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Journal of Advanced Nursing Nov 2009Surgical facial cancer treatment: the silencing of disfigurement in nurse-patient interactions.
TITLE
Surgical facial cancer treatment: the silencing of disfigurement in nurse-patient interactions.
AIM
The aim of this study was to explore and explain how disfigurement is addressed in interactions between patient and nurse during the period in hospital immediately after undergoing disfiguring facial surgery.
BACKGROUND
Facial disfigurement as a result of head and neck or eye cancer surgery is associated with psychosocial problems; however no successful intervention program has been developed. Empirically derived knowledge about what goes on in the patient-nurse interaction is missing.
METHOD
A grounded theory design was used, with data derived from audio-recorded conversations between and individual interviews with 14 patients and their connected nurses, from three participating university hospitals. Data were collected in 2007.
FINDINGS
A substantive model with silencing disfigurement as a core category was developed. The model included three categories; minimizing disfigurement, disfigurement is a luxurious problem and another time, another place. A condition of implicit and unverified professional assumptions about addressing the issue of disfigurement became an underlying character. Without this the core category could not exist.
CONCLUSION
The model elucidates a silencing process maintained by preconceived assumptions which need to be challenged to help patients adjust to their changed appearance after facial cancer treatment.
Topics: Adaptation, Psychological; Adult; Aged; Body Image; Eye Neoplasms; Facial Injuries; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Nurse-Patient Relations; Qualitative Research
PubMed: 19737320
DOI: 10.1111/j.1365-2648.2009.05102.x -
ORL-head and Neck Nursing : Official... 1997The purpose of this study is to determine if an individual's use of coping strategies prior to sustaining facial disfigurement/dysfunction is predictive of coping...
The purpose of this study is to determine if an individual's use of coping strategies prior to sustaining facial disfigurement/dysfunction is predictive of coping effectiveness after head and neck cancer surgery. The specific aims of the study are as follows: (1) describe the relationship between demographic data, preoperative coping strategies, severity of disfigurement/dysfunction, postoperative healing progress, and length of postoperative hospital stay; (2) describe the relationship between demographic data, preoperative coping strategies, and postoperative coping behaviors; (3) determine the relationship between postoperative coping behaviors and length of hospital stay. The Stress-Coping Model of Scott, Oberst and Dropkin (1980) provides the theoretical framework for this study. The sample consisted of 117 adults who were about to undergo head and neck cancer surgery associated with disfigurement/dysfunction. Zero-order correlations were computed among the variables, including preoperative use of coping strategies, degree of postoperative disfigurement/dysfunction, postoperative coping behaviors, postoperative complications, and length of hospital stay. Multiple regression analyses were conducted on the major outcome variables: length of stay and postoperative coping behaviors. Gender (female), preoperative radiation therapy, preoperative chemotherapy and postoperative problems were found to significantly increase length of stay. The 16 predictors in this study contributed to 56% of the variance in length of stay. Fifteen predictors accounted for 25% of the variance in postoperative coping.
Topics: Activities of Daily Living; Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Body Image; Female; Head and Neck Neoplasms; Humans; Length of Stay; Male; Middle Aged; Models, Psychological
PubMed: 9180583
DOI: No ID Found -
Body Image Dec 2018This study systematically reviewed the impact of cosmetic camouflage use on different psychosocial outcomes in patients with disfiguring skin disorders. Electronic...
This study systematically reviewed the impact of cosmetic camouflage use on different psychosocial outcomes in patients with disfiguring skin disorders. Electronic databases and reference lists were searched in February 2018 for studies reporting the impact of cosmetic camouflage on different quality of life (QoL) outcomes. Eighteen studies met the inclusion criteria: six randomized controlled trials, two quasi-experimental studies, nine single group 'before and after' interventions, and one comparative study with single post-intervention measurement. Quality appraisal of included studies was undertaken using the Joanna Briggs critical appraisal tools. While the studies varied in design, those included in this review indicated significant improvement in QoL after the use of cosmetic camouflage. The mean reduction in Dermatological Life Quality Index scores ranged from 1.4 to 6.4 signifying improvement in QoL of participants after treatment with cosmetic camouflage. Cosmetic camouflage can be an effective therapy in improving QoL among patients with skin disfigurement.
Topics: Body Image; Cosmetics; Humans; Quality of Life; Skin Diseases
PubMed: 30212716
DOI: 10.1016/j.bodyim.2018.08.004 -
The Journal of Clinical and Aesthetic... May 2016Basal cell carcinoma is the most commonly occurring cancer in the world and overall incidence is still on the rise. While typically a slow-growing tumor for which... (Review)
Review
Basal cell carcinoma is the most commonly occurring cancer in the world and overall incidence is still on the rise. While typically a slow-growing tumor for which metastases is rare, basal cell carcinoma can be locally destructive and disfiguring. Given the vast prevalence of this disease, there is a significant overall burden on patient well-being and quality of life. The current mainstay of basal cell carcinoma treatment involves surgical modalities, such as electrodessication and curettage, excision, cryosurgery, and Mohs micrographic surgery. Such methods are typically reserved for localized basal cell carcinoma and offer high five-year cure rates, but come with the risk of functional impairment, disfigurement, and scarring. Here, the authors review the evidence and indications for nonsurgical treatment modalities in cases where surgery is impractical, contraindicated, or simply not desired by the patient.
