Abstract
Purpose
Individuals with head and neck cancer (HNCa) face myriad biopsychosocial challenges. Even after treatment completion, these challenges may cause continued disablement and diminished quality of life (QoL). Resilience may serve to minimize the disabling impact of HNCa and, in turn, maximize QoL. The purpose of this study was to formally assess resilience in HNCa survivors and explore its relationship with QoL.
Methods
A cross-sectional descriptive study was conducted. Forty HNCa survivors completed three validated, self-report questionnaires pertaining to the collection of resilience and QoL data. Descriptive and correlational analyses were performed.
Results
Resilience was identified in HNCa survivors and a positive correlation was found between resilience and QoL.
Conclusions
Data suggest that resilience may buffer the influence of HNCa on QoL. Thus, screening for reduced levels of resilience may proactively facilitate identification of those who are most vulnerable to the psychosocial impact of HNCa. Interventions that foster resilience may ameliorate the challenges of HNCa and maximize QoL.
Similar content being viewed by others
Data Availability
Data and material can be made available upon approval through ethics.
References
Giuliani M, Mcquestion M, Jones J et al (2016) Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck 38(7):1097–1103. https://doi.org/10.1002/hed.24411
Newell S, Sanson-Fisher RW, Girgis A, Ackland S (1999) The physical and psycho-social experiences of patients attending an outpatient medical oncology department: a cross-sectional study. Eur J Cancer Care 8(2):73–82. https://doi.org/10.1046/j.13652354.1999.00125.x
Clasen D, Keszte J, Dietz A, Oeken J, Meister EF, Guntinas-Lichius O, Pabst F, Büntzel J, Jenzewski EM, Singer S, Meyer A (2018) Quality of life during the first year after partial laryngectomy: longitudinal study. Head Neck 40(6):1185–1195. https://doi.org/10.1002/hed.25095
Vilaseca I, Chen AY, Backscheider AG (2006) Long-term quality of life after total laryngectomy. Head Neck 28:313–320. https://doi.org/10.1002/hed.20268
Todres L, Galvin KT, Holloway I (2009) The humanization of healthcare: a value framework for qualitative research. Int J Qual Stud Health Well Being 4(2):68–77. https://doi.org/10.1080/17482620802646204
Deshields TL, Heiland MF, Kracen AC, Dua P (2016) Resilience in adults with cancer: development of a conceptual model. Psychooncology 25:11–18. https://doi.org/10.1002/pon.3800
Gillespie BM, Chaboyer W, Wallis M (2007) Development of a theoretically derived model of resilience through concept analysis. Contemp Nurse 25:124–135. https://doi.org/10.5172/conu.2007.25.1-2.124
Pieters HC (2016) I’m Still Here. Cancer Nurs 39(1):20–28. https://doi.org/10.1097/NCC.0000000000000248
Tan WS, Beatty L, Koczwara B (2019) Do cancer patients use the term resilience? A systematic review of qualitative studies. Support Care Cancer 27:43–56. https://doi.org/10.1007/s00520-018-4456-y
Markovitz SE, Schrooten W, Arntz A, Peters ML (2015) Resilience as a predictor for emotional response to the diagnosis and surgery in breast cancer patients. Psychooncology 24:1639–1645. https://doi.org/10.1002/pon.3834
National Scientific Council on the Developing Child (2015) Supportive relationships and active skill-building strengthen the foundations of resilience: Working paper 13. http://www.developingchild.harvard.edu. Accessed May 2017
Tian J, Hong J (2014) Assessment of the relationship between resilience and quality of life in patients with digestive cancer. World J Gastroenterol 20(48):18439–18444. https://doi.org/10.3748/wjg.v20.i48.18439
Wu W, Tsai S, Liang S, Liu C, Jou S, Berry D (2015) The mediating role of resilience on quality of life and cancer symptom distress in adolescent patients with cancer. J Pediatr Oncol Nurs 32(5):304–313. https://doi.org/10.1177/1043454214563758
