Abstract
This study aimed to investigate the factors influencing quality of life (QOL) among patients with corrosive injuries, considering the rising incidence of such cases, particularly in developing countries. Corrosive ingestion is a serious global public health problem and a common form of self-harm. This was a cross-sectional study using purposive sampling. A total of 82 patients with corrosive injuries who were admitted to the gastroenterology ward of a medical center in Taiwan between June 2018 and July 2020 completed the Perceived Stress Scale, Coping Strategy Scale, and World Health Organization Quality of Life Scale. We used an independent t-test and analysis of variance to examine the distribution and differences in demographic and disease characteristics, perceived stress, and the coping strategy scale. Multiple linear regression was then used to analyze the main predictors of QOL. The mean patient age was 58.2 (standard deviation = 2.4) years. A significant difference was observed between patients with a history of mental illness and perceived stress (P < .05). The patients were highly stressed and used emotional coping strategies to solve problems. Stress perception was significantly negatively correlated with overall QOL. Multiple linear regression analysis showed that a history of mental illness was a significant factor for overall QOL. The results of this study suggest that a history of mental illness significantly affects the QOL of patients with corrosive gastrointestinal injuries, and regular assessment and monitoring are essential.
Keywords: corrosive ingestion, gastrointestinal, mental illness, quality of life
1. Introduction
Corrosive ingestion is a serious global public health challenge and a common form of self-harm; its incidence has increased in developing countries in recent years.[1–3] Ingestion of acids or bases damages the digestive tract. The triggering factors vary according to age, with the incidence in adults mostly influenced by stress or suicidal ideation.[3,4] However, many studies have focused on the treatment outcomes and impact of corrosive injuries.[5,6]
The annual incidence of corrosive injury in Taiwan is approximately 4 to 5 cases per 100,000 people.[7] Adults have a low incidence of accidentally ingesting corrosive substances, and intentional ingestion mostly occurs in patients with suicidal tendencies or mental illness. Among Taiwanese, the incidence of esophageal strictures is as high as 50%, and the mortality rate is as high as 8%. However, cases of corrosive injury are few among foreign patients, with the ingestion of corrosive substances mostly occurs by mistake, and the swallowing volume is small; therefore, the rate of esophageal strictures is 20%, with a mortality rate of only 1%. The prognosis of patients in Taiwan is poor.[8]
Treatment methods differ according to the clinical symptoms and grades. Swallowing a small amount of corrosive substances causes severe oral burns and ulceration, leading to pain, salivation, and bleeding of the esophagus and gastrointestinal tract mucosa, which result in esophageal stricture and a higher risk of esophageal cancer. Severe cases are associated with necrosis and rupture, requiring surgical treatment.[6,9] Treatment measures may control the progression of the disease, but the symptoms, treatment, and side effects may seriously affect the patients quality of daily life (QOL).[10,11] Esophageal stenosis occurs in 70% to 80% of patients with corrosive gastrointestinal injury, which requires changes in lifestyle and diet. In addition, physical function declines after surgery, and the need to rely on assistance from others increases. The physical and mental suffering of the patients increases, which inevitably leads to hopelessness and low QOL.[12,13] Because most patients have difficulty eating, esophageal dilatation or reconstruction surgery using the large intestine can be performed, and it takes some time to resume oral feeding. However, this treatment process is time-consuming and laborious. Family members are physically and mentally affected and burdened.[14,15] Therefore, it is necessary to provide individualized care measures to allow patients to return to daily life as soon as possible to reduce the family burden and social expenditure. Nurses are the first-line healthcare providers in these cases and should assist patients in physical and mental adjustment, including stress response and QOL, to successfully control disease progression. When patients cannot self-adjust and have emotional reactions, such as anxiety and depression, their willingness to receive treatment is affected, thereby reducing their QOL.
