Relationship between positive psychological traits, perceived spousal support and head and neck cancer-specific health-related quality of life: a cross-sectional study in oncology treatment settings

Objectives Data on how positive psychological traits and perceived spousal support are related to head and neck cancer (HNC)-specific health-related quality of life (QOL) using validated instruments in the Malay language in oncology settings are scarce. Hence, this study: (1) evaluated the association between demographic and clinical characteristics, optimism, posttraumatic growth (PTG), hope, perceived spousal support and HNC specific health-related QOL; and (2) assessed the mediation associations of PTG, perceived spousal support and hope on the relationship between optimism and HNC specific health-related QOL among a cohort of patients with HNC. Design Cross-sectional study. Settings This study was conducted in two tertiary referral centres for oncology treatment in Malaysia. Participants Data were collected from a total of 240 patients with HNC. Primary and secondary outcome measures The primary outcome was HNC specific health-related QOL assessed with the 35-item European Organisation for Research and Treatment of Cancer Quality of Life-Head and Neck Module, while the secondary outcomes were optimism measured with the Life Orientation Test-Revised, PTG measured with the Posttraumatic Growth Inventory-Short Form, perceived spousal support evaluated with the Sources of Social Support Scale and hope assessed with the Dispositional Hope Scale. Results Higher perceived spousal support (B=−0.454, 95% CI −0.781 to −0.126, p=0.007) and optimism (B=−2.001, 95% CI −2.660 to −1.342, p<0.001) were significantly associated with greater HNC specific health-related QOL but not PTG (p=0.772) and hope (p=0.081). In addition, those with nasopharyngeal carcinoma and those on chemotherapy alone had significantly greater HNC specific health-related QOL than those with other HNC tumours (B=−8.586, 95% CI 2.927 to 14.245, p=0.003) and those who combined surgery, chemotherapy and radiotherapy, respectively (B=−10.864, 95% CI −18.897 to −2.831, p=0.008). Meanwhile, greater perceived spousal support partially mediated the association of optimism and improved HNC-specific health-related QOL but not PTG and hope. Conclusion Optimism and perceived spousal support may have a positive association with HNC-specific health-related QOL.