Department of Surgical Sciences, Faculty of Medicine, University of Bergen, 5021 Bergen, Norway.
Eur Arch Otorhinolaryngol. 2012 Sep;269(9):2121-8. doi: 10.1007/s00405-011-1884-4. Epub 2011 Dec 27.
The aim of the present study was to investigate to what extent TNM stage, treatment level, personality, choice of coping, mood and health-related quality of life (HRQoL) scores predicted distress as measured by general health questionnaire (GHQ) in successfully treated head and neck squamous cell carcinoma (HNSCC) patients. All patients younger than 80 years who had been diagnosed with HNSCC in western Norway in the period from 1992 to 1997, and who had survived until 1999, were sampled. Ninety-six patients (90% response rate) were included 48 ± 2 months after diagnosis. We determined personality by the Eysenck personality inventory, coping by the COPE questionnaire; HRQoL by EORTC QLQ questionnaire; and mood by Beck depression inventory (BDI). Fifty-five of 58 eligible patients were interviewed a second time 47 ± 1 months after the first interview where neuroticism and GHQ-30 questionnaires were answered. Both HRQoL [explained variance (EV), 9-40%] and BDI (EV 26-30%) scores predicted the GHQ scores. Numerical T stage was inversely associated with GHQ scores (EV ~10%). High neuroticism generally predicted high GHQ scores (EV 16-28%). Avoidance focused, problem focused, drinking to cope predicted GHQ scores (EV 8-14%) and high alcohol consumption (EV ~8%) predicted GHQ scores. The present association pattern could still be shown when adjusted for gender, age and educational level when studied by multiple regression analyses. In conclusion, lowered HRQoL, low mood, a high T stage, high alcohol consumption, high neuroticism, coping by avoidance and coping by problem solving directly predicted worse distress as measured by high GHQ scores, whereas neuroticism was also associated with GHQ through choice of coping.
本研究旨在探讨 TNM 分期、治疗水平、人格、应对方式选择、情绪和健康相关生活质量（HRQoL）评分在多大程度上预测了成功治疗的头颈部鳞状细胞癌（HNSCC）患者的总体健康问卷（GHQ）测量的困扰。所有在 1992 年至 1997 年期间在挪威西部被诊断为 HNSCC 且在 1999 年之前存活的年龄小于 80 岁的患者都被抽样。96 例患者（90%的反应率）在诊断后 48±2 个月被纳入研究。我们通过艾森克人格问卷确定人格，通过应对方式问卷（COPE）确定应对方式；通过 EORTC QLQ 问卷确定 HRQoL；通过贝克抑郁量表（BDI）确定情绪。58 名符合条件的患者中有 55 名在第一次访谈后 47±1 个月再次接受访谈，在此期间回答了神经质和 GHQ-30 问卷。HRQoL[解释方差（EV），9-40%]和 BDI（EV 26-30%）评分均预测 GHQ 评分。T 期越高，GHQ 评分越低（EV10%）。高神经质通常预示着 GHQ 评分较高（EV 16-28%）。回避型、问题解决型应对方式、饮酒应对方式均预示着 GHQ 评分较高（EV 8-14%），而高饮酒量（EV8%）也预示着 GHQ 评分较高。当通过多元回归分析进行研究时，调整性别、年龄和教育水平后，仍可显示出这种关联模式。总之，较低的 HRQoL、较低的情绪、较高的 T 期、较高的饮酒量、较高的神经质、回避应对和问题解决应对直接预测了 GHQ 评分较高的更严重的困扰，而神经质也通过应对方式与 GHQ 相关联。
