Healthcare professionals understanding, perceptions and experiences of head and neck lymphoedema to promote self-management for patients following completion of head and neck cancer treatment: a qualitative study

Purpose: Head and neck lymphoedema (HNL) is a chronic and often debilitating consequence of head and neck cancer (HNC) treatment. Despite the chronicity, it is often under-recognised and under-treated. There is a finite resource of specialists to provide HNL intervention, necessitating self-management as an important pillar of patient management. This study aims to explore healthcare professionals (HCPs) understanding, perceptions and experiences of HNL management to promote self-management and adherence to HNL interventions in patients following completion of HNC treatment. Methods: Eight focus groups were conducted with HCPs (n = 39) from different professional disciplines, acute and community settings and countries. Reflexive thematic analysis was adhered to in the development of key themes using an inductive approach. Results: Two main themes were established: (1) ‘Raising awareness of HNL as a chronic and complex condition’ and (2) ‘What are the solutions for promoting HNL self-management?’ Data demonstrated that HCPs lack confidence and understanding in providing HNL support. There was a lack of clarity towards roles and responsibilities of HNL management among HCPs, with many having a desire to be better equipped to promote patient self-management and adherence. Conclusion: HCPs involved in care delivery of patients with HNC require education and training on HNL, to support patient and family engagement with HNL self-management. To advance adherence and compliance of HNL self-management, there is a need to develop a dedicated HNL self-management intervention, integrating theory and evidence.