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Keywords:

  • cancer;
  • disfigurement;
  • grounded theory;
  • interviews;
  • nurse–patient interaction;
  • nursing;
  • theory development

Abstract

Title. Surgical facial cancer treatment: the silencing of disfigurement in nurse–patient interactions.

Aim.  The aim of this study was to explore and explain how disfigurement is addressed in interactions between patient and nurse during the period in hospital immediately after undergoing disfiguring facial surgery.

Background.  Facial disfigurement as a result of head and neck or eye cancer surgery is associated with psychosocial problems; however no successful intervention program has been developed. Empirically derived knowledge about what goes on in the patient–nurse interaction is missing.

Method.  A grounded theory design was used, with data derived from audio-recorded conversations between and individual interviews with 14 patients and their connected nurses, from three participating university hospitals. Data were collected in 2007.

Findings.  A substantive model with silencing disfigurement as a core category was developed. The model included three categories; minimizing disfigurement, disfigurement is a luxurious problem and another time, another place. A condition of implicit and unverified professional assumptions about addressing the issue of disfigurement became an underlying character. Without this the core category could not exist.

Conclusion.  The model elucidates a silencing process maintained by preconceived assumptions which need to be challenged to help patients adjust to their changed appearance after facial cancer treatment.