Anxiety, Coping Strategies, and Coping Behaviors in Patients Undergoing Head and Neck Cancer Surgery

BACKGROUND: Little is reported in the scientific literature about the modulating effect of anxiety on the coping process before and after surgical treatment for head and neck cancer. OBJECTIVES: The major purpose of this article is to describe the relationships among preoperative anxiety and use of coping strategies, and postoperative self-care and resocialization behaviors in patients who sustain facial disfigurement/dysfunction with head and neck cancer surgery. METHODS: Using a prospective descriptive design, 75 (N = 75) adults who were about to sustain facial disfigurement and dysfunction associated with head and neck cancer surgery were entered into the study. The State Trait Anxiety Inventory and the Ways of Coping Questionnaire were administered to the respondents. The Disfigurement/Dysfunction Scale and Coping Behaviors Score values were calculated by the investigator. RESULTS: Self-care and anxiety were significantly correlated on postoperative day 4 (r = 2.30; p < .05) and on postoperative day 5 (r = 2.35; p < .05). For the 3 days under study, the relationship between total self-care and anxiety became stronger on postoperative day 5 (r = 2.39; p < .01), indicating that self-care on postoperative day 4 is related to reduced anxiety on postoperative day 5. In other words, self-care appears to precede reduction in anxiety in this sample. Secondly, there was a negative relationship between self-care and anxiety that increased over the early postoperative period. CONCLUSIONS: This study prospectively documents anxiety in surgical head and neck cancer patients. The findings suggest that at a specific point in time (postoperative day 5), self-care precedes reduction in anxiety, and that this negative relationship increases over time. Additional investigation is now critical in order to describe long-term recovery after surgical treatment for head and neck cancer and to develop appropriate interventions to meet the unique needs of this population.