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The SEA CHANGE Study: A Self Management Intervention for Head and Neck Cancer Survivors

Not Applicable
Conditions
Head and Neck Cancer
Interventions
Behavioral: SEA CHANGE intervention
Registration Number
NCT04051697
Lead Sponsor
Dublin City University
Brief Summary

This study aims to test the feasibility of implementing the Self-Management after Cancer of the Head and Neck Group Intervention (SEA-CHANGE), designed to promote quality of life and participation in life activities and reduce distress in people who have completed primary treatment for head and neck cancer as compared to usual care.

Detailed Description

Head and neck cancer (HNC) and its treatment are associated with specific challenges such as facial disfigurement and impairments in speech, breathing and swallowing, and can have a negative impact on well-being. Self-management interventions can provide people with skills to deal with health-related problems, maintain life roles, and manage negative emotions, and have been found to increase confidence, improve quality of life, and reduce health service use across a range of chronic conditions.

The aim of this study is to pilot a self-management intervention (SEA-CHANGE) designed to promote quality of life and participation in life activities, and reduce distress in people who have completed primary treatment for HNC as compared to usual care. The study includes: (1) a pilot randomised study to assess the feasibility and acceptability of the intervention and its related procedures; (2) a qualitative process evaluation of the intervention; and (3) a systematic decision-making process regarding progression to a definitive trial. The expected outcome is a self-management intervention that is feasible and acceptable to HNC survivors and has the potential to realise both health benefits and economic gains.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • had a pathologically confirmed diagnosis of an invasive primary tumour in the head and neck (oral cavity, salivary glands, nasal cavity, sinuses, middle ear, pharynx and larynx);
  • have undergone and completed treatment by surgery, chemotherapy, radiotherapy or a combination thereof;
  • are aged 18 or older at the time of their HNC diagnosis;
  • are within 12 months of having completed their primary treatment; and
  • have provided written informed, consent.
Exclusion Criteria
  • are unable to read or speak English;
  • had a second invasive primary cancer other than non-melanoma skin cancer diagnosed after the HNC (as these patients are likely to be more focused on the treatment of their second cancer rather than self-management of their HNC);
  • are unable to provide informed consent (e.g., if they have dementia/Alzheimer's disease); or
  • have other known medical condition or other reason why they would be unable to take part.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention armSEA CHANGE interventionParticipants in the intervention group will receive usual care and will be offered access to the self-management intervention (SEA CHANGE). Healthcare professionals within the designated sites will deliver aftercare treatment as usual, with no changes to the patient's clinical care.
Primary Outcome Measures
NameTimeMethod
Change in the Functional Assessment of the Cancer Therapy scale (FACT-G and Head and Neck Cancer Subscale (FACT H&N)) from baseline up to 12 months12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

FACT-G consists of 4 domains and 27 statements, asking participants to consider the previous week and rate their Quality of life (QoL) across physical, social/family, emotional, and functional domains on a five point likert scale (0-4). FACT H\&N comprises 12 statements about HNC specific challenges and can be used independently of the FACT-G to indicate HNC specific QoL. Higher domain scores indicate higher QoL (Maximum domain scores: Physical 28; Social/Family 28; Emotional 24; Functional 28; FACT H\&N subscale 48). The FACT-G and FACT H\&N subscale have been widely used and validated and are commonly used to assess the QoL of HNC survivors.

Secondary Outcome Measures
NameTimeMethod
Changes in The Distress Thermometer scale from baseline up to 12 months12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

The distress thermometer measures an individuals level of distress during the past week and is scored on a 0 to 10 point Likert scale with 0 indicating "No distress" and 10 indicating "Extreme distress". Scores of 4 or more indicate moderate to extreme distress.

Changes in the Social Role Participation Questionnaire (SRPQ) from baseline up to 12 months12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

The SRPQ assesses an individual's perceptions of: 1) the importance of participation in diverse roles; 2) restrictions in role participation; and 3) satisfaction with performance in social roles. Mean scores are calculated separately for each of the 3 social role dimensions on Likert scales: 1) salience or role importance (scores; 1 "Not at all important" to 5 "Extremely important"); 2) physical difficulty with each role (i.e., role limitations) (scoring; 1 "No difficulty" to 4 "Unable to do") and 3) satisfaction with role performance (scoring; 1 "Not satisfied" to 5 "Extremely satisfied"). Because individuals may not engage in all roles, mean role satisfaction scores are calculated if participants respond to at least 9 of 12 role domains.

Changes in the Fear of Recurrence/Relapse Scale from baseline up to 12 months12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

The Fear of Recurrence/Relapse Scale is a five-item scale measuring patients' beliefs about recurrence of their cancer using 5-point Likert scales from 1 (Strongly agree) to 5 (Strongly disagree). Scores range from 5-25 and higher scores reflect a greater fear of cancer relapse.

Changes in the UK Cancer Costs Questionnaire (UKCC) from baseline up to 12 months12 months; change from baseline (before randomisation) to post intervention, 6 months and 12 months

The UKCC is a modular questionnaire designed to capture the resources used by people with a current or previous diagnosis of cancer. Each question can be used in isolation. Captured activity includes primary care usage, community care usage, medications and personal social services. Societal costs are also captured including patient out-of-pocket costs, costs incurred by carers and time taken off work. The questionnaire has been appropriately modified for the Irish context.

Trial Locations

Locations (3)

St James Hospital, Ireland

🇮🇪

Dublin, Ireland

St Lukes Hospital, Ireland

🇮🇪

Dublin, Ireland

Royal Victoria Eye and Ear Hospital, Ireland

🇮🇪

Dublin, Ireland

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