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Annals of Surgery May 2022This study examines and contrasts the effect of risk disclosure on risk acceptance and perceived changes in quality of life (QoL) among individuals with and without...
OBJECTIVE
This study examines and contrasts the effect of risk disclosure on risk acceptance and perceived changes in quality of life (QoL) among individuals with and without facial disfigurement.
SUMMARY OF BACKGROUND DATA
Psychological distress has been previously shown to alter patients' perception of certain treatments. Due to the grave risks and complications of FT, it is important to understand whether the psychological trauma associated with facial disfigurement alters their perception of FT and its associated risks.
METHODS
Participants with and without facial disfigurement were recruited to complete a questionnaire about their perceived QoL, sense of identity, and willingness to proceed with FT in the context of 3 different hypothetical scenarios involving facial disfiguration.
RESULTS
Four hundred nine nonfacially disfigured and 74 facially disfigured participants were included. When both healthy and facially disfigured individuals were presented with the risks and benefits of a FT, they both perceived their QoL to be as low, or significantly lower, than if they had severe facial disfigurement. Furthermore, presenting the risks of FT significantly altered the decision making and risk acceptance of healthy individuals with no facial disfigurement. However, risk disclosure did not affect the decision making among facially disfigured individuals.
CONCLUSION
This study highlights that presenting the complication profile of FT decreases risk acceptance of FT in healthy individuals but has no significant effects on facially disfigured individuals. The psychological impact of facial disfigurement and its influence on accepting the significant risks of FT should be considered and warrants further investigation.
Topics: Decision Making; Face; Facial Transplantation; Humans; Psychological Trauma; Quality of Life
PubMed: 32649465
DOI: 10.1097/SLA.0000000000004156 -
Indian Journal of Palliative Care 2017Fear of disfigurement affects patients with cancer, in whom the disease or its treatment leaves them permanently marked. Contrary to our thought, disfigurement is...
Fear of disfigurement affects patients with cancer, in whom the disease or its treatment leaves them permanently marked. Contrary to our thought, disfigurement is equally distressing to male patients, and it causes severe dislocation in their lives. We describe two cases in which disfigurement caused tremendous change in our patients; these cases underline the need for psychotherapy in patients suffering from cancer.
PubMed: 28827945
DOI: 10.4103/IJPC.IJPC_33_17 -
Current Opinion in Ophthalmology Oct 2002Removal of the eye may be necessary after severe ocular trauma, to control pain in a blind eye, to treat some intraocular malignancies, in endophthalmitis unresponsive... (Review)
Review
Removal of the eye may be necessary after severe ocular trauma, to control pain in a blind eye, to treat some intraocular malignancies, in endophthalmitis unresponsive to medical therapy, and for cosmetic improvement of a disfigured eye. The choice of procedure to accomplish this is best made by an informed patient. Enucleation and evisceration can each achieve the desired goals, but several factors must be considered in choosing the most appropriate procedure.
Topics: Eye Diseases; Eye Enucleation; Eye Evisceration; Humans; Orbital Implants; Prosthesis Implantation
PubMed: 12218460
DOI: 10.1097/00055735-200210000-00002 -
Head & Neck Surgery 1983The primary purpose of this investigation was to construct a quantitative scale to measure the perception of severity of visible disfigurement and dysfunction following... (Comparative Study)
Comparative Study
The primary purpose of this investigation was to construct a quantitative scale to measure the perception of severity of visible disfigurement and dysfunction following ablative head and neck cancer surgery. Facial disfigurement and disruption of physical function induced by head and neck surgery pose formidable obstacles to the medical and psychosocial adaptation of cancer patients. Although this problem is widely acknowledged, virtually no research has attempted reliable and valid measurement of such concepts. Consequently, the present study investigated the psychological perceptions of 100 registered nurses regarding 11 disfiguring surgical procedures and loss of associated functions. Results indicated that the nurses' judgments of disfigurement and dysfunction were highly consistent and not a function of patient gender. Judgments of the severity of disfigurement, moreover, were independent of the perceived severity of associated dysfunction. It was concluded that this is a reliable method for measuring the relative degree of disfigurement and dysfunction and represents a critical precursor to prediction of a patient's psychological rehabilitation and compliance with medical care after surgery.
