Mahmood R, Butterworth C, Lowe D, Rogers S N
Regional Maxillofacial Unit, University Hospital Aintree, Regional Maxillofacial Unit, Aintree University Hospitals NHS Foundation Trust, Aintree, Liverpool, L9 7AL, United Kingdom.
1] Regional Maxillofacial Unit, University Hospital Aintree, Regional Maxillofacial Unit, Aintree University Hospitals NHS Foundation Trust, Aintree, Liverpool, L9 7AL, United Kingdom [2] Edge Hill University, Liverpool and Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St. Helens Road, Ormskirk, United Kingdom.
Br Dent J. 2014 Jun 13;216(11):E25. doi: 10.1038/sj.bdj.2014.453.
Patients experience considerable dental-related difficulties following head and neck cancer (HNC) treatment including problems with chewing, dry mouth, oral hygiene, appearance and self-esteem. These can go unrecognised in busy follow-up clinics. The Patient Concerns Inventory (PCI) is specifically for HNC patients, enabling them to select topics they wish to discuss and members of the multi-professional team they want to see.
The study aimed to identify the clinical characteristics of patients raising dental concerns on the PCI and to explore the outcome of onward referral. Assessments included the PCI and the University of Washington Quality of Life Questionnaire (UW-QOL) version 4, with clinic details collated from hospital and cancer databases.
PCI data were obtained from 317 HNC patients between 2007 and 2011. Their mean age was 63 years and 60% were male. Most had oral squamous cell carcinoma and underwent surgery. The median (IQR) time from treatment to first PCI was 13 (4-42) months.
Three comparison groups were identified: patients with significant chewing problems, patients without significant chewing problems who wanted to discuss dental-related concerns and patients without significant chewing problems who did not want to discuss such concerns. Fifty-two percent reported either a significant chewing problem on the UW-QOL or a wish to discuss dental-related concerns. A quarter specifically asked to talk to a dental professional. Clinical characteristics significantly associated with dental issues were stage, primary treatment and free flap reconstruction. Clinic letters were copied to only 10% of general dental practitioners (GDPs).
Better communication with GDPs is essential.
头颈部癌症（HNC）患者在接受治疗后会经历相当多与牙齿相关的困难，包括咀嚼问题、口干、口腔卫生、外观和自尊方面的问题。在繁忙的随访诊所中，这些问题可能未被识别。患者关注清单（PCI）专门针对HNC患者，使他们能够选择想要讨论的话题以及想见的多专业团队成员。
本研究旨在确定在PCI上提出牙齿相关问题的患者的临床特征，并探讨转诊的结果。评估包括PCI和华盛顿大学生活质量问卷（UW-QOL）第4版，并从医院和癌症数据库中整理诊所详细信息。
从2007年至2011年期间的317例HNC患者中获取PCI数据。他们的平均年龄为63岁，60%为男性。大多数患有口腔鳞状细胞癌并接受了手术。从治疗到首次PCI的中位（IQR）时间为13（4-42）个月。
确定了三个比较组：有严重咀嚼问题的患者、没有严重咀嚼问题但想讨论牙齿相关问题的患者以及没有严重咀嚼问题且不想讨论此类问题的患者。52%的患者报告在UW-QOL上有严重咀嚼问题或希望讨论牙齿相关问题。四分之一的患者特别要求与牙科专业人员交谈。与牙齿问题显著相关的临床特征是分期、初始治疗和游离皮瓣重建。只有10%的普通牙科医生（GDPs）收到了诊所信件的副本。
与GDPs进行更好的沟通至关重要。
