An exploration of the perceived changes in intimacy of patients’ relationships following head and neck cancer

Abstract

Aims and objectives. This paper reports the experiences of former patients who have undergone a range of head and neck cancer treatments and their perceptions of the changes in intimacy experienced, as an individual and through their relationships with partners, family and friends. Background. A diagnosis of head and neck cancer, subsequent surgical treatment and radiotherapy can lead to an altered quality of life. Whilst important developments have been made to improve the quality of life for this patient group from a functional perspective, psychosocial perspectives are much less understood. Design. A qualitative study approach. Methods. Data were collected in 2007/2008 via interview using open‐ended questions from a purposive sample of 16 participants who were at least one year post‐treatment. A thematic analysis was employed to interpret the findings. Results. Analysis of the data produced three broad themes. These were ‘personal identity’, ‘re‐establishing social networks’ and ‘intimate relationships’ and explored the person as an individual and their perceived changes to self‐esteem and image. The perception of their altered position in society, the impact this has on their willingness to re‐engage with society and the degree to which treatment can alter an individual’s ability to resume former intimate relationships with family and partners. Conclusion. Patients’ definitions of intimacy are multifaceted and related directly to the type of relationship that existed prior to treatment. The concerns and challenges faced by patients need to be addressed and support opportunities considered as part of the rehabilitation process. Relevance to clinical practice. The paper gives insight for nurses and other healthcare professionals who are expected to provide effective emotional and therapeutic support for patients who have undergone treatment for head and neck cancer. Understanding of patient concerns and recognition of adaptive and coping strategies are essential for this practice.

Validated questionnaires on intimacy in patients who have had cancer

“…O'Brien et al 14 showed that in patients treated for cancer of the head and neck, definitions of intimacy are multifaceted. Radical treatment regimens change a patient's health-related quality of life and can alter their ability to resume former intimate relationships.…”

“…[6][7][8][9] Problems with intimacy in patients with a history of gynaecological, 10 breast, 11 and prostate 12 cancer are often identified during consultations because of their obvious effects on sexual function, but this is not the case in patients with cancer of the head and neck. Other problems need to be resolved in a limited consultation time, [13][14][15][16] and, perhaps, clinicians fail to recognise the mouth as a "sexual organ".…”

Psychosexual therapy and education in patients treated for cancer of the head and neck

“…First, as reflected in the work of O'Brien et al, the definitions of intimacy are multifaceted. 6 Secondly, when trying to unfold problems in a busy head and neck clinic, it is important to know about the state of the relationship before diagnosis and treatment. 6 Thirdly, there is a lack of validated assessment tools, and head and neck clinicians are often reluctant to talk about a "difficult" issue because of lack of time or training.…”

The symbolic value of prostheses in maxillofacial rehabilitation

“…Other authors who have conducted qualitative research have reported on the subjectivity involved in the oncological treatment of the head and neck [2][3][4][5], but without specifically focusing on the role of maxillofacial prostheses. Other authors who have conducted qualitative research have reported on the subjectivity involved in the oncological treatment of the head and neck [2][3][4][5], but without specifically focusing on the role of maxillofacial prostheses.…”