Research On Quality Of Life And Its Influencing Factors In Postoperative Patients With Acoustic Neuroma

ObjectiveThis study aims toto investigate the current status of quality of life in patients with acoustic neuroma after surgery,to analyze the relationship of different demographic characteristics;clinical data,levelofhope,coping style,anxiety and depression,with quality of life,and to further study the factors influencing the quality of life in patients with acoustic neuroma after surgery.The present study may provide empirical evidence for clinical nursing measures,so as to effectively improve the quality of life of patients with acoustic neuroma after surgery.MethodsThis study was a cross-sectional survey study.On the basis of a convenient sampling method,a total of 424 patients with acoustic neuroma after resection through sigmoid posterior approach were enrolled in six tertiary general hospitals in Shandong Province from September 2016 to July 2018.Then,questionnaires were designed and distributed,which included general information questionnaire,assessment on quality of life using SF-36 scale,medical response questionnaire(MCMQ),Herth hope scale,hospital anxiety and depression scale(HADS),and facial nerve function evaluation.The data were statistically analyzed by SPSS 20.0 statistical software.The statistical methods mainly included descriptive statistical analysis,independent sample ttest,analysis of variance,Pearson correlation analysis and multiple linear regression analysis.Results1.A total of 475 questionnaires were distributed in this study,and 424 valid questionnaires were returned,with an effective rate of 89.2%.The average age of the patients was(47.85± 14.71)years old of the enrolled patients,including 178 males and 246 females.There were 62 patients with grade Ⅱ tumors,333 patients with grade III tumors,and 29 patients with grade IV tumors.Besides,73.1%of patients with acoustic neuroma had underlying disease and85.4%patients showed grade I and IIfacial nerve function.2.The overall score of quality of life in 424 patients with acoustic neuroma was(327.59±53.46),which was lower than that of the normal population.The overall hope level scorein patients with acoustic neuroma was(32.77±2.78)after three months of operation,indicating a medium level.Furthermore,considering the coping style of patients with acoustic neuroma three months after surgery,the face-to-face dimension had the highest points of(19.55±2.43),whereas theyield dimension was the least of reaching(13.57±1.97)points.The overall score for the assessment of anxiety and depression assessment was(11.55±3.49)and(11.66±3.61),respectively,suggesting obvious symptoms of anxiety and depression in patients with acoustic neuroma compared with the normal population.3.Univariate analysis showed that there was statistical difference in the quality of life of patients with acoustic neuroma(P<0.05)in terms of gender,age,marriage,religious belief,education,monthly income and occupation(P<0.05).Furthermore,the quality of life of patients was also significantly different in the aspects ofcurrent frequency of hospitalizations,length of stay in hospital,surgical approaches,underlying diseased,diameter of tumor,and facial nerve function(P<0.01).4.Pearson correlation analysis results revealed that the total score of quality of life was positively correlated with the attitude dimension,action dimension,relationship dimension and total score of hope level(P<0.01);the total quality of life score was positively correlated with the face dimension of coping style(P<0.01),however,it was negatively correlated with the avoidance dimension and yield dimension of coping styles(P<0.01).In addition,there was a significant negative correlation of anxiety and depression with total score of quality of life(P<0.01).5.Multiple linear regression analysis showed that the patient’s gender,tumor diameter,underlying disease,avoidance,yield,and action were important predictors of postoperative quality of life in patients with acoustic neuroma.The gender of patients significantly affected their quality of life(P<0.001),and female patients had relatively lower quality of life scores;choosing the appropriate surgical method was beneficial to the improvement of patients’ quality of life(P<0.01);while the tumor diameter indicated a negative correlation with the quality of life score(P<0.001);The quality of life scores of patients with acoustic neuroma with underlying diseases were lower than those without underlying diseases(P<0.001);those with avoidance coping styles had lower quality of life scores,and those with yield and action coping styles had higher quality of life scores(P =0.007,<0.001 and 0.031,respectively).The model explained 73.1%of the total variation in quality of life,and there was statistical significance in the model.Conclusions1.The overall quality of life of patients with acoustic neuroma aftersurgery is lower than that of normal population,and the emotional function(13.99±28.69)has the lowest score.Nursing staff are advised to take a variety of interventions such as targeted comprehensive treatment,holistic nursing,health education and psychological counseling to improve the quality of life of patients with acoustic neuroma after surgery.2.The quality of life of patients with acoustic neuroma is affected by social demographic data such as marriage,monthly income,occupation,and clinical data such as surgical approaches,underlying diseases,and tumor diameter.It is recommended that medical personnel guide patients to make full use of social support and adopt positive strategies to maximize the therapeutic effect of surgery for acoustic neuroma and improve the quality of life of patients.3.There are statistical differences in the anxiety and depression,the level of hope,and the coping style in patients with acoustic neuroma.Medical staff should correctly assess the patient’s mental condition,understand the patient’s negative emotional source,and take appropriate nursing measures to accurately identify the patient’s negative emotions and reduce the patient’s emotional burden,thereby improving the patient’s quality of life.4.Avoidance,yield,action,gender,surgical approach,tumor diameter,and the existence of underlying diseases are important factors influencing postoperative quality of life in patients with acoustic neuroma.It is suggested that in the daily postoperative care of patients with acoustic neuroma,the patient should be guided to adopt a positive behavioral approach to promote the establishment of high hope levels,thereby improving the patient’s therapeutic effect and quality of life.