Topics: Adaptation, Psychological; Adult; Disability Evaluation; Esthetics; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neck Dissection; Postoperative Period
PubMed: 6629792
DOI: 10.1002/hed.2890060104 -
BMJ Open Nov 2018To explore the influences of facial disfigurement and social support for psychosocial adjustment in patients with oral cancer.
OBJECTIVE
To explore the influences of facial disfigurement and social support for psychosocial adjustment in patients with oral cancer.
DESIGN
A cross-sectional design was used for the study.
PARTICIPANTS AND SETTING
A convenience sample of 77 patients with oral cancer was recruited from the otolaryngology and oral and maxillofacial surgery outpatient clinics of three general hospitals in Taiwan.
MEASURES
Data were collected using the study questionnaires, including the Facial Disfigurement Scale, the Social Support Scale and the Psychosocial Adjustment to Illness Scale.
RESULTS
The mean score on the Psychosocial Adjustment to Illness Scale was 413.01 (SD=32.32); 71.4% of the participants were maladjusted. Results of multiple regression analysis showed statistically significant main effects of tumour site (beta=0.37), facial disfigurement (beta=0.35) and social support (beta=-1.01), and the interaction effect of facial disfigurement and social support (beta=0.79) (all p<0.05) on psychosocial adjustment after controlling for other sociodemographic and clinical variables. All variables together explained 62% of the variance in psychosocial adjustment (F(16, 55)=14.98, p<0.001).
CONCLUSIONS
The level of psychosocial adjustment in patients with oral cancer was suboptimal. Poorer psychosocial adjustment was reported by patients with more severe facial disfigurement and less social support. Patients with cancers in other areas of the oral cavity also reported poorer psychosocial adjustment than patients with cancers in the buccal mucosa. Medical professionals may use these variables to identify higher risk groups for early intensive intervention.
Topics: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Emotional Adjustment; Face; Female; Humans; Male; Middle Aged; Mouth Neoplasms; Psychological Tests; Social Support; Surveys and Questionnaires; Taiwan
PubMed: 30478118
DOI: 10.1136/bmjopen-2018-023670 -
Health Psychology : Official Journal of... Sep 2006This study investigated the moderating role of social self-efficacy (i.e., the belief that one is capable of exercising control over the reactions and openness of other...
This study investigated the moderating role of social self-efficacy (i.e., the belief that one is capable of exercising control over the reactions and openness of other people) with respect to the link between facial disfigurement and psychological and n = 76) as well as their physicians. In line with the hypotheses, the results revealed that the degree of facial disfigurement, as judged by patients as well as their physicians, was positively related to psychological distress and distress in reaction to unpleasant behavior of others, but only when patients did not feel self-efficacious in social encounters. Furthermore, social self-efficacy mitigated the positive link between facial disfigurement as judged by patients and social isolation.
Topics: Body Image; Depression; Facial Injuries; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Radiotherapy; Self Concept; Self Efficacy; Social Desirability; Social Identification; Social Isolation
PubMed: 17014282
DOI: 10.1037/0278-6133.25.5.643 -
International Journal of Clinical... Jan 2014Epidermal nevi are hamartomas that are characterized by hyperplasia of the epidermis and adnexal structures, and may be associated with serious disfiguration. Germline...
Epidermal nevi are hamartomas that are characterized by hyperplasia of the epidermis and adnexal structures, and may be associated with serious disfiguration. Germline mutations in the FGFR3 gene have found to be the etiology of epidermal nevus. Patients often seek treatment from dermatologic surgeons but even an alert dentist can help to diagnose the lesion from its clinical appearance. Various treatment modalities are available and it is the clinician's choice to choose depending upon the patient's condition. How to cite this article: Arora B, Khinda VIS, Bajaj N, Brar GS. Congenital Epidermal Nevus. Int J Clin Pediatr Dent 2014;7(1): 43-46.
