Psychological outcome of patients following treatment of oral cancer and its relation with functional status and coping mechanisms.
BACKGROUND
Traditionally health-care providers have measured outcome of treatment of disease by focusing on tumour response and disease-free survival. However, it has become increasingly apparent that the behavioural and functional impact of treatment on the patient is important. This study investigates the psychological outcome and its relationship with functional status and coping mechanisms following treatment of oral cancer patients.


METHODS
Sixty-eight patients were evaluated 6 months to 6 years after treatment (from October 1992 to October 1997) for oral cancer. The Hospital Anxiety and Depression Scale (HADS) was used for psychological evaluation, the University of Washington Quality of Life Questionnaire (UW-QOL) and The European Organisation for Research and Treatment of Cancer Questionnaire (EORTC QLQ-C30) for evaluating the head and neck specific and general functional status, respectively. Finally, the "Mental Adjustment to Cancer Questionnaire" (MAC-Q) was used for evaluation of coping mechanisms.


RESULTS
The incidence of anxiety and/or depression was 25% and the socio-demographic and medical characteristics showed poor correlation with the psychological outcome in this study. The results indicated that there was a strong association between psychological outcome and head and neck specific and general quality-of-life (QOL) domains, and style of coping. The p-value was less than 0.01 for most of the domains and items of functional status and the effective coping style.


CONCLUSIONS
Deteriorated functional status and ineffective coping strategies are strongly associated with poor psychological outcome in patients with oral cancer.
Hassanein
Kamal Abdel-Aal Mohamed
KA
Department of Oral and Maxillofacial Surgery, Manchester Royal Infirmary, Manchester M13 9WL, UK.
Musgrove
Brian T
BT
Bradbury
Eileen
E
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D003071:Cognition; D003679:Deglutition / Q000502:physiology; D003863:Depression / Q000523:psychology; D005157:Facial Pain / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012917:Social Adjustment; D013060:Speech / Q000502:physiology; D016896:Treatment Outcome