Distress, quality of life, neuroticism and psychological coping are related in head and neck cancer patients during follow-up

Figures & data

Table I. Primary tumor site, education level and treatment given of the included HNSCC patients.

Tumor primary site of the included patients
Base of tongue (C01)		5
Tongue (C02)		21
Gingival (C03)		9
Oral cavity (C04-06)		13
Tonsil (C09)		24
Oro/hypopharynx (C10/12)		5
Sinus/nasal cavity/nasopharynx (C11/30–31)		6
Larynx (C32)		52
Met. unknown primary (C77)		3
Lung (C34)		1
Educational status of the included patients
Primary school		31
Blue collar		38
Secondary school		16
High school		24
College		16
Master degree		14
Treatment given to the included patients	No	Yes
Primary tumor RT	44	95
Neck radiation therapy	72	67
Primary tumor surgery	53	86
Neck dissection	87	52
Flap reconstruction	123	16

Table II. TNM stage of the included patients.

		N stage
		0	1	2	3	Total
T stage	is	2	0	4	0	6
	1	55	3	6	2	66
	2	28	3	8	0	39
	3	7	4	4	0	15
	4	6	3	4	0	13
Total		98	13	26	2	139

Table III. General health questionnaire (GHQ) and EORTC C30/H&N35 QoL sum-scores versus Eysenck personality inventory (EPI) neuroticism, selected COPE scores, sense of humor, smoked years, cigarettes smoked per week and alcohol consumption level scored by included patients.

	GHQ		EORTC QLQ sum scores
	Likert	case	C30 function	C30 symptom	H&N35
GHQ case/control	.81***
C30 function sum	−.57***	−.62***
C30 symptom sum	.52***	.56***	−.82***
H&N35 sum	.45***	.45***	−.64***	.61***
EPI Neuroticism	.59***	.51***	−.52***	.52***	.44***
EPI Lie	−.07	−.13	.21*	−.11	−.09
COPE suppression of competing activities	.43***	.31***	−.42***	.30***	.30***
COPE social support of emotional reasons	.05	.06	−.12	.13	.06
COPE behavioral disengagement	.51***	.54***	−.51***	.33***	.40***
COPE humor	−.01	.00	−.08	.06	.18*
Svebak humor questionnaire (L-scale)	.28***	.18*	−.20*	.21*	.30***
No. cigarettes smoked per week	.12	.13	−.24**	.28***	.22*
Years smoked	−.06	−.09	−.08	.17*	.11
Use of alcohol	.17	.21*	−.31***	.22**	.15

* = p<0.05, **p<0.01, ***p<0.001.

Table IV. Correlations between TNM stage, indicated given treatment and GHQ/sum QoL scores.

		EORTC QLQ sum scores
	GHQ Likert	C30 functional	C30 symptom	H&N35
T stage	.16	−.24**	.21*	.37***
N stage	.17*	−.05	−.04	.24
Local surgery (0/1)	−.03	.02	.07	−.09
Neck dissection (0/1)	.20*	−.20*	.16	.44***
Flap surgery (0/1)	.22*	−.18*	.17*	.24**
RT (0/1)	.16	−.13	.10	.41***
RT dose	.15	−.15	.12	.41***
RT primary tumor (0/1)	.15	−.13	.11	.39***
RT neck	.24**	−.15	.06	.47***

RT=radiation therapy.

= p<0.05, **p<0.01, ***p<0.001.

Table V. Individual EORTC C30/H&N35 QoL scores versus neuroticism, selected COPE scores and sense of humor scored by included patients.

EORTC QLQ index	EPI–N	COPE suppr	COPE ss emo	COPE beh dis	GHQ Likert	GHQ Case control
EORTC QLQ C30 scores
General health/QoL	−.51***	−.37***	−.04	−.38***	−.59***	−.51***
Physical functioning	−.24**	−.25**	.01	−.26**	−.28***	−.34***
Role functioning	−.37***	−.30***	−.03	−.29***	−.39***	−.44***
Emotional functioning	−.62***	−.40***	−.10	−.46***	−.60***	−.60***
Cognitive functioning	−.44***	−.21*	−.22**	−.36***	−.36***	−.46***
Social functioning	−.35***	−.37***	−.11	−.54***	−.48***	−.48***
Fatigue	.40***	.29***	.12	.32***	.43***	.46***
Nausea and vomiting	.39***	.34***	.06	.29***	.41***	.45***
Pain	.41***	.28***	.15	.34***	.34***	.40***
Dyspnoea	.22*	.12	−.01	.12	.22*	.27**
Insomnia	.47***	.21*	.09	.16	.40***	.36***
Appetite loss	.32***	.19*	.12	.18*	.38***	.40***
Constipation	.21*	.12	.08	−.08	.23*	.23*
Diarrhea	.15	.03	.09	.09	.20*	.21*
Financial difficulties	.34***	.17*	.03	.35***	.30***	.40***
EORTC QLQ H&N35 scores
Pain	.25**	.27**	.12	42***	.36***	.45***
Swallowing	.18*	.25**	−.02	.22*	.35***	.33***
Senses	.10	.17*	.09	.08	−.02	−.01
Speech	.29***	.26**	.07	.33***	.32***	.28***
Social eating	.29***	.22*	−.03	.19*	.38***	.33***
Social contact	.35***	.28***	−.12	.48***	.50***	.49***
Sexuality	.35***	.17	−.00	.29***	.28**	.29***
Teeth	.25**	−.01	−.09	.26**	.26**	.30***
Open mouth	.18*	.14	−.04	.17*	.29***	.29***
Dry mouth	.29***	.21*	.11	.28***	.29***	.24**
Sticky saliva	.21*	.19*	.07	.20*	.19*	.12
Coughing	.14	−.03	.09	−.04	.02	.08
Feeling ill	.44***	.29***	.17	.33***	.41***	.45***

Psychosocial variables as named in Table II.

* = p<0.05, **p<0.01, ***p<0.001.

Table VI. Multiple stepwise regression analysis with GHQ–Likert/QoL-sum scores as dependent variable and neuroticism, COPE scores, Svebak humor questionnaire (SHQ) (L-scale) and TNM stage as independent variables.

	GHQ .48			C30 Function sum .425			H&N35 sum .40
Adjusted r^2 total	β*	t	p	β	t	p	β	t	p
EPI Neuroticism	.41	5.9	.000	−.40	−5.6	.000	.24	4.2	.000
COPE beh. Dis.	.25	3.4	.001	−.34	−4.8	.000	.22	3.0	.004
SHQ (L scale)	.14	2.2	.027				.16	2.3	.024
COPE suppr.	.15	2.2	.034
T stage				−.20	−3.0	.003	.29	4.3	.000
N stage	.14	2.1	.042				.18	2.7	.008

Psychosocial variables as named in Table II.

*=standardized.

Figure 1. Model depicting the associations between the investigated variables. Thicknesses of lines indicate strength of association.