Availability and use of web-based interventions for patients with head and neck cancer: A Scoping Review

Introduction : The impact of treatment for head and neck cancers on function (speech and swallow) and appearance varies hugely, depending on head and neck subsite and treatment modalities, and consequently effects individual’s social, work and personal relationships [1]. In an era with improved long-term survival rates, it is increasingly important that patients receive person-centred care, to include stratified information relevant to their condition [2]. When accurate and representative information is provided, this can promote shared decision-making [3].
With increased availability of the internet patients and relatives often assess health information via web-based resources, which can inform decision-making about healthcare options [4]. Therefore a scoping review has been conducted aiming to identify and review the nature, scope and use of web-based interventions for patients with head and neck cancer (HNC).
Method: A scoping review guided by the methodological framework described by the Joanna Briggs Institute was performed to review empirical studies and websites. Seven electronic databases (CINAHL, Medline, Scopus, Embase, Cochrane, Pubmed and PsychoInfo) were searched from 2010-2020, data extracted and narratively summarised, using thematic analysis. The Google search engine was employed, identifying the first 100 websites, using the using search term head and neck cancer. Websites meeting eligibility criteria were assessed using the QUEST analysis tool, and descriptively summarised.
Results: Thirteen empirical studies and 32 websites were included. As identified by empirical studies (n=13), web-based interventions were developed to provide: (1) patient information on HNC and related treatments, (2) advice and support during treatment, and (3) management strategies promoting adjustment to life with and beyond HNC. However, the reviewed websites (n=32) provided minimal information to aid pre-treatment shared decision-making and facilitate preparedness for treatment, with few utilising patient narratives. Web-based interventions for HNC patients were mainly text-based and focused on survivorship issues.
Conclusions: As patients increasingly look to the internet for advice and support, healthcare professionals are in a position to provide high quality web-based interventions. There is an opportunity to rigorously develop a web-based intervention, containing narratives of peoples’ lives before and after HNC treatment, aiding decision-making, preparedness for treatment and self-management. There is a paucity of theory-based, co-designed web-based interventions using patient narratives.