Nixon Jodie L, Cartmill Bena, Turner Jane, Pigott Amanda E, Brown Elizabeth, Wall Laurelie R, Ward Elizabeth C, Porceddu Sandro V
Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia.
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
J Med Radiat Sci. 2018 Dec;65(4):282-290. doi: 10.1002/jmrs.308. Epub 2018 Oct 30.
While use of a thermoplastic mask during radiotherapy (RT) treatment for head and neck cancer (HNC) is an essential component of safe patient care, there is little understanding of the extent to which this evokes anxiety (i.e. "mask anxiety") for the person undergoing treatment.
A mixed method, convergent design was used to examine the prevalence and experience of mask anxiety using two clinical cohorts. In phase one, a cohort of 100 patients undergoing RT for HNC were assessed for self-perceived mask anxiety using a modified distress thermometer screening tool. In phase two, a separate cohort of 20 patients who identified as having mask anxiety participated in individual interpretative descriptive interviews to explore the nature of their experience.
In phase one, 26% of participants self-identified as being anxious about the use of a thermoplastic mask. In phase two thematic analysis of the interviews revealed two over-arching themes relating to the person's experience of mask anxiety: contributors to the mask anxiety (vulnerability, response to experience and expectations); and how the person was going to manage the mask anxiety during treatment (strategies and mindset).
Mask anxiety impacted a quarter of participants undergoing radiotherapy for HNC. In line with the themes elicited from the participants, implementation of routine screening to ensure early identification, and patient education to assist preparation for wearing the mask during RT are strategies that could improve current management of mask anxiety.
虽然在头颈癌（HNC）放射治疗（RT）期间使用热塑性面罩是安全护理患者的重要组成部分，但对于接受治疗的患者而言，这种面罩会在多大程度上引发焦虑（即“面罩焦虑”）却鲜为人知。
采用混合方法、收敛性设计，通过两个临床队列来研究面罩焦虑的患病率和体验。在第一阶段，使用改良的痛苦温度计筛查工具对100名头颈癌放疗患者进行自我感知的面罩焦虑评估。在第二阶段，另外20名确定有面罩焦虑的患者参与了个体解释性描述访谈，以探讨其体验的本质。
在第一阶段，26%的参与者自我认定对面罩的使用感到焦虑。在第二阶段，访谈的主题分析揭示了与患者面罩焦虑体验相关的两个总体主题：面罩焦虑的促成因素（脆弱性、对体验的反应和期望）；以及患者在治疗期间将如何应对面罩焦虑（策略和心态）。
面罩焦虑影响了四分之一的头颈癌放疗参与者。根据参与者提出的主题，实施常规筛查以确保早期识别，以及开展患者教育以帮助患者为放疗期间佩戴面罩做好准备，这些策略可以改善当前对面罩焦虑的管理。
