| Summary: | 碩士 === 國立台北護理學院 === 護理研究所 === 98 === Swallowing difficulty is common among patients with oral cancer (OC), as relation to the tumor involvement, surgery, radiation and chemotherapy. Difficulty in swallowing may lead to poor nutrition status and quality of life. Little has been known about the trajectory of swallowing change along the whole treatment process for OC. Thus, the purposes of this study were to describe the change of swallowing status during 6 months after surgery and relationship of body weight among patients with OC. A consecutive sample of 65 patients with OC was recruited from a medical center in Taipei, Taiwan; and 56 of them completed the data collection 6 months after the surgery. Swallowing difficulty was measured 6 times at pre-surgery, 1, 2, 3, 4 and 6 months after, and measured as perceived swallowing difficulty and size of mouth-opening, and by water swallowing test. A 17-item, 4-point Swallowing Difficulty Scale was developed, and tested as reliable and valid to measure the perceived level of difficulty. General Estimating Equation and simple liner regression via SPSS was used to analyze the change of swallowing during the 6 months after surgery and swallowing relationship to body weight.
The sample had a mean age of 54.7. A majority of them were married and with formal education <10years, and received adjuvant radiation or/and chemotherapy. Swallowing after surgery has significant declined, include decreasing mouth-opening 0.6 - 1cm（p＜.001）、increasing difficulty to turn aside （p＜.05）、increasing self-reproted swallowing difficulty (p＜.001); and 23％~33％ feel swallowing difficulty in medium or severe degree.At 6-month post-surgery, 8.9% can’t swallow 30cc water, 12% of the remaining were observed to have dripping, chocking or pain as dringking water, and just only 50% can eat solid food during the test. The perceived swallowing difficulty significantly increased after the surgery, and indicated the difficulty at 1-month post-surgery as the first peak and recovering during 2-4-month post-surgery, and reaching to another peak at 6-month while completing adjuvant therapy. After controlling the change along the time course, the patient who was older, unmarried, without job, with limited mouth opening, receiving adjuvant therapy, having mucositis or pain had worse swallowing difficulty at 6 month and that was display statistically significant associated with body weight.
This study has developed an in-depth knowledge of swallowing difficulty along the treatment course and may assist the development of intervention to improve the swallowing status in OC, and to help these patients to return to the community as early as possible.
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