Journal of Clinical and Diagnostic Research. 2018 Aug, Vol-12(8): XC01-XC05 1 1 DOI: 10.7860/JCDR/2018/30770.11875 Original Article Oncology Section Self-Image and Quality of Life among Head and Neck Cancer Patients SHALINI G. NAYAK 1 , MAMATHA SHIVANANDA PAI 2 , LINU SARA GEORGE 3 Keywords: Adult, Head and neck tumour, Karnataka, QOL, Self-concept ABSTRACT Introduction: Cancers affecting the parts of head and neck hugely impact the patients. Among Head and Neck Cancer (HNC) patients, the visible signs and symptoms of the disease or the side effects of treatment modalities can cause various degrees of functional impairment such as mastication, swallowing and communication or disfigurement. Aim: To study the relationship between self-image and quality of life among head and neck cancer patients. Materials and Methods: This was a descriptive cross sectional survey conducted among 54 head and neck cancer patients. Data were collected through self-administered demographic proforma, disease related proforma, self-image scale and Functional Assessment of Head and Neck Cancer (FACT; H&N). Association between self-image and demographic and disease related variables were assessed by computing Chi-square. Kruskal Wallis was computed to find the association between quality of life and demographic and disease related variables. Results: Majority of patients i.e., 36 out of 54 (66.7 %) were above 50 years, 43 (79.6%) were men, 47 (87%) were married, 46 (85.18%) had the disease duration of less than six months, 43 (79.6%) were receiving both radiation therapy and chemotherapy as a mode of treatment, 49 (90.7%) of them did not have any co-morbidity, 16 (29.6%) had a mode of feeding other than oral (ryles tube and PEG feeding) and six (11.1%) had undergone tracheostomy. There was a significant association between self-image and monthly income, treatment modality and radiotherapy dose with p =0.013, 0.006 and 0.046 respectively. Kruskal Wallis test value for mode of feeding (4.881) was also statistically significant (0.027) with quality of life. There is positive correlation (r=0.613, p=0.001) between self-image and quality of life of head and neck cancer patients. Conclusion: HNC patients suffer with the disease 24 hours a day. Self-image and quality of life of these patients is interrelated. As the self-image improves, the quality of life will be better and vice versa. INTRODUCTION HNC are malignant tumours which arise above the clavicle within the structures located in the aero-digestive tract of the face and neck including glands, organs, soft tissues and bony structures of head and neck [1]. Head and neck area is placed colossal significance by individuals comparing other part of the body as it reflects our internalised sense of personality [2]. Every treatment options for head and neck cancer such as surgery, radiation therapy, chemotherapy or combination of these can change the structure and function of head and neck and leads to dysfunction and disfigurement. The obvious visibility of signs and symptoms among many HNC patients results in coping problems, inability to adapt to changes and curtails the quality of life [1,2]. Self-image can be described as the way one thinks about self and their abilities or appearance. In other words it’s one's conception of oneself or of one's role [3]. Portraying themselves is an innate enthusiasm of human beings. Self-concept possesses convincing impact on one’s life [4]. The belief of “self” is imperative human need and is of major interest [5]. Self-concept is multifaceted [6], unique to individual and changes overtime with context [4]. Development of positive or negative self-concept mainly results from physical, appearance and performance changes, health challenges and from feedback from significant others. Loss of a body part or alteration in health status can also affect the self-concept [4]. Treatment modalities and HNC have effect on functional changes and facial disfigurement. Such in-capabilities directly influence the client’s self-concept [7]. Findings of a study conducted by same authors also show that, suffering from HNC has effect on different domains of self-image such as body image, self-esteem and integrity [8]. Adverse side effects of radiation therapy include dryness of skin, skin reactions, redness or rash which is evidently visible to others. The functional disturbances leads to dysphagia, changes in the consistency of saliva, mucositis, disturbances in the speech and suppression of cell-mediated and humoral immunity [1]. HNC affects the basic functioning of many patients and it is very difficult to conceal the signs and symptoms for many of them. This in term leads to psychological disintegration and varying degrees of facial disfigurement. Thus changes in performance, physical changes associated with HNC affects the self-concept enormously. HNC patients with disturbed body image have significant association with depressive symptoms at the end of the treatment [9]. However, very little is known about the relationship between self-concept and quality of life of patients with HNC. Hence, researcher carried out a mixed method research on the functional assessment, self- image and lived experiences of head and neck cancer patients. Present study adopted a concurrent triangulation strategy of mixed method design, as the aim of the study was to determine the functional assessment and self-image of HNC patients and to acquire a deeper understanding of lived experiences. This model was selected to confirm and corroborate findings on self-image, functional assessment and lived experiences of patients with HNC in a single study. Both quantitative and qualitative data were collected concurrently by paying equal weight to both methods (QUAN+QUAL). Part of study findings conducted on same set are