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  4. Impacts of Psychological Distress on Recurrence and Survival in Head and Neck Cancer Patients
 
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Impacts of Psychological Distress on Recurrence and Survival in Head and Neck Cancer Patients

Date Issued
2016
Date
2016
Author(s)
Chen, Yen-Ju
DOI
10.6342/NTU201600786
URI
http://ntur.lib.ntu.edu.tw//handle/246246/277556
Abstract
Head and neck cancer (HNC) is one of the top ten most common cancers in Taiwan. The diagnosis of cancer can generate great stress and impact on physical and psychological. Progressive cancer treatment induced functional impairment, including appearance, physical performance, and eating, leading to daily life dysfunction, especially psychological distress. HNC patients’ psychological distress was reported higher than other cancer patients. Evidence reported biological factors (diagnosis, cancer stage, and symptom) contributed to the patients’ likelihood of prognosis and survival. Although some studies have explored psychological distress, limited is known about psychological distress affects the recurrence and survival and longitudinal follow-up this issue. The purposes of the study were to explore: (1) the characteristics of psychological distress, symptom severity, recurrence and survival; (2) the univariate effect of demographic and disease characteristic, symptom severity, and psychological distress on recurrence and survival; (3) the predictors of recurrence and survival after controlling the cancer stage and symptom; and (4) the predictors of psychological distress. This prospective cohort study was conducted from July 2010 to December 2015. A set of questionnaires, including Hospital Anxiety and Depression Scale (HADS), Symptom Severity Scale (SSS), and background information were assessed at 6 months after completing treatment. Recurrence and survival were analyzed from the Cancer Registry Database a medical center in northern Taiwan. Logistic regression and survival analysis were used to reveal the factors related to psychological distress and recurrence. A total of 270 HNC patients were included in this study. The results found that (1) of these patients, 137 patients (50.7%) were identified recurrence or death, and 76 patients (28.1%) were death; (2) patients with lymph invasion (HR=1.67, p=0.035), higher symptom severity (HR=1.12, p=0.015), continued alcohol, tobacco, and betel nut used post-treatment (HR=1.84, p=0.043), and depression (HR=2.82, p=0.031) were more likely to recurrence; (3) patients with lymph invasion (HR=3.95, p=0.000), higher symptom severity (HR=1.06, p=0.011), unmarried (HR=1.79, p=0.041), recurrence (HR=4.63, p=0.000), and depression (HR=2.67, p=0.007) were more likely to poor survival; and (4) of these patients, 18.2% were identified as depression cases. (4) of these patients, 32% were identified as anxiety cases or depression cases, patients were single (OR=2.53, p=0.023, OR=2.48, p=0.023, respectively), continued alcohol, tobacco, and betel nut used (OR=10.56, p=0.002, OR=9.09, p=0.004, respectively) post-treatment had more risk of psychological distress (anxiety and depression); patients with early cancer stage (OR=3.72, p=0.002) and higher symptom severity (OR=1.02, p=0.020) had more risk of anxiety; Male patients (OR=5.04, p=0.040) and had advanced cancer stage (OR=3.65, p=0.002) were significantly more likely to develop depression. HNC survivors still suffered from psychological distress after treatment, after controlling cancer stage and symptom. This study suggested that health care provides should routinely assess psychological distress and provide mental support or referral service to improve prognosis and survival.
Subjects
Head and Neck Cancer
Psychological Distress
Recurrence
Survival
SDGs

[SDGs]SDG3

Type
thesis
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