An exploration of the perceived changes in intimacy of patients' relationships following head and neck cancer

Aims and objectives.  This paper reports the experiences of former patients who have undergone a range of head and neck cancer treatments and their perceptions of the changes in intimacy experienced, as an individual and through their relationships with partners, family and friends. Background.  A diagnosis of head and neck cancer, subsequent surgical treatment and radiotherapy can lead to an altered quality of life. Whilst important developments have been made to improve the quality of life for this patient group from a functional perspective, psychosocial perspectives are much less understood. Design.  A qualitative study approach. Methods.  Data were collected in 2007/2008 via interview using open-ended questions from a purposive sample of 16 participants who were at least one year post-treatment. A thematic analysis was employed to interpret the findings. Results.  Analysis of the data produced three broad themes. These were 'personal identity', 're-establishing social networks' and 'intimate relationships' and explored the person as an individual and their perceived changes to self-esteem and image. The perception of their altered position in society, the impact this has on their willingness to re-engage with society and the degree to which treatment can alter an individual's ability to resume former intimate relationships with family and partners. Conclusion.  Patients' definitions of intimacy are multifaceted and related directly to the type of relationship that existed prior to treatment. The concerns and challenges faced by patients need to be addressed and support opportunities considered as part of the rehabilitation process. Relevance to clinical practice.  The paper gives insight for nurses and other healthcare professionals who are expected to provide effective emotional and therapeutic support for patients who have undergone treatment for head and neck cancer. Understanding of patient concerns and recognition of adaptive and coping strategies are essential for this practice.