Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington 98105, USA.
Otolaryngol Head Neck Surg. 2012 Jun;146(6):959-65. doi: 10.1177/0194599812437315. Epub 2012 Feb 3.
To investigate how ways of coping and traditional factors (age, sex, time postlaryngectomy, stage of disease, radiation, alaryngeal speech method) predict global quality of life, head and neck cancer-specific quality of life, and voice-related quality-of-life outcomes after total laryngectomy.
Cross-sectional survey.
University-based laboratory and speech clinic.
Sixty-seven individuals who underwent total laryngectomy secondary to cancer were recruited from support groups and professional contacts. Individuals were at minimum 9 months postlaryngectomy. All outcomes were patient reported and included demographic data as well as a number of validated questionnaires: the Ways of Coping-Cancer Version (WOC-CV) scale, the Voice-Related Quality of Life (V-RQOL) scale, and the University of Washington Quality of Life (UW-QOL) composite and global QOL scores.
Fifty-three individuals identified a stressful aspect of their laryngectomy. As a set, traditional variables (age, time postlaryngectomy, alaryngeal speech method) accounted for only 5% of global QOL scores but between 25% and 30% of the variance of composite UW-QOL and V-RQOL scores. Time postlaryngectomy was the strongest traditional predictor. Ways of coping accounted for 23% to 32% of all QOL scores. Avoidant coping strategies (both cognitive and behavioral escape) were among the strongest predictors of poorer QOL. When traditional variables were combined with ways of coping, they together accounted for 26% to 46% of the variance of QOL outcomes.
Coping is important to consider when evaluating postlaryngectomy outcomes, above and beyond traditionally investigated factors.
研究应对方式和传统因素（年龄、性别、喉切除术后时间、疾病分期、放疗、非言语性言语方式）如何预测全喉切除术后的总体生活质量、头颈部癌症特异性生活质量和与嗓音相关的生活质量结局。
横断面调查。
基于大学的实验室和言语诊所。
从支持小组和专业联系人中招募了 67 名因癌症而行全喉切除术的个体。这些个体在喉切除术后至少 9 个月。所有结果均由患者报告，包括人口统计学数据以及一些经过验证的问卷：应对方式-癌症版（WOC-CV）量表、嗓音相关生活质量（V-RQOL）量表以及华盛顿大学生活质量（UW-QOL）综合和总体 QOL 评分。
53 名个体确定了他们喉切除术的一个有压力的方面。作为一个整体，传统变量（年龄、喉切除术后时间、非言语性言语方式）仅占总体 QOL 评分的 5%，但占 UW-QOL 综合和 V-RQOL 评分变异的 25%至 30%。喉切除术后时间是最强的传统预测因素。应对方式占所有 QOL 评分的 23%至 32%。回避应对策略（认知和行为逃避）均是较差 QOL 的最强预测因素之一。当传统变量与应对方式相结合时，它们共同占 QOL 结局变异的 26%至 46%。
在评估喉切除术后的结局时，应对方式比传统研究的因素更为重要。