There is a lack of literature on the stress response and QOL in patients with corrosive gastrointestinal injuries. Although patients mainly relieve their symptoms in the acute phase, the long-term recovery process can be daunting and patients may easily feel tired, which increases their emotional load and affects their QOL. This study aimed to investigate the QOL and related factors in patients with corrosive gastrointestinal injuries. The research results will be useful for clinical care and constructing empirical knowledge on corrosive gastrointestinal injuries as a reference for patient management.
2. Methods
2.1. Design
This study adopted a cross-sectional design and purposive sampling to select patients with corrosive gastrointestinal injuries. This single-center study was conducted in the gastroenterology ward of a medical center in Taiwan between June 2018 and July 2020.
2.2. Inclusion and exclusion criteria
All adult patients ( > 18 years of age) who had consecutive symptoms of erosive esophagus or gastropathy and were treated in the gastroenterology department were included in this study after obtaining written informed consent. The exclusion criteria were a < 6-month history of corrosive ingestion, unwillingness to participate in the study, poor medical condition, or being too sick to participate in the study.
2.3. Measures
All assessments were performed by a single person in the local dialect upon patient admission after the index ingestion episode to ensure that the acute physical and emotional effects of caustic ingestion had abated. The research tool was a structured questionnaire comprising basic information, a stress scale, a coping behavior scale, and a QOL scale, as described below.
2.3.1. Basic demography.
These data were drawn from references, the researcher’s own experience, and expert opinions and included sex, age, education level, religious beliefs, working status, economic and marital status, number of children, and mental illness.
2.3.2. Perceived stress scale.
The perceived stress scale, a well-known and validated tool originally developed in 1983, scores the level of subjective perceived stress (e.g., feelings and thoughts; psychological component) related to conditions and stressful life events that occurred in the last month (environmental component). Factors associated with higher perceived stress have also been described. The scale was translated by Assistant Professor Chu Lijuan of Sun Yat-sen Medical University and has good internal and test-retest reliability (the Cronbach alpha value of the original scale is between 0.84 and 0.86, and the test-retest reliability is between 0.55 and 0.85). The scoring method adopts a 5-point Likert scale; the higher the score, the higher the perceived stress of the subject. The Cronbach α value in this study was 0.94.
2.3.3. Coping strategy scale.
This study used the Jalowiec coping scale developed by Jalowiec and Powers, and Cronbach α value was 0.80.[16] It is used to measure the coping strategies for physical, psychological, social, and other pressures. It includes 40 items on coping behaviors, of which 15 items are problem-oriented and 25 items are emotional-oriented. The scale uses a 5-point scoring method, with a score range is 40 to 200 points. The higher the score, the more often a particular type of coping behavior is used. Cronbach α value in this study was 0.91.
2.3.4. QOL.
QOL was measured using the abbreviated World Health Organization Quality of Life questionnaire. The abbreviated World Health Organization quality of life questionnaire measures QOL in the domains of physical and psychological health, social relationships, and environment. The raw cores obtained were transformed into a scale of 0 to 100, with higher scores indicating better QOL. Cronbach α for the scale was 0.90, and Cronbach α for the subscales ranged from 0.83 to 0.89. Cronbach α value for the formal test of the scale was 0.92.
2.4. Ethics
The study protocol was approved by the Institutional Review Board of Chang Gung Medical Foundation of Linkou Chang Gung Memorial Hospital (approval no: 201700316B0C501). All procedures involving human participants performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1975 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all study participants.
2.5. Statistical analysis
The data were decoded and entered into a computer and checked for validity. SPSS software (version 20.0; International Business Machines Corp., Armonk, NY) was used for the statistical analysis. The statistical measures included frequency distribution, percentage, average, and standard deviation, and the scores for basic attributes, stress perception, coping strategies, and QOL were counted. One-way analysis of variance and Pearson correlation analysis were used to analyze differences in stress perception, coping strategies, and QOL scores. The variables included in the multiple linear regression analysis were the presence or absence of mental illness and perceived stress. In multiple linear analyses, P values < .05 were considered statistically significant.
