Dodd, RH;
(2016)
Examining the psychosocial impact of human papillomavirus oropharyngeal cancer.
Doctoral thesis , UCL (University College London).
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Abstract
The causal role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OSCC) has been well established. The work presented in this thesis sets out to explore the information available about HPV-OSCC and examine the psychosocial issues associated with a diagnosis of HPV-OSCC. Six studies were carried out between 2013 and 2016. Study 1 systematically reviewed the existing literature examining the psychosocial impact of HPV-OSCC in patients (n=10 studies) and current knowledge of the relationship between HPV and OSCC (n=41 studies). Study 2 was a content analysis examining the media coverage in the UK of the link between HPV and OSCC (n=112 articles). Study 3 was a qualitative study with health professionals caring for HNC patients (n=15). Study 4 was an extension of study 3, developing a survey for dissemination among health professionals working with HPV-OSCC patients (n=260). Both studies explored their experiences of and attitudes to discussing HPV with their patients, with study 4 additionally measuring knowledge of HPV-OSCC. Study 5 was a qualitative study with patients diagnosed with HPV-OSCC (n=20) and with some of these patients’ partners (n=12), examining their experiences around the diagnosis of HPV-OSCC. Study 6 involved the development of an information booklet about HPV-OSCC, based on the findings of studies 1-5. The existing literature examining the psychosocial impact of HPV-OSCC provided limited evidence about the impact of HPV in OSCC patients. Knowledge of HPV in OSCC was not well known across most populations, and the HPV-OSCC content presented in the media lacked basic facts about HPV. The increasing incidence of HPV-OSCC was a significant issue for health professionals and key messages to communicate to HPV-OSCC were found. Reactions about HPV were mixed among participants whose cancer or partners’ cancer was caused by HPV. An information booklet developed about HPV-OSCC was well received by patients and health professionals and could act as a discussion tool to provide patients with evidence-based information. De-escalation of treatment in the future may help minimise some of the negative psychosocial outcomes associated with HPV-OSCC and improve long-term functioning.
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