Exploring the change in quality of life of patients newly diagnosed with head and neck cancer across the cancer trajectory

Autor: Ya-Hui Tsan, 詹雅惠
Rok vydání: 2017
Druh dokumentu: 學位論文 ; thesis
Popis: 105
Background: Head and neck cancer is the fifth cancer incidence in Taiwan. It often occurs in the middle-aged, male adults with a negative impact on the family and society. Once the cancer diagnosis is established, the treatment may include surgery, radiotherapy, chemotherapy, and target therapy. Side effects from cancer and its treatment may affect patients’ appearance, swallowing, speaking, and breathing functioning. The aforementioned cause patients’ symptom burden and decline their quality of life (QOL). However, evidence shows that hope may help patients maintaining their QOL through a better adjustment from the limitation and threatening of cancer. Lot of cross-sectional studies explore the QOL in head and neck cancer, but still few longitudinal studies discover the QOL change and its predictors across the cancer trajectory. Purpose: The primary objective of this study was to investigate the predictors of QOL change in patients with head and neck cancer from the diagnosis to completion of treatment. The secondary one was to understand the trends of symptom burden, hope and the QOL in these patients. Methods: This was a longitudinal design with purposive sampling study. A total of 62 patients newly diagnosed with oral cancer, oropharyngeal cancer, hypopharyngeal cancer or laryngeal cancer done with the first concurrent chemoradiotherapy (CCRT) were recruited form a medical center located in Taipei. The demographic and medical information sheets, M.D. Anderson Symptom Inventory, Herth Hope Index, and Functional Assessment of Cancer Therapy-Head and Neck Cancer Scale were collected. The four measurement time points were as followings; before the CCRT (T1), the 3rd to 4th week after treatment (T2), one week after the end of treatment (T3), and one month after the end of treatment (T4). Data were analyzed with SPSS 22.0 for Window software package utilizing of descriptive and inferential statistics. Results: The majority of participants were male (90.3%) with an average age of 53.29 (SD=7.98) years old. Results indicated that types of diagnosis (F=3.52, p=0.04) and surgery (F=4.43, p=0.01) significantly influence the T1 QOL. The target therapy (t=2.61, p=0.01) significantly impacts on the T2 QOL. A negative correlation between symptom burden and the QOL was detected at T1-T4. While, a positive correlation between hope and the QOL was detected at T1-T4. The trend of symptom burden was raised first and then declined. However, the trends of hope and QOL were declined first and then raised. The predictors of QOL change were the employee status (β=-4.48, p=0.006), the change of symptom burden (β=-0.47, p
Databáze: Networked Digital Library of Theses & Dissertations
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