Exploring the prevalence and experience of mask anxiety for the person with head and neck cancer undergoing radiotherapy
Open accessAbstract
INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
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Thermoplastic masks used for immobilization in head, neck, and brain radiation are commonly reported as anxiety-provoking.
“As thermoplastic masks used for immobilization in these sites are commonly reported as anxiety-provoking,16”
From Impacts of Intrafraction Virtual Reality-Based Environment Modification on Procedural Anxiety, Heart Rate, and Overall Radiation Therapy Experience During External Beam Radiation Therapy (2024) · cites this paper as [16]
The Abstract Results report that 26% of participants with head and neck cancer identified anxiety about the thermoplastic mask. The Introduction says masks are also used for brain radiotherapy, but the paper does not establish how commonly brain-radiotherapy patients report mask anxiety. Page numbers are not available in our copy. (LLM, conf=0.84)
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- Authors
- Nixon, J. L., Cartmill, B., Turner, J., Pigott, A. E., Brown, E., Wall, L. R., Ward, E. C., & Porceddu, S. V.
- Affiliations
- The University of Queensland (AU)
- Princess Alexandra Hospital (AU)
- School of Health and Rehabilitation Sciences University of Queensland Brisbane Australia
- Corresponding author
- Nixon, Jodie L.
- ORCID
- Venue
- Journal of Medical Radiation Sciences
- Publisher
- Wiley
- Published
- 2018-10-30
- Volume
- 65
- Issue
- 4
- Pages
- 282-290
- ISSN
- 2051-3895 (ISSN-L)
- 2051-3909
- PMC
- PMC6275267
- OpenAlex
- W2898978222
- Cited by
- 69
- References
- 20
- Citations by year
- 2026: 11 · 2025: 21 · 2024: 9 · 2023: 9 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 1
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Medical Radiation Sciences (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Keywords
- head and neck cancer, radiotherapy, thermoplastic mask, patient experience, anxiety prevalence, distress screening, coping strategies, patient education, anxiety screening
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Female, Head and Neck Neoplasms, Humans, Male, Masks, Middle Aged
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