The purpose of this study was to learn more about how rehabilitation professionals in Sweden assess and treat head- neck lymphedema.
Web-based surveys were distributed in January 2024 to speech- language pathologist, physiotherapists and lymphedema therapists in Sweden who are working with patients having undergone head and neck cancer treatment. The respondents were asked about assessment and treatment of head neck lymphedema and asked to rate their own competence concerning external and internal head neck lymphedema. Quantitative data was analyzed descriptively using SPSS and qualitative data was analyzed using Systematic Text Condensation.
Physiotherapists, lymphedema therapists and speech-language pathologists (N=65) all describe a lack of competence in internal head neck lymphedema. Physiotherapists and lymphedema therapists also describe a lack of visibility/reach into the pharynx.Tthey are more confident in treating external head neck lymphedema, though addressing a lack of evidence-based methods.Speech language pathologists in Sweden usually have access to FEES (endoscopic swallowing examination) and can easily see the edema, but don't assess or treat the condition.
The informants express a lack of competence in assessment of head neck lymphedema and a need of more research to ensure evidence-based methods of treatment. Patients with internal head neck lymphedema risk being left without assessment and treatment since neither physiotherapists, lymphedema therapists or speech-language pathologists express that this is an area within their competence.
Patients with head neck lymphedema would benefit from an increased multidisciplinary teamwork – where methods and skills from physiotherapists and speech- language pathologists can complement each other. There is an evident need for more research in treatment methods for head neck lymphedema.
Lymphedema
Multidisciplinary team
