Return to work and living healthy after head and neck cancer (RELIANCE): Pilot results of a randomized controlled trial

Introduction:

Patients with head and neck cancer have an increased risk of not returning to work compared to other cancer patients. Among those who return to work a third loses their work in the medium term. Despite their psychological, social and physical distress and their expressed need for psychological support the majority of head and neck cancer patients does not receive psychological counseling or psychotherapeutic support. So far there are no intervention programs that aim to support this patient group in their return to work. Therefore, we have developed a group intervention program that is targeted at improving work ability in patients with head and neck cancer. Furthermore, we want to improve patients' quality of life, self-efficacy expectation and psychological well-being.

Materials & Methods:

In a randomized controlled trial head and neck cancer patients either receive a manualized psychosocial group intervention or two sessions of socio-legal advice. Inclusion criteria are psychological and work-related distress; patients who receive retirement pension, with acute alcohol dependency and suicidality were excluded. The group intervention consists of eight two-hour sessions, where each session addresses a specific topic such as communication and stress at work, coping mechanisms and health-related behavior. Groups are led by a psychotherapist and a former head and neck cancer patient (peer). Patients in the control group can address any socio-legal topic during two sessions with a social consultant. Work ability, quality of life, self-efficacy expectation and psychological well-being are assessed after eight weeks and at six months follow-up.

To test the feasibility of the group intervention we conducted a pilot study. Semi-structured interviews were used to assess adherence to the intervention and practicability.

Results:

Four male patients took part in the pilot group. Two patients were present at every session and two patients were present at six sessions (85.5% attendance rate). All patients said the intervention fit well with their daily life and three patients expressed high satisfaction with it. Three patients emphasized the importance of the peer.

Discussion:

Adherence to the RELIANCE intervention was high. Next to expert input the presence of the peer as identification figure seems to be of crucial importance.

Conclusion:

The RELIANCE intervention is feasible and was well received by the patients.