Psychosocial barriers and social acceptance in patients with head and neck cancer after disfiguring surgery: a cross-sectional study

INTRODUCTION: Head and neck cancer (HNC) survivors often experience permanent visible disfigurement and func­tional impairments following surgical treatment. These changes can lead to significant psychosocial difficulties, including body image distress, social withdrawal, and perceived stigma. Despite growing awareness of these issues, limited research has focused on patients’ perceived social acceptance and psychosocial barriers across different demographic subgroups. This study aimed to assess psychosocial barriers and perceived social accept­ance among patients with HNC after disfiguring surgery and to examine differences according to age, gender, education level, and place of residence. MATERIAL AND METHODS: A cross-sectional survey was conducted among 200 adult HNC survivors at least 6 months after surgery who had permanent visible disfigurement. Participants completed validated instruments assessing body image (Body Image Scale), anxiety and depression (Hospital Anxiety and Depression Scale), psychosocial barriers, and perceived social acceptance. Group comparisons and multivariate regression analy­ses were performed. RESULTS: High levels of psychosocial burden were observed: 72% reported frequent appearance-related distress, 46% depressive symptoms, and 58% social avoidance. The mean Social Acceptance Score was 61.5 ± 18.4. Younger age, female gender, and rural residence were associated with significantly lower perceived social acceptance. Multivariate analysis identified younger age, female gender, and rural residence as independ­ent predictors of reduced social acceptance. CONCLUSIONS: HNC survivors experience substantial psychosocial barriers and limited perceived social accept­ance, particularly younger patients, women, and those living in rural areas. These findings highlight the need for targeted psychosocial support and community-based interventions to improve social reintegration and quality of life.