Prehabilitation and rehabilitation guidelines for allied healthcare professionals working in head and neck cancer: a narrative review.

Abstract

The aim of this review is to give an overview of prehabilitation and rehabilitation guidelines for allied healthcare professionals (AHPs) working in head and neck cancer (HNC). Guidelines were retrieved via CINAHL, Medline, Embase, and Google, and via the authors' research network. Inclusion criteria were English-language AHP guidelines for HNC. They were reviewed for inclusion of specific AHPs and core areas of function. Rigour of development and applicability was analysed using an appraisal of guidelines checklist. Six multi-disciplinary team (MDT) and seven discipline-specific guidelines for HNC AHPs were retrieved and analysed. There was significant variation in scope and detail. Dietetics, occupational therapy, physiotherapy, psychology, and speech and language therapy are considered core disciplines within the MDT, responsible for communication, swallowing, nutrition, jaw, neck and shoulder mobility, lymphoedema, airway management and quality of life. AHP guidelines place greater weight on assessment than intervention and do not always provide suggestions for either. Some AHPs and sub-categories of HNC are adequately catered for by current guidelines. However, there are certain disciplines, sub-types and stages of HNC which require more specific guidelines. There should be greater emphasis on intervention.