The psychological effect of facial and neck surgery Flashcards
Chronic disease definition
last 3 months or more and may get worse
treatment for head and neck cancers are as follows
- Recovery
- Prevention
- Surveillance and continued screening
- Management of the consequences of cancer and cancer treatment
Psychological factors related to head and neck cancer
- Health-related Quality of Life
- psychological distress
- anxiety
- depression - fascial appearance
- fear of cancer recurrence
Quality of life comprises:
- physical health and functioning • psychological state
- level of independence
- social relationships
- occupation and finance
- personal beliefs
Key issues in Head & Neck cancer: with QOL
- Comorbidity and disability
- Self-care
- Pain
- Speech
- Eating and swallowing
- Financial and work
- Impact on family and friends
Why measure QoL?
- Evaluating treatment outcomes
- Identifying patients priorities, values & expectations
- Development of interventions and support
How to measure QoL
• Questionnaires or interviews – No gold standard
What are the three main cautions with appearance changes in H and N cancers
- context of the disease
- context of social world
- contact of the self
Psychosocial consequences of disfigurement
- Higher rates of anxiety and depression
- Lower self esteem
- Negative body image and self-perceptions
- Difficulties forming relationships
- Negative reactions from others
- Stigma and discrimination
- Severe facial deformities may be less of a psychological burden than those that are more mild
Psychosocial consequences of disfigurement
- Higher rates of anxiety and depression
- Lower self esteem
- Negative body image and self-perceptions
- Difficulties forming relationships
- Negative reactions from others
- Stigma and discrimination
- Severe facial deformities may be less of a psychological burden than those that are more mild
Assessing appearance concerns
• Communication skills: Careful and sensitive questioning to gauge level of difficulty that appearance concerns may have for patient
• Seek out family, carers or close friend’s opinions of possible patient concerns
• Appearance and body image concerns can be validated by considering how it
impacts on behaviour (avoidance of social situations)
• Seek specialist assessment if necessary (clinical psychologist, liaison psychiatrist)
Fear of cancer recurrence (FCR)
• Sustained heightened FCR can impact on quality of life and exacerbate anxiety and depression.
• Linked to increased medication use and service utilisation.
• 35% of head and neck cancer patients has significant levels of FCR,
which was sustained longitudinally.
Fear of cancer recurrence (FCR)
• Sustained heightened FCR can impact on quality of life and exacerbate anxiety and depression.
• Linked to increased medication use and service utilisation.
• 35% of head and neck cancer patients has significant levels of FCR,
which was sustained longitudinally.
Carers in patient treatment and recovery
• Retain structure to daily life
• Assist with medication, treatments and adherence to medical
recommendations
• Practical and mobility support
• Emotional support
• Family interactions are complex and not always supportive (‘toxic’ environment)
