title: Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers.
abstract: OBJECTIVE
  Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers.
  
  
  METHODS
  Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set.
  
  
  RESULTS
  Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes.
  
  
  CONCLUSIONS
  These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population.
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia, Brisbane , Australia.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Nund
authors.forename: Anna F
authors.initials: AF
authors.lastname: Rumbach
authors.forename: Bridget C
authors.initials: BC
authors.lastname: Debattista
authors.forename: Martha N T
authors.initials: MN
authors.lastname: Goodrow
authors.forename: Kori A
authors.initials: KA
authors.lastname: Johnson
authors.forename: Laura N
authors.initials: LN
authors.lastname: Tupling
authors.forename: Nerina A
authors.initials: NA
authors.lastname: Scarinci
authors.forename: Bena
authors.initials: B
authors.lastname: Cartmill
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
authors.forename: Sandro V
authors.initials: SV
authors.lastname: Porceddu
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003142:Communication; D017281:Cost of Illness; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019986:Persons with Hearing Disabilities / Q000523:psychology; D036301:Qualitative Research; D011788:Quality of Life; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*
keywords: Head and neck cancer; carers; chemoradiotherapy; communication; qualitative research