Llewellyn C D, McGurk M, Weinman J
Health Psychology Section, Department of Psychology, Institute of Psychiatry, King's College London, Guy's Hospital, London SE1 9RT, UK.
Oral Oncol. 2005 May;41(5):440-54. doi: 10.1016/j.oraloncology.2004.12.006. Epub 2005 Apr 9.
The survival rate in advanced cancer of the head and neck has remained at approximately 50%, and efforts are now directed towards reducing the impact of the disease and its treatment in terms of functioning and health related-quality of life (HR-QoL). Factors such as stage, site of disease and type of treatment all impact on HR-QoL, but it is unclear what additional factors influence HR-QoL. A systematic review was undertaken of studies that have investigated psycho-social or behavioural factors associated with HR-QoL in this patient group. Literature was systematically searched using electronic databases and hand-searching relevant journals. Data were sought on HR-QoL and studies were only included if the measurement instrument was recognised as a reliable and valid measure of HR-QoL. Studies had to include at least one psycho-social or behavioural predictor variable. Sixteen studies fulfilling the inclusion criteria were identified and reviewed. Five main factors were associated with varying degrees with HR-QoL, personality, social support, satisfaction with consultation and information, behavioural factors, such as consuming alcohol and smoking, and depressive symptoms. The major difficulty with synthesising the findings was the amount of different indices of QoL that have been used. However, a number of psycho-social factors have been investigated in relation to HR-QoL in head and neck cancer patients, some of which are potentially modifiable, such as those related to informational needs. Further research is needed to investigate other psychological factors which may influence aspects of HR-QoL. By understanding the relationship between HR-QoL and potentially modifiable variables, interventions can be designed with the aim of improving a patient's long-term well-being.
晚期头颈癌的生存率一直维持在约50%，目前的努力方向是减轻该疾病及其治疗对功能和健康相关生活质量（HR-QoL）的影响。疾病分期、发病部位和治疗类型等因素都会对HR-QoL产生影响，但尚不清楚还有哪些其他因素会影响HR-QoL。对调查该患者群体中与HR-QoL相关的心理社会或行为因素的研究进行了系统综述。通过电子数据库和手工检索相关期刊对文献进行了系统检索。寻找有关HR-QoL的数据，只有当测量工具被认为是可靠且有效的HR-QoL测量方法时，相关研究才会被纳入。研究必须至少包括一个心理社会或行为预测变量。确定并审查了16项符合纳入标准的研究。有五个主要因素在不同程度上与HR-QoL相关，即个性、社会支持、对咨询和信息的满意度、行为因素（如饮酒和吸烟）以及抑郁症状。综合研究结果的主要困难在于所使用的生活质量不同指标的数量。然而，已经对一些与头颈癌患者HR-QoL相关的心理社会因素进行了调查，其中一些因素可能是可以改变的，比如那些与信息需求相关的因素。需要进一步研究以调查其他可能影响HR-QoL各个方面的心理因素。通过了解HR-QoL与潜在可改变变量之间的关系，可以设计干预措施以改善患者的长期健康状况。
