Influencing factors on the quality of life and medical coping style of patients with oral cancer

doi:10.7518/hxkq.2018.03.008

Abstract

Abstract:

Objective To evaluate the influencing factors on the postoperative quality of life and to analyze the coping styles of patients with oral cancer. Methods A total of 131 oral cancer cases confirmed through diagnostic criteria were investigated to analyze the influencing factors on the quality of life (QOL) and the relationship between coping style and QOL of these patients by using the fourth edition of the University of Washington Quality of Life Questionnaire (UWQOL) and medical coping modes questionnaires (MCMQ), respectively. Results Among the 131 questionnaires collected, only 126 were valid with a recovery rate of 96.18% (126/131). Single factor analysis showed that age, marital status, educational level, other systemic diseases, personal income level, tooth loss, operation times, adjuvant radiotherapy, cancer staging, cervical lymph node dissection, recurrence, and jaw resection yielded different UWQOL scale scores (P<0.05). Multiple regression analysis showed that the loss of teeth, cancer staging, recurrence, and jaw resection yielded statistically significant differences in the total score of UWQOL (P<0.05). Among the coping styles, the average scores of “confrontation”, “avoidance”, and “yielding” were 17.54±4.97, 17.79±2.19, and 12.97±5.70, respectively. Compared with the norm, the difference was statistically signifi-cant (P<0.05). Correlation analysis showed that “confronta-tion” and “avoidance” were positively correlated, whereas “yielding” was negatively correlated to QOL (P<0.05). Conclusion Age, marital status, educational level, other systemic diseases, personal income level, tooth loss, operation times, adjuvant radiotherapy, cancer staging, cervical lymph node dissection, recurrence, and jaw resection have different effects on the quality of QOL. Tooth loss, cancer staging, recurrence, and jaw resection are the main causative factors affecting the patients’ perceived QOL. Personalized treatment and nursing care should be strengthened to improve the coping style and quality of life of patients.

Key words: oral cancer, quality of life, coping style

CLC Number:

R739.8

Shuaihua Qin, Xinming Li, Wenlu Li. Influencing factors on the quality of life and medical coping style of patients with oral cancer[J]. West China Journal of Stomatology, 2018, 36(3): 271-276.

Figures/Tables 5

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调查项目		例数	百分比/%	调查项目		例数	百分比/%
性别	男	73	57.94	牙齿缺失	有	82	65.08
	女	53	42.06		无	44	34.92
年龄/岁	≤50	47	37.30	手术次数	1次	93	73.81
	>50	79	62.70		1次以上	33	26.19
婚姻状况	已婚且配偶健在	79	62.70	辅助放疗	有	25	19.84
	未婚、离婚或丧偶	47	37.30		无	101	80.16
文化程度	初中及以下	68	53.97	分期	T1或T2	52	41.27
	高中及以上	58	46.03		T3或T4	74	58.73
其他系统性疾病	有	41	32.54	颈淋巴清扫术	有	81	64.29
	无	85	67.46		无	45	35.71
个人收入水平/	≤3 000	57	45.24	复发	有	51	40.48
（元·月^-1）	>3 000	69	54.76		无	75	59.52
随访时间/年	≤1	73	57.94	颌骨切除	有	49	38.89
	>1	53	42.06		无	77	61.11

因素	疼痛	外貌	活动	娱乐	吞咽	咀嚼	语言	肩部功能	味觉	唾液	情绪	焦虑	总分
性别	0.770	0.785	0.189	0.559	0.635	0.395	0.395	0.612	0.216	0.621	0.097	0.316	0.684
年龄	0.272	0.305	0.127	0.119	0.024^*	0.784	0.278	0.301	0.989	0.847	0.180	0.122	0.608
婚姻状况	0.060	0.709	0.022^*	0.001^**	0.062	0.074	0.052	0.101	0.655	0.235	0.933	0.785	0.077
文化程度	0.333	0.930	0.183	0.936	0.820	0.427	0.961	0.120	0.490	0.247	0.009^**	0.019^*	0.601
其他系统性疾病	0.219	0.057	0.175	0.200	0.224	0.263	0.051	0.372	0.762	0.696	0.032^*	0.020^*	0.941
个人收入水平	0.118	0.988	0.053	0.066	0.054	0.052	0.063	0.619	0.225	0.709	0.208	0.649	0.034^*
随访时间	0.260	0.150	0.206	0.185	0.190	0.244	0.940	0.499	0.246	0.166	0.311	0.540	0.089
牙齿缺失	0.058	0.002^**	0.06 2	0.009^**	0.054	0.000^**	0.007^*	0.117	0.002^*	0.025^*	0.067	0.650	0.000^**
手术次数	0.622	0.006^**	0.638	0.246	0.912	0.304	0.429	0.511	0.146	0.804	0.001^**	0.117	0.107
辅助放疗	0.081	0.634	0.011^*	0.229	0.434	0.456	0.203	0.448	0.936	0.000^**	0.336	0.533	0.179
分期	0.010^*	0.003^**	0.065	0.008^**	0.024^*	0.016^*	0.138	0.161	0.137	0.051	0.064	0.084	0.001^**
颈淋巴清扫术	0.367	0.005^**	0.232	0.620	0.427	0.499	0.918	0.000^**	0.156	0.497	0.918	0.777	0.371
复发	0.000^**	0.009^**	0.000^**	0.000^**	0.001^**	0.010^*	0.067	0.137	0.079	0.067	0.002^**	0.004^**	0.000^**
颌骨切除	0.921	0.000^**	0.744	0.048^*	0.022^*	0.009^**	0.093	0.004^**	0.054	0.873	0.001^**	0.025^*	0.001^**

影响因素	非标准化系数		标准系数	t值	P值	B的95%置信区间
影响因素	B	标准误	（试用版）	t值	P值	下限	上限
常量	15.869	7.561		2.099	0.038	0.901	30.837
复发	15.927	2.216	0.470	7.188	0.000	11.541	20.314
颌骨切除	11.211	2.086	0.331	5.375	0.000	7.802	15.340
分期	-7.522	2.366	-0.207	-3.180	0.002	-12.206	-2.839
牙齿缺失	5.541	2.101	0.161	2.637	0.009	1.381	9.700

维度	常模/分,n=650	口腔癌患者/分,n=126	t值	P值
面对	19.48±3.81	17.54±4.97	4.15	<0.05
回避	14.44±2.97	17.79±2.19	14.74	<0.01
屈服	8.81±3.17	12.97±5.70	5.66	<0.01

应对方式	疼痛	外貌	活动	娱乐	吞咽	咀嚼	语言	肩部功能	味觉	唾液	情绪	焦虑	总分
面对r值	0.270	-0.104	0.506	0.405	0.316	0.175	0.396	-0.199	0.184	0.098	-0.069	-0.084	0.227
P值	0.034^*	0.423	0.000^**	0.001^**	0.012^*	0.175	0.001^**	0.121	0.152	0.450	0.596	0.517	0.076
回避r值	0.183	0.170	0.213	0.278	0.368	0.309	0.333	-0.006	0.228	0.140	0.184	0.167	0.321
P值	0.155	0.188	0.097	0.029^*	0.003^**	0.015^*	0.008^**	0.964	0.075	0.277	0.151	0.196	0.011^*
屈服r值	-0.520	-0.241	-0.723	-0.669	-0.488	-0.304	-0.411	0.097	-0.303	-0.248	-0.424	-0.388	-0.651
P值	0.000^**	0.059	0.000^**	0.000^**	0.000^**	0.016^*	0.001^**	0.451	0.017^*	0.052	0.001^**	0.002^**	0.000^**