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头颈部恶性肿瘤患者术前和术后的生活质量及其相关因素:一项 6 个月随访研究。

Presurgery and Postsurgery Quality of Life and Associated Factors in Patients With Malignant Neoplasms of the Head and Neck: A 6-Month Follow-up Study.

机构信息

Author Affiliations: Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi'an Jiaotong University (Mss Hu, Duan, and Lei); The First Affiliated Hospital of Xi'an Jiaotong University (Ms Zhou); and School of Public Health, Xi'an Jiaotong University Health Science Center (Ms Zhang and Dr Zeng), P.R. China.

出版信息

Cancer Nurs. 2019 Sep/Oct;42(5):410-417. doi: 10.1097/NCC.0000000000000621.

Abstract

BACKGROUND

Maintenance of good functional status and improvement of quality of life (QOL) in patients with head and neck cancer help to determine the efficacy of anticancer therapies.

OBJECTIVE

The aims of this study were to describe the profile of QOL changing over time and evaluate the correlation between anxiety, pain severity, and shoulder and neck function with QOL in patients.

METHODS

A prospective cohort study was conducted. Quality of life, neck and shoulder function, anxiety, and pain were assessed at the time of presurgery, 1 week, and 3 and 6 months postsurgery. The measurement tools included University of Washington-Quality of Life, Constant-Murley score, Zung Self-rating Anxiety Scale, and WHO Pain Grading Standards.

RESULTS

The mean (SD) scores of QOL in 69 patients were 91.8 (6.1) presurgery, 71.6 (9.0) 1 week after surgery, and 78.1 (8.3) and 85.2 (7.0) at 3 and 6 months postsurgery, respectively. Quality of life scores were positively correlated with shoulder and neck function and negatively correlated with anxiety and pain. The improvement of postsurgery QOL was significantly associated with sex and incision healing grade.

CONCLUSION

Improvement of QOL of patients with head and neck cancer is a long process, which is associated with the clinical and demographic characteristics of patients.

IMPLICATIONS FOR PRACTICE

Focusing nursing practice on shoulder and neck function rehabilitation, incision care, and pain management could positively affect QOL among patients with head and neck cancer treated by surgery.

摘要

背景

维持良好的功能状态和提高生活质量(QOL)是头颈部癌症患者疗效的关键。

目的

本研究旨在描述 QOL 随时间的变化情况,并评估焦虑、疼痛严重程度以及肩颈功能与患者 QOL 的相关性。

方法

进行了一项前瞻性队列研究。在术前、术后 1 周、3 个月和 6 个月时,评估生活质量、颈肩功能、焦虑和疼痛。使用的测量工具包括华盛顿大学生活质量量表、Constant-Murley 评分、Zung 焦虑自评量表和世界卫生组织疼痛分级标准。

结果

69 例患者的 QOL 平均(SD)评分分别为术前 91.8(6.1)分、术后 1 周 71.6(9.0)分、术后 3 个月 78.1(8.3)分和术后 6 个月 85.2(7.0)分。QOL 评分与肩颈功能呈正相关,与焦虑和疼痛呈负相关。术后 QOL 的改善与性别和切口愈合等级显著相关。

结论

头颈部癌症患者的 QOL 改善是一个漫长的过程,与患者的临床和人口统计学特征有关。

实践意义

将护理实践重点放在肩颈功能康复、切口护理和疼痛管理上,可能会对头颈部癌症手术患者的 QOL 产生积极影响。

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