title: The head and neck symptom checklist©: an instrument to evaluate nutrition impact symptoms effect on energy intake and weight loss.
abstract: OBJECTIVE
  This study aimed to validate the Head and Neck Patient Symptom Checklist(©) (HNSC(©)) by tracing the prevalence and interference with eating of nutrition impact symptoms (NIS) over time and by examining relationships among NIS included in the HNSC, energy intake, and weight loss.
  
  
  METHODS
  Height, weight, 3-day diet records, and HNSC(©) were obtained at baseline, posttreatment, and 2.5 month follow-up for 52 treatment-naive head and neck cancer (HNC) patients. Relationships among energy intake, weight loss, age, sex, treatment, tumor stage, and NIS were evaluated using general estimating equation (GEE) modeling. Cumulative hazard (CH) analysis was used to determine the time and risk of weight loss.
  
  
  RESULTS
  From baseline to posttreatment, 71 % of patients had 5 % body weight loss. Despite energy intakes returning to baseline levels at follow-up, 88 % of patients continued to lose weight. At posttreatment, 100 % of patients reported 2 or more NIS (range 2-12); these symptoms were still present at follow-up in 83 % of the patients. Univariate GEE analysis demonstrated that most NIS predicted energy intake and weight loss, while multivariate GEE analysis showed that depression, dysphagia, and sore mouth predicted energy intake, and dysphagia and sore mouth predicted weight loss. CH analysis showed that NIS accelerated the time and probability of weight loss.
  
  
  CONCLUSIONS
  The HNSC(©) is a valid tool for assessing NIS in HNC. Identification of NIS may aid in the management of symptoms associated with reduced energy intake and weight loss and thus decrease the malnutrition risk in HNC patients.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, AB, Canada, ckubrak@ualberta.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kubrak
authors.forename: Kärin
authors.initials: K
authors.lastname: Olson
authors.forename: Vickie E
authors.initials: VE
authors.lastname: Baracos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D057189:Checklist / Q000379:methods / Q000592:standards*; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D006258:Head and Neck Neoplasms / Q000178:diet therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000378:metabolism; D009752:Nutritional Status; D015203:Reproducibility of Results; D015431:Weight Loss; D055815:Young Adult