EFFECT ON THE QUALITY OF LIFE IN PATIENTS WITH ORAL CANCER AFTER ORTHOPEDIC SURGERY: A LONGITUDINAL STUDY

探討口腔癌病患接受整型手術後影響生活品質因素：縱貫研究

鄭森隆(Sun-Long Cheng) ； 張啟昌(Chi-Chang Chang)

《品質學報》 27卷4期 (2020/08) Pp. 265-279

https://doi.org/10.6220/joq.202008_27(4).0004

摘要

We aim to study health seeking behavior effects in patients with oral cancer after orthopedic sugery on quality of life (QOL) and posttraumatic growth (PTG). Depression, PTG, QOL, posttraumatic stress disorder (PTSD), health seeking behavior, and social support (SS) questionnaires were used. Pearson's correlation and hierarchical regression analyses were used to analyze their correlations. Of 54 subjects were enrolled at month 6 (T_1) and 12 (T_2) after a definite cancer diagnosis was obtained. T_1 results showed that SS (β = 0.33, p = 0.005) and QOL (β = 0.26, p = 0.044) significantly correlated with PTG. Depression (β = -0.82, p ＜ 0.001) significantly correlated with QOL. T_2 results showed that decisional regret (β = -0.22, p ＜ 0.001), shared decision making (β = 0.74, p ＜ 0.001) and QOL (β = 0.22, p = 0.016) significantly correlated with PTG. Depression (β = -0.81, p ＜ 0.001) significantly correlated with QOL. Full mediators affecting QOL were depression, PTSD, and decisional regret. QOL at T_1 correlated with PTG at T_2. After multiple reconstruction surgeries, health seeking behavior significantly affected PTG. In addition, depression is important for short- and long-term QOL observations and the mediator effects of decisional regret and moderating effects of trust may provide a reference for patient participation in clinical decision-making.

關鍵字

oral cancer ； quality of life ； posttraumatic growth ； medical seeking behavior

並列摘要

本研究目的探討口腔癌患者整型手術後長期求醫行為對生活品質和創傷後生長的影響。研究工具採用憂鬱、創傷後成長、生活品質、創傷後壓力疾患、求醫行為和社會支持問卷。研究方法為皮爾森相關分析和階層回歸分析進行脈絡分析。觀察有效癌症病患共54位，分別在確診後的6個月（T_1）和12個月（T_2）進行問卷調查。T_1結果顯示，社會支持（β=0.33,p=0.005）和生活品質（β=0.26,p=0.044）與創傷後生長，呈現顯著相關；憂鬱（β=-0.82,p＜0.001）與生活品質，呈現顯著相關。T_2結果顯示，決策後悔（β=-0.22,p＜0.001）、共同醫療決策（β=0.74,p＜0.001）和生活品質（β=0.22,p=0.016）與創傷後生長，呈現顯著相關；憂鬱（β=-0.81，p＜0.001）與生活品質，呈現顯著相關。整體而言，影響生活品質的完全中介因素是憂鬱、創傷後壓力疾患和決策後悔；T_1的生活品質是扮演影響T_2創傷後生長的重要因子。口腔癌病患在歷經多次整型重建手術後，憂鬱不僅決定短期和長期的生活品質，更是中介影響決策後悔和信任的調節效果的關鍵，是臨床醫病參與決策的重要參考。

並列關鍵字

口腔癌 ； 生活品質 ； 創傷後生長 ； 求醫行為

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