頭頸癌病人治療後口腔黏膜炎與生活品質之相關性研究分析

A correlative analysis of oral mucositis and quality of life in patients with head and neck cancer after treatment

洪春金(Chun-Ching Hung)

指導教授 ： 林佑樺

義守大學/醫學院/醫務管理學系/碩士(2017年)

摘要

目的:本研究探討頭頸癌病人在接受治療後口腔黏膜炎情形及對生活品質影響，並找出頭頸癌病人生活品質之相關預測因素。
方法:採橫斷性相關研究設計，以南部某區域教學醫院門診之頭頸癌病人為研究對象，於2016年1月至2017年5月以結構式問卷包括病人基本屬性、醫療變項、世界衛生組織之口腔黏膜炎分級及歐洲癌症研究與治療組織所發展EORTC QLQ-H & N 35生活品質量表進行收案，共計160位。
結果:頭頸癌病人治療後生活品質較差前五項依序為口乾、唾液黏稠、疼痛、吞嚥、病識感。口腔黏膜炎與癌症期別有顯著差異p<.05)。口腔黏膜炎等級與生活品質的疼痛(P<.001)、吞嚥(P<.001)、與人進食P<.001)、社交接觸(P<.001)、口乾P<.001)、唾液黏稠(P<.001)症狀及與整體生活品質(P<.001)均呈現顯著相關。放射治療次數與頭頸部疼痛、吞嚥、感覺、口乾、唾液黏稠呈現顯著相關。逐步迴歸分析顯示，口腔黏膜炎(12%)、性別(5%)、口腔癌(4%)和下咽癌(4%)等4個因子可解釋頭頸癌病人生活品質25％變異量。
結論與臨床應用:本研究結果提供臨床護理人員除對疾病診斷了解，癌症分期及治療後口腔黏膜炎評估，適時提供相關照護並能於治療前做預防性照護，作為預防口腔黏膜炎發生及降低黏膜炎之等級，進而提升生活品質。

關鍵字

頭頸癌 ； 口腔黏膜炎 ； 生活品質

並列摘要

Objective: This study was examined the mucositis and the quality of life and related factors among patients with head and neck cancer after treatment.
Methods: Using a cross-sectional design, 160 patients who were diagnosed head and neck cancer, and recruited from a general hospital in southern Taiwan. Data was collected from January 2016 to May 2017 by face to face interview using a self - reported structured questionnaires. Outcome measurements included the World Health Organization (WHO) oral mucositis grade and the European Cancer Research and Treatment Organization developed the EORTC QLQ-H & N 35 Quality of Life Scale.
Results: The top five impact of patients’ quality of life after head and neck cancer treatment were: dry mouth, saliva sticky, pain problems, swallowing problems, and disease awareness. There were a significantly different between oral mucositis grade and cancer staging. There were significant correlation between oral mucositis grade, life-quality pain, swallowing, eating with people, social contact, dry mouth, saliva sticky problems and overall quality of life. There were significant correlation between the frequency of radiotherapy, head and neck pain, swallowing, feeling, dry mouth, and saliva stickiness. In the stepwise regression model, four factors were the predictors of overall global quality of life, included oral mucositis (12%), sex (5%), oral cancer (4%), and hypopharyngeal carcinoma (4%), and account for 25.0% total variance.
Conclusions and clinical applications: This study might provide appropriate clinical educational oral care before treatment of patients with head and neck cancer. Health care professionals are responsible to aware the cancer staging, patients sex different, cancer type, and provide appropriate nursing intervention to decrease the oral mucositis after treatment and improve the quality of life.

並列關鍵字

head and neck cancer ； mucositis ； quality of life

參考文獻

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