# Barriers to Oral Hygiene Self-Management Among Patients with Oral Cancer Treated with Radiotherapy: A Qualitative Study Using the COM-B Model

## TL;DR

This study explores why patients with oral cancer undergoing radiotherapy struggle to manage their oral hygiene, using a model that considers capability, motivation, and opportunity.

## Contribution

The study applies the COM-B model to identify barriers to oral hygiene self-management in oral cancer patients undergoing radiotherapy.

## Key findings

- Barriers include poor awareness, limited knowledge, and symptomatic distress.
- Financial burden and lack of specialized resources also hinder oral hygiene management.
- Low motivation and psychological pressure further impede self-care efforts.

## Abstract

Based on the capability, motivation, and opportunity-behaviour (COM-B) model, a qualitative study was conducted involving 18 patients with oral cancer receiving radiotherapy at a tertiary hospital from March to June 2024. Semi-structured face-to-face interviews were performed to investigate the oral hygiene self-management experience of patients. The results of the interviews were assessed by visual thematic analysis using NVivo 12 software. This article complied with the consolidated criteria for reporting qualitative research (COREQ).

Barriers to self-oral hygiene management in patients with oral cancer undergoing radiotherapy were grouped into three themes: (1) lack of capability (poor oral hygiene awareness, limited oral care knowledge, symptomatic distress), (2) lack of opportunity (financial burden, oral care product accessibility limitations, lack of specialised medical resources, inadequate family functioning), and (3) lack of motivation (low intrinsic motivation, heavy psychological pressure, lifestyle entrenchment).

The capability and motivation of patients undergoing radiotherapy for oral cancer to manage their oral hygiene must be improved, along with external resources for oral hygiene management. The medical team needs to continuously improve guidance on self-oral hygiene management to meet individual needs.