Rehabilitation Nursing Program in Oncological Surgery of the Head and Neck: A Retrospective Cohort Study

Abstract

Background: Head and neck cancer (HNC) has a considerable mortality and morbidity rate. Surgery is one of the most effective treatments; however, it may compromise the independence of patients after its performance. Early start rehabilitation is essential for the recovery of these patients, preventing functional capacity limitations. Objective: The objective of this study was to compare the independence between hospitalized patients who underwent rehabilitation nurse (RN) intervention versus general health care after HNC surgery. Methods: Patients submitted to different types of HNC surgery were divided into two groups intervention by the RN versus general health care, the outcome was the independence categorized as dichotomic to assess the patient independence at discharge and their differences calculated by statistical analysis. To analyze the effect of the RN intervention on independence, a Poisson regression model was used, adjusting the confounding factors initial Barthel Index and age in the variable Barthel Index independence. Results: Independence at discharge (p = 0.01) improved significantly in the RN intervention group compared to the general health care group. The intervention of the RN after surgery had a positive effect on the independence of the patients, after adjusting the confounding factors (RR: 1.47; 95% CI: [1.02; 2.12]). In the middle/late postoperative period, in the group with RN intervention (n = 79), the hospitalization time was reduced by 4.29 days versus general health care (n = 72). Conclusion: The RN intervention is an added value in the independence of the patient submitted to HNC surgery. It is an innovative study in patients after diagnosis of HNC, showing that the intervention of RN through rehabilitation programs allows independence after his surgery.