Institutional members access full text with Ovid®

Share this article on:

Caregiver-Reported Neuropsychiatric Symptoms in Patients Undergoing Treatment for Head and Neck Cancer: A Pilot Study

Bond, Stewart M. PhD, RN, AOCN; Hawkins, Deborah K. RN, MSN, ACNP-BC; Murphy, Barbara A. MD

doi: 10.1097/NCC.0b013e31829194a3

Background: Patients with cancer experience multiple neuropsychiatric symptoms. Whereas individual symptoms have been studied in patients with head and neck cancer, the broader context of neuropsychiatric symptoms needs to be explored.

Objective: The aims of this pilot study were to (a) determine the caregiver-reported prevalence and severity of neuropsychiatric symptoms in patients with head and neck cancer, (b) determine the associated level of caregiver distress, and (c) describe the effects of neuropsychiatric symptoms on patients and their caregivers.

Methods: Twenty-three family caregivers of patients with head and neck cancer completed the Neuropsychiatric Inventory Questionnaire and participated in a semistructured interview.

Results: All caregivers reported that patients experienced at least 1 neuropsychiatric symptom (mean, 7.5; range, 1–12). The most frequently reported symptoms were trouble with appetite and eating (95.7%), altered nighttime behaviors (82.6%), depression/dysphoria (78.3%), decreased alertness (69.6%), inattention (60.9%), apathy/indifference (56.5%), anxiety (56.5%), irritability/lability (52.5%), agitation/aggression (52.2%), and slowed behavior (43.5%). The mean severity rating for 9 symptoms was moderate to severe. Most symptoms caused mild to moderate levels of caregiver distress. Qualitative data indicated that neuropsychiatric symptoms negatively affected patients, their caregivers, and other family members. Patients required more caregiver support resulting in increased caregiver burden and distress.

Conclusions: Neuropsychiatric symptoms are common and troubling in patients with head and neck cancer during treatment. Further investigation of their effects on patients and family caregivers is needed.

Implications for Practice: Clinicians should monitor for and treat neuropsychiatric symptoms throughout treatment and provide caregiver and patient education and support.

Author Affiliations: Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts (Dr Bond); Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee (Ms Hawkins and Dr Murphy); and School of Medicine, Vanderbilt University, Nashville, Tennessee (Dr Murphy).

This study was funded in part by the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Program through the American Academy of Nursing, the Vanderbilt University School of Nursing Postdoctoral Program, and the Vanderbilt CTSA Grant (UL1 RR024975-01) from National Center for Research Resources/National Institutes of Health. Dr Bond was the recipient of a John A. Hartford Foundation Claire M. Fagin Fellowship. The funding source was not involved in the conduct of the study or development of this article.

The authors have no conflicts of interest to disclose.

Correspondence: Stewart M. Bond, PhD, RN, AOCN, 336D Cushing Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467 (

Accepted for publication March 9, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins