Factors associated with delay in presentation among patients for oral cancer

2019 ◽  
Vol 8 (12) ◽  
pp. 1003-1071
Author(s):  
Xinyan Zhang ◽  
Dongling Liu ◽  
Hongmei Dong ◽  
Yuxiang Li ◽  
Ye Zhang ◽  
...  

Aim: This study aimed to determine factors that influence delay in presentation among oral cancer patients. Materials & methods: A cross-sectional study with 128 Oral cancer patients receiving treatment from the Hospital of Stomatology, at Jilin University, in China, was conducted. Results: A total of 78 patients delayed seeking treatment for more than 3 weeks after noticing symptoms of oral anomaly. Patients who were male, farmers (Odds ratio [OR] = 2.617; 95% CI: 1.90–3.64), or currently smoking (OR = 4.651; 95% CI: 1.21–9.46), were more likely to delay. Patients alerted to the problem at a physical exam had much lower risk of delay than patients who discovered the disease independently (OR = 0.029; 95% CI: 0.01–0.30). Higher coping style scores (OR = 0.747; 95% CI: 0.47–1.18) and oral cancer knowledge scores (OR = 0.886; 95% CI: 0.60–2.01) were significantly correlated with shorter delays. Conclusion: Delay in presentation may be achieved through regular oral health screening and improved public education about factors influencing delay.

2020 ◽  
Author(s):  
Ying Zhang ◽  
Chun-Ying Cui ◽  
Yu Wang ◽  
Lie Wang

Abstract BackgroundImprovement of quality of life (QoL) has been one of goals in health care for people living with oral cancer. This study aimed at assessing the QoL and investigate the effects of stigma, hope, social support on QoL among Chinese oral cancer patients. MethodsA multiple center cross-sectional study was conducted at the Department of Stomatology, Shengjing Hospital of China Medical University and Stomatology Hospital of China Medical University in Liaoning province, China between May 2016 and October 2017. A total of 230 oral cancer patients were recruited to complete a questionnaire including the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), the Social Impact Scale (SIS), the Herth Hope Index (HHI) and the Multidimensional Scale of Perceived Social Support (MSPSS). Univariate one-way ANOVA/t-test, Person’s r and hierarchical linear regression analysis were conducted to explore the influence factors of QoL and the relationships between stigma, hope, perceived social support and QoL. ResultsThe mean QoL score was 90.85±20.15 among the patients with oral cancer. Stigma was negatively related to QoL, explaining 39.3% of the variance. In addition, hope and perceived social support were positively associated with QoL, explaining 8.1% of the variance.ConclusionOverall, Chines patients with oral cancer are suffering from a relatively low level of QoL. Stigma was significantly and negatively associated with QoL, while hope and perceived social support were positively associated with QoL. Oral cancer patients’ psychological status should be addressed and adequate intervention based on positive psychological resources should be provided to improve the QoL of patients with oral cancer.


Author(s):  
Shivaraj Nallur Somanna ◽  
Nandakumar Bidare Sastry ◽  
Ramesh Cheluvarayaswamy ◽  
K. S. Sabitha ◽  
Murthy Nandagudi Srinivasa ◽  
...  

Background: Oral cancer is one of the major health problems in India. Patient delay in seeking medical help usually contributes to late stage at diagnosis, high mortality and low survival. Our study aims to find the time span from first onset of oral cancer symptoms to cancer specific primary treatment.Methods: A cross-sectional study was carried out from October 2015-September 2016 in one of the tertiary care cancer center in Bangalore. Histopathologically confirmed 212 incident oral cancer patients were interviewed using a pre-tested semi structured questionnaire.Results: The median time span between onset of symptoms and seeking medical care was 60 [IQR 30, 104] days, the median time between seeking medical care and diagnosis was 30 [IQR 15, 90] days, and the median time between diagnosis and initiation of treatment was 20 [IQR 12, 33] days.Conclusions: There is considerable delay in seeking cancer specific primary treatment among oral cancer patients. Efforts should be undertaken to increase awareness in the population and all stakeholders regarding symptoms and improve early diagnostics and access to care.


2020 ◽  
Author(s):  
Lulu Yuan ◽  
Bochen Pan ◽  
Weiren Wang ◽  
Lie Wang ◽  
Xujie Zhang ◽  
...  

Abstract Background Anxiety and depression are common mental health related problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. Objective To explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms, and to identify the sequence of their contributions. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test, Spearman test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms. Results The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Age (β=0.047, OR=1.049, CI:1.013~1.086), gender (β=1.146, OR=3.147, CI:1.196~8.278), social isolation dimension of stigma (β=0.546, OR=1.726, CI:1.318~2.260), optimism (β=-0.310, OR=0.734, CI:0.594~0.906), and perceived stress (β=0.239, OR=1.270, CI:1.105~1.459) were predictors of anxiety symptoms. Marriage (β=1.158, OR=4.749, CI:1.301~17.330), positive readiness and expectancy dimension of hope (β=-0.476, OR=0.621, CI:0.401~0.961), social isolation dimension of stigma (β=0.329, OR=1.390, CI:1.060~1.823) and perceived stress (β=0.263, OR=1.300, CI:1.138~1.501) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of depressive symptoms was higher than anxiety symptoms among oral cancer patients in China. In addition to higher level of perceived stress and social isolation leading to anxiety and depressive symptoms, lower level of optimism not hope might lead to anxiety symptoms and lower level of hope, especially lower level of active action, might lead to depressive symptoms in oral cancer patients.


Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.


2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia.Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors.Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05.Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.


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