I have quality of life ... but ... : Exploring support needs important to quality of life in head and neck cancer

Purpose of research: Head and neck cancer (HNC) treatment disrupts quality of life and is associated with individualised supportive care needs. This study aimed to describe the support needs that affected the QoL of HNC patients, and to describe how patients coped with unmet support needs. Methods: Qualitative, semi-structured interviews were held with 8 participants previously treated for HNC. Participants were identified through snowball and convenience sampling methods. Interview data was analysed using content analysis (CA). Inductive CA was used to describe support needs and directed CA was guided by the stress appraisal and coping model to describe coping with unmet support needs. Results: Support needs that affected QoL related to acute needs while undergoing treatment and support in coping with permanent treatment side effects. Coping with psychological stressors (i.e. depression and anxiety) affected QoL in the first six to twelve months following treatment. Coping was influenced by loss of access to the supportive hospital environment after treatment, and resulted in feelings of isolation post treatment. Conclusions: HNC patients drew support from professional and personal networks while undergoing treatment and post treatment. Patients described difficulties in coping with the side effects of treatment and accessing supportive care when away from the hospital setting. The transactional model of stress, appraisal and coping is useful in understanding the psychosocial outcomes of head and neck cancer; however conclusions from this study are limited by a small and homogenous sample. (C) 2013 Elsevier Ltd. All rights reserved.