The overall purpose of the study is to decrease negative sequelae, and improve tumor status, performance status, quality of life and satisfaction with health care providers by improving patient learning and compliance through a nursing education and compliance program specifically tailored for the needs of the elderly head and neck cancer patient. Compliance is defined as adherence of head and neck cancer patients to the prescribed radiation treatment schedule, self-care plan, and follow-up schedule. Learning is defined as patient acquisition of knowledge about the negative sequelae of radiotherapy and self-care activities to cope with these sequelae. Compliance is necessary for treatment effectiveness and health maintenance. Learning is a prerequisite to compliance. The study will also evaluate the cost of the program, and the impact of a number of variables on learning, compliance, and patient health related outcomes. Data will be collected on a sample of 186 to 200 eligible cancer patients from four radiation oncology facilities. All subjects receive radiation treatment to the head and neck. The design includes 2 groups (experimental, control) with four stratification factors: intent of treatment (primary, adjuvant), tumor stage (I & II, III & IV), sex (male, female), and age (less than or equal to 60 years, greater than or equal to 61 years). Analyses of variance for repeated measures will be used to test whether type of learning and compliance program impacts on amount of learning, compliance, satisfaction with health care providers, and cost; and to test the impact of stratification factors and other variables like mental function, control preference, and emotional state on learning, compliance, patient outcomes. Multiple regression, and discriminant analyses will be used to examine the predictive relationships of the variables of interest.
