation (GEE) modeling. Cumulative hazard (CH) analysis was used to determine the time and risk of weight loss.

Results

From baseline to posttreatment, 71 % of patients had 5 % body weight loss. Despite energy intakes returning to baseline levels at follow-up, 88 % of patients continued to lose weight. At posttreatment, 100 % of patients reported 2 or more NIS (range 2–12); these symptoms were still present at follow-up in 83 % of the patients. Univariate GEE analysis demonstrated that most NIS predicted energy intake and weight loss, while multivariate GEE analysis showed that depression, dysphagia, and sore mouth predicted energy intake, and dysphagia and sore mouth predicted weight loss. CH analysis showed that NIS accelerated the time and probability of weight loss.

Conclusions

The HNSC© is a valid tool for assessing NIS in HNC. Identification of NIS may aid in the management of symptoms associated with reduced energy intake and weight loss and thus decrease the malnutrition risk in HNC patients.

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Acknowledgment of funding

This study was supported by the Minton Endowment Fund Bursary, Faculty of Nursing, University of Alberta. No financial relationship exists between authors and endowment bursary fund.

The authors have full control of all the primary data.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

    Catherine Kubrak & Kärin Olson

  2. Department of Oncology (Division of Palliative Care Medicine), University of Alberta, Edmonton, AB, Canada

    Vickie E. Baracos

  3. 136 Health Services Center, Royal Alexandra Hospital, Edmonton, AB, Canada, T6G 2B7

    Catherine Kubrak

Authors
  1. Catherine Kubrak
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  2. Kärin Olson
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  3. Vickie E. Baracos
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Corresponding author

Correspondence to Catherine Kubrak.

Appendix

Appendix

Table 6 Head and neck patient symptom checklist. Instructions: Below is of 17 symptoms. Please circle that describes how often you experienced the symptom during the past 3 days, and if it interfered with your eating
Full size table

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Kubrak, C., Olson, K. & Baracos, V.E. The head and neck symptom checklist©: an instrument to evaluate nutrition impact symptoms effect on energy intake and weight loss. Support Care Cancer 21, 3127–3136 (2013). https://doi.org/10.1007/s00520-013-1870-z

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  • DOI: https://doi.org/10.1007/s00520-013-1870-z

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