RESUMO
OBJECTIVE: We conducted a qualitative study of patients' perspectives on dry mouth outcomes to explore their personal experiences and investigate which outcomes are most important to them. This work was part of the WONDER initiative (World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research) exploring Core Outcome Measures in Effectiveness Trials. STUDY DESIGN: Using a study-specific topic guide, we conducted digitally recorded, semi-structured interviews of focus groups of patients with dry mouth secondary to Sjögren syndrome and head and neck radiotherapy. We conducted interviews until data saturation had been achieved and evaluated all transcripts for accuracy before we anonymized the data. RESULTS: Two focus groups consisting of 4 participants per group identified 4 distinct themes: (1) impact on oral health and function, (2) social isolation and withdrawal, (3) frustration with dry mouth management, and (4) limited knowledge of the medical community and lack of understanding of family and friends. CONCLUSIONS: The diversity of self-reported outcomes and the complexity of patient perceptions identified in our work may represent additional barriers to successful dry mouth management that should be considered in the design of future clinical trials.
Assuntos
Síndrome de Sjogren , Xerostomia , Humanos , Xerostomia/terapia , Pesquisa Qualitativa , Pacientes , Avaliação de Resultados em Cuidados de SaúdeRESUMO
PURPOSE: The purpose of this study is to assess the late oral complications and the role of salivary gland hypofunction in the severity of mucosal reaction in nonsurgical head and neck cancer patients, submitted to radiotherapy with or without chemotherapy. METHODS AND MATERIALS: Five hundred fifteen charts from patients treated between 2005 and 2009 were reviewed, and 41 patients met the inclusion criteria. Salivary gland function was assessed using a simplified grading system (GSX) and sialometry. Late effects were assessed using the Common Toxicity Criteria (CTC Version 2.0). RESULTS: The average follow-up was 17.1 (4-51) months. A statistical correlation was found for whole salivary flow rates and the average CTC grades for the mucous membrane. Both unstimulated/stimulated whole salivary flow rates (<0.09 mL/min) were identified as potential risk factors (p < 0.05) and an independent predictor for late mucous membrane toxicity (≥ grade 2). A significant correlation was also found between unstimulated salivary flow rates-GSX scores (p = 0.001) and CTC grades for salivary glands. Eighty-five percent of the patients were classified as suffering from salivary gland hypofunction, as well as 58.2 % considered dryness of the mouth the most debilitating complication. CONCLUSIONS: Considering the late effects assessed, the salivary gland hypofunction was the most significant and received the highest morbidity graduation (grade 2/grade 3); xerostomia was also considered the most debilitating complication after treatment. Data show the role of salivary gland hypofunction in the severity of late mucous membrane complication.