Coping with disfigurement and dysfunction after head and neck cancer surgery: a conceptual framework.

The relationship between coping effectiveness and degree of postoperative disfigurement and dysfunction has been described. Current nationwide mandates for more cost-effective health care warrant continued efforts to describe this patient population in relation to coping patterns. Those patients who do not cope adequately should be considered for more intensive intervention while still in the therapeutic environment of the hospital. More creative and innovative solutions are needed to facilitate effectiveness of intervention and predictability of outcomes within an appropriate time frame and in a fiscally responsible manner. In the interim, inability to cope with disfigurement and dysfunction at discharge can predispose the patient to infection or noncompliance with follow-up care, pathological obsession with or denial of the defect, depression, and social isolation.