Examination Date

4-2024

Degree

Dissertation

Degree Program

Nursing (PhD)

Examination Committee

Gloria Giarratano, Marsha Bennett, Marie Adorno, Laura S. Bonnano, Linda M. Ledet, Bethany Rhoten

Abstract

Background: Women with head and neck cancer (HNC) are at risk for changes in body image due to tumor presence and the side effects of the treatments. Physical, psychological, and social constructs of body image (BI) can influence the patient’s perception of body image.

Problem: Little is known about women’s experiences during HNC treatment and how body image is perceived in the process. As healthcare professionals it is important to hear their stories and understand the struggles they experience in their own words during their treatment.

Study Method: A hermeneutical phenomenological inquiry into the lived experiences of women diagnosed with HNC (excluding thyroid cancer and skin cancers), undergoing treatment (currently or within three months) was conducted with a sample of 20 participants with both data and theoretical saturation obtained. Participants were recruited from three different sites where women with HNC are undergoing active treatment of HNC cancer with radiation therapy, chemotherapy/immunotherapy, surgical treatment, or any multimodal treatment of cancer and from an online support group where several participants had membership. Individual interviews were recorded face to face or using a virtual platform, transcribed, and analyzed using van Manen’s method.

Findings: Data analysis revealed three themes, (1) Being and becoming: Seeing myself as a changed person, with subthemes (a) physical changes and body image, and (b) role, social,

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psychological changes and body image; (2) Inward feelings and meanings, and (3) Navigating the journey, with subthemes (a) internal motivation and (b) external support.

Conclusion: Women treated for HNC experience life-changing alterations in BI demonstrated through the physical, psychological, and social constructs of BI. The physical components of dysfunction, disfigurement, and debility, contributed to women perceiving themselves as less than ideal. Psychological components included negative emotional well-being and altered perceptions of self and sexuality. Social components included changes in social functioning around food, changing roles and relationships with others, and feelings of stigma. The BI changes women experienced as a result of HNC are intertwined with a feminine viewpoint and resulted in women reaching out to personal female friends and support groups with women in similar situations to help them cope. Women relied on support from partners, family and friends to help them find an inner strength to work through the struggles of the disease and treatment and eventually look to the future as a changed person. It is essential for healthcare providers to recognize how treatment side effects holistically impact BI and quality of life. Continued research is needed to determine the best supportive interventions that best promote coping and long-term recovery related to changes in BI.

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