title: Patient experiences and outcomes following facial skin cancer surgery: A qualitative study.
abstract: Early melanoma and non-melanoma skin cancer of the facial area are primarily treated with surgery. Little is known about the outcomes of treatment for facial skin cancer patients. The objective of the study was to identify concerns about aesthetics, procedures and health from the patients' perspective after facial skin surgery. Semi-structured in-depth interviews were conducted with 15 participants. Line-by-line coding was used to establish categories and develop themes. We identified five major themes on the impact of skin cancer surgery: appearance-related concerns; psychological (e.g., fear of new cancers or recurrence); social (e.g. impact on social activities and interaction); physical (e.g. pain and swelling) concerns and satisfaction with the experience of care (e.g., satisfaction with surgeon). The priority of participants was the removal of the facial skin cancer, as this reduced their overall worry. The aesthetic outcome was secondary but important, as it had important implications on the participants' social and psychological functioning. The participants' experience with the care provided by the surgeon and staff also contributed to their satisfaction with their treatment. This conceptual framework provides the basis for the development of a new patient-reported outcome instrument.
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Erica H
authors.initials: EH
authors.lastname: Lee
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Klassen
authors.affiliation: Yeshiva University, New York, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Lawson
authors.affiliation: Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Cano
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Amie M
authors.initials: AM
authors.lastname: Scott
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Pusic
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000523:psychology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000523:psychology / Q000601:surgery; D004954:Esthetics; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000523:psychology / Q000601:surgery; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods*; D017063:Outcome Assessment, Health Care; D036301:Qualitative Research; D011788:Quality of Life; D012878:Skin Neoplasms / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D055815:Young Adult
keywords: Mohs surgery; basal cell carcinoma; dermatological surgery; facial skin cancer; melanoma; patient-reported outcome; patients' satisfaction; skin cancer; squamous cell carcinoma
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