Page 85 - HHR-HNR 2.0

Chapter 1 Introduction\u000D1.1 Background\u000DDue to improved treatment methods, the survival rate for cancer patients is on the rise. This is also evident in the head and neck cancer population. The survival time of patients who receive non- curative treatment is similarly increasing. Tumours in the head and neck area hold a special place in cancer care, due to their location in a directly visible area and their impact on vital functions such as breathing, eating and drinking, and speaking. Head and neck cancer patients more often face difficulties with food consumption, communication, pain, and cosmetic issues (List, D\u0027Antonio et al. 1996, Murry, Madasu et al. 1998, van der Molen, van Rossum et al. 2009). Furthermore, tumour treatment frequently leads to worse physical functioning, impaired functioning of the shoulder, lymphedema of the face and neck, overall fatigue and psychosocial complaints (Taylor, Terrell et al. 2004, Stuiver, van Wilgen et al. 2008). These problems and complaints have a major impact on patients\u0027 quality of life, because of which patients in this particular group may end up in a downward spiral (Rogers, Courneya et al. 2008, Tschiesner, Rogers et al. 2009). Recent research has shown that targeted rehabilitation can significantly improve recovery and optimisation of functional impairments, participation in social activities and, thus, patients\u0027 quality of life (Reilly 1990, Lazarus, Logemann et al. 2000, Salerno, Cavaliere et al. 2002, List and Bilir 2004, Rosenthal, Lewin et al. 2006, Burkhead, Sapienza et al. 2007, Kubrak, Olson et al. 2009, Passchier, Stuiver et al. 2016).\u000DBy combining the expertise of the Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL) in this specialty area with the extensive expertise of Reade3, the first version of a tailored head and neck rehabilitation (HNR) programme was drawn up in 2009. This HNR programme was published in 2010 and approved as multidisciplinary rehabilitation programme by health insurance companies. The simultaneous development of the guideline \u0027Cancer Rehabilitation\u0027 (http://www.oncoline.nl/cancer- rehabilitation) also underlines the importance of multidisciplinary rehabilitation, as was emphasised in version 1.0 of the HNR programme (IKNL 2011).\u000D1.2 Head and Neck Rehabilitation programme\u000DThe target group of this head and neck rehabilitation (HNR) programme consists of head and neck cancer patients (and their significant others) treated at the NKI-AVL, or referred to the NKI-AVL after treatment elsewhere. The HNR programme aims to help head and neck cancer patients regain their place in society. The programme has been devised in line with the ICF model (International Classification of Functioning, Disability and Health). Using this model, the patient\u0027s daily functioning can be mapped out in detail (see Figure A, page 86). The HNR programme consists of a comprehensive package of rehabilitation modules tailored to the individual needs and circumstances of the patient. The HNR is provided by a multidisciplinary team of medical specialists and allied health professionals, specialised in head and neck oncology. The rehabilitation outcomes are assessed with (where possible) valid and reliable measuring instruments in terms of improvements in functioning on the ICF components (body functions and structures, activities and participation, see Figure A, page 89). The rehabilitation process is formally closed with an overall quality-of-life assessment and discipline- specific measurements.\u000D3 As of 31 December 2009 the Rehabilitation Centre Amsterdam and the Jan van Breemen Institute have joined forces and from 1 September 2010 onwards they have continued under the new name Reade.\u000D84\u000D