{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:17:24Z","timestamp":1778566644853,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Locally advanced oral squamous cell carcinoma (OSCC) and its surgical treatment precipitate profound body image disturbance and psychological distress. With the increasing adoption of neoadjuvant immunochemotherapy (NICT), patients now experience fundamentally different treatment trajectories, yet the psychological implications of this paradigm shift remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective, comparative mixed-methods cohort study investigated longitudinal trajectories of body image disturbance (Body Image Scale, BIS) and psychological distress (Hospital Anxiety and Depression Scale, HADS) in OSCC patients undergoing either NICT followed by surgery (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f77) or upfront surgery (US;\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f77) following propensity score matching. Assessments occurred at baseline, post-neoadjuvant therapy (for the NICT group) or immediately pre-surgery (for the US group), at discharge, and 3\u202fmonths post-surgery. Linear mixed-effects models analyzed time-by-group interactions. A qualitative phenomenological phase (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f15) explored subjective experiences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant time-by-group interactions were observed for both BIS [\n                      <jats:italic>F<\/jats:italic>\n                      (3,456)\u202f=\u202f18.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001] and HADS-Total (\n                      <jats:italic>F<\/jats:italic>\n                      (3,456)\u202f=\u202f14.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The NICT group exhibited elevated distress pre-surgery (T1: HADS-Total 15.8 vs. 12.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004) but demonstrated superior recovery by three months (T3: BIS 11.5 vs. 14.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002; HADS-Total 12.2 vs. 15.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Qualitative analysis revealed divergent psychological experiences: NICT patients endured prolonged anticipatory grief (\u201csaying goodbye slowly\u201d), while US patients experienced traumatic shock (\u201cwaking up to a stranger\u201d).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NICT and US pathways generate fundamentally different psychological trajectories. Despite heightened pre-surgical distress, NICT patients demonstrate more robust psychological recovery, potentially facilitated by gradual adaptation. These findings support pathway-specific psychosocial interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1819611","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:44:35Z","timestamp":1778564675000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Re-authoring the altered self: the impact of a three-phase narrative nursing intervention on body image and distress in oral squamous cell carcinoma"],"prefix":"10.3389","volume":"17","author":[{"given":"Na","family":"Tian","sequence":"first","affiliation":[{"name":"The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Liu","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huijie","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qigen","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Head Neck, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.3332\/ecancer.2020.1118","article-title":"Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation?","volume":"14","author":"Aminnudin","year":"2020","journal-title":"Ecancermedicalscience"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1001\/jamaoto.2023.4672","article-title":"Neighborhood deprivation and symptoms, psychological distress, and quality of life among head and neck cancer survivors","volume":"150","author":"Balogun","year":"2024","journal-title":"JAMA Otolaryngol. 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