Barriers to Oral Hygiene Self-Management Among Patients with Oral Cancer Treated with Radiotherapy: A Qualitative Study Using the COM-B Model.

Abstract

Purpose: This study aimed to assess the factors that hinder self-oral hygiene management behaviour in patients with oral cancer undergoing radiotherapy to inform intervention programme development.

Materials and methods: Based on the capability, motivation, and opportunity-behaviour (COM-B) model, a qualitative study was conducted involving 18 patients with oral cancer receiving radiotherapy at a tertiary hospital from March to June 2024. Semi-structured face-to-face interviews were performed to investigate the oral hygiene self-management experience of patients. The results of the interviews were assessed by visual thematic analysis using NVivo 12 software. This article complied with the consolidated criteria for reporting qualitative research (COREQ).

Results: Barriers to self-oral hygiene management in patients with oral cancer undergoing radiotherapy were grouped into three themes: (1) lack of capability (poor oral hygiene awareness, limited oral care knowledge, symptomatic distress), (2) lack of opportunity (financial burden, oral care product accessibility limitations, lack of specialised medical resources, inadequate family functioning), and (3) lack of motivation (low intrinsic motivation, heavy psychological pressure, lifestyle entrenchment).

Conclusion: The capability and motivation of patients undergoing radiotherapy for oral cancer to manage their oral hygiene must be improved, along with external resources for oral hygiene management. The medical team needs to continuously improve guidance on self-oral hygiene management to meet individual needs.