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口腔鳞状细胞癌成功治疗患者及其妻子的生活质量与精神疾病发病率

Quality of life and psychiatric morbidity in patients successfully treated for oral cavity squamous cell cancer and their wives.

作者信息

Zwahlen Roger A, Dannemann Christine, Grätz Klaus W, Studer Gabriela, Zwahlen Diana, Moergeli Hanspeter, Drabe Natalie, Büchi Stefan, Jenewein Josef

机构信息

University Hospital, Zurich, Switzerland.

出版信息

J Oral Maxillofac Surg. 2008 Jun;66(6):1125-32. doi: 10.1016/j.joms.2007.09.003.

Abstract

PURPOSE

To assess quality of life (QOL) and psychiatric morbidity in successfully treated oral cavity squamous cell cancer (OC-SCC) survivors and their wives.

PATIENTS AND METHODS

Thirty-one men successfully treated for OC-SCC (mean, 3.7 years since diagnosis; UICC stages I to IV) together with their wives were assessed by questionnaires referring to QOL (WHOQOL-BREF), physical complaints (EORTC QOL-H&N35), and symptoms of anxiety and depression (HADS). Prevalence of psychiatric disorders was assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.).

RESULTS

Irrespective of tumor stage, a considerably high global QOL both in OC-SCC survivors and their wives could be detected when compared with an age-matched cancer-free population. No significant difference between the mean scores of 4 domains of the QOL (exception: environmental domain) was found between patients and their wives. In patients, lower QOL was associated with more physical complaints (social eating, swallowing, and pain) and higher levels of psychological distress (HADS); whereas in wives, QOL was found to be related to levels of psychological distress. In the M.I.N.I., a high prevalence of psychiatric disorders, particularly anxiety disorders, was found in wives (38.7%); but was lower in patients (16.2%). Patients and wives diagnosed with a psychiatric disorder reported significantly lower QOL.

CONCLUSION

Both in OC-SCC patients and their wives a considerably high overall QOL can be found. "Social eating," "swallowing," and "sexuality" in patients and psychiatric disorders in wives seem to be strongly related to global QOL. The high prevalence of anxiety disorders in wives, however, should alert clinicians and the health care community. Thus, surgical improvement of somatic problems and treatment of psychiatric disorders should be addressed in individuals reporting an impaired global QOL.

摘要

目的

评估成功治疗的口腔鳞状细胞癌(OC-SCC)幸存者及其妻子的生活质量(QOL)和精神疾病发病率。

患者与方法

对31名成功治疗OC-SCC的男性(自确诊起平均3.7年;国际抗癌联盟(UICC)分期为I至IV期)及其妻子进行问卷调查,内容涉及生活质量(世界卫生组织生活质量简表(WHOQOL-BREF))、身体不适(欧洲癌症研究与治疗组织生活质量问卷头颈部模块(EORTC QOL-H&N35))以及焦虑和抑郁症状(医院焦虑抑郁量表(HADS))。通过迷你国际神经精神访谈量表(M.I.N.I.)评估精神障碍的患病率。

结果

与年龄匹配的无癌人群相比,无论肿瘤分期如何,OC-SCC幸存者及其妻子的整体生活质量均相当高。患者及其妻子在生活质量4个领域(环境领域除外)的平均得分无显著差异。在患者中,较低的生活质量与更多的身体不适(社交进食、吞咽和疼痛)以及更高水平的心理困扰(HADS)相关;而在妻子中,生活质量与心理困扰水平相关。在M.I.N.I.评估中,妻子中精神障碍的患病率较高,尤其是焦虑症(38.7%);而患者中的患病率较低(16.2%)。被诊断患有精神障碍的患者和妻子报告的生活质量显著较低。

结论

OC-SCC患者及其妻子的整体生活质量均相当高。患者的“社交进食”“吞咽”和“性功能”以及妻子的精神障碍似乎与整体生活质量密切相关。然而,妻子中焦虑症的高患病率应引起临床医生和医疗保健界的警惕。因此,对于报告整体生活质量受损的个体,应解决躯体问题的手术改善和精神障碍的治疗问题。

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