Following surgery, early involvement with self-care procedures (managing dressing, socialisation, even combing hair) all contribute to an ethos of self-management and independence which are precursors of long-term coping well, and self-confidence.

Dropkin (1992) studied coping skills in head and neck cancer specifically, and suggests that self-care and social affiliation were the earliest manifestations of positive coping behaviour during the post-operative period. Days 4 - 6 were considered vital stages in the acceptance of the visible change in appearance.

The contact with medical staff and the beginnings of socialisation on the ward represent gradual exposure to social situations. Extra nursing input at this stage to establish these primary coping skills can help to promote long-term coping.

Patients may have to be encouraged to use their non-preferred hand to use a flannel or a comb if there is pain on lifting one shoulder...

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