title: Communication dysfunction, body image, and symptom severity in postoperative head and neck cancer patients: factors associated with the amount of speaking after treatment.
abstract: OBJECTIVE
  The purpose of this study was to determine the relationships of communication dysfunction, body image, and amount of speaking in patients who were treated for head and neck cancers (HNCs).
  
  
  METHODS
  This was a cross-sectional study of postoperative HNC patients at the otolaryngology outpatient departments of two leading medical centers in northern Taiwan. Data were collected using questionnaires to assess perceived communication dysfunction, body image, symptom severity, and amount of speaking after treatment.
  
  
  RESULTS
  A total of 130 HNC patients were included in the analysis, and 70.8 % of patients reported speaking less after surgery as compared to the period before having HNC surgery. Overall, patients perceived a moderate level of communication dysfunction. Those with higher distress over their body image, higher symptom severity, and with hypopharyngeal and laryngeal cancer reported speaking less. Patients with advanced stage cancer and a tumor in a facial area and those that received reconstructive surgery were more likely to have a negative body image.
  
  
  CONCLUSIONS
  Dissatisfaction with body image, greater symptom severity, and hypopharyngeal and laryngeal cancer are predictive of the amount HNC patients speak, as compared with the amount they spoke before having HNC. Clinicians should be aware of and systematically assess communication problems of HNC patients to promote their social function. Further research on interventions that facilitate the development of a positive body image and communication is strongly suggested.
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
authors.forename: Po-Jui
authors.initials: PJ
authors.lastname: Yu
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Hong
authors.forename: Mei-Hui
authors.initials: MH
authors.lastname: Chen
authors.forename: Pen-Yuan
authors.initials: PY
authors.lastname: Chu
authors.forename: Yen-Ju
authors.initials: YJ
authors.lastname: Chen
authors.forename: Chen-Ping
authors.initials: CP
authors.lastname: Wang
authors.forename: Yeur-Hur
authors.initials: YH
authors.lastname: Lai
mesh_terms: D001828:Body Image / Q000523:psychology*; D003142:Communication; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D007822:Laryngeal Neoplasms; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011184:Postoperative Period; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D013624:Taiwan; D016896:Treatment Outcome