Department of Otolaryngology Head and Neck Surgery, Xi Jing Hospital, Air Force Medical University, Changle West Road 127, Xi'an, 710032, Shaanxi, China.
The School of Nursing, Fujian Medical University, No.1 Xueyuan Road, Shangjie, Minhou, Fuzhou, Fujian, China.
Support Care Cancer. 2024 Jul 23;32(8):535. doi: 10.1007/s00520-024-08728-4.
Dysphagia, a serious symptom of oral cancer, is also the most common. Further, patients who are more uncertain regarding their illness tend to catastrophize, which may affect their rehabilitation and long-term survival rate. Considering this relationship, this study aimed to investigate the occurrence of dysphagia in Chinese patients with oral cancer and explore the correlation between catastrophic cognition, illness uncertainty, and dysphagia.
Applying a cross-sectional design, convenience sampling was used to recruit 180 patients with oral cancer. Advanced statistical methods were employed to analyze the mediating effects of catastrophic cognition on illness uncertainty and dysphagia.
Chinese patients with oral cancer had a mean dysphagia score of 52.88 ± 10.95. Catastrophic cognition and illness uncertainty in patients with oral cancer were significantly positively correlated (r = 0.447, P < 0.001). There was a significant negative correlation between dysphagia score and catastrophic cognition (r = -0.385, P < 0.001), and between dysphagia and illness uncertainty (r = -0.522, P < 0.001). Bootstrapping results indicated that the mediating effect of catastrophic cognition between illness uncertainty and dysphagia was -0.07 (95% CI: [-0.15, -0.03]) and significant, and the mediation effect accounted for 15.6% of the total effect.
Chinese patients with oral cancer have poor swallowing function. Results suggest that catastrophic cognition partially mediated the relationship between illness uncertainty and dysphagia in patients with oral cancer. Medical staff can improve patients' swallowing function by reducing the level of catastrophic cognition via decreasing the level of illness uncertainty.
吞咽困难是口腔癌的严重症状，也是最常见的症状。此外，对疾病不确定性较高的患者更容易产生灾难化认知，这可能会影响他们的康复和长期生存率。考虑到这种关系，本研究旨在调查中国口腔癌患者吞咽困难的发生情况，并探讨灾难化认知、疾病不确定性与吞咽困难之间的相关性。
采用横断面设计，便利抽样法招募了 180 名口腔癌患者。采用高级统计方法分析灾难化认知对疾病不确定性和吞咽困难的中介效应。
中国口腔癌患者的吞咽困难平均得分为 52.88±10.95。口腔癌患者的灾难化认知和疾病不确定性呈显著正相关(r=0.447，P<0.001)。吞咽困难评分与灾难化认知呈显著负相关(r=-0.385，P<0.001)，与疾病不确定性呈显著负相关(r=-0.522，P<0.001)。Bootstrapping 结果表明，灾难化认知在疾病不确定性和吞咽困难之间的中介效应为-0.07(95%CI：[-0.15，-0.03])，且具有统计学意义，中介效应占总效应的 15.6%。
中国口腔癌患者的吞咽功能较差。结果表明，灾难化认知部分中介了口腔癌患者疾病不确定性与吞咽困难之间的关系。医务人员可以通过降低疾病不确定性水平来降低灾难化认知水平，从而改善患者的吞咽功能。
