Associations of religiosity and spiritual well‐being with appearance concerns after head and neck cancer surgery

Objective To investigate whether religiosity and spiritual well‐being are associated with appearance concerns among people with visible sequelae due to cancer surgery in the head and neck region. Methods A cross‐sectional study was carried in 202 adult patients in a referral hospital for cancer treatment in Midwest Brazil. Data on sociodemographic, psychosocial and clinical aspects and cancer‐related behaviours were collected through interviews, clinical examination and medical records. The outcome was the patients' appearance concerns (Derriford Appearance Scale—DAS24). The independent explanatory variables were religiosity (Duke University Religiousness Index—DUREL) and spiritual well‐being (Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐Being Scale—FACIT‐Sp12). Data were analysed using Pearson's chi‐square and Poisson regression. Results Most of the participants were male (76.2%), and mean age was 58.6 years (SD = 11.6). The scores of appearance concerns (DAS24) ranged from 21 to 75 (median = 33.0). In the bivariate analysis, appearance concerns were associated with spiritual well‐being (FACIT‐Sp12), degree of disfigurement and treatment with radiotherapy/chemotherapy. Religiosity (DUREL) was not associated with the outcome. In the adjusted regression model, a lower prevalence of appearance concerns was found among patients with higher levels of spiritual well‐being (PR = 0.86; CI = 0.79‐0.94), males (PR = 0.87; CI = 0.79‐0.95), those with lower degrees of disfigurement (PR = 0.89; CI = 0.82‐0.98) and those who had no treatment with radiotherapy/chemotherapy (PR = 0.83; CI = 0.72‐0.94). Conclusion High spiritual well‐being was independently associated with lower levels of appearance concerns in people with visible sequelae due to cancer surgery in the head and neck region. Understanding the role of this psychosocial determinant may help in the coping process.