Open Access Open Badges Study protocol

The ENHANCES study—Enhancing Head and Neck Cancer patients’ Experiences of Survivorship: study protocol for a randomized controlled trial

Jane Turner12, Patsy Yates3*, Lizbeth Kenny2, Louisa G Gordon4, Bryan Burmeister5, Damien Thomson5, Brett Hughes2, Alexandra L McCarthy36, Chris Perry5, Raymond J Chan23, Alana Fraser2, Helen Skerman3, Martin Batstone2 and Kathryn Carswell5

Author Affiliations

1 School of Medicine, University of Queensland, Herston Rd, Herston, QLD 4029, Australia

2 Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston Rd, Herston, QLD 4029, Australia

3 Institute of Health and Biomedical Innovation, Queensland University of Technology, Musk Ave, Kelvin Grove, QLD 4059, Australia

4 Centre for Applied Health Economics, Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD 4131, Australia

5 Cancer Care Services, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD 4101, Australia

6 Cancer Services Southern Clinical Network, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD 4101, Australia

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Trials 2014, 15:191  doi:10.1186/1745-6215-15-191

Published: 28 May 2014



Few cancers pose greater challenges than head and neck (H&N) cancer. Residual effects following treatment include body image changes, pain, fatigue and difficulties with appetite, swallowing and speech. Depression is a common comorbidity. There is limited evidence about ways to assist patients to achieve optimal adjustment after completion of treatment. In this study, we aim to examine the effectiveness and feasibility of a model of survivorship care to improve the quality of life of patients who have completed treatment for H&N cancer.


This is a preliminary study in which 120 patients will be recruited. A prospective randomised controlled trial of the H&N Cancer Survivor Self-management Care Plan (HNCP) involving pre- and post-intervention assessments will be used. Consecutive patients who have completed a defined treatment protocol for H&N cancer will be recruited from two large cancer services and randomly allocated to one of three study arms: (1) usual care, (2) information in the form of a written resource or (3) the HNCP delivered by an oncology nurse who has participated in manual-based training and skill development in patient self-management support. The trained nurses will meet patients in a face-to-face interview lasting up to 60 minutes to develop an individualised HNCP, based on principles of chronic disease self-management. Participants will be assessed at baseline, 3 and 6 months. The primary outcome measure is quality of life. The secondary outcome measures include mood, self-efficacy and health-care utilisation. The feasibility of implementing this intervention in routine clinical care will be assessed through semistructured interviews with participating nurses, managers and administrators. Interviews with patients who received the HNCP will explore their perceptions of the HNCP, including factors that assisted them in achieving behavioural change.


In this study, we aim to improve the quality of life of a patient population with unique needs by means of a tailored self-management care plan developed upon completion of treatment. Delivery of the intervention by trained oncology nurses is likely to be acceptable to patients and, if successful, will be a model of care that can be implemented for diverse patient populations.

Trial registration

ACTRN12613000542796 (registered on 15 May 2013)

Head and neck cancer; Self-management; Survivorship