Predictive Model of Quality of Life in Patients with Head and Neck Cancer After Radiotherapy

Main Article Content

Montira Khamho
Napaporn Wanitkun
Suporn Danaidutsadeekul
Kullathorn Thephamongkhol

Abstract

           Purpose: To determine the predictive power of personal factors, weight loss, health literacy, self-management, patient engagement, and perceived person-centered care on quality of life (QOL) among patients with head and neck cancer during 4-8 weeks after radiotherapy.


          Design: Predictive study.


          Methods: One hundred and ten patients with head neck cancer during 4-8 weeks after radiotherapy were randomly recruited from 3 university/college hospitals specializing in head and neck cancer treatment in the Bangkok metropolitan area. Questionnaires consisted of demographic and health data, quality of life, health literacy, self-management, patient engagement, and perceived person-centered care. Hierarchical regression analysis was applied for the analysis.


          Main findings: The result demonstrated that overall quality of life of this group of patients was in a moderate level (gif.latex?\bar{X} = .67, SD = .19) with having lower psychosocial score than physical score (gif.latex?\bar{X} = .39, SD = .19 and gif.latex?\bar{X} = .59, SD = .19, respectively). For the personal characteristic, only fatigue could significantly explain 10.5% of the variance in the quality of life (p < .01). Final model demonstrated self-management and health literacy significantly explained 36% of the variance in the quality of life (p < .001). Self-management was the factor with the highest predictive power (β = .32, p < .01). Self-management and health literacy explained the variance of quality of life above and beyond fatigue approximately 25.5%.


          Conclusion and recommendation: Nurses should find promoting activities to enhance patients’ health literacy and self-management ability along with their treatment based on their fatigue levels to help patients having good quality of life after completing the treatment course.

Article Details

How to Cite
Khamho, M., Wanitkun, N., Danaidutsadeekul, S., & Thephamongkhol, K. (2018). Predictive Model of Quality of Life in Patients with Head and Neck Cancer After Radiotherapy. Nursing Science Journal of Thailand, 36(2), 54–66. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/146586
Section
Research Papers

