Analysis Of Postoperative Quality Of Life And Influencing Factors In Patients With Oral And Maxillofacial Malignancies

Background: Oral and maxillofacial malignancies are the eighth most common malignant tumors in the world,poses a serious threat to health.Due to the special anatomical location,surgical treatment has damaged the normal function of the oral cavity and the appearance of the face to varying degrees,resulting in a variety of physical and mental problems of patients,which seriously affects the physical and mental rehabilitation and the quality of life of patients.Factors affecting quality of life postoperatively in patients with oral and maxillofacial malignant tumor,determine the main factors influencing the postoperative quality of life,for patients with postoperative rehabilitation plan,improve the quality of postoperative survival have important clinical significance,but at present domestic postoperative quality of life in patients with oral and maxillofacial malignant tumor factors affecting research still focus on the disease and treatment,for patients with practical experience and the factors affecting the quality of survival after illness lack of in-depth discussion.Objective: The purpose of this study was to investigate the main factors affecting the postoperative quality of life of patients with oral and maxillofacial malignancies,and to provide reference for improving postoperative quality of life of patients with oral and maxillofacial malignant tumors and formulating intervention measures.Methods: Firstly: using qualitative research method,physical condition,social and family life,emotional state,postoperatively in patients with head and neck cancer related problems,the continuation of care needs and medical experience,etc.,interviews with the outline of 15 patients with oral and maxillofacial malignant tumor postoperative in-depth interviews,using auxiliary Nvivo 11 qualitative analysis software and Colaizzi phenomenon analysis sorting and analyzing the interview data.Secondly: the analysis of factors affecting the quality of life.Patients with oral and maxillofacial malignant tumors who received surgical treatment from January 2016 to March 2018 were selected as the research objects in a third-class oral hospital in China.The data were collected through on-site interviews,questionnaires and data measurement.The collected information included: demographic data,surgical status,psychological status,shoulder joint movement,basic diseases,speech articulation,nutritional status,social support and other 29 influencing factors.The postoperative quality of life of patients was assessed by the Fact-H&N(Version 4)quality of life questionnaire.Single factor analysis was used to determine the influencing factors with statistical significance,and then the Logistic regression model was included for multifactor analysis to determine the main factors affecting the quality of life.Results:(1)Qualitative research results: after reading and summarizing,the interview data were divided into three parts: "pre-admission stage","in-hospital stage" and "post-discharge stage",and a total of 8 themes were extracted.That is,the stage before admission: poor access to medical care,lack of medical information,discontinuous family support;Hospitalization stage: poor negative emotional catharsis,body dysfunction;After discharge stage: continuous medical service is not perfect,discharge guidance lacks long-term plan,and patient compliance is poor.(2)Analysis the results of influencing factors of quality of life: the results of single factor analysis showed statistical differences(P<0.05),including: radical neck dissection,jaw segmental resection,tongue resection,whether to return to the hospital on time,language articulation,social support,anxiety,MNA score,CMS score,MDADI score;Logistic regression analysis showed that the influencing factors with statistical difference(P<0.05)included: Maxillary segmentectomy(OR=67.714,P=0.016,95%CI = 2.167-2116.349),MDADI score(OR=1.258,P=0.002,95%CI = 1.088-1.454),poor social support(OR=673.352,P=0.047,95%CI = 1.100-412078.069),MNA score(OR=26.523,P=0.046,95%CI = 1.053-668.085).Conclusion: It is an important way of improving patients' medical experience and patients' quality of life to actively explore the continuous nursing system in line with the characteristics of oral malignant tumor diseases.Jaw continuity,postoperative swallowing function,nutritional status and social support of patients with oral and maxillofacial malignant tumor are significantly correlated with the quality of life.In view of the above main influencing factors,the development of postoperative continuous health management measures can promote the recovery of patients and improve the quality of life.