Clinicians in a head and neck surgical oncology team generally saw quality-of-life assessment as important, but only two of the 10 practitioners interviewed said they regularly used formal tools, a qualitative study at one UK tertiary referral and teaching hospital found.
All 10 participants described assessing quality of life informally during consultations. The pattern points to a gap between what clinicians said they valued and their regular use of structured tools, a disconnect the authors highlighted in their interpretation of the findings.
Support did not mean routine use
Most participants said quality-of-life assessment mattered for treatment planning and for helping patients make informed decisions. Most also regarded formal tools as useful in clinical practice, for patients and in research. The researchers did not report exact numbers for either result, so the study cannot show how widely those views were shared.
That distinction is central to the study. Positive views coexisted with limited regular use among those interviewed. The authors recommend making quality-of-life assessment feasible and embedding it in clinical work, rather than treating it as an extra activity detached from care.
Both regular users were speech and language therapists. Their main routine instrument was the MD Anderson Dysphagia Inventory, or MDADI, which uses 20 questions across four domains to assess swallowing function. The interviews did not evaluate the instrument's measurement performance or whether it changed care.
Inside one hospital team
The researchers used semi-structured interviews and a qualitative, description-based content analysis at a UK tertiary referral and teaching hospital. They were seeking detailed accounts of practitioners' awareness, perceptions and use of quality-of-life tools in a multidisciplinary head and neck surgical oncology team.
Purposeful sampling was designed to recruit around eight to 12 practitioners. The researchers used information power, role diversity and expected richness of the interviews to guide the sample, rather than setting a predefined point of thematic saturation. Ten practitioners were approached, and all agreed to take part.
Participants included ENT and OMF surgeons, an altered airway nurse, speech and language therapists, a clinical nurse specialist and a dietitian. One author read all the transcripts at least twice, coded ideas as they emerged, built inductive subcategories and then grouped them into broader themes, with peer debriefing from the senior author.
The study was sponsored by University Hospitals Birmingham NHS Foundation Trust, registered prospectively in IRAS under number 343373, and based on written informed consent from every participant. The researchers said REC approval was not required because patients were not involved.
The obstacles were practical
Practitioners described barriers at several points in the process. Time, resources and cost were concerns, as was the possibility that formal assessment could make a consultation feel less authentic. Some also questioned whether teams had enough capacity or funding to analyze the results and act on them.
Other concerns involved limited training and the possibility that patients might struggle with comprehension or language when using the tools. These were reported as perceived barriers, not measured explanations for why structured assessment was used inconsistently.
The study captures a practical tension: clinicians could regard the information as useful while still perceiving training, analysis and action as difficult parts of the process. The interviews did not rank the barriers by frequency or relative importance.
A signal, not a verdict
The findings are about practitioner perceptions and self-reported practice in one multidisciplinary team at one UK hospital. The authors identify the single-center sample of 10 participants as a limitation, and say some members of the wider team may be underrepresented. That makes it uncertain whether the same pattern would appear in other services.
Researchers also did not use participant member checking or keep decision logs, and they note that social desirability, hierarchical influence, favorable views held by the authors and institutional bias could affect the study's trustworthiness. The interviews describe perceptions and reported practice; they did not test whether formal tools improved patients' quality of life or clinical care.
The study cannot establish that any single barrier explains inconsistent use. The authors call for feasible, clinically embedded quality-of-life integration, with future work needed to connect asking the questions with reviewing and acting on the answers.
No funding was reported, and the authors declared no conflicts of interest.
Paper data and sources
Original title: Healthcare Practitioners' Perceptions of Quality-of-Life Tools in Head and Neck Surgical Oncology: A Qualitative Descriptive Content Analysis.
Authors: Keshav Kumar Gupta, Jameel Muzaffar
Journal/Repository: Laryngoscope investigative otolaryngology
Status: Peer-reviewed
First online: 2026-08-20
DOI: 10.1002/lio2.70531
Original paper