Symptom Severity and Demoralization Associated With Functional Ability Impairment in Oral Cancer Patients

Background: Oral cancer (OC) is the most common head and neck cancer and is associated with the highest recurrence rate of cancers of this type. OC recurrence and its treatment may cause symptoms and demoralization that result in impaired functional ability. Purpose: This study was designed to: (1) assess symptom severity, demoralization, and functional impairment in patients with recurrent OC, (2) identify factors associated with functional impairment, and (3) compare functional impairment among patients with recurrent OC with respect to work status and number of cancer recurrences. Methods: In this cross-sectional study, data collected by convenience sampling of patients with recurrent OC at a cancer center in Northern Taiwan were used. Assessments included the World Health Organization Disability Assessment Schedule 2.0, the Symptom Severity Scale, the Demoralization Scale, the Karnofsky Performance Status Index, and demographic and clinical information. Results: Being of older age, working as a laborer, having a higher level of symptom severity, being affected by demoralization, or having a higher level of demoralization were identified as significant risk factors for functional impairment. Unemployed participants faced a higher risk of functional impairment in the realms of cognition, mobility, self-care, getting along with people, life activities, and participating in society than their employed peers. Conclusions: The findings indicate that patients with recurrent OC who are older, do manual labor, have more severe symptoms, or have higher levels of demoralization face a significantly higher risk of functional impairment. Health care professionals should be aware of patients’ age, symptoms, and demoralization status and monitor related changes during disease-free survival.