# Psychosocial Barriers and Social Perceptions in Oncology Patients with Tracheostomy: Case–Control Study

## TL;DR

This study finds that cancer patients with tracheostomies face significant social and emotional challenges, especially younger and female patients, highlighting the need for better support.

## Contribution

The study introduces a matched case–control design to quantify psychosocial barriers in tracheostomy patients compared to cancer patients without tracheostomies.

## Key findings

- Tracheostomy patients reported higher social withdrawal and self-consciousness compared to controls.
- Women and younger adults with tracheostomies experienced the greatest psychosocial difficulties.
- The study identifies a need for targeted psychosocial support to improve quality of life for these patients.

## Abstract

Patients with cancers of the throat or windpipe sometimes need a surgical opening in the neck called a tracheostomy to help them breathe. Although this procedure can save lives, it also changes how a person looks and speaks, which may affect everyday social interactions. In this study, we compared people living with a tracheostomy to people with similar cancers who did not need one. We found that those with a tracheostomy felt more judged by others, avoided social situations more often, and reported lower confidence in public. Women and younger adults were especially affected. These results show that the emotional and social consequences of a tracheostomy can be significant and should not be overlooked. The findings highlight the need for better support programs, counseling, and rehabilitation services to help patients adjust and feel more comfortable returning to their normal lives.

Patients with respiratory tract malignancies who undergo tracheostomy often experience profound psychosocial challenges related to visible anatomical changes and altered communication. The aim of this study was to evaluate psychosocial barriers and perceived social acceptance in patients living with a tracheostomy, compared with patients treated for similar cancers without requiring a tracheostomy. A matched case–control study with frequency matching at the group level was conducted including 150 patients with permanent tracheostomies and 150 matched controls treated with organ-preserving approaches. Groups were frequency-matched at the group level based on age, sex, primary tumor site, and disease stage at diagnosis. Participants completed a study-specific questionnaire assessing social withdrawal, self-consciousness, and perceived reactions of others using a five-point Likert scale. A composite Psychosocial Barrier Score was calculated, and subgroup analyses examined differences according to gender and age. Patients with tracheostomies demonstrated significantly higher psychosocial burden than controls, with markedly elevated composite scores and higher endorsement of stigma-related items. Female and younger patients within the tracheostomy group reported the greatest psychosocial difficulties, including increased social avoidance and reduced confidence in public settings. In contrast, gender- and age-related differences were minimal in the control group. These findings indicate that tracheostomy is strongly associated with heightened psychosocial barriers and perceived social stigma, particularly among younger and female patients. Integrating targeted psychosocial support into routine post-treatment care may be essential to improve social reintegration and quality of life in this population.