A Study On Family Factors Effecting Quality Of Life In Patients Without Larynx

OBJECTIVE1. Use the Chinese quality of life instrument for cancer patients-head and neck cancer(QLICP-HN) to analyze the quality of life in patients without larynx and explore the influencing factors of the quality of life. Expecting to provide a theoretical basis for patients without larynx to improve teir quality of life.2. To develop a Laryngectomy-specific Family Support Scale(LFSS), and assess its reliability and validity.Then provide a quantitative tool for Laryngectomy patients to assess their family support.3.To explore the correlatiom between quality of life in patients without larynx and their family support investigated by QLICP-HN scale and LFSS scale,and probe the effect of family sopport on quality of life in patients without larynx and propose a family-centerd care model,expecting to improve the quality of life in patients whiout larynx.METHODSA cross-sectional study was undertaken , use the questionnaire survey ,108 patients without larynx were investigated by the Chinese quality of life instrument for cancer patients-head and neck cancer(QLICP-HN) and general sociodemographic questionnaire and anlyze the influencing factors on the quality of life in patients without larynx using the single factor analysis and generalized linear regression analysis. Developed a Laryngectomy-specific Family Support Scale(LFSS) according to precedures by ourselves, then investigated 184 laryngectomy patients including 69 total laryngectomy patients and 115 partial laryngectomy patients and verified the feasibility, reliability, validity and responsiveness of LFSS scale.According to the check result , 48 patients without larynx were investigated by the Chinese quality of life instrument for cancer patients-head and neck cancer(QLICP-HN) and Laryngectomy-specific Family Support Scale(LFSS), then analyzed the correlation between family support and quality of life.RESULTS:1. The total standard score of patients without larynx was 56.34±7.40 , the score of five dimensionalities including physical function, psychological function, social function, common symptom and side-effect, special module were 49.64±15.37,51.63±15.87,54.65±17.17,69.52±13.66,57.86±10.10, copared to other head and neck cancer patients the overall score and every dimension score were relatively low expect the physical function. The economic status ,social support status,family support status,age,educational background and complication were seen to have a strong impact on the overall quality of life.2. The LFSS scale had good feasibility in evaluating the family support for laryngectomy patients.The four dimensions including moral support,therapy and care support ,material support and social activity support ,their Cronbach coefficient were ranged from 0.612 to 0.893,and their test-retest reliability were 0.827 to 0.858. While the construct validity, the dimension of the members and their dimention's correlation coefficient was above 0.6(P<0.01),except the 7th item in moral support,the 5th item in material support and the 4th item in social activity support,and the dimention and their items had low correlation with the other dimention. A Correlation Analysis between LFSS total score and the total score of Family APGAR Index and there was a significantly positive inter-relationship between them, the correlation coefficient r = 0.818 (P <0.05).There had a statistical difference between different gender or different time,(P <0.05), this showed a certain degree of reaction.3. Patients without larynx's LFSS scale total score was 61.27±19.67, which was wholly at middle level. the score of moral support, therapy and care support,material support,social activity support were 64.69±21.74 , 58.96±23.11 , 64.67±19.77 , 59.21±18.33 respectively,the score of moral support and material support were higher than the therapy and care support and social activity support.QLICP-HN QOL total score showed a significant positive correlation whith moral support, therapy and care support, material support and social activity support(r=0.504,0.416, 0.439and 0.479 respectively,P<0.01).CONCLUSION:1. The quality of life in patients whithout larynx were not optimistic, especially the psychological function and social function, there were many factors affecting the quality of life in patients without larynx , the key to improve patients without larynx's quality of life is to increase social and family support and intense community care.2. LFSS scale had a good feasibility, reliability, validity and responsiveness, could be used for laryngectomy patients to measure their family support.3.It had a positive correlation between family support and quality of life, family support had a great significance to improve the quality of life in patients without larynx. It's necessary to put forward a nursing model which can improve patients'family support and their quality of life .