References

1. Imsamran W, Chaiwerawattana A, Wiangnon S, Pongnikorn D, Suwanrungrung K, Sangrajrang S, et al. Cancer in Thailand. Vol.VIII, 2010-2012. Bangkok: New Thammada Press (Thailand); 2015.
2. Yeh SA. Radiotherapy for head and neck cancer. Semin Plast Surg. 2010;24(2):127-36.
3. Cabrera AR, Yoo DS, Brizel DM. Contemporary radiotherapy in head and neck cancer: balancing chance for cure with risk for complication. Surg Oncol Clin N Am. 2013;22(3):579-98.
4. Sawada NO, de Paula JM, Sonobe HM, Zago MM, Guerrero GP, Nicolussi AC. Depression, fatigue, and health-related quality of life in head and neck cancer patients: a prospective pilot study. Supportive Care Cancer. 2012;20(11):2705-11.
5. Tribius S, Reemts E, Prosch C, Raguse M, Petersen C, Kruell A, et al. Global quality of life during the acute toxicity phase of multimodality treatment for patients with head and neck cancer: Can we identify patients most at risk of profound quality of life decline? Oral Oncology. 2012;48(9):898-904.
6. Youdoung W, Wittayapun Y, Dumnean P, Musikka A, Hankla W, Lagampan S. Quality of life among head- and neck-cancer patients undergoing radiotherapy at Suratthani Cancer Hospital. Thai Cancer Journal. 2015;35(1):14-25. (in Thai).
7. Klein J, Livergant J, Ringash J. Health related quality of life in head and neck cancer treated with radiation therapy with or without chemotherapy: a systematic review. Oral Oncol. 2014;50(4):254-62.
8. McCormack B, McCance T. Person-centred nursing: theory and practice. Chichester: Wiley-Blackwell; 2010.
9. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988;260(12):1743-8.
10. Bilal S, Doss JG, Cella D, Rogers SN. Quality of life associated factors in head and neck cancer patients in a developing country using the FACT-H&N. J Craniomaxillofac Surg. 2015;43(2):274-80.
11. So WK, Chan RJ, Chan DN, Hughes BG, Chair SY, Choi KC, et al. Quality-of-life among head and neck cancer survivors at one year after treatment--a systematic review. Eur J Cancer. 2012;48(15):2391-408.
12. Langius JAE, Dijk AMv, Doornaert P, Kruizenga HM, Langendijk JA, Leemans CR, et al. More than 10% weight loss in head and neck cancer patients during radiotherapy is independently associated with deterioration in quality of life. Nutr Cancer. 2013;65(1):76-83.
13. Sjogren K, Lindkvist M, Sandman PO, Zingmark K, Edvardsson D. Person-centredness and its association with resident well-being in dementia care units. J Adv Nurs. 2013;69(10):2196-205.
14. Rose P, Yates P. Patients' outcomes related to person-centred nursing care in radiation oncology: a case study. Eur J Oncol Nurs. 2015;19(6):731-9.
15. Husson O, Mols F, Fransen MP, van de Poll-Franse LV, Ezendam NP. Low subjective health literacy is associated with adverse health behaviors and worse health-related quality of life among colorectal cancer survivors: results from the profiles registry. Psychooncology. 2015;24(4):478-86.
16. Shneerson C, Taskila T, Greenfield S, Gale N. A survey investigating the associations between self-management practices and quality of life in cancer survivors. Supportive Care Cancer. 2015;23(9):2655-62.
17. Chen WT, Wantland D, Reid P, Corless IB, Eller LS, Iipinge S, et al. Engagement with health care providers affects self- efficacy, self-esteem, medication adherence and quality of life in people living with HIV. J AIDS Clin Res. 2013;4(11):256.
18. Griffiths J, Putthinoi S, Pongsaksri M. The general practitioner assessment of cognition; GPCOG (Thai version): validity and reliability. Poster session presented at: Rewinding the aging clock. 9th Pan-Pacific Conference on Rehabilitation cum, 21st Annual Congress of Gerontology; 2014 Nov 29-30; Jockey Club Auditorium, the Hong Kong Polytechnic University. Hong Kong, China.
19. Brodaty H, Pond D, Kemp NM, Luscombe G, Harding L, Berman K, et al. The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002;50(3):530-4.
20. Wanitkun N, Pattaramongkolrit S, Vichathai C, Bhechrung B, Kloyahem S, Batterham R, et al. Thai health literacy. Nonthaburi: Health System Research Institute; 2014. (in Thai).
21. Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39(4 Pt 1):1005-26.
22. Choocherd S, Wanitkun N, Danaidusadeekul S, Yottasurodom C. Relationships among health literacy, severity of disease, patient engagement, perception of person-centered care and quality of life in patients after coronary artery bypass graft surgery. Journal of Nursing Science. 2016;34 Suppl 1:94-106. (in Thai).
23. Graffigna G, Barello S, Bonanomi A, Lozza E. Measuring patient engagement: development and psychometric properties of the Patient Health Engagement (PHE) Scale. Front Psychol. 2015 Mar 27;6:274. doi: 10.3389/fpsyg.2015.00274. PubMed PMID: 25870566; PubMed Central PMCID: PMC4376060.
24. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. 4th ed. New York, NY: Springer Publishing Company; 2010.
25. Little P, Everitt H, Williamson I, Warner G, Moore M, Gould C, et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ. 2001;323(7318):908-11.
26. Richardson J, Sinha K, Lezzi A, Khan MA. Modelling the utility of health states with the Assessment of Quality of Life (AQoL) 8D instrument: overview and utility scoring algorithm. Clayton, Australia: Centre for Health Economics, Faculty of Business and Economics, Monash University; 2011.
27. Maxwell A, Özmen M, Iezzi A, Richardson J. Deriving population norms for the AQoL-6D and AQoL-8D multi-attribute utility instruments from web-based data. Qual Life Res. 2016;25(12):3209-19.
28. Suzuki M. Quality of life, uncertainty, and perceived involvement in decision making in patients with head and neck cancer. Oncol Nurs Forum. 2012;39(6):541-8.
29. Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70(4):351-79.