Study On Relationship Of Stigma,Social Support,Resilience And Quality Of Life Among Chinese Patients With Oral Cancer

Objective:Because it’s difficult to evaluate the curative effect of cancer with cure rate and the evaluation effect of survival rate is relatively limited,quality of life(QoL)assessment in cancer field became the mainstream direction of QoL research.The World Health Organization(WHO)also has identified improving QoL as one of the three major targets of cancer treatment.In the research of oral cancer,it also has become a trend to combine QoL assessment with traditional clinical endpoints.The purpose of our study was to explore the status and distribution of QoL in oral cancer patients.The relationship between stigma and QoL was studied.On this basis,social support and resilience were introduced to explore whether social support and mental resilience played a mediating role in the relationship between stigma and QoL.Based on the results,we will provide scientific basis for improving QoL of patients with oral cancer.Methods:In this study,oral cancer patients in the Department of Stomatology,Shengjing Hospital of China Medical University and Stomatology Hospital of China Medical University in Liaoning Province,China were recruited by convenience sampling to complete self-administered questionnaires.271 questionnaires were distributed and 230 questionnaires were collected.The effective response rate was 84.87%.The Functional Assessment of Cancer Therapy-Head and Neck(FACT-H&N)was used to measure the QoL of oral cancer patients.The Social Impact Scale(SIS)was used to measure the stigma of oral cancer patients.the Multidimensional Scale of Perceived Social Support(PSSS)was used to measure the perceived social support of oral cancer patients.The Ego-Resiliency Scale(ERS)was used to measure the level of resilience among oral cancer patients.The general situation questionnaire was used to investigate demographic and clinical-related factors in oral cancer patients.One-way ANOVA and t-test were used to compare the difference of quality of life among oral cancer patients in different general characteristics;Pearson correlation analysis was used to evaluate the relationship between QoL and its related factors in oral cancer patients;hierarchical regression analysis was used to explore the effects of influencing factors of QoL,and to explore whether the social support and resilience mediates the relationship between stigma and QoL.Finally,we use the Bootstrap method to verify the mediating effect of social support and resilience.Results:The average score of QoL of oral cancer patients was 93.04±20.02.Gender,age,marital status,residence,smoking,partial mandibular resection,and distant metastasis might be the influencing factors of QoL.After controlling the covariate variables,stigma,social support and resilience were all important influencing factors of QoL,which accounted for 38.5%,6.4%,and 5.2%variance of QoL,respectively.Moreover,both social support and resilience played an incomplete mediating role in the relationship between stigma and QoL in oral cancer patients.Conclusion:Compared with other cancer populations,patients with oral cancer were suffer from lower QoL.The stigma intensity,the ability to perceive social support and the level of psychological resilience are all factors affecting their QoL;the higher the stigma of oral cancer patients,the lower QoL;social support and psychological resilience are both positive psychological resources which could improve the mental health of patients with oral cancer and improve the QoL.In addition,social support and resilience both play an incomplete mediating role between stigma and QoL among patients with oral cacner.Therefore,the health department should pay more attention to the popularization of disease-related knowledge;medical workers should pay more attention to the patient’s psychological condition when performing routine nursing work;the family members of the patient should give patients more attention in their daily lives psychological comfort;more importantly,by mastering active coping strategies,mindfulness training and other measures to develop and improve the level of psychological flexibility to alleviate the psychological distress of patients,so as to achieve the purpose of improving the quality of life of patients.