PubMed: 27386043
DOI: No ID Found -
Nurse Researcher Jul 1998Writing for publication can be a tricky business. Finding the time, finding the words, submitting your work to be disfigured by the sharp red pens of reviewers and...
Writing for publication can be a tricky business. Finding the time, finding the words, submitting your work to be disfigured by the sharp red pens of reviewers and editors, and doing a day job at the same time, can conspire to deter even the most motivated and diligent potential author. However, and at risk of boring you on a topic that has probably been done to death, writing for publication is an important issue. Especially for researchers. So important in fact, that at the Workgroup of European Nurse Researchers (WENR) conference in Helsinki earlier in July scientific writing featured heavily in workshops and symposia.
PubMed: 27712403
DOI: 10.7748/nr.5.4.3.s1 -
Work (Reading, Mass.) 2005Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with disfigurement is...
Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with disfigurement is documented. Key dimensions of workplace discrimination involving Americans with disfigurement and persons with missing limbs are compared and contrasted. Specifically, the researchers examine demographic characteristics of Charging Parties; the industry designation, location and size of Respondents/employers; the discrimination Issue (i.e., type of adverse action) alleged to occur; and the legal outcome or Resolution of these allegations. Charging Parties with disfigurement who are female or between 30 and 39 years of age are more likely to encounter employment discrimination than their counterparts with missing limbs. Harassment and Non-wage Benefits are the Issues that emerge in higher proportion. Allegations derived from persons with disfigurement are more common in among mid-size employers, those located in the South, or those in Retail or Service industries. Following investigation, allegations derived from persons with disfigurement are less likely to have Merit Resolutions than those brought by Charging Parties with missing limbs.
Topics: Adult; Demography; Disabled Persons; Employment; Facial Injuries; Female; Humans; Male; Middle Aged; Research; Social Justice; United States; Workplace
PubMed: 16006676
DOI: No ID Found -
British Journal of Nursing (Mark Allen...Surgery for head and neck cancer can leave patients with obvious facial disfigurements. Some individuals adjust remarkably well to their altered appearance and require... (Review)
Review
Surgery for head and neck cancer can leave patients with obvious facial disfigurements. Some individuals adjust remarkably well to their altered appearance and require very little emotional support. Conversely, individuals with poor coping skills or limited support from those close to them can become socially isolated and depressed. Nurses, caring for patients during their hospital stay, are in the ideal position to assess how they are emotionally adapting to having a disfigurement. By listening to the patient, and their family's concerns, nurses can make a real difference to their recovery and quality of life. Through facilitating the development of the individual's practical coping skills and confidence in social situations, nurses can help patients to start to constructively adjust to their new appearance. It is crucial to put patients and their families in touch with ongoing support before they go home.
Topics: Adaptation, Psychological; Attitude to Health; Body Image; Depression; Family; Head and Neck Neoplasms; Humans; Information Services; Internet; Nurse's Role; Nurse-Patient Relations; Perioperative Care; Self Care; Social Isolation; Social Support; Stereotyping
PubMed: 18414280
DOI: 10.12968/bjon.2008.17.2.28135 -
Dermatology Nursing Aug 2000Appearance is one of the most powerful factors influencing social interactions with others. What patients with disfigurements experience from society on a daily basis is...
Appearance is one of the most powerful factors influencing social interactions with others. What patients with disfigurements experience from society on a daily basis is a very real stigma. Cosmetic rehabilitation is a system of cosmetic techniques devised for patients to use to assist themselves to cope constructively with the psychological and physical trauma of their disfigurements.
Topics: Cosmetics; Humans; Skin Diseases
PubMed: 11912665
DOI: No ID Found -
Plastic and Reconstructive Surgery Aug 2007Although the first face transplants have been attempted, the social and psychological debates concerning the ethics and desirability of the procedure continue. Critics...
Although the first face transplants have been attempted, the social and psychological debates concerning the ethics and desirability of the procedure continue. Critics contend that these issues have not yet been sufficiently addressed. With this in mind, the present article seeks to elaborate on key psychological and social factors that will be central for addressing the ethical and psychosocial challenges necessary to move face transplantation into mainstream medicine. The goals of this article are to (1) discuss the psychosocial sequelae of facial disfiguration and how face transplantation may relieve those problems, and (2) delineate inclusion and exclusion criteria for the selection of research subjects for face transplantation. The article uses concepts from symbolic interaction theory in sociology to articulate a theoretically coherent scheme for comprehending the psychosocial difficulties of facial disfiguration and the advantages offered by facial transplantation. The authors conclude that the psychosocial implications of disfigurement warrant surgical intervention and that research in the area of face transplantation should continue.
Topics: Adaptation, Psychological; Body Image; Ethics, Medical; Face; Humans; Patient Selection; Self Concept; Transplantation
PubMed: 17632364
DOI: 10.1097/01.prs.0000267584.66732.e5 -
Journal of Wound Care May 1993A study of the aftermath of facial disfigurement and a report of an initiative to tackle the inner scars of that experience.
A study of the aftermath of facial disfigurement and a report of an initiative to tackle the inner scars of that experience.
PubMed: 27911639
DOI: 10.12968/jowc.1993.2.3.168