Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
surgery such as a mastectomy can be devastating as highlighted by
some of the patients’ comments, but other physical symptoms such
as hair loss can be just as devastating to some patients.
Ever since the increased use of drugs in the treatment of cancer in
the 1970’s, the distressing effect of alopecia has been recognised.
Many female patients in this study mentioned this. It was described
as ‘the worst moment of their treatment’ and ‘totally devastating’.
Although alopecia is usually reversible and wigs are made available
routinely through the National Health Service, it appears that health
care professionals are perhaps rather blasé when it comes to
recognising and addressing the traumatic emotional effect it has on
patients. The patients in this study said that the wig service which
was provided by the NHS and the private sector was variable and
their experiences ranged from excellent to very poor. Choosing a
wig is a very emotional and distressing time for patients, therefore
they need all the support possible to make this a good experience.
Psychological distress due to alopecia is also generally considered to
be worse for females as opposed to males. This may be true but the
men who participated in this study did not receive a drug that
causes hair loss, so it was not an issue for them anyway. Batchelor
(2001) suggests men are probably able to cope more easily with
alopecia because male baldness, even in young males, is more
socially acceptable.
Attempts have been made to overcome this problem by reducing
the blood supply to the hair follicles during drug administration by
using scalp cooling but this is not effective in all cases. In this study
patients were not offered scalp cooling as an option because the
equipment was not available in the department and some health
care professionals did not see alopecia as a major priority for
investment. Patients interviewed described how their ‘femininity
was gone’ when their hair fell out. Others described how they knew
there was nothing that anyone could do to prevent their hair loss
but having someone to listen and support them through this difficult
time was very important to them. As already discussed,
chemotherapy nurses are well placed to help manage some of the
difficulties that these patients face. Nurses could therefore highlight
the choices available to patients, provide a willingness to listen,
have the knowledge and skills to identify patients’ needs and
worries and adapt a collaborative approach to maintaining the
physical and psychological well-being to produce an overall positive
impact. Collaborative and negotiated care that fully integrates the
patient’s view of care promotes compliance and is essential to the
planning of treatment (Gower et al 1995).
- 211 -