CONCERNS, COPING AND QUALITY-OF-LIFE IN HEAD AND NECK-CANCER PATIENTS

This study was conducted to explore the concerns and coping mechanisms used by patients with head and neck cancer and assess their quality o f life. A group of 50 consecutive patients with oral and laryngeal can cers were interviewed using a coping and concerns checklist and a semi structured interview proforma to elicit the common concerns in relatio n to head and neck cancers and their surgical treatment. The Hospital Anxiety and Depression Scale was used to detect anxiety and depression . Concerns were compared between oral and laryngeal cancers and betwee n preoperative and postoperative patients. Commonest concerns were abo ut the future (64%), subjective physical evaluation (60%), finances (5 6%), being upset (54%), communication (54%), current illness (52%) and inability to do things (50%). The commonest coping mechanisms used we re helplessness and fatalism. Resolution was noted in less than 40% of the frequent concerns. As compared to laryngeal cancer patients: thos e with oral cancer significantly more often had concerns about current illness, subjective evaluation of health, eating and chewing, social interactions, pain and disfigurement (P < 0.05). Most subjects had num erous unresolved concerns. Mainly ineffective coping mechanisms such a s helplessness and fatalism were employed leading to incomplete resolu tion. Interventions to minimise these concerns and to handle associate d anxiety and depression would improve their quality of life.