3. Results
3.1. Demography and baseline data
A total of 82 patients (men: 48.8%; mean age: 58.2 ± 2.4 years) with corrosive gastrointestinal injuries were admitted to our hospital. Of all cases, 92.7% had a history of mental illness. The basic attributes and overall QOL were significantly different between those with and without a history of mental illness (P ˂ .05). In terms of the differences between the basic attributes in the 4 categories, sex showed significant differences in the psychological category, men had higher QOL scores in the psychological category than women, and age had significant differences in the physical category (P ˂ .05) (Table 1).
Table 1.
Patient demographics and quality of life (N = 82).
| Variables | M ± SD/n (%) | Physical | Psychological | Environment | Social relations | Total QoL |
|---|---|---|---|---|---|---|
| M ± SD | M ± SD | M ± SD | M ± SD | M ± SD | ||
| Sex | ||||||
| Male | 40 (48.8) | 21.2 ± 2.3 | 17.6 ± 2.2 | 26.1 ± 2.7 | 10.8 ± 1.5 | 79.0 ± 5.5 |
| Female | 42 (51.2) | 21.6 ± 2.9 | 16.4 ± 2.7 | 25.6 ± 2.5 | 10.5 ± 1.7 | 77.3 ± 5.8 |
| t/p | 0.473 | 0.031* | 0.383 | 0.321 | 0.181 | |
| Age | 58.2 ± 2.4 | ③˃②,① | ||||
| ①<44 | 26 (31.7) | 20.5 ± 2.1 | 17.4 ± 2.2 | 25.4 ± 2.2 | 10.6 ± 1.5 | 76.9 ± 4.7 |
| ②45–64 | 25 (30.5) | 21.5 ± 2.8 | 16.8 ± 2.8 | 25.7 ± 2.9 | 10.6 ± 1.6 | 78.0 ± 6.5 |
| ③≥65 | 31 (37.8) | 22.0 ± 2.8 | 16.7 ± 2.8 | 26.3 ± 2.7 | 10.7 ± 1.7 | 79.2 ± 5.7 |
| t/p | 0.045* | 0.587 | 0.427 | 0.698 | 0.221 | |
| Education level | ||||||
| Under junior high school | 51 (62.2) | 21.6 ± 2.8 | 17.0 ± 2.7 | 26.2 ± 2.8 | 10.7 ± 1.7 | 78.9 ± 6.3 |
| High school (vocational) | 16 (19.5) | 21.0 ± 2.3 | 17.4 ± 2.2 | 24.8 ± 1.9 | 10.4 ± 1.5 | 76.7 ± 3.5 |
| Junior college | 15 (18.3) | 21.1 ± 2.5 | 16.3 ± 2.1 | 25.7 ± 2.4 | 10.7 ± 1.3 | 76.9 ± 5.3 |
| t/p | 0.458 | 0.533 | 0.315 | 0.809 | 0.145 | |
| Religious | ||||||
| No | 18 (22.0) | 20.7 ± 1.8 | 17.2 ± 2.8 | 24.8 ± 2.7 | 10.1 ± 1.2 | 76.2 ± 6.1 |
| Yes | 64 (78.0) | 21.6 ± 2.8 | 16.9 ± 2.5 | 26.1 ± 2.5 | 10.8 ± 1.7 | 78.6 ± 5.5 |
| t/p | 0.349 | 0.741 | 0.197 | 0.062 | 0.120 | |
| Work | ||||||
| Yes | 26 (31.7) | 21.0 ± 2.4 | 16.5 ± 2.3 | 25.7 ± 2.2 | 10.4 ± 1.7 | 76.6 ± 4.7 |
| No | 56 (68.3) | 21.6 ± 2.7 | 17.1 ± 2.6 | 25.9 ± 2.8 | 10.8 ± 1.5 | 78.8 ± 6.0 |
| t/p | 0.318 | 0.284 | 0.700 | 0.387 | 0.103 | |
| Economic status | ||||||
