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Presurgery and Postsurgery Quality of Life and Associated Factors in Patients With Malignant Neoplasms of the Head and Neck

A 6-Month Follow-up Study

Hu, Zhiping, MPH; Zhou, Xiaoling, MSc; Duan, Weiwei, BSc; Lei, Wenge, BSc; Zhang, Min, MSc; Zeng, Lingxia, PhD

doi: 10.1097/NCC.0000000000000621
Article: PDF Only

Background Maintenance of good functional status and improvement of quality of life (QOL) in patients with head and neck cancer help to determine the efficacy of anticancer therapies.

Objective The aims of this study were to describe the profile of QOL changing over time and evaluate the correlation between anxiety, pain severity, and shoulder and neck function with QOL in patients.

Methods A prospective cohort study was conducted. Quality of life, neck and shoulder function, anxiety, and pain were assessed at the time of presurgery, 1 week, and 3 and 6 months postsurgery. The measurement tools included University of Washington-Quality of Life, Constant-Murley score, Zung Self-rating Anxiety Scale, and WHO Pain Grading Standards.

Results The mean (SD) scores of QOL in 69 patients were 91.8 (6.1) presurgery, 71.6 (9.0) 1 week after surgery, and 78.1 (8.3) and 85.2 (7.0) at 3 and 6 months postsurgery, respectively. Quality of life scores were positively correlated with shoulder and neck function and negatively correlated with anxiety and pain. The improvement of postsurgery QOL was significantly associated with sex and incision healing grade.

Conclusion Improvement of QOL of patients with head and neck cancer is a long process, which is associated with the clinical and demographic characteristics of patients.

Implications for Practice Focusing nursing practice on shoulder and neck function rehabilitation, incision care, and pain management could positively affect QOL among patients with head and neck cancer treated by surgery.

Author Affiliations: Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi’an Jiaotong University (Mss Hu, Duan, and Lei); The First Affiliated Hospital of Xi’an Jiaotong University (Ms Zhou); and School of Public Health, Xi’an Jiaotong University Health Science Center (Ms Zhang and Dr Zeng), P.R. China.

This research project was funded by the Youth Foundation (project number 201503) of the College of Stomatology, Xi’an Jiaotong University, and China Scholarship Council (no. 201606285114).

The authors have no conflicts of interest to disclose.

Correspondence: Lingxia Zeng, PhD, School of Public Health, Xi’an Jiaotong University Health Science Center, No 76, Yanta W Rd, Xi’an, Shaanxi 710061, P.R. China (

Accepted for publication March 20, 2018.

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