Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2020
Communicative Participation and Quality of Life in Pretreatment Oral and Oropharyngeal Head and Neck Cancer.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Sauder Cara, Kapsner-Smith Mara, Baylor Carolyn, Yorkston Kathryn, Futran Neal, Eadie Tanya
Аннотация
OBJECTIVE: To determine how communicative participation is affected in patients with oral and oropharyngeal head and neck cancers (HNCs) pretreatment and whether communication function predicts HNC-specific quality of life (QOL) before treatment, beyond known demographic, medical, psychosocial, and swallowing predictors.
STUDY DESIGN: Cross-sectional study.
SETTING: Tertiary care academic medical center.
METHODS: Eighty-seven patients with primary oral (40.2%) or oropharyngeal (59.8%) HNC were recruited prior to treatment. T stage, tumor site, and p16 status were extracted from medical records. Demographic and patient-reported measures were obtained. Communicative participation was measured using the Communicative Participation Item Bank (CPIB) General short form. A hierarchical regression analysis included demographic, medical, psychosocial, and functional measures of swallowing and communication as predictors; the University of Washington Quality of Life (UW-QOL v4) composite score was the predicted variable.
RESULTS: Median (SD) baseline CPIB scores were 71.0 (11.83); patients with oral cancers reported worse scores. A final sequential hierarchical regression model that included all variables explained 71% of variance in QOL scores. Tumor site, T stage, and p16 status accounted for 28% of variance (P < .001). Perceived depression predicted an additional 28% of the variance (P < .001). Swallowing and communicative participation together predicted an additional 12% of variance (P = .005). Tumor site, perceived depression, swallowing, and communication measures were unique predictors in the final model. Finally, communicative participation uniquely predicted QOL, above and beyond other predictors.
CONCLUSION: Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.
STUDY DESIGN: Cross-sectional study.
SETTING: Tertiary care academic medical center.
METHODS: Eighty-seven patients with primary oral (40.2%) or oropharyngeal (59.8%) HNC were recruited prior to treatment. T stage, tumor site, and p16 status were extracted from medical records. Demographic and patient-reported measures were obtained. Communicative participation was measured using the Communicative Participation Item Bank (CPIB) General short form. A hierarchical regression analysis included demographic, medical, psychosocial, and functional measures of swallowing and communication as predictors; the University of Washington Quality of Life (UW-QOL v4) composite score was the predicted variable.
RESULTS: Median (SD) baseline CPIB scores were 71.0 (11.83); patients with oral cancers reported worse scores. A final sequential hierarchical regression model that included all variables explained 71% of variance in QOL scores. Tumor site, T stage, and p16 status accounted for 28% of variance (P < .001). Perceived depression predicted an additional 28% of the variance (P < .001). Swallowing and communicative participation together predicted an additional 12% of variance (P = .005). Tumor site, perceived depression, swallowing, and communication measures were unique predictors in the final model. Finally, communicative participation uniquely predicted QOL, above and beyond other predictors.
CONCLUSION: Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.