Breaking the silence: integration of facial disfigurement after surgical treatment for cancer

Little is known about the psychosocial effects of facial disfigurement. We present the results of a qualitative study following 15 patients who had been surgically treated for head, neck, or eye cancer over the course of their first postoperative year. Taped nurse-patient conversations and individual interviews were analyzed using the grounded theory method. The findings revealed that the main concern of the patients was feeling isolated, which was resolved using a process of interactional integration. Interactional integration begins by breaking the silence to enable the progression from a disfigured person to a person with a disfigurement. The model explains the process of adjustment and demonstrates various elements that could be used in interventions targeting patients who experience psychosocial problems.