Screening for levels of social difficulties and unemployment in head and neck cancer patients by University of Washington Quality of Life Questionnaire (UW-QOL): Current status and cut-off point establishment.

Background/purpose: Social function and employment are vital to the quality of life in head and neck cancer (HNC) survivors. This study aimed to (1) assess the status of social difficulties (including getting along with others, social participation and unemployment); (2) examine their associations with the University of Washington Quality of Life Questionnaire (UW-QOL); and (3) establish UW-QOL cut-off points for identifying social difficulties after primary treatment. Materials and methods: The cross-sectional study was conducted at a medical center in Taiwan, involving HNC survivors under 65 years who completed primary treatments. Data collection included the UW-QOL, the "getting along" and "social participation" subscales of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), employment status, and demographic and clinical characteristics. Results: A total of 164 HNC survivors was recruited. Among them, 49.4 % reported difficulty in social participation, 20.7 % had difficulty getting along with others, and 25.6 % were unemployed. UW-QOL scores were highly correlated with the two social function subscales and significantly differed between employed and unemployed individuals. UW-QOL cut-off scores indicating mild to severe difficulty were 75.0, 73.3, and 63.9 for social participation; 63.9, 60.8, and 58.5 for getting along; and 76.8 for unemployment. Conclusion: The study showed that social difficulties are a concern for HNC survivors. Importantly, the study provides strong evidence to support that UW-QOL can be used to concurrently assess for QOL and the main social difficulties through the cut-off points in UWQOL.