| ① Well | 12 (14.6) | 20.8 ± 2.0 | 16.0 ± 1.6 | 25.5 ± 2.3 | 10.6 ± 1.3 | 76.3 ± 4.0 |
| ② Enough | 52 (63.4) | 21.7 ± 2.8 | 17.1 ± 2.5 | 26.0 ± 2.5 | 10.6 ± 1.6 | 78.4 ± 5.9 |
| ③ Inadequate | 18 (22.0) | 20.9 ± 2.3 | 17.2 ± 3.0 | 25.6 ± 3.2 | 10.9 ± 1.7 | 78.3 ± 6.1 |
| t/p | 0.981 | 0.264 | 0.949 | 0.555 | 0.396 | |
| Marital status | ||||||
| Single | 43 (52.4) | 21.4 ± 2.6 | 17.0 ± 2.7 | 26.1 ± 2.6 | 10.4 ± 1.6 | 78.3 ± 5.5 |
| Married | 39 (47.6) | 21.3 ± 2.6 | 16.9 ± 2.4 | 25.5 ± 2.6 | 10.9 ± 1.6 | 77.8 ± 5.9 |
| t/p | 0.853 | 0.957 | 0.314 | 0.173 | 0.691 | |
| Number of children | ||||||
| 0 | 15 (18.3) | 21.1 ± 2.5 | 16.3 ± 2.1 | 25.7 ± 2.4 | 10.7 ± 1.3 | 76.9 ± 5.3 |
| ≤2 | 36 (43.9) | 21.3 ± 2.6 | 16.6 ± 2.6 | 25.6 ± 3.0 | 10.8 ± 1.7 | 77.9 ± 6.4 |
| >2 | 31 (37.8) | 21.6 ± 2.8 | 17.6 ± 2.6 | 26.1 ± 2.2 | 10.5 ± 1.5 | 78.4 ± 5.1 |
| t/p | 0.575 | 0.069 | 0.602 | 0.544 | 0.267 | |
| History of mental illness | ||||||
| No | 6 (7.3) | 23.0 ± 2.8 | 18.0 ± 1.9 | 26.0 ± 4.0 | 11.3 ± 0.8 | 82.8 ± 5.3 |
| Yes | 76 (92.7) | 21.3 ± 2.6 | 16.9 ± 2.5 | 25.8 ± 2.5 | 10.6 ± 1.6 | 77.7 ± 5.6 |
| t/p | 0.113 | 0.158 | 0.523 | 0.316 | 0.015* | |
QOL = quality of life, SD = standard deviation.
P < .05.
3.2. Perceived stress, coping strategies, and QOL score analysis
Among patients with corrosive gastrointestinal injury, the mean perceived stress score was 61.1 ± 3.5 points, and the use of overall coping strategies had a score range of 96 to 173 points. The emotional coping strategy had a higher frequency than the problem-oriented coping approach. The QOL scores ranged from 62 to 94 points, with an average total score of 78.1 ± 5.7 points. The order of QOL scores from high to low was as follows: physical health, environment, mental health, and social relationships (Table 2).
Table 2.
Perceived stress, coping strategies, and quality of life score analysis (N = 82).
| Item | Score range | Mean | SD | Standardized score* | Sequence |
|---|---|---|---|---|---|
| Perceived stress | 54–69 | 61.1 | 3.5 | ||
| Coping strategies | 96–173 | 126.2 | 14.2 | ||
| Emotional | 70–135 | 96.4 | 11.1 | 77.1 | 1 |
| Problem | 16–42 | 29.8 | 7.7 | 39.7 | 2 |
| Quality of life | 62–94 | 78.1 | 5.7 | ||
| Physiological | 17–28 | 21.4 | 2.6 | 61.1 | 1 |
| Mental | 12–22 | 16.9 | 2.5 | 56.3 | 3 |
| Environmental | 18–32 | 25.8 | 2.6 | 57.3 | 2 |
| Social relations | 6–14 | 10.6 | 1.6 | 53.0 | 4 |
SD = standard deviation.
Standardized score = (mean × 100) divided by the total score of the subscale (M × 100/total score).
3.3. Relationship between perceived stress, coping strategies, and QOL
Perceived stress was significantly negatively correlated with overall QOL (r = −.252, P ˂ .05) (Tables 3). The higher the degree of perceived stress, the lower the overall QOL. The use of emotional or problem-oriented coping strategies and overall coping had no correlation with QOL.
Table 3.
Relationship between perceived stress, coping strategies, and quality of life.
| Variable | Perceived stress | Emotional | Problem | Total coping strategies |
|---|---|---|---|---|
| r | r | r | r | |
| Physiological | −.009 | −.017 | 0.025 | −.004 |
| Mental | −.108 | 0.035 | −.025 | 0.021 |
| Environmental | −.102 | −.033 | 0.050 | −.007 |
| Social relations | −.038 | −.039 | 0.062 | −.007 |
| Total QoL | −.252* | 0.123 | 0.098 | 0.071 |
QOL = quality of life.
P˂.05.
3.4. Factors influencing quality of life in patients with esophageal corrosive injuries
This study examined the impact of various factors on the QOL of patients with esophageal corrosive injuries. Following chi-square tests and Pearson correlation coefficient analysis, we initially considered variables such as a history of mental illness and the perceived level of stress. We hypothesized that these variables would influence the QOL of patients with esophageal corrosive injuries. The results of multiple linear regression analysis revealed that a history of mental illness significantly influences the QOL of patients with esophageal corrosive injuries. This factor comprised 20.1% of the total variance in overall QOL (Table 4).
Table 4.
Multiple regression analysis results on the overall quality of life of patients with corrosive gastrointestinal injury.
| Variable | R 2 | Adjust R2 | F | B | Standard error | β | t |
|---|---|---|---|---|---|---|---|
| Perceived Stress | 0.019 | 0.007 | 1.59 | −2.82 | 0.22 | −0.14 | −1.26 |
| Mental illness | 0.211 | 0.201 | 21.33 | −31.43 | 6.81 | −0.46 | −4.62* |
P < .05.
4. Discussion
This study found that the QOL of patients with corrosive gastrointestinal injury is related to a history of mental illness and the degree of perceived stress, and a history of mental illness was responsible for 20.1% of the total variation in overall QOL. The average QOL of the patients was 78.1 ± 5.7 points, which is higher than that reported by Anand et al[17] using the same QOL tool. The difference could be due to the varied circumstances of each study regarding the enrollment of the participants. This study was conducted when patients were hospitalized for corrosive injuries. Patients may have focused on symptom relief and treatment in the acute phase and had no obvious perception of QOL. However, in the study by Anand et al,[17] when patients were admitted to the outpatient clinic for esophageal corrosive injury for more than 6 months, they were discharged from the hospital and returned home to resume their normal lives, which may explain the difference in the QOL experience. In the present study, the QOL in the category of social relations was low, followed by the category of mental health, environment, and physical health. This shows that patients were worried about follow-up social relationships and psychological levels during acute hospitalization. The results are similar to those of Anand et al,[17] who discussed patients with corrosive esophageal strictures treated with endoscopic dilatation. However, the research results differ from those of Ohkura et al,[18] probably because of different population groups, as they focused on patients with esophageal cancer. Patients with cancer are likely to experience a decline in their mental health-related QOL.
The study found that patients with corrosive gastrointestinal injury experienced pain and discomfort. In addition, wounds around the lips or chin affected their esthetic appearance, which further lowered their QOL in the social relations category. Other side effects, such as treatment-induced dysphagia and reduced appetite, also cause functional decline and changes in social skills.[19–21] Provision of care to these patients is difficult, and healthcare providers adopt supportive treatment. Given the treatment challenges of corrosive gastrointestinal injury, prevention is better than cure; thus, strong acid and alkali items should be clearly marked, not repackaged, and stored safely. Physicians should offer patients with mental illness support in drug control and strengthening of family care.[8] Therefore, the implementation of relevant intervention measures during treatment and recovery is to improve the patient’s functional status, reduce the number of cases of accidental ingestion or intentional suicide, and increase social relations.
There were more women than men in the present study, with an average age of 58.2 ± 2.4 years. No significant differences were observed in the basic characteristics or QOL of the patients. In addition, patients with a history of mental illness had lower overall QOL scores and perceived stress levels than those without a history of mental illness. As reported previously, a significant negative correlation was observed between perceived stress level and overall QOL.[18,20,22,23] Some studies have reported that various sociodemographic variables affect the QOL of patients with gastrointestinal corrosive injuries. On the other hand, a significant sex difference was found in the psychological aspect of QOL, with men scoring higher than women in this study. Unlike previous research, there were no similar findings or discussions. This difference may be attributed to the personal traits of the male participants, including their personality or societal expectations. Men may exhibit better psychological adaptation than women in dealing with illnesses of this nature, leading to sex-related disparities. Healthcare professionals should provide individualized treatment and rehabilitation plans based on patients specific needs and conditions to enhance their QOL. Bilal et al[24] found that factors related to patients’ QOL were treatment method, marital status, work type, and age. In addition, family economy and marital status were also observed to affect the patients QOL.[25] The patient’s own will, assistance of family members, and care of the medical team affect the treatment outcomes. Moreover, healthcare providers should help patients formulate a care demand plan and focus on life changes after treatment and surgery,[26] which will consequently improve the patients physical health and psychological stress.
The average perceived stress score of patients with corrosive gastrointestinal injury in the present study was 61.1 ± 3.5 points, indicating high perceived stress. Previous research has not explored the level of stress in patients with corrosive gastrointestinal injury. Ohkura et al[18] studied patients with esophageal cancer. Anand et al[17] reported that the degree of psychological distress in patients with corrosive esophageal strictures treated with endoscopic dilatation was relatively high. These findings indicate that the accidental or intentional ingestion of corrosive liquids results in a high degree of stress in patients. When hoarseness or stridor occurs, the throat and epiglottis may be invaded. Aspiration pneumonia may lead to esophageal and gastrointestinal mucosal bleeding, resulting in esophageal strictures. In addition, these patients are at a higher risk of esophageal cancer. In severe cases, necrosis and rupture may occur, requiring subsequent surgery and rehospitalization.[9] Therefore, nurses should assess the source of personal stress before the patient is hospitalized, remove the source of stress promptly, provide relevant assistance, and seek social resources to address the impact of the current physical condition and economic ability. Some of the interventions, in this case, include the involvement of hospital social workers or related medical subsidies to reduce perceived stress and increase the patients QOL.
Regarding coping strategies, studies have shown that patients mostly use emotional orientation. Lazarus and Folkman[27] stress coping theory states that individuals generally adopt emotion-oriented coping for unchangeable situations and problem-oriented coping to deal with changeable situations. Although long-term observation and treatment are required after gastrointestinal corrosive injury, proper control of the complications can alleviate the deterioration of the patients clinical course and the risk of related complications.[28] Nurses should provide emotional channels to face the illness, adopt coping strategies to solve problems, correctly solve problems, and plan for the future.
The results of this study only represent the QOL of patients at a certain point in time, and it is difficult to understand the changes in the QOL. Owing to manpower and time considerations, this study adopted a cross-sectional design. Thus, a longitudinal design should be adopted for long-term follow-up. Moreover, the significant factors identified in this study need to be explored further. In addition, future assessments of the QOL should consider the patients’ inner feelings and thoughts, as this may help discover other factors influencing the patients QOL.
Our results suggest that the risk of developing a psychiatric disorder can be inferred with reasonable accuracy using the clinical factors investigated in this study. Therefore, the preliminary results may be important for patient care in the future and can increase the accumulation of clinical data useful for improving the psychological aspects of recovering patients.
