DOI: 10.6084/m9.figshare.14134952.v1
title: Illness-related stressors, perception regarding chemotherapy received, and posttraumatic growth among head and neck cancer patients

description: This cross-sectional study investigated the degree of PTG among head and neck cancer patients within 1 year of the cancer diagnosis and treatment with chemotherapy. While controlling for confounding sociodemographic and clinical factors, it also determined the association between the physical symptoms and complications of head and neck cancer and its treatment; expectations, experience of side effects, and satisfaction related to chemotherapy; and PTG. <br>Subject sampling was carried out by consecutive sampling. Patients diagnosed with head and neck cancer who presented to the targeted centers were approached by the research team and screened for eligibility criteria. Those who met all the eligibility criteria were informed of the study procedures, study purposes, researchers’ responsibility, and rights of the participants and assured anonymity. Those who voluntarily agreed to participate in the study signed written informed consent for study participation before they were enrolled in the study. This study received approval from the Medical Research Committee of the Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2019-279), and the Human Research Ethics Committee of USM (USM/JEPeM/18100483) and abided by the ethical principles for medical research involving human subjects according to the Declaration of Helsinki and subsequent amendments. <br>A total of 200 participants completed the study. Data on the sociodemographic and clinical characteristics of the participants were collected, including gender, age, religion, education level, type of head and neck cancer, duration of diagnosis, stage of cancer, and modes of treatment received. In addition, the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire—Head and Neck 35 module (EORTC-QLQ-H&N-35) was administered to assess the perceived health-related QoL in terms of the physical symptoms and complications of head and neck cancer and its treatment; the Cancer Treatment Satisfaction Questionnaire (CTSQ) was administered to measure the degree of satisfaction with chemotherapy, experience of side effects, and treatment expectations; and the Posttraumatic Growth Inventory—Short Form (PTGI-SF) was administered to evaluate the degree of PTG among the participants. <br>Descriptive statistics for sociodemographic and clinical characteristics, the EORTC-QLQ-H&N-35 subscale and single-item scores, the CTSQ domain scores, and the total PTGI-SF score were reported. The categorical variables were reported in frequency and percentage, while the continuous variables were computed in mean and standard deviation (SD). Hence, objective 1 of the study was achieved. To achieve objective 2, initially, univariate linear regression analysis was applied to determine the association between individual confounding sociodemographic and clinical variables (independent variables) and the total PTGI-SF score (dependent variable). Variables with <i>p</i> &lt; 0.25 were considered statistically significant. Then, two multiple linear regression models were constructed as follows:(1) Model 1 included the EORTC-QLQ-H&N-35 subscale and single-item scores, as well as the CTSQ domain scores, as independent variables, and the total PTGI-SF score as the dependent variable, while adjusting for confounding sociodemographic and clinical variables that were not significantly associated with PTG in the univariate analysis (<i>p</i> &gt; 0.25), including religion, type of head and neck cancer, stage of cancer, and mode of treatment. (2) Model 2 included all variables as in model 1 and adjusted for sociodemographic and clinical variables that were significantly associated with PTG in the univariate analysis (<i>p</i> &lt; 0.25), including gender, age, education level, and duration of diagnosis. Statistical significance was set at <i>p</i> &lt; 0.05 for the two multiple linear regression models and were two-sided. <b> </b> <br>