Early melanoma and nonmelanoma skin cancer of the facial area are primarily treated with surgery. There is little known about patient outcomes of the facial skin cancer population. The objective of the study was to identify aesthetic, procedure and health-related concerns from the patient's perspective after facial skin surgery. Semi-structured in-depth interviews were conducted with 15 participants. Line-by-line coding was used to establish categories and develop themes. We identified five major themes related to the impact of skin cancer surgery: appearance-related concerns; psychological function (e.g. fear of new cancers, recurrence); social function (e.g. impact on social activities and interaction); adverse problems (e.g. pain, swelling) and satisfaction with the experience of care (e.g. satisfaction with surgeon). The priority of participants was the removal of the facial skin cancer as this diminished their overall worry. The aesthetic outcome was secondary but important as it had important implications on the participant's social and psychological functioning. The participant's experience with the care provided by the surgeon and staff also contributed to treatment satisfaction. This conceptual framework provides the basis for the development of a new patient-reported outcome (PRO) instrument.

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BackgroundFormal psychosocial support programs after weight-loss surgery are limited in scope and availability.ObjectiveThis randomized pilot study evaluated the feasibility of a postoperative behavioral intervention program.Materials and methodsPostoperative weight-loss surgery patients (N = 50) were recruited from February 2017–July 2017 and randomized to a four-month behavioral program or usual care wait-list. Outcomes evaluated in addition to feasibility included health-related quality of life (Short Form -36), psychosocial functioning and adherence. Secondary outcomes included within-group changes for each outcome.ResultsOut of eight possible sessions, intervention participants attended a mean of 4.2 sessions. Intervention group participants experienced greater improvements in the social functioning domain of health-related quality of life compared to usual care. Self-reported dietary adherence in the intervention group remained stable, while usual care group dietary adherence declined. Within the intervention group, participants also reported gains in the physical function, pain and general health aspects of quality life from baseline to post-treatment. No differences in weight, mood or other eating behaviors (e.g., loss of control, emotional eating) were evident between groups.ConclusionThough participation in a postoperative behavioral intervention varied, the program helped participants to maintain aspects of quality of life and self-reported adherence to dietary recommendations.Trial registrationClinicalTrials.gov NCT03092479

A conceptual framework of concepts of interest to individuals with CL/P formed the basis of the scales in the CLEFT-Q. Each subdomain represents an independently functioning scale. Understanding what matters to patients is essential in guiding PRO measurement.

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