Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Carmen Rodriguez, Ph.D.

Committee Member

Laura Szalacha, Ed.D.

Committee Member

Paula Cairns, Ph.D.

Committee Member

Susan Hartranft, Ph.D.


treatment, compliance, nursing, oncology, symptoms


Nonadherence to radiation therapy schedules is a documented problem among head and neck cancer patients. This retrospective dissertation study examined whether demographics, clinical characteristics, or physical and psychological symptoms were related to nonadherence in head and neck cancer patients. The electronic medical records of 262 head and neck cancer patients at a southeastern U.S. cancer center were reviewed to determine whether nonadherence was related to symptom scores and other patient and clinical-related factors. Nonadherent patients were more likely to be female, be admitted to the cancer center as inpatients during treatment and receive outpatient IV fluids during treatment. Nonadherent patients reported higher mean symptom scores on 9 out of 12 symptoms measured during treatment, illustrating that this group had a higher symptom burden. The logistic regression modeling contained significant predictors of treatment nonadherence: concurrent chemotherapy and radiation treatment regimens as well as the symptoms of tiredness and depression predicted patients were more likely to be nonadherent. Tumor location at the tongue, spiritual well-being, and constipation predicted patients were less likely to be nonadherent. Findings support routine screening for symptoms and distress in this population, as well as future research to confirm and build on the results.

Included in

Nursing Commons