Brearley SG, Stamataki Z, Addington-Hall J, Foster C, Hodges L, Jarrett N, Richardson A, Scott I, Sharpe M, Stark D, Siller C, Ziegler L, Amir Z (2011) The physical and practical problems experienced by cancer survivors: a rapid review and synthesis of the literature. Eur J Oncol Nurs 15(3):204–212. https://doi.org/10.1016/j.ejon.2011.02.005
Feuerstein M (2007) Defining cancer survivorship. J Cancer Surviv 1(1):5–7. https://doi.org/10.1007/s11764-006-0002-x
Miller MC, Shuman AG (2016) Survivorship in head and neck cancer: a primer. JAMA Otolaryngol Head Neck Surg 142(10):1–7. https://doi.org/10.1001/jamaoto.2016.1615
Mullan F (1985) Seasons of survival: reflections of a physician with cancer. N Engl J Med 313:270–273. https://doi.org/10.1056/NEJM198507253130421
Connor KM, Davidson JRT (2003) Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 18:76–82. https://doi.org/10.1002/da.10113
Davidson JRT, Connor KM (2016) Connor-Davidson Resilience Scale (CD-RISC) Manual. Unpublished. Partly accessible at www.cd-risc.com. Accessed May 2017
Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ, Kaasa S (1994) 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. EORTC Quality of Life Study Group. Acta Oncol 33(8):879–885. https://doi.org/10.3109/02841869409098450
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, Haes JCJM, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European Organisation for Research and Treatment of Cancer QLQ C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376. https://doi.org/10.1093/jnci/85.5.365
Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A (2001) The EORTC QLQ-C30 scoring manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels
IBM Corp (2017) IMB SPSS statistics for Windows. Armonk
Bornbaum CC, Doyle PC, Skarakis-Doyle E, Theurer JA (2013) A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision. J Multidiscip Healthc 6:75–86. https://doi.org/10.2147/JMDH.S40020
Bornbaum CC, Fung K, Franklin JH, Nichols A, Yoo J, Doyle PC (2012) A descriptive analysis of the relationship between quality of life and distress in individuals with head and neck cancer. Support Care Cancer 20:2157–2165. https://doi.org/10.1007/s00520-011-1326-2
Howren MB, Christensen AJ, Karnell LH, Funk GF (2012) Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 81(2):299–317. https://doi.org/10.1037/a0029940
McDonough E, Boyd J, Varvares M, Maves M (1996) Relationship between psychological status and compliance in a sample of patients treated for cancer of the head and neck. Head Neck 18:269–276. https://doi.org/10.1002/(SICI)1097-0347(199605/06)18:3<269::AID-HED9>3.0.CO;2-Y
McQuade JL, Gunn GB, William WN, Kies MS (2016) Head and Neck Cancer. In: Edmonson KG, Pancotti R (eds) The MD Anderson manual of medical oncology, 3rd edn Retrieved from http://accessmedicine.mhmedical.com.proxy1.lib.uwo.ca/content.aspx?bookid=1772§ionid=121898533
Pateman KA, Ford PJ, Batstone MD, Farah CS (2015) Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer 23:2365–2373. https://doi.org/10.1007/s00520-015-2607-y
Semple CJ, Sullivan K, Dunwoody L, Kernohan WG (2004) Psychosocial interventions for patients with head and neck cancer: past, present and future. Cancer Nurs 27(6):434–441. https://doi.org/10.1097/00002820-200411000-00002
Threats TT (2007) Use of the ICF in dysphagia management. Semin Speech Lang 28(4):323–333. https://doi.org/10.1055/s-2007-986529
Dubey C, De Maria J, Hoeppli C, Betticher DC, Eicher M (2015) Resilience and unmet supportive care needs in patients with cancer during early treatment: a descriptive study. Eur J Oncol Nurs 19:582–588. https://doi.org/10.1016/j.ejon.2015.03.004
