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

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.