Appearance-based concerns and psychosocial functioning following complex plastic surgery for female melanoma survivors

Yates, Sarah and Murray, Craig and Munks, Emma (2024) Appearance-based concerns and psychosocial functioning following complex plastic surgery for female melanoma survivors. PhD thesis, Lancaster University.

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Abstract

This thesis aimed to qualitatively explore the experiences of living with an altered appearance related to the skin, and compromises a systematic literature review, an empirical research paper, and critical appraisal of the research undertaken. The literature review synthesised qualitative research exploring the psychological experiences and appearance concerns of people with psoriasis. Utilising thematic synthesis, the results of 21 papers were synthesised to generate three themes: ‘Constructing and navigating the psoriasis-identity’, ‘Appearance stigmatisation’ and ‘Acceptance and coping with an altered appearance’. Although there are individual differences in adjustment and coping, findings highlight the impact of psoriasis upon identity, psychological, and social functioning. Clinical implications and suggestions for future research are discussed. The research paper explored the psychosocial functioning and appearance-based concerns of female melanoma survivors, who have undergone reconstructive plastic surgery as part of their treatment. Interpretative phenomenological analysis was utilised to analyse data from seven interviews. Three themes were identified: ‘Constructing the melanomaidentity’, ‘Relating to others: experiencing dismissal and self-stigmatisation’ and ‘Grieving the life you had: psychosocial adjustment’. Findings highlighted the impact of appearance changes upon participants’ sense of self and identity, in the context of beauty norms and societal narratives related to skin cancer. These findings are considered in relation to existing literature, and the implications for clinical practice are discussed. The critical appraisal provides a summary of the research, along with reflections on methodological and ethical considerations. Limitations and clinical implications are also highlighted. The importance of reflexivity is considered, and personal reflections of the research process, such as the impact of the lead researchers own lived experience, are discussed.