Comparisons of Performance Status, Pain, Nutrition Impact Symptoms, Sleep Quality, and Nutritional Status between Adult and Older Adult Patients with Head and Neck Cancer


  • Areeya Prasertsang Mahidol University
  • Virapun Wirojratana Mahidol University
  • Prangtip Chayaput Mahidol University
  • Phawin Keskool Mahidol University


Adult, Comparison, Head and neck cancer, Older adult, Roy adaptation model


This research aimed to investigate the differences among performance status, pain, nutrition impact symptoms, sleep quality and nutritional status in 140 adult and older adult patients with head and neck cancer in a single tertiary hospital, Bangkok. A sample was enrolled regarding study criteria which comprised of 75 adults (53.6%) and 65 older adults (46.4%). The Roy Adaption Model was employed as a conceptual framework of study. Data were collected using the Palliative Performance Scale for Adult Suandok version, the Short-Form McGill Pain Questionnaire-Thai version, the Head and Neck Patient Symptom Checklist, the Pittsburgh Sleep Quality Index and the Mini-Nutritional Assessment-Short Form. Data analysis for comparing differences between groups was performed using Two Way ANOVA.

The results reported that adult and older adult groups had average ages of 47.61 years (SD=9.09) and 70.58 years (SD=7.40). Most of them were males (77.3% and 72.3%, respectively). Concerning clinical data, tumor sites and histological findings differed significantly (χ2 = 19.108, p = .003 and χ2 = 19.512, p = .001, respectively). Comparative analyses after controlling tumor sites and histological findings revealed no differences among performance status, pain, nutritional impact symptoms, sleep quality and nutritional status between adult and older adult groups (p>.05). In conclusion, even though, selected study factors demonstrated some alterations regarding adaptation, no statistical differences found between two age groups.


Download data is not yet available.


Economopoulou P, Psyrri A. Epidemiology, risk factors and pathogenesis of squamous cell tumours. In: Licitra L, Karamouzis MV, editors. Logano, SZ: European Society for Medical Oncology; 2017.

Tangjaturonrasme N, Vatanasapt P, Bychkov A. Epidemiology of head and neck cancer in Thailand. Asia Pac J Clin Oncol. 2018;14(1): 16-22.

Bressan V, Bagnasco A, Aleo G, Catania G, Zanini MP, Timmins F, et al. The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis. Support Care Cancer. 2017;25(5):1699-712.

Khemthong U, Chayaput P, Chanruangvanich W, Chuthapisith S. Influence of degrees of pain, type of food and oral health on postoperative oral cancer patients’ consumption of food. Thai Journal of Nursing Council. 2015;30(2): 60-74. (in Thai)

Rojanapan K, Chayaput P, Kimpee S, Ieumwananonthachai N. Influences of staging, neck node metastasis, receiving opioid medication, and radiation technique on nutritional status in head and neck cancer patients. Thai Journal of Nursing Council. 2013;28(2):13-29. (in Thai)

Tana-amornpong C, Kimpee S, Chayaput P, Wongkongkam K, Keskool P. Correlation between cancer care needs, tongue condition, comorbidity and oral functional status in post-operative tongue cancer and mouthfloor cancer patients. Thai Journal of Nursing Council. 2014;29(1):67-81. (in Thai)

Assantachai P. The common Health problems in elderly and prevention. 5th ed. Bangkok: Union Creation; 2017. (in Thai)

Roy C, Bakan G, Li Z, Nguyen TH. Coping measurement: creating short form of coping and adaptation processing scale using item response theory and patients dealing with chronic and acute health conditions. Appl Nurs Res. 2016;32:73-9.

Molton IR, Terrill AL. Overview of persistent pain in older adults. Am Psychol. 2014;69(2): 197-207.

Leslie W, Hankey C. Aging, nutritional status and health. Healthcare. 2015;3(3):648-58.

Kubrak C, Olson K, Baracos VE. The head and neck symptom checklist(c): an instrument to evaluate nutrition impact symptoms effect on energy intake and weight loss. Support Care Cancer. 2013;21(11):3127-36.

Roy C. The Roy adaptatation model. Upper Saddle River, NJ: Pearson; 2008.

Griffiths J, Putthioi S, Pongsuksri M. The General Practitioner Assessment of Cognition; GP-COG (Thai version): validity and reliability. Chiangmai: Faculty of Associated Medical Sciences, Chiang Mai University; 2013. (in Thai)

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.

Chewaskulyong B, Sapinun L, Downing GM, Intaratat P, Lesperance M, Leautrakul S, et al. Reliability and validity of the Thai translation (Thai PPS Adult Suandok) of the Palliative Performance Scale (PPSv2). Palliat Med. 2011;26(8):1034-41.

Kitisomprayoonkul W, Klaphajone J, Kovindha A. Thai short-form McGill pain questionnaire. J Med Assoc Thai. 2006;89(6):846-53.

Chen D, Yin Z, Fang B. Measurements and status of sleep quality in patients with cancers. Support Care Cancer. 2018;26(2):405-14.

Rubenstein LZ, Harker JO, Salvà A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the shortform mini-nutritional assessment (MNA-SF). J Gerontol. 2001;56(6):M366-M72.

Saxon SV, Etten MJ, Perkins EA. Physical change and aging: a guide for the helping profession. 6th ed. New York: Springer; 2015.

Langley P. The prevalence, correlates and treatment of pain in the European Union. Curr Med Res Opin. 2011;27(2):463-80.

Krok JL, Baker TA, McMillan SC. Age differences in the presence of pain and psychological distress in younger and older cancer patients. J Hosp Palliat Nurs. 2013;15(2):107-13.

Cataldo JK, Paul S, Cooper B, Skerman H, Alexander K, Aouizerat B, et al. Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study. BMC cancer. 2013; 13(6):1-16.

Shuman A, Duffy S, Ronis D, Garetz S, McLean S, Fowler K, et al. Predictors of poor sleep quality among head and neck cancer patients. Laryngoscope. 2010;120(6):1166-72.

de Matos-Neto EM, Lima JD, de Pereira WO, Figuerêdo RG, Riccardi DMdR, Radloff K, et al. Systemic inflammation in cachexia: is tumor cytokine expression profile the culprit. Front Immunol. 2015;6(629):1-11.

Soowit B, Pongsathonviboon K, Wangkachornkiat C, Panasakulkan S. Needs assessment of spiritual well-being in head and neck cancer patients, Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Journal of The Royal Thai Army Nurses. 2017;18(2):194-202. (in Thai)




How to Cite

Prasertsang A, Wirojratana V, Chayaput P, Keskool P. Comparisons of Performance Status, Pain, Nutrition Impact Symptoms, Sleep Quality, and Nutritional Status between Adult and Older Adult Patients with Head and Neck Cancer. J Royal Thai Army Nurses [Internet]. 2021 Dec. 29 [cited 2023 Dec. 10];22(3):160-7. Available from:



Research Articles