| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學碩士在職專班 === 92 === Abstract
Background:
During the time from obtaining an initial diagnosis to receiving surgery operations, will a series of treatment procedures such as C/T and R/T have a severe impact on patients with oral cancer and pre-cancer lesion in their quality of life related to physical, psychological, and social aspects? To date, there was no study investigating the relationships between dental care demands, oral function and quality of life in patients with oral cancer and pre-cancer lesion. We would like to examine this area and look for findings to serve as clinical references in oral health care and further promote the quality of life for these patients.
Study objective:
The purpose of this study was to determine 1) the characteristics of patients with oral cancer and pre-cancer lesion; 2) the relationships between their dental care demands, oral function and oral health-related quality of life, and other relative factors.
Methods
Patients with oral cancer and pre-cancer lesion in Oral Maxillofacial Surgery Department of KMUH were recruited to complete the constructive questionnaire: Oral Health Impact Profile (OHIP-49) interview. Three hundred and six valid samples of questionnaire were obtained during two and a half months. The statistic methods utilized to analyze the data were t-test, Chi-square test, ANOVA, and multiple regression method.
Results:
In “oral assessment”, the total rating of oral cancer group was 11.89 ± 2.40(M ± SD) and the total rating of pre-cancer group was 10.88 ± 1.67(M ± SD). That means oral cancer patients in this study have poorer oral health condition than the pre-cancer group. In oral function, most patients in both groups achieved maximum in mouth open≧2 cm and their drooling condition was “non-drooling” . Many patients in the oral cancer group were “non-dysphasia” and “acceptable articulation” but no “dysphasia” and “unclear articulation” were found in the pre-cancer group. In “general quality of life,” the oral cancer group rating was 87.99 ± 50.64(M ± SD) and the pre-cancer group rating was 70.96±40.06(M ± SD). The average scores in the subgroups of “male,” “married,” and “no influence to work” in the oral cancer group were significantly higher than in the pre-cancer group. Significant differences were noted from these scores between the two groups. Thereafter, the scores of “general quality of life” in the oral cancer group were analyzed through the analysis from multiple regression method. The score of OHIP in the subgroup of “patients received C/T, R/T, or C/T combined R/T” was 29.44 more, which means a worse quality of life, than “patients received surgery.” The OHIP score in the subgroup of “non-ostectomy patients” was 26.91 less, which means a better quality of life, than the subgroup of “ostectomy patients.” The OHIP score in the “non-drooling” subgroup was 8.29 less, which means a better quality of life, than in the “drooling patients” subgroup. The OHIP score in the “dysphasia” subgroup was 21.83 more, which means a worse quality of life, than “non-dysphasia patients”. In the pre-cancer group, the score of “general quality of life” in the “disease influence to work” subgroup was 24.68 more, which means a worse quality of life, than in the “non influence to work” subgroup. The score in the “more than one time surgery” subgroup was 32.24 more, which means a worse quality of life, than in the “only one time surgery” subgroup.
Conclusion:
The oral cancer group was significantly worse than the pre-cancer group in “oral health status”, “maximum in mouth open”, “drooling”, and “general quality of life”. For general quality of life, poorer quality of life was found in the oral cancer group with the characteristics of “influence to work”, “staging IV”, “received C/T or R/T or combined C/T and R/T”, “betel nut chewing”, “OAG score from 17 to 24”, and “poor oral function”. Then “Treatment modality”, “type of surgery”, “drooling,” and “swallowing” were the major related factors. In the pre-cancer group, poorer quality of life was noted with the characteristics of “ten to thirty thousands average monthly income”, “influence to work”, “more than one surgery”, and “drooling”. Then “influence to work” and “surgery requirement” were the major related factors.
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