[Factors associated with psychological distress after surgery and quality of life before and after radiotherapy in 216 patients with oral squamous cell carcinoma].

PURPOSE: To investigate the degree of psychological distress of patients with oral squamous cell carcinoma after operation and its influencing factors, and the impact of radiotherapy on their quality of life. METHODS: Univariate analysis and regression analysis were used to evaluate the relationship between psychological distress and socio-economic and therapeutic factors. The quality of life of the subjects before and after radiotherapy was evaluated by paired t-test using the Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/ Head and Neck 35. SPSS 22.0 software package was used to deal with the data. RESULTS: Age, AJCC stage and median incision of lower lip were the main factors affecting psychological distress. In addition, there were significant differences in scores of most functional areas and specific items before and after radiotherapy. CONCLUSIONS: Clinicians should select individualized treatment programs and procedures for patients of different ages and stages, and screen high-risk groups for psychological distress and provide additional psychological and social support. In addition, radiotherapy can improve or aggravate some special symptoms of patients. Clinicians should take targeted preventive measures.

[Systematic retrospective study of oral cancer-related quality of life scale].

OBJECTIVE: The quality of life (QOL) related to oral cancer has recently become a focus of clinical studies. This study aims to systematically review the current research situation of QOL of local and foreign oral cancer patients and explore the existing related problems and future research directions to provide references and solutions. METHODS: Through relevant key words, PubMed, Wiley InterScience, Science Direct, CNKI, and Wanfang databases were first searched. The related target literature from 2000 to 2017 were screened. Finally, the frequency of oral cancer related to QOL scale used in literature was calculated, and the related scales were briefly introduced. RESULTS: From the target literature, 218 English target literature, 55 Chinese target literature, 24 English scales, and 12 Chinese scales were selected. The most widely used scales for assessing the QOL of patients with oral cancer were as follows: University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Head and Neck 35 (EORTC QLQ-C30/H&N35), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), and Oral Health Impact Profile (OHIP). CONCLUSIONS: The QOL related to oral cancer was well underway, and the study of geographical distribution was widespread. However, the work on self-developed scale remains inadequate. UW-QOL, EORTC QLQ-C30/H&N35, and FACT-H&N can be utilized as the preferred scales for evaluating the QOL of oral cancer patients. A specific disease-related function scale can also be selected according to specific research objectives.

[Influencing factors on the quality of life and medical coping style of patients with oral cancer].

OBJECTIVE: To evaluate the influencing factors on the postoperative quality of life and to analyze the coping styles of patients with oral cancer. METHODS: A total of 131 oral cancer cases confirmed through diagnostic criteria were investigated to analyze the influencing factors on the quality of life (QOL) and the relationship between coping style and QOL of these patients by using the fourth edition of the University of Washington Quality of Life Questionnaire (UWQOL) and medical coping modes questionnaires (MCMQ), respectively. RESULTS: Among the 131 questionnaires collected, only 126 were valid with a recovery rate of 96.18% (126/131). Single factor analysis showed that age, marital status, educational level, other systemic diseases, personal income level, tooth loss, operation times, adjuvant radiotherapy, cancer staging, cervical lymph node dissection, recurrence, and jaw resection yielded different UWQOL scale scores (P<0.05). Multiple regression analysis showed that the loss of teeth, cancer staging, recurrence, and jaw resection yielded statistically significant differences in the total score of UWQOL (P<0.05). Among the coping styles, the average scores of  "confrontation", "avoidance", and "yielding" were 17.54±4.97, 17.79±2.19, and 12.97±5.70, respectively. Compared with the norm, the difference was statistically significant (P<0.05). Correlation analysis showed that "confrontation" and "avoidance" were positively correlated, whereas "yielding" was negatively correlated to QOL (P<0.05). CONCLUSIONS: Age, marital status, educational level, other systemic diseases, personal income level, tooth loss, operation times, adjuvant radiotherapy, cancer staging, cervical lymph node dissection, recurrence, and jaw resection have different effects on the quality of QOL. Tooth loss, cancer staging, recurrence, and jaw resection are the main causative factors affecting the patients' perceived QOL. Personalized treatment and nursing care should be strengthened to improve the coping style and quality of life of patients.

[Use of Zhengzhou University-quality of life scale in 218 postoperative patients with oral cancer].

