The Study On Quality Of Life And Its Influencing Factors Among Surgical Patients With Non-melanoma Skin Cancer

Objective:1.To understand the current status of quality of life in surgical patients with non-melanoma skin cancer.2.To analyze the differences of the quality of life among the surgical patients with non-melanoma skin cancer.3.To explore the influencing factors of the quality of life in surgical patients with non-melanoma skin cancer.Method:A convenience sampling method was used.202 non-melanoma skin cancer patients who were hospitalized for surgical treatment in a tertiary dermatology hospital in Nanjing from November 2020 to February 2022 were recruited according to the inclusion and exclusion criteria.The self-designed general information questionnaire,Social Science Research Solutions(SSRS),Athens Insomnia Scale(AIS),Self-rating Anxiety Scale(SAS),and Dermatology Life Quality Index(DLQI)were used as research instruments to understand the current status and to analyze the influencing factors of non-melanoma skin cancer patients’quality of life.All data were entered into SPSS 21.0 software for statistical analysis,t-test or non-parametric test was used for measurement data,χ~2test or Fisher’s exact test was used for categorical data,and Spearman correlation analysis and multiple linear regression analysis were used for further statistical analysis.Result:A total of 202 questionnaires were distributed in this study,and 176 valid questionnaires were collected,with an effective rate of 87.13%.The age of the patients was ranged from 30 to 96 years old,118 patients were over 60 years old(67%).There were 83 cases of basal cell carcinoma(47.2%),68 cases of invasive squamous cell carcinoma(38.6%),17 cases of extramammary Paget’s disease(9.7%)and 8 cases of Bowen’s disease(4.5%).The gender distribution was 83 males(47.2%)compared to 93 females(52.8%).The average score of quality of life of non-melanoma skin cancer patients was 3(1,7),among which 116(65.9%)non-melanoma skin cancer patients were impacted on their quality of life.The number of patients that have been impacted by the disease on quality of life was 593.5%(3)in mild level,28(15.9%)in moderate level,26(14.8%)in severe level and 3(1.7%)in very severe level.The subscores of the quality of life questionnaire were as follows:the symptoms and feelings dimension scored the highest with 2(1,3)and the work and learning dimension scored the lowest with 0(0,0).Multiple linear stepwise regression analysis indicated that primary skin disease,a history of prolonged mechanical irritation,sleep condition,anxiety level were the influencing factors of quality of life and explained for 43.5%of the total variation of the equation.The subscore of objective social support and the total score of quality of life was positively correlated to the dimensions of daily activities,leisure time,work and study,interpersonal relationships,and treatment.The DLQI scores was higher in patients with invasive squamous cell carcinoma and extramammary Paget’s disease than with basal cell carcinoma.Multiple linear stepwise regression analysis illustrated that payment method,long history of oral medication were the influencing factors of patients’sleep conditions,while a prolonged history of UV exposure was the influencing factor of patients’anxiety level.Conclusion:1.The quality of life of patients undergoing surgery for non-melanoma skin cancer was affected,of which 32.4%were affected in and above moderate level,and the symptom and feeling dimensions had the greatest impact.Patients with primary skin disease,a history of prolonged mechanical irritation,poor sleep and bad mood had poorer quality of life.2.Among patients with non-melanoma skin cancer,quality of life was significantly lower in patients with invasive squamous cell carcinoma and extramammary Paget’s disease than in patients with basal cell carcinoma.The subscore of objective social support and the total score of quality of life was positively correlated to dimensions of daily activities,leisure time,work and study,interpersonal relationships,and treatment.