Identification of predictors and construction of a prediction model for the quality of life in laryngeal carcinoma patients in China using revised core nursing outcomes.

Abstract

Background: This study aimed to identify potential predictors and construct a predictive model for the quality of life (QoL) in patients with laryngeal carcinoma (LC) using the revised core nursing outcomes.

Methods: We recruited 331 LC patients underwent laryngectomy between March 2018 and March 2022 from three hospitals. The revised core nursing outcomes contained 14 items in the "Physiologic Health," "Psychosocial Health," "Health Knowledge & Behavior," and "Perceived Health", while the QoL was assessed using the Chinese version of the Functional Assessment of Cancer Therapy-Head and Neck. Potential predictors of QoL were explored using logistic regression analysis, and odds ratio (OR) with 95% confidence interval (CI) was applied as effect estimates. A prediction model was constructed to predict QoL using the receiver operating characteristic (ROC) curve, and the predictive value was assessed using the area under the ROC curve (AUC).

Results: Of the 331 included patients, 137 had a poor QoL. After adjusting for potential confounding factors, we noted female sex (OR: 10.91; 95%CI: 1.24-96.14; P = 0.031), and alcohol consumption (OR: 4.55; 95%CI: 1.32-14.29; P = 0.017) were associated with an elevated incidence of poor QoL, while age 50.0-65.0 years (OR: 0.02; 95%CI: 0.00-0.15; P < 0.001), junior high school as the highest level of schooling (OR: 0.10; 95%CI: 0.03-0.33; P < 0.001), living in cities and towns (OR: 0.07; 95%CI: 0.02-0.37; P = 0.002), and partial laryngectomy (OR: 0.10; 95%CI: 0.03-0.41; P = 0.001) were associated with a lower incidence of poor QoL. Moreover, Physiologic Health score (OR: 1.16; 95%CI: 1.06-1.27; P = 0.001), Psychosocial Health score (OR: 0.48; 95%CI: 0.39-0.58; P < 0.001), Health Knowledge & Behavior score (OR: 0.92; 95%CI: 0.86-0.97; P = 0.006), and Perceived Health score (OR: 0.36; 95%CI: 0.25-0.52; P < 0.001) were associated with the incidence of QoL in LC patients. The constructed prediction model based on these factors had an AUC for predicting QoL of 0.96 (95% CI: 0.94-0.98).

Conclusions: This study found age, sex, educational status, residential location, alcohol consumption, surgical approach, and the revised core nursing outcomes are significantly associated with QoL in LC patients. The predictive value of the constructed model was high, which suggesting the clinical nurses should pay attention to the evaluation of postoperative care outcomes in order to enhance QoL.