Improving compliance with swallowing exercise to decrease radiotherapy-related dysphagia in patients with head and neck cancer

Jizhe Zhu; Xin Wang; Suxiang Chen; Ruofei Du; Haoning Zhang; Menghan Zhang; Mengwei Shao; Changying Chen; Tao Wang

doi:10.1016/j.apjon.2022.100169

Improving compliance with swallowing exercise to decrease radiotherapy-related dysphagia in patients with head and neck cancer

Asia Pac J Oncol Nurs. 2022 Nov 19;10(1):100169. doi: 10.1016/j.apjon.2022.100169. eCollection 2023 Jan.

Authors

Jizhe Zhu¹, Xin Wang¹, Suxiang Chen², Ruofei Du^{1

3}, Haoning Zhang¹, Menghan Zhang¹, Mengwei Shao¹, Changying Chen⁴, Tao Wang^{1

5

6

7}

Affiliations

¹ College of Nursing and Health, Zhengzhou University, Zhengzhou, China.
² Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.
³ Academy of Medical Sciences of Zhengzhou University, Zhengzhou, China.
⁴ Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁵ Telethon Kids Institute, Perth, WA, Australia.
⁶ Medical School, University of Western Australia, Perth, WA, Australia.
⁷ People' s Hospital of Hebi, Hebi, China.

Abstract

Objective: Dysphagia, one of the most common complications in head and neck cancer (HNC) treated with radiotherapy, can severely affect patients' quality of life. Currently, because no "gold standard" treatment exists, swallowing exercise remains the main rehabilitation strategy for dysphagia. However, patients' compliance with long-term swallowing exercise is only 40%, thus, greatly compromising outcomes. This article aims to analyze thefactors influencing swallowing exercise compliance in patients with HNC and explains strategies developed to date for improved rehabilitation outcomes.

Methods: Research studies published between 2005 and 2022 were retrieved from seven databases: PubMed, Cochrane Library, Embase, CINAHL, CNKI, Wan Fang Database, and VIP Database, and 21 articles were shortlisted and systematically reviewed.

Results: The swallowing exercise compliance in patients with HNC undergoing radiotherapy was affected by multiple factors, including socio-demographic factors, illness-associated factors, treatment-associated factors, and psychosocial factors. Regarding the interventions, current strategies mainly address psychosocial issues via developing various education programs.

Conclusions: Different factors influencing swallowing exercise compliance are important and should be observed. Measures including developing multidisciplinary teams, applying innovative equipment, refining the intervention procedure, and applying systematic theory frameworks should be performed to achieve better outcomes of compliance interventions.

Keywords: Compliance; Dysphagia; Head and neck cancer; Influence factor; Rehabilitation; Swallowing exercise.

Publication types

Review