Evaluation of a novel telemedicine‐based intervention to manage body image disturbance in head and neck cancer survivors

Abstract

Objectives: The study aimed to evaluate the feasibility, acceptability, and preliminary clinical impact of BRIGHT (Building a Renewed ImaGe after Head & neck cancer Treatment), a novel telemedicine-based cognitive-behavioral intervention to manage body image disturbance (BID) in head and neck cancer (HNC) survivors. Methods: Head and neck cancer survivors with BID were enrolled into a single-arm pilot trial. Participants completed study measures at baseline, 1-and 3-months post-BRIGHT to assess its acceptability and clinical impact. Participants completed semistructured interviews to evaluate the feasibility and acceptability of BRIGHT and refine the intervention. Results: Ten HNC survivors with BID were enrolled into the trial of tablet-based BRIGHT. BRIGHT was feasible, as judged by low dropout (n = 1), high session completion rates (100%; 45/45) and low rates of technical issues with the tablet-based delivery (11% minor; 0% major). Ninety percent of participants were highly likely to recommend BRIGHT, reflecting its acceptability. BRIGHT was associated with a 34.5% reduction in mean Body Image Scale scores at 1-month post-BRIGHT (mean difference from baseline = 4.56; 95% CI 1.55, 7.56), an effect that was durable at 3-months post-BRIGHT (mean decrease from baseline = 3.56; 95% CI 1.15-5.96). Program evaluation revealed high levels of satisfaction with BRIGHT, particularly the delivery platform. During the qualitative evaluation, participants highlighted that BRIGHT improved image-related coping behavior. Conclusions: BRIGHT is feasible, acceptable to HNC survivors, and has significant potential as a novel approach to manage BID in HNC survivors. Additional research is necessary to refine BRIGHT and evaluate its clinical efficacy and scalability.

‘I Didn’t Even Recognise Myself’: Survivors’ Experiences of Altered Appearance and Body Image Distress during and after Treatment for Head and Neck Cancer

“…Stigma is generally likely for people with altered appearance regardless of gender [45]; however, it is possibly harder for men to disguise an altered appearance as they tend not to use makeup, scarves or other accessories which could hide the area. Being able to camouflage visible altered appearance has been found to lower distress for female survivors of HNC [46], however, Graboyes et al point to the inability of cosmetic interventions to effectively address complex psychosocial aspects of body image disturbance [7].…”

“…Research on survivors of HNC has shown that altered appearance is a source of psychological distress [1,5]. Changes in appearance and function can be the result of surgery [6] and chemo-radiotherapy [7]. Surgical treatment to the face and neck has been found to create negative changes in autoperceived body image in 1/3 of survivors with head and neck cancer (n = 36) [8].…”

“…Psychosocial interventions have proven effective for conditions of altered facial appearance [22] including in HNC [7]. However, almost all of these interventions have been offered reactively post-treatment [23][24][25][26].…”

Concerns and Needs of Patients With Head and Neck Cancer in the COVID‐19 Era

“…Survey data were qualitatively and statistically interpreted to describe the impact of COVID- 19 AK, HI). The status of the survey responder was defined as a patient undergoing active treatment, a caregiver of a patient speaking on behalf of the patient, or a patient in the survivorship period (\2, 2-5, or .5 years from the end of treatment).…”

“…The social distancing restrictions of COVID-19 and the impact on health care, including delays in treatment and cancelations of routine clinic visits, may also affect patients with HNC and have long-lasting consequences on psychosocial and physical health. [5][6][7][8] Yet, these precautionary measures may be especially prudent to follow as providers may be more at risk for infection and patients may be more at risk of severe sequelae from COVID- 19.…”