Posttreatment Distress, Problems, and Oral Health Behavior of Oral Cancer Patients after Cancer Treatment Completion: A Multi-Centric Mixed Method Assessment

Abstract Background: Oral cancer (OC) patients experience psychological distress and poor oral health. Assessing these issues helps improve the quality of life and supportive care interventions. Aim: To analyze the association between distress and problems with time-lapsed postOC treatment, assess oral health behavior, and explore patients’ opinions on problems related to high distress. Settings and Design: Multi-centric, mixed-method study was conducted across three cancer centers, on OC patients posttreatment completion. Materials and Methods: A structured validated questionnaire of Distress Thermometer, Problem List, and Oral Health Behavior was distributed among the participants and collected once answered. Interviews were conducted on patients with high distress to explore the problems significantly associated with distress. Statistical Analysis Used: Quantitative data were analyzed to determine the associations between distress levels (DLs), time elapsed since treatment, and problem domains using t -test and ANOVA. Results: Of 370 participants, 70% were in high distress. Significant association was found between DLs and time-lapsed posttreatment ( P = 0.039). Problems related to worry, sleep disturbance, and financial difficulties showed significant associations with time since treatment ( P = 0.000). 85.1% had not visited a dentist. Depression ( P = 0.002), fear ( P = 0.000), and nervousness ( P = 0.000) were significantly associated with distress. Qualitative analysis revealed dependence, altered speech and appearance, unemployment, and poor financial status as distress contributors. Conclusion: Majority of OC patients experienced high DLs posttreatment. Distress, financial issues, worry, and sleep disturbance were related to time-lapsed posttreatment. Emotional, functional challenges, and poor oral health behavior were the key factors contributing to persistent distress.