PubMed: 25206237
DOI: 10.5005/jp-journals-10005-1232 -
Saudi Journal of Anaesthesia 2023Takotsubo cardiomyopathy is accompanied by transitory left ventricular dysfunction without substantial coronary artery disease. A history of acute physical or mental...
Takotsubo cardiomyopathy is accompanied by transitory left ventricular dysfunction without substantial coronary artery disease. A history of acute physical or mental stress typically precedes such a presentation. We want to highlight a case of Takotsubo cardiomyopathy in the early postoperative period in a young female patient who underwent extensive surgery for buccal mucosal carcinoma. The onset of this cardiomyopathy can be ascribed to a fear of disfigurement and prolonged surgical stress.
PubMed: 37601518
DOI: 10.4103/sja.sja_906_22 -
Cancer Metastasis Reviews Sep 2017Head and neck cancer (head and neck squamous cell carcinoma (HNSCC)) is a devastating disease. Patients require intensive treatment that is often disfiguring and... (Review)
Review
Head and neck cancer (head and neck squamous cell carcinoma (HNSCC)) is a devastating disease. Patients require intensive treatment that is often disfiguring and debilitating. Those who survive are often left with poor speech articulation, difficulties in chewing and swallowing, and cosmetic disfigurement, as well as loss of taste. Furthermore, given that HNSCC survivors are frequently disabled and unable to return to work, the economic and societal costs associated with HNSCC are massive. HNSCC is one of many cancers that are strongly associated with tobacco use. The risk for HNSCC in smokers is approximately ten times higher than that of never smokers, and 70-80% of new HNSCC diagnoses are associated with tobacco and alcohol use. Tobacco products have been used for centuries; however, it is just within the last 60-70 years that we have developed an understanding of their damaging effects. This relatively recent understanding has created a pathway towards educational and regulatory efforts aimed at reducing tobacco use. Understanding the carcinogenic components of tobacco products and how they lead to HNSCC is critical to regulatory and harm reduction measures. To date, nitrosamines and other carcinogenic agents present in tobacco products have been associated with cancer development. The disruption of DNA structure through DNA adduct formation is felt to be a common mutagenic pathway of many carcinogens. Intense work pertaining to tobacco product constituents, tobacco use, and tobacco regulation has resulted in decreased use in some parts of the world. Still, much work remains as tobacco continues to impart significant harm and contribute to HNSCC development worldwide.
Topics: Animals; Carcinogenesis; Carcinoma, Squamous Cell; Head and Neck Neoplasms; History, 20th Century; History, 21st Century; Humans; Smoking; Squamous Cell Carcinoma of Head and Neck
PubMed: 28801840
DOI: 10.1007/s10555-017-9689-6 -
Der Hautarzt; Zeitschrift Fur... May 2007"Nihilodermia" refers to a group of difficult "problem" patients in dermatology without objective findings but with recurrent symptoms and stubborn demand for medical... (Review)
Review
"Nihilodermia" refers to a group of difficult "problem" patients in dermatology without objective findings but with recurrent symptoms and stubborn demand for medical examination. These primary emotional disorders are somatoform disorders, but the patients usually strictly deny a psychosocial aspect and expect purely somatic treatment. Clinical patterns include pruritus, pain, paresthesias, feelings of disfiguration, eco-syndromes, erythrophobia and psychogenic pseudoeffluvium. The relevant somatoform disorders in dermatology can be differentiated as somatization disorders, hypochondriacal disorders, somatoform autonomous disorders, persistent somatoform pain disorders and "other somatoform disorders". A precise differential diagnostic division is necessary in order to initiate adequate therapy strategies.
Topics: Affective Symptoms; Diagnosis, Differential; Humans; Hypochondriasis; Patient Care Team; Recurrence; Referral and Consultation; Sick Role; Skin Diseases; Somatoform Disorders
PubMed: 17431558
DOI: 10.1007/s00105-007-1329-6