The effect of a 5-week head & neck surgical oncology practicum on nursing students' perceptions of facial disfigurement: part I.

Abstract

Purpose: This pilot study tested the effectiveness of a head and neck surgical oncology clinical practicum on nursing students' perceptions of facial disfigurement in these patients. Hypotheses also addressed the impact of patient and student gender; patterns in perceptions based on patient gender and surgical procedure were noted.

Design: A two-group pretest-posttest repeated measures experimental design was used with King's Theory of Goal Attainment (King, 1971, 1981) serving as the framework.

Sample/setting: Thirty-seven junior-level male (n=9) and female (n=28) nursing students enrolled in a baccalaureate program's adult medical-surgical course were randomly assigned to a 5-week clinical experience in an urban university-affiliated medical center. The Experimental Group (n=19) was assigned to a head and neck surgical oncology unit and the Control Group (n=18) was assigned to a general surgical unit.

Procedures: All students completed the Demographic Data Form-Student Version (DDF-SV) and the Modified Disfigurement Scale (MDS) (Lockhart, 1992a, 1992b, 1999, 2000) prior to attending a 4-hour lecture Care of Head and Neck Surgical Patients, a 45-minute clinical conference Care of Facially Disfigured Patients, and the 5-week clinical practicum. All students repeated the MDS after their clinical practicum.

Results: A two-way repeated measures analysis of variance and analysis of covariance revealed no significant differences in ratings, irrespective of clinical group or student gender; all photos were described as being "moderately disfigured". All students rated female patients as being significantly more disfigured than male patients with identical surgical procedures. Both male and female photos were similarly rank-ordered according to severity of disfigurement; surgeries that involved the central portion of the face were rated as being more severely disfigured than surgeries that affected peripheral portions.