title: The experiences of head and neck cancer patients requiring major surgery.
abstract: BACKGROUND
  The prevalence of head and neck cancers is lower (3.5% of total cancers in Australia) than for a number of other cancers. Treatment for head and neck cancer is often drastic and debilitating and patient outcomes are poorer.
  
  
  OBJECTIVE
  This qualitative study explored the experiences of cancer patients who underwent surgery for head and neck cancer.
  
  
  METHODS
  In-depth face-to-face interviews were conducted with 12 patients 7 to 26 months after surgery. Interviews were thematically analyzed to produce a rich description of patients' experiences from diagnosis through surgery and beyond.
  
  
  RESULTS
  Critical aspects of patients' experiences are described through the following themes: only having half the story, shocks and aftershocks, living with the aftermath, and being supported. Participants identified difficulties arising from receiving insufficient, confusing, and often untimely information. The persistent and traumatic nature of what patients endure challenges their physical, mental, and emotional coping capacity and, in some cases, their motivation to live.
  
  
  CONCLUSIONS
  There is a need to address gaps in support and education of patients and carers. Of particular concern is the problem related to information provision and comprehension. Critical examination of current practices, together with efforts toward coordinated care tailored to individual needs, is required, along with outreach services for patients in rural areas.
  
  
  CONCLUSIONS
  The development and evaluation of targeted resources in a variety of forms such as DVD, Internet, and pamphlets are needed. Robust assessment strategies are required to inform supportive interventions matched to stages and significant events in patients' journeys.
authors.affiliation: Author Affiliations: School of Health, University of New England, Armidale, New South Wales, Australia (Dr Parker); Cancer Services, John Hunter Campus (Mr Bellamy); Royal Newcastle Centre (Ms Graham); Psychooncolgy Unit, Calvary Mater Newcastle (Dr Britton); Centre for Practice Opportunity and Development (Ms Giles), Hunter New England Health Services (Ms Bennett); and School of Nursing and Midwifery, Callaghgan Campus, University of Newcastle, Callaghan, New South Wales, Australia (Dr Rossiter).
authors.forename: Vicki
authors.initials: V
authors.lastname: Parker
authors.forename: Douglas
authors.initials: D
authors.lastname: Bellamy
authors.forename: Rachel
authors.initials: R
authors.lastname: Rossiter
authors.forename: Vicki
authors.initials: V
authors.lastname: Graham
authors.forename: Ben
authors.initials: B
authors.lastname: Britton
authors.forename: Leearna
authors.initials: L
authors.lastname: Bennett
authors.forename: Michelle
authors.initials: M
authors.lastname: Giles
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000451:nursing* / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D015399:Nursing Research; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers