From diagnosis to recovery: emotional wellbeing in head and neck cancer

Abstract

Receiving a diagnosis of head and neck cancer (HNC) can lead to shock and fear. Treatments such as radiotherapy and surgery are invasive and lead to significant side effects such as lack of saliva, poor nutrition and difficulties with eating and drinking. Research has shown that wellbeing and quality of life, both before and after treatment, impact recovery times and survival rates. This thesis explores patient experience from prehabilitation (the time between receiving a diagnosis and starting treatment) to the rehabilitation period and recovery posttreatment. This thesis aims to explore patients experiences of receiving diagnosis and treatment for HNC; considering the impact on mental wellbeing and the support patients need.

Chapter one provides a bridging chapter to introduce the two projects of this thesis. It considers aspects important to the research such as the patient journey, prehabilitation and personalised care – exploring the wider literature and barriers to implementing change. Ontological and epistemological positions are discussed alongside reflexivity.

Chapter two reports on the systematic review that explores the factors that help or harm quality of life in adults who have received treatment for HNC. This chapter uses a synthesis without meta-analysis, with an accompanying narrative synthesis to explore and summarise the data. The findings suggest that a range of factors influence quality of life, but that further research is required to better understand these relationships.

Chapter three explores the experiences of individuals diagnosed with HNC,
specifically within the prehabilitation time period. The researcher also investigated what, if any, psychological support patients would have liked to have received during this time period. Four themes are presented: 1) cancer challenges, alters and expands self-view and identity; 2) coping strategies utilised to increase control – context is important; 3) dual states before treatment: normalcy vs living in limbo; 4) balancing act: getting the right support at the right time. The findings highlight the need for individualised care and summarises the findings within the context of the Common-Sense Model.

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Identifiers

ORCID for Holly Stokes: orcid.org/0009-0006-9980-4341

ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

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