title: Changes of satisfaction with appearance and working status for head and neck tumour patients.
abstract: OBJECTIVE
  The aim of this survey was to examine changes of satisfaction with appearance and working status of head and neck tumour patients after tumour excision and micro-reconstructive surgery.
  
  
  BACKGROUND
  Most research related to head and neck tumour reconstruction deals with surgical techniques and complications. No reports discussed impact on personal appearance and working status.
  
  
  METHODS
  This is a retrospective cross-sectional study design with systematical sampling.
  
  
  METHODS
  One questionnaire which included three instruments was mailed to patients selected systematically from a patient list; 525 questionnaires were mailed to the potential participants and 125 returned. However, only 97 effective questionnaires were analysed. Non-parametric statistics such as Spearman correlation, Wilcoxon signed rank test, Kolmogorov-Smirnov Z test and Kruskal-Wallis test were performed as the data were not normally distributed.
  
  
  RESULTS
  Participants reported that they were least satisfied with their face (mean = 2.88 SD 1.34). Compared with presurgery condition, the satisfaction with current appearance was significantly lower (Wilcoxon signed rank test, Z = -6.39, p < 0.001). A total of 35.8% employed participants changed their jobs after cancer treatments. Their major reason for job change was discomfort caused by cancer treatment. Gender, employment status, type of job, type of treatment, age, duration from last radiotherapy and number of treatment modalities had an impact on satisfaction with appearance.
  
  
  CONCLUSIONS
  Compared with presurgery, satisfaction with personal appearance did change negatively even after micro-reconstructive surgery had been conducted. In addition, certain participants changed their jobs because of cancer treatments.
  
  
  CONCLUSIONS
  We should include job rehabilitation and body image into the daily care of head and neck cancer patients. For example, participants could learn how to use cosmetic strategies to improve their facial appearance during OPD follow-up. Thus, the negative impact might be reduced.
authors.affiliation: School of Nursing, Chang Gung University, Tao Yuan, Taiwan, Republic of China. sarah@mail.cgu.edu.tw
authors.forename: Hsueh-Erh
authors.initials: HE
authors.lastname: Liu
mesh_terms: D000223:Adaptation, Psychological; D001828:Body Image; D002321:Career Choice; D003357:Cosmetic Techniques; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000523:psychology*; D008875:Middle Aged; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010146:Pain / Q000209:etiology / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010563:Personnel Turnover; D011788:Quality of Life / Q000523:psychology; D019651:Plastic Surgery Procedures / Q000523:psychology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013624:Taiwan; D016896:Treatment Outcome