Yang Hui-Ching, Wang Li-Fei, Chang Joseph Tung-Chieh, Fang Fumin
Department of Early Childhood Care and Education, Taoyuan Innovation Institute of Technology, Taiwan, ROC.
Hu Li Za Zhi. 2013 Oct;60(5):41-52. doi: 10.6224/JN.60.5.41.
Because of the therapies and methods involved in its treatment, head and neck cancer patients often face unpredictable changes in both quality of life (QoL) and psychological status over the long course of their disease. Most studies have used fixed-term measurements that do not consider time variance and its effects. To facilitate medical communication and rehabilitation interventions, we investigated changes in HNC (head and neck cancer) patients' bio-psycho-social status and QoL over time.
This study examines QoL growth patterns and the bio-psycho-social adaptation effect in HNC patients as well as how various variables affect within-individual and between-individual level factors during the 4 stages of HNC.
A total of 109 HNC patients participated in this study. Two hundred and fifty-seven valid questionnaires were gathered. Questionnaires were given to each patient at 4 times: initial disease diagnosis; during the therapy period; 3 months after therapy; and 6 months after therapy. Descriptive statistics and hierarchical linear models were used in data analysis.
The main results revealed that: (1) degree of mood disturbance decreased linearly as illness stage progressed. Age, gender, religion, and job impacted patients' initial status, while gender, cancer stage, and education degree were significant moderators of the rate at which a participant's adaptation effect grew; (2) patient QoL showed no significant difference over time. Age and job were significant impact factors affecting patients' initial status. Cancer stage, educational degree, and marital status had a significant moderating effect on the growth rate of participants' adaptation effect score.
Our results indicate that participants in this study had a higher level of anxiety and depression than the average population and that their QoL was negatively influenced by the side effects of their therapy. Therefore, study findings recommend that timely psycho-social intervention and side-effect education should be reinforced to enhance patients' quality of life.
由于头颈部癌的治疗涉及多种疗法和手段，患者在疾病的漫长过程中，生活质量（QoL）和心理状态常常面临不可预测的变化。大多数研究采用的是固定时间点测量，未考虑时间变化及其影响。为促进医疗沟通和康复干预，我们对头颈部癌（HNC）患者的生物 - 心理 - 社会状态及生活质量随时间的变化进行了调查。
本研究考察头颈部癌患者的生活质量增长模式、生物 - 心理 - 社会适应效果，以及在头颈部癌的四个阶段中，各种变量如何影响个体内和个体间水平的因素。
共有109名头颈部癌患者参与了本研究。收集到257份有效问卷。在4个时间点向每位患者发放问卷：疾病初诊时；治疗期间；治疗后3个月；治疗后6个月。数据分析采用描述性统计和分层线性模型。
主要结果显示：（1）情绪困扰程度随疾病阶段进展呈线性下降。年龄、性别、宗教和职业影响患者的初始状态，而性别、癌症分期和教育程度是参与者适应效果增长速率的显著调节因素；（2）患者的生活质量随时间无显著差异。年龄和职业是影响患者初始状态的显著因素。癌症分期、教育程度和婚姻状况对参与者适应效果得分的增长率有显著调节作用。
我们的结果表明，本研究中的参与者焦虑和抑郁水平高于一般人群，且他们的生活质量受到治疗副作用的负面影响。因此，研究结果建议应加强及时的心理 - 社会干预和副作用教育，以提高患者的生活质量。
