| Summary: | 博士 === 臺北醫學大學 === 醫學研究所 === 96 === Oral cancer is one of the major cancers in Taiwan. Surgery and radiotherapy are major treatment. These oral cancer patients are mostly younger and meridian population, patient had experience physical and psychological distress from diagnosis, biopsy, and treatment. The purposes of the study were to (1) explore the physical distress (performance status, symptom severity, pain, and wound status) changes in oral cancer patients receiving surgery and radiotherapy. (2) explore the psychological distress (disease impact, anxiety, and depression) changes in oral cancer patients receiving surgery and radiotherapy. (3) explore the each domain care needs changes in oral cancer patients receiving surgery and radiotherapy. (4) explore the predictive factors of disease related factors (age, cancer stage), physical distress (performance status, symptom severity, pain, and wound status), psychological distress (disease impact, anxiety, and depression) for each domain care needs, under control “time” variable. This study is a prospective longitudinal design five times of data collection time point will be arranged to collect data. It includes Discharge Day (T0), Day before Radiotherapy (T1), Complete 4 Week Radiotherapy (T2), Complete Radiotherapy (T3), and Complete Radiotherapy 4 Week (T4). Patients will be also assessed by using Cancer Needs Questionnaire short-form (CNQ-SF), Karnofsky Performance Status Index (KPS), Symptom Severity Scale (SSS), UCSF Oral Cancer Pain Questionnaire (UCSF OCPQ), Bates-Jensen Wound Status Tool (BWST), and Hospital Depression and Anxiety (HADS) in T0, T1, T2, T3 and T4. Patients will be recruited from ENT inpatient ward, plastic surgery inpatient ward, and radiationtherapy outpatient department of a medical center at Northern Taiwan. A total of fifty-four eligible subjects were recruited by convenience sampling. Data was analyzed by descriptive statistics, and General Estimating Equation (GEE). The results were as following: (1) physical distress, the peak level of physical performance, symptom severity, and oral pain intensity were in the complete radiotherapyand it decrease in the complete radiotherapy 4 week, the major physical distress were lose of appetite, oral mucositis, swallowing difficulty, pain, and fatigue, however, wound condition was healing progressively by the time. (2) psychological distress, the peak level of disease impact, anxiety, and depression were in the complete radiotherapyand it decrease in the complete radiotherapy 4 week. (3) care needs, the peak level of care needs except the interpersonal communication care needs, including the physical and daily living care needs, psychological care needs, patient care and support care needs, health information care needs, and oral cancer related care needs were in the complete radiotherapyand it decrease in the complete radiotherapy 4 week. (4) the predictive factors of care needs, patients with younger age, poor wound healing, higher disease impact, anxiety, lower depression had more likely overall care needs; patients with poor wound healing, higher symptom severity had more likely physical and daily living needs; patients with lower performance status, poor wound healing, higher disease impact, anxiety had more likely psychological needs; younger age patients had interpersonal communication care needs; patients with poor wound healing, higher disease impact had more likely patient care and support care needs; patients with younger age, poor wound healing, higher disease impact, and anxiety, lower depression had more likely health information care needs; patients with younger age, higher oral pain intensity had more likely oral cancer related care needs. Results of this syudy supported that physical distress, psychological distress, and care needs are common experienced problem in oral cancer patients received radiotherapy. The results of this study provide more information to medical professionals to develop adaptable nursing interventions when patients need symptom management, emotional supports and encouragements, and to help patients to cope the physical and psychosocial distress.
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