Quality of life assessment in patients undergoing head and neck surgery asevaluated by lay caregivers

Objectives/Hypothesis: Rehabilitation following head and neck cancer surger y has steadily moved into the outpatient realm and become dependent on care givers with no formal medical background (lay caregivers.) Satisfactory reh abilitation and quality of life (QOL) depend on successful relationships be tween patients and the lay caregivers, This study evaluates the QOL assessm ents of patients by themselves and their primary lay caregivers before head and neck surgery, Study Design: Institutional Review Board-approved study using validated QOL assessment instrument. Materials and Methods: The preop erative QOL status in 50 patients undergoing extensive head and neck surger y was evaluated using the self-administered Medical Outcomes Survey Short F orm 36 (SF-36). The patient's primary lay caregiver (spouse, child, or frie nd) completed a similar questionnaire evaluating the patient's status. Resu lts: Thirty-three (66%) questionnaires were returned. Twenty-five (50%) que stionnaire sets were successfully completed by both parties and employable for comparison. Sixty percent of the caregivers were within the 90% confide nce interval of the patient's assessment for six or more of the eight param eters evaluated by the SF-36. Likewise, caregiver assessments for specific parameters were consistently congruent with patient evaluation, except for the parameters of bodily pain and general health, for which caregivers demo nstrated a trend for overrating pain and underestimating general health. Ca regivers of the same generation as the patient demonstrated significantly h igher congruence (P =.007). Similarly, a trend for higher congruence was no ted in patients with recurrent disease. Conclusions: The importance of the lay caregiver has increased in the era of greater outpatient rehabilitation . This pilot study indicates that QOL assessment by lay caregivers may be e xamined with existing instruments and highlights QOL parameters critical to both the head and neck surgery patient and his or her primary lay caregive r.