Social Support, Psychosocial Adjustment, Depression, and Quality of Life in Patients with Oral Cancer After Reconstruction Surgery

Wednesday, July 13, 2011: 4:05 PM

Tsae-Jyy Wang, PhD, ARNP, RN
Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

Learning Objective 1: The learner will be able to know the relationships among social support, psychosocial adjustment, depression, and quality of life in oral cancer patients.

Learning Objective 2: The learner will be able to know risk factors for poor adjustment, depression, and poor quality of life in oral cancer patients.

Purpose: The study aim was to explore the relationships among social support, psychosocial adjustment, depression, and quality of life in oral cancer patients.

Methods: The study was a cross-sectional descriptive predictive design. A convenient sample of 77 oral cancer patients post reconstruction surgery was recruited from a medical center in Taiwan from January to June 2009. Data were collected by using the study questionnaire, which included Social Support Scale, Psychosocial Adjustment to Illness Scale, Center for Epidemiologic Studies Depression Scale, EORTC QOL-C30 and QOL-H&N35. The statistics analysis included descriptive, t-test, One-way ANOVA, Pearson correlation, stepwise linear regression, and Sobel test 

Results: Results showed that participants received social supports primarily from families and friend. The average score of psychosocial adjustment and quality of life were 48.7 (SD: 15.8) and 56.4 (SD: 25.3) respectively. 33.8 % of the study participants were clinically depressed. Stepwise linear regression showed that marital status and perceived economic status explained 24 % of variance in psychosocial adjustment. Social support from family members, occupation status, perceived disease severity, and perceived facial disfigurement explained 47% variance in psychosocial adjustment. Psychosocial adjustment, social support from family members explained 56% of variance in depression. Psychosocial adjustment and depression explained 35% of variance in quality of life. Additionally, the Sobel test result showed that 42% of the effect of psychosocial adjustment on quality of life was mediated through depression.

Conclusion: In general, oral cancer patients were depressed, poorly adjusted, and had low quality of life. Those with less social support and poorer psychosocial adjustment were in greater risk for depression. Depressed and poorly adjusted patients showed worse quality of life. Nurses should pay additional attention to these high risk groups. Interventions are needed to enhance patients’ psychosocial adjustment in order to ease depression and boot quality of life.