PURPOSE: The purpose of this study was to explore the best threshold of Zhengzhou University-quality of life(ZZU-QOL) scale in patients with oral cancer 3 to 6 months after operation. METHODS: A questionnaire survey was conducted on 218 patients with oral cancer who met the inclusion criteria. The patients were asked to fill in the ZZU-QOL and the University of Washington Quality of Life Scale(UWQOL). A total of 178 valid questionnaires were collected and the recovery rate was 81.65%. The UWQOL was used as "the gold standard", and the receiver operating characteristic curve (ROC) was drawn to determine the optimal threshold of quality of life scale of Zhengzhou University. Statistical analysis was performed by using SPSS 20 software package. RESULTS: There was a moderate positive correlation between total score of quality of life scale of Zhengzhou University and the total score of the UWQOL (r=0.685, P<0.05). When the ZZU-QOL threshold was 55.682, ROC curve was closest to the upper left corner, its sensitivity and specificity, false negative rate, false positive rate and Youden index were 0.797, 0.676, 0.203, 0.324 and 0.473, respectively. The area under the ROC curve was 0.809, the standard error of the area was 0.047, the 95% confidence interval was 0.718 - 0.901, and the threshold was 56 when the integer was taken. CONCLUSIONS: The optimal threshold of ZZU-QOL in oral cancer patients 3 to 6 months after operation was 56 points, which may be used as the theoretical guidance and basis for evaluation and screening of postoperative quality of life in patients with oral cancer.

[Study of psychological distress and quality of life in patients with oral cancer].

PURPOSE: To explore the relationship between the status quo and influencial factors of oral cancer patients and their quality of life. METHODS: Using the Distress Themometer (DT) and the University of Washington Quality of Life Questionnaire (UW-QOL), 250 patients admitted to the First Affiliated Hospital of Zhengzhou University from October 2016 to September 2017 with oral cancer were investigated. Chi-square test, t test, logistic regression analysis and Spearman correlation analysis were used to analyze the data with SPSS20.0 software package. RESULTS: A total of 250 questionnaires were issued, 239 valid questionnaires were available for analysis. In 239 oral cancer patients, 139 (58.2%) had DT score ≥4. The average total score of UWQOL scale was 53.3±17.1, score <4 was noted in 100 patients (41.8%); the average UWQOL scale was 52.8±17.4. Univariate analysis showed that psychological distress was related to age, educational level, income level, pathological stage, jaw resection and recurrence (χ2 values were 5.12,21.31,34.2,10.69,31.3 and 7.84, respectively, P<0.05 ). Logistic regression analysis showed that age, jaw resection and relapse were the risk factors of psychological distress in patients with oral cancer (OR=4.06, 5.12 and 5.79, respectively; P<0.05). Spearman correlation analysis showed that the scores of pain, recreation, emotion and anxiety in UWQOL scale were negatively correlated with psychological distress scores (r=-0.58, -0.84, -0.66 and -0.69, respectively; P<0.05). CONCLUSIONS: Oral cancer patients have a higher incidence of psychological distress. Younger patients,and those with maxillectomy and recurrence have more serious symptoms of distress.

[Development of a quality of life instrument for evaluation of the quality of life scale for Chinese patients with oral cancer].

PURPOSE: To develop a quality of life instrument for Chinese patients with oral cancer and to assess its reliability, validity and sensitivity. METHODS: A 44-item QOL questionnaire was developed with reference to the 36-item medical outcomes study on short-form health status (SF-36) and University of Washington Quality of Life Questionnaire (UW-QOL), combining with China's population and socio-cultural characteristics, named as Zhengzhou university oral cancer quality of life (ZZU-QOL) scale. Based on 271 patients, student's t test, correlation analysis, factor analysis were performed for its reliability and validity using SPSS 19.0 software package. RESULTS: Test-retest reliability: in all areas and for total score between 2 measurements of the correlation coefficient in the range of 0.86-1.00, there was no significant difference. Homogeneity reliability: Cornbrash'a coefficient in all fields was larger than 0.6, indicating the scale had good reliability. Construct validity: ZZU-QOL, SF-36 analysis and UW-QOL scale factor selected by the first seven cumulative contribution factor variance were 69.3%, 63.4% and 66.5%. The criterion validity with SF-36 and UW-QOL was 0.768 and 0.634, respectively. The ZZU-QOL scale can sensitively distinguish differences in preoperative and postoperative quality of life of oral cancer. CONCLUSIONS: The ZZU-QOL scale is practical, reliable and valid, and might be used for measuring the quality of life in Chinese patients with oral cancer.