title: Distress in spouses and patients after treatment for head and neck cancer.
abstract: BACKGROUND
  The objective of this study is to obtain insight into distress in spouses and patients treated for head and neck cancer.
  
  
  METHODS
  Forty-one patient-spouse pairs completed the Hospital Anxiety and Depression Scale (HADS). Inclusion criteria included curative treatment for head and neck cancer. Exclusion criteria were visiting the clinic without a spouse, bad news at the routine follow-up examination, diseases causing cognitive dysfunction, and poor understanding of the Dutch language. Next to the HADS, the assessment protocol included age, gender, health status, coping strategy, time since cancer treatment, tumor stage and site, treatment modality, functional and social impairment, and caregiving burden.
  
  
  RESULTS
  A clinical level of distress was noted in 20% of the spouses and in 27% of the patients. Distress in spouses was related to the presence of a feeding tube in patients, a passive coping style, less vitality, and a disrupted daily life schedule resulting from caregiving. Distress in patients was related to the presence of a feeding tube, speech and swallowing problems, less social contacts, a passive style of coping, and nonexpression of emotions.
  
  
  CONCLUSIONS
  Distress is often present in spouses and patients treated for head and neck cancer. Routine screening for psychologic distress is recommended.
authors.affiliation: Departments of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. im.verdonck@vumc.nl
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
authors.forename: Simone E
authors.initials: SE
authors.lastname: Eerenstein
authors.forename: Mecheline H
authors.initials: MH
authors.lastname: Van der Linden
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Kuik
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: C Rene
authors.initials: CR
authors.lastname: Leemans
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000523:psychology; D002277:Carcinoma / Q000523:psychology* / Q000628:therapy; D017028:Caregivers / Q000523:psychology; D003680:Deglutition Disorders / Q000523:psychology; D003863:Depression / Q000523:psychology; D004644:Emotions; D004750:Enteral Nutrition / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012737:Sex Factors; D012919:Social Behavior; D013064:Speech Disorders / Q000523:psychology; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*