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Claustrophobia and anxiety have been associated with wearing an immobilisation mask whilst undergoing radiotherapy (RT) to the head and neck (H&N) area (Keast et al., 2019; Nixon et al., 2018). The management of psychological distress is therefore fundamental to achieving positive outcomes for patients whilst delivering accurate treatment. Keast et al. (2019) concluded that comprehensive intervention is recommended to minimise mask-related anxiety. Nixon et al. (2019) also recommended that routine screening be implemented to assess mask anxiety during RT. To ensure treatment is successful for the patient, a comprehensive patient centred program has been developed to manage mask-anxiety.

Two radiation therapists investigated mask-related resources from several sources. Reflective practice regarding previous experiences with patients was incorporated. A mask-making video resource was evaluated with feedback sought from the wider department regarding its effectiveness. Coping strategies for claustrophobia were analysed and pooled into a resource, including attending a claustrophobia workshop run by a specialised H&N radiation therapist. Finally, the program was reviewed in an MDT setting by senior RTs, nursing and admin. Aria Carepaths were updated to ensure this was routinely integrated with ease for both the department and patient.

A comprehensive claustrophobia management program has been developed which consists of several key interventions. Firstly, a video link is emailed to the patient 1 week prior to their CT which demonstrates the mask making process and includes patient testimonials to familiarise the patient with the process. The email encouraged patients to contact the department if they anticipate any distress relating to the mask. A personalised care-plan and referral pathways can then be established prior to CT such as medication intervention to reduce anxiety hence shortening appointment length. In addition, a claustrophobia brochure has been developed to be given out before CT. This again emphasises the purpose of the mask and interventions available such practicing mindfulness, manipulating the mask, relaxation music and controlled breathing. Providing a video resource and written resource means patients and their support people can process the information in their own time away from the clinical setting. A patient alert is also added on day 2 of treatment which prompts the radiation therapist to have a conversation with the patient about how they are managing with the mask, making any adaptations to their care plan as necessary.

A radiotherapy mask can cause significant anxiety in patients. To improve a patient’s experience and deliver patient centred care our department has created a comprehensive intervention program. The effectiveness of this program will be evaluated in future work for on-going development.