Page 88 - HHR-HNR 2.0

2.1 Target group\u000DThe HNR programme is aimed at:\u000D- Cancer patients (and their significant others) with a head and neck tumour treated at the\u000DNetherlands Cancer Institute \u2013 Antoni van Leeuwenhoek.\u000D- Cancer patients (and their significant others) referred for rehabilitation after treatment for a head\u000Dand neck tumour elsewhere.\u000DPatients are eligible for rehabilitation when they present with (extensive) impairments that they cannot resolve themselves. Often, the person involved (and/or their significant others) will have care needs in several areas, requiring input from multiple disciplines. Someone may, for instance, experience limitations both on the level of functioning, such as eating and drinking (activities) and work (participation), as on underlying factors, such as learning to cope with limitation/acceptance (personal factors).\u000D2.2 Selection of the target group\u000DAn indication for head and neck rehabilitation treatment is often established in an intake with the rehabilitation physician. The most important components of the intake are: detecting the problem, mapping out complaints and problems in daily functioning in terms of the condition and/or treatment, checking counter-indications for treatment and assessing the patient\u0027s suitability for treatment. The decision on the most suitable treatment is made in a multidisciplinary meeting (for more details, see chapter III Treatment planning).\u000D2.3 Care needs of the target group\u000DThe rehabilitation of head and neck cancer patients used to be limited primarily to one or more monodisciplinary therapy forms (where possible in primary care). The expertise available in primary care for the \u2013 often complex \u2013 problems proved to be limited too, because of which head and neck cancer patients\u0027 care needs would often not be responded to in full. The arrival of the HNR programme and the general oncological guidelines have made it evident that, in the last few years, the need for multidisciplinary rehabilitation to answer to patients\u0027 care needs has increased. However, a head and neck cancer rehabilitation programme can only be realised effectively if in combination with optimal oncological care with curative intent, which in the Netherlands in any case can be provided in centres recognised by the Dutch Head and Neck Society (NWHHT).\u000DProblems experienced by the target group can be described on several levels of the ICF classification. Care needs in the area of rehabilitation of this patient group are drawn from this. For patients with head and neck tumours problems most commonly occur in the following areas (N is the number of items in that particular category; brief core set/comprehensive core set) (Tschiesner, Rogers et al. 2009):\u000D\u2022 Body function (N=6/34)\u000DEnergy and motivation, emotional functions, pain sensation, voice functions, respiratory functions and swallowing functions.\u000D\u2022 Body structure (N=4/33)\u000DThe mouth, the pharynx, the larynx, and other parts of the head and neck area.\u000D87\u000D