title: Third-party disability in carers of people with dysphagia following non-surgical management for head and neck cancer.
abstract: OBJECTIVE
  Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC.
  
  
  METHODS
  Twelve carers of people with dysphagia following HNC participated in individual semi-structured, in-depth interviews. Categories and sub-categories identified from the qualitative analysis were mapped to the ICF using the established linking rules.
  
  
  RESULTS
  The majority of the categories and sub-categories from the qualitative analysis were successfully linked to the ICF with most linking to the Activities and Participation component. A number of contextual factors were also identified as impacting on the functioning of carers.
  
  
  CONCLUSIONS
  The ICF can be successfully used to describe the third-party disability in carers of people with dysphagia following HNC management. This information could be used by clinicians, researchers and policy makers to help establish evidence-based guidelines that include carers in the assessment and management of dysphagia associated with HNC.
  
  
  CONCLUSIONS
  Clinical levels of distress and reduced quality of life have been associated with caring for a person with dysphagia following head and neck cancer. The flow-on effects of dysphagia experienced by a carer or close family member can be understood as a third-party disability, which impacts on their functioning, activities and participation in the context of the environment and personal factors. Using the ICF to describe the indirect effects of dysphagia on the carer may help to guide the assessment and support of this population, and advocate for the inclusion of the concerns of the carer in dysphagia management.
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , QLD , Australia .
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Nund
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , QLD , Australia .
authors.forename: Nerina A
authors.initials: NA
authors.lastname: Scarinci
authors.affiliation: b Centre for Functioning and Health Research, Metro South Hospital and Health Services District, Queensland Health , Buranda , QLD , Australia .|c Speech Pathology Department, Princess Alexandra Hospital , Woolloongabba , QLD , Australia .
authors.forename: Bena
authors.initials: B
authors.lastname: Cartmill
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , QLD , Australia .|b Centre for Functioning and Health Research, Metro South Hospital and Health Services District, Queensland Health , Buranda , QLD , Australia .
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
authors.affiliation: b Centre for Functioning and Health Research, Metro South Hospital and Health Services District, Queensland Health , Buranda , QLD , Australia .|d Population and Social Health Research Program, Griffith Health Institute, Griffith University , Logan , QLD , Australia .
authors.forename: Pim
authors.initials: P
authors.lastname: Kuipers
authors.affiliation: e School of Medicine, The University of Queensland , Herston , QLD , Australia , and.|f Radiation Oncology Department, Princess Alexandra Hospital , Woolloongabba QLD , Australia.
authors.forename: Sandro V
authors.initials: SV
authors.lastname: Porceddu
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D059019:Clinical Coding; D003680:Deglutition Disorders / Q000534:rehabilitation*; D004185:Disability Evaluation; D019468:Disease Management; D005192:Family Health; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000534:rehabilitation; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life
keywords: Carers; ICF; dysphagia; head and neck cancer; radiotherapy; third-party disability