Assistant Professor, Department of Prosthodontics, National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece; Maxillofacial Prosthodontist, Former Fellow, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas.
Professor, Department of Psychology, University of Crete, Rethymno, Greece.
J Prosthet Dent. 2022 Dec;128(6):1387-1397. doi: 10.1016/j.prosdent.2021.04.009. Epub 2021 Jun 10.
Tumors of the soft palate and the adjacent tissues often create considerable soft palate defects that are challenging for the maxillofacial prosthodontist. Soft palate obturator prostheses can usually address functional and esthetic concerns; however, the effectiveness of the prosthetic rehabilitation in improving the patient's well-being and overall quality of life (QOL) has not been extensively researched.
The purpose of the present research was to evaluate the function of the prosthesis, to review the interrelation between sociodemographic, medical, and treatment (SMT) characteristics, QOL, and prosthesis functioning, and to analyze the role of the prosthesis in how the patient represents the illness and the psychological coping response.
Thirty-three patients who underwent resection of the soft palate and had been using a technically successful soft palate obturator prosthesis for at least 1 year were interviewed by means of 5 questionnaires: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), Head and Neck Cancer Module (QLQ-HN35), Obturator Functioning Scale (OFS), Illness Perceptions Questionnaire (IPQ-R), and Mental Adjustment to Cancer Scale (MAC). Data analysis was performed at α=.01.
The QOL (r=-0.53, P=.001), personal control (r=-0.53, P=.001), negative adjustment to cancer (r=0.47, P=.005), treatment control (r=-0.55, P=.001), consequences (r=0.62, P<.001), and emotional representations (r=0.30, P=.009) were significantly related to prosthesis functioning. Better QOL was significantly related to prosthesis functioning (P=.006), age (P=.001), sex (P=.011), and type of soft palate defect (P=.009). The most important predictors of favorable soft palate obturator functioning were age (P<.001) and type of soft palate defect (P=.01).
A patient-perceived effective soft palate obturator prosthesis was a significant predictor for advanced QOL, better adjustment to illness and illness-related disabilities, as well as the overall coping response to cancer.
软腭和相邻组织的肿瘤常导致较大的软腭缺损,这对颌面修复医生来说是一个挑战。软腭堵塞器修复体通常可以解决功能和美观问题;然而,修复体在改善患者的幸福感和整体生活质量(QOL)方面的效果尚未得到广泛研究。
本研究的目的是评估修复体的功能,回顾社会人口统计学、医学和治疗(SMT)特征、生活质量和修复体功能之间的相互关系,并分析修复体在患者如何代表疾病和心理应对反应中的作用。
对 33 名接受软腭切除术且至少使用 1 年成功技术软腭堵塞器修复体的患者进行了采访,采用 5 种问卷进行采访:欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷(QLQ-C30)、头颈部癌症模块(QLQ-HN35)、堵塞器功能量表(OFS)、疾病认知问卷(IPQ-R)和癌症心理调整量表(MAC)。数据分析的置信度为α=0.01。
生活质量(r=-0.53,P=.001)、个人控制(r=-0.53,P=.001)、癌症消极调整(r=0.47,P=.005)、治疗控制(r=-0.55,P=.001)、后果(r=0.62,P<.001)和情绪表达(r=0.30,P=.009)与修复体功能显著相关。更好的生活质量与修复体功能(P=.006)、年龄(P=.001)、性别(P=.011)和软腭缺损类型(P=.009)显著相关。软腭堵塞器功能良好的最重要预测因素是年龄(P<.001)和软腭缺损类型(P=.01)。
患者认为有效的软腭堵塞器修复体是提高生活质量、更好地适应疾病和疾病相关残疾以及整体应对癌症的重要预测因素。