How do environmental factors influence post-traumatic growth in Head and Neck Cancer survivors?


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Laura-Jayne Watson, Laura-Jayne Watson, Fiona Menger, Linda Sharp, Joanne Patterson, James O'Hara

Abstract

Background

Survivors of Head and Neck Cancer (HNC) suffer from sometimes permanent and often visible, life-changing treatment effects.

Post-traumatic growth (PTG) is the phenomenon of positive psychological change following highly challenging life circumstances. Few qualitative studies explore PTG in HNC. It is unknown whether an individual’s environment influences PTG following HNC; with theoretical models not adequately considering possible environmental influences as potential contributory factors towards PTG. We used the International Classification of Functioning, Disability and Health (ICF) HNC environmental codes to provide a potential framework for analysis.

Method

HNC survivors were recruited from one centre in North-East England. A sub-group analysis of participants diagnosed with oropharyngeal cancer was conducted for this study.

Semi-structured interviews using a pre-designed interview schedule were conducted. Interviews were transcribed verbatim and anonymised. Participants also completed the PTG Inventory. This is a self-reported questionnaire which asks participants to rate statements about change that occurred in their life following HNC. High levels of PTG were identified if participants scored >30 on the PTG Inventory and demonstrated 3 or more aspects of PTG.  

Framework analysis was applied using the HNC environmental codes from the ICF. Additional codes were added during analysis.

Results

11 HNC survivors were included. 55% were male and 64% had multi-modality treatment. 45% of participants demonstrated strong evidence for the development of PTG.

23 environmental factors were included in preliminary analysis. Following the mapping process, 2 codes were combined and 7 codes were dropped due to lack of content. Interpretation to date shows six environmental factors as possible important influences on PTG e.g. support and reaction of immediate family, health services. 

Further analysis of the data is ongoing to understand this in more detail. 

 

Conclusion

The results so far are promising in exploring key environmental factors which may be important in influencing PTG in HNC survivors. 

Further analysis and larger studies are required to understand what combination of environmental factors are important for people to live well following HNC, and identify barriers which could inhibit PTG.

Impact statement

This pilot study provides a basis for further exploration of the role of environmental factors in the development of PTG following cancer.