Loprinzi CE, Prasad K, Schroeder DR, Sood A (2011) Stress Management and Resilience Training (SMART) Program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial. Clin Breast Cancer 11(6):364–368. https://doi.org/10.1016/j.clbc.2011.06.008
Padilla-Ruiz M, Ruiz-Roman C, Perez-Ruiz E, Rueda A, Redondo M, Rivas-Ruiz F (2019) Clinical and sociodemographic factors that may influence the resilience of women surviving breast cancer: cross-sectional study. Support Care Cancer 27:1279–1286. https://doi.org/10.1007/s00520-018-4612-4
World Health Organization (1997) WHOQOL: Measuring quality of life. Retrieved from http://www.who.int/mental_health/media/68.pdf. Accessed May 2017
Eadie TL, Otero D, Cox S, Johnson J, Baylor CR, Yorkston KM, Doyle PC (2015) The relationship between communicative participation and postlaryngectomy speech outcomes. Head Neck 38(S1):E1955–E1961. https://doi.org/10.1002/hed.24353
Moukarbel RV, Doyle PC, Yoo JH, Franklin JH, Day AM, Fung K (2011) Voice related quality of life (V-RQOL) outcomes in laryngectomees. Head Neck 33:31–36
Robertson SM, Yeo JC, Dunnet C, Young D, Mackenzie K (2012) Voice, swallowing, and quality of life after total laryngectomy: results of the west of Scotland laryngectomy audit. Head Neck 34:59–65. https://doi.org/10.1002/hed.21409
Ganzer H, Rothpletz-Puglia P, Byham-Gray L, Murphy BA, Touger-Decker R (2015) The eating experience in long-term survivors of head and neck cancer: a mixed methods study. Support Care Cancer 23:3257–3268
Lee Y-H, Goo-Yoshino S, Lew HL, Chi W-C, Yen C-F, Liao H-F, Chen SC, Liou TH (2020) Social participation in head and neck cancer survivors with swallowing disorder: World Health Organization Disability Assessment Schedule 2.0 study. Head Neck 42(5):905–912
Hutcheson KA, Bhayani MK, Beadle BM, Gold KA, Shinn EH, Lai SY, Lewin J (2013) Eat and exercise during radiotherapy or chemoradiotherapy for pharyngeal cancers: use it or lose it. JAMA Otolaryngol Head Neck Surg 139(11):1127–1134. https://doi.org/10.1001/jamaoto.2013.4715
Krisciunas GP, Sokoloff W, Stepas K, Langmore SE (2012) Survey of usual practice: dysphagia therapy in head and neck cancer patients. Dysphagia 27(4):538–549. https://doi.org/10.1007/s00455-012-9404-2
Roe JW, Carding PN, Rhys-Evans PH, Newbold KL, Harrington KJ, Nutting CM (2012) Assessment and management of dysphagia in patients with head and neck cancer who receive radiotherapy in the United Kingdom - a web-based survey. Oral Oncol 48(4):343–348. https://doi.org/10.1016/j.oraloncology.2011.11.003
Sharpley CF, Wootten AC, Bitsika V, Christie DRH (2013) Variability over time since-diagnosis in the protective effect of psychological resilience against depression in Australian prostate cancer patients: implications for patient treatment models. Am J Mens Health 7(5):414–422. https://doi.org/10.1177/1557988313477126
Jacobson MC (2018) The experience of head and neck cancer survivorship (including laryngectomy): an integrated biopsychosocial model. Curr Opin Support Palliat Care 12(1):65–73. https://doi.org/10.1097/SPC.0000000000000322
Acknowledgments
The authors would like to thank the editor and the anonymous reviewer for their valuable and highly constructive feedback and input on this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors declare that they have no conflict of interest.
Ethics approval
Ethical approval granted by the Western University Health Sciences Ethics Board (REB Approval # 108785).
Consent to participate
All participants gave informed consent in compliance with ethical approval.
Consent for publication
N/A.
Code availability
N/A.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
MacDonald, C., Theurer, J., Fung, K. et al. Resilience: an essential element in head and neck cancer survivorship and quality of life. Support Care Cancer 29, 3725–3733 (2021). https://doi.org/10.1007/s00520-020-05873-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-020-05873-4