This study demonstrated that perceived stress and mental illness were significantly associated with QOL in patients with corrosive injuries. Thus, nursing staff should continue to evaluate relevant symptoms, pay attention to individual differences, and actively provide treatment measures and health education guidance to such patients to alleviate adverse effects. They can also teach family members or main caregivers about the best practices in caring for the patients. In particular, those in the acute phase of hospitalization must pay attention to the impact of frequent courses of treatment on patients, as well as their needs, and provide referrals or community resources, when necessary, to help them cope with the possible problems caused by the treatment process and improve their QOL. In addition to teaching theories related to corrosive injury care, education on empirical research and the application of physical and mental symptom distress assessment and treatment measures should be provided in clinical education. The present study has some limitations. There are only a few reports on QOL in patients with corrosive injury, and this study’s single-center design and small sample size were limitations. An external validation study or an international multicenter trial with more cases is needed to confirm our observations. Second, several factors potentially associated with the psychological distress related to corrosive injury treatment could not be controlled for in this study. Nevertheless, our results confirm that the risk of psychological distress can be estimated with reasonable accuracy using the clinical factors investigated in this study. Therefore, our preliminary risk analysis could be useful for risk stratification in actual clinical settings. The prospective accumulation of clinical data using this model could provide important information for the improved psychological management of patients undergoing treatment for corrosive injury.
Acknowledgments
The authors would like to thank the participants who completed the intervention.
Author contributions
Conceptualization: Wen-Chuan Hsu, Hao-Tsai Cheng, Chiu-Tzu Lin, Jui-Hsiang Lin, Hsiao-Yean Chiu, Wen-Pin Yu.
Data curation: Wen-Chuan Hsu, Hao-Tsai Cheng.
Formal analysis: Wen-Chuan Hsu, Hao-Tsai Cheng, Jui-Hsiang Lin, Yen-Yi Lu.
Investigation: Wen-Chuan Hsu, Hao-Tsai Cheng, Jui-Hsiang Lin, Hsiao-Yean Chiu, Yen-Yi Lu.
Methodology: Hao-Tsai Cheng, Chiu-Tzu Lin, Hsiao-Yean Chiu, Wen-Pin Yu.
Project administration: Wen-Chuan Hsu, Hao-Tsai Cheng, Jui-Hsiang Lin, Hsiao-Yean Chiu, Yen-Yi Lu.
Resources: Hao-Tsai Cheng.
Software: Wen-Chuan Hsu, Hsiao-Yean Chiu, Yen-Yi Lu.
Supervision: Chiu-Tzu Lin, Wen-Pin Yu.
Validation: Hao-Tsai Cheng, Hsiao-Yean Chiu.
Visualization: Hao-Tsai Cheng, Jui-Hsiang Lin, Hsiao-Yean Chiu.
Writing – original draft: Wen-Chuan Hsu, Yen-Yi Lu.
Writing – review & editing: Wen-Chuan Hsu, Hsiao-Yean Chiu, Yen-Yi Lu.
Abbreviation:
- QOL
- quality of life
All data generated or analyzed during this study are included in this published article [and its supplementary information files].
The authors have no funding and conflicts of interest to disclose.
How to cite this article: Hsu W-C, Cheng H-T, Lin C-T, Lin J-H, Chiu H-Y, Yu W-P, Lu Y-Y. Factors affecting quality of life among patients with corrosive injury. Medicine 2024;103:1(e36853).
Contributor Information
Wen-Chuan Hsu, Email: d432109003@tmu.edu.tw.
Hao-Tsai Cheng, Email: hautai@cgmh.org.tw.
Chiu-Tzu Lin, Email: a0938057540@gmail.com.
Jui-Hsiang Lin, Email: a0938057540@gmail.com.
Hsiao-Yean Chiu, Email: hychiu0315@tmu.edu.tw.
Wen-Pin Yu, Email: ithanyang0820@yahoo.com.tw.
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