[Experience of their environment and disease by facially disfigured patients--recognition of the handicap as a prerequisite for rehabilitation].

In an investigation of psychosocial strain in persons having a facial or skin impairment, a total of 25 patients of Fachklinik Hornheide (a special clinic for the treatment of tumors, tuberculosis, and for facial and skin reconstruction) had participated in in-depth interviewing. It was found with unexpected clarity that these clients are exposed to a high measure of negative environmental reaction. In addition to having to cope with stressful disease consequences, often entailing a "loss of face" with the major problems of self-worth this involves, these negative experiences in many instances lead to behavioural problems, withdrawal reaction, occupational repercussions, or severe emotional crisis in those concerned. The degree to which these patients can overcome their problems is to a large extent dependent on how parents, spouse, colleagues, and important others respond. Early enough involvement of significant others, possibly already at the time of medical information, as well as support during emotional crisis are capable of considerably alleviating the coping process. The psychosocial problems confronting persons with disfiguring facial conditions have to be taken into account during therapy in order to successfully enhance the purpose of integration into the social environment.