Abstract
Objectives
1) To investigate the sensitivity to change of the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (S-SECEL), addressing communication dysfunction in patients treated for laryngeal cancer. 2) To evaluate longitudinal score changes in relation to established and validated quality of life instruments.
Methods
100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered 4 questionnaires at 6 occasions during 1 year; the S-SECEL, the EORTC Quality of Life Questionnaire, the EORTC Head and Neck cancer module, and Hospital Anxiety and Depression (HAD) scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between-group analyses were carried out using the Mann-Whitney U test. Magnitude of group differences was analyzed by means of effect sizes.
Results
S-SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement (p < 0.001), demonstrating the sensitivity of the S-SECEL to changes in communication over time. The S-SECEL was more sensitive than EORTC regarding communication dysfunction.
Conclusions
The questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. As a routine screening instrument, the S-SECEL could be a valuable tool for identifying patients at risk for psychosocial problems, to help plan rehabilitation and in-depth counselling. It is therefore recommended for clinical use in evaluation of communication dysfunction for all patients with laryngeal cancer, irrespective of treatment.
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