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Saita E, Ferraris G, Acquati C, Molgora S, Sorge A, Valenti F, Grassi MM, Vagnini D. Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Front Psychol 2022; 13:869905. [PMID: 35401315 PMCID: PMC8983958 DOI: 10.3389/fpsyg.2022.869905] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Sara Molgora
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Antonia Sorge
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | | | | | - Denise Vagnini
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
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Nikita, Rani R, Kumar R. Body image distress among cancer patients: needs for psychosocial intervention development. Support Care Cancer 2022; 30:6035-6043. [PMID: 35412075 PMCID: PMC9002224 DOI: 10.1007/s00520-022-07049-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/06/2022] [Indexed: 11/07/2022]
Abstract
Objectives This study examines the body image distress among patients with head and neck cancer (HNC) visiting a tertiary care hospital for follow-ups. Design A cross-sectional survey purposively enrolled 170 head and neck cancer (HNC) patients who had undergone cancer surgery at a newly established tertiary care hospital, North India. Methods A structured pre-tested socio-demographic and clinical profile checklist and the Derriford Appearance Scale-24 (DAS-24) were used to collect information. An appropriate descriptive and inferential statistic was applied to compute the findings. Results The median age of the participants was 46.0 years, and 80% of the participants were unemployed. The mean body image distress score was 57.95 (SD = 10.3, 47–66.75, range 42–77). The body image distress shows a significant association with age (p < .001), gender (p = 0.003), and working status (p = 0.032) of the HNC patients. Multilinear regression reported gender as an independent predictor (95% CI: 0.615–8.646, p = 0.025) for body image distress in HNC patients. Conclusions HNC patients reported substantial body image distress due to changes in body appearance. Female patients who had undergone surgery at young age reported higher body image distress. Recommending cosmetic surgery and nurse-led psychosocial nursing intervention on routine follow-ups are other potential strategies to improve facial appearance to overcome the negative impact of body image.
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Affiliation(s)
- Nikita
- All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India, 751029
| | - Ruchika Rani
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, 249203
| | - Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, 249203.
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Body Image Issues in Patients With Colorectal Cancer: A Scoping Review. Cancer Nurs 2022; 46:233-247. [PMID: 35349543 DOI: 10.1097/ncc.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stomas in colorectal cancer (CRC) survivors lead to body image problems. Advances in treatment help reduce the rate of stoma formation, but body image distress is still frequently experienced in CRC survivors. OBJECTIVES This review is aimed toward mapping and describing the state of knowledge regarding body image in patients with CRC. METHODS A systematic literature search complying with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. Screening and data extraction were performed by 2 reviewers independently for all potentially eligible studies. RESULTS A total of 56 eligible articles were selected. The majority of these studies were quantitative studies (85%). The eligible studies were classified into 4 broad categories: instruments used to assess body image, prevalence of body image distress, factors related to body image, and impact of body image distress. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-CR38) colorectal questionnaire was the most common measurement tool found among the reviewed studies (70%), and body image distress was reported by 25.5% to 86% of participants. Excluding gender, age, type of surgery, adjuvant therapy, time from diagnosis, social support, and stoma status, changes in bowel habits was identified as affecting the body image of patients with CRC. CONCLUSION Changing bowel habits emerged as a significant factor causing body image distress for CRC survivors. IMPLICATIONS FOR PRACTICE Clinicians should raise awareness about body image distress in patients with CRC, focus on finding effective measures and interventions intended to help alleviate symptoms of bowel dysfunction, and prepare patients to adapt to altered bowel functions.
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An J, Zhou K, Li M, Li X. Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China. BMC Womens Health 2022; 22:61. [PMID: 35246115 PMCID: PMC8896367 DOI: 10.1186/s12905-022-01635-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 01/18/2023] Open
Abstract
Background Breast cancer survivors experience altered body image and quality of life (QoL) due to the disease and its treatment. The multidimensional nature of body image and QoL makes their relationships complex. This study aimed to examine the associations between the two concepts in Chinese breast cancer survivors and test whether these associations are moderated by rural–urban residence. Methods A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (the Body Image Self-Rating Questionnaire for Breast Cancer and 36-item Short-Form Health Survey) and questions assessing demographic and clinical covariates were administered. Multiple linear regressions were used to assess the relationship between body image and QoL domains and to examine the moderating effect of rural–urban residence. Results In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical (β ranged from − 0.15 to − 0.11, p < 0.05) and mental (β ranged from − 0.46 to − 0.34, p < 0.001) well-being. Better perception of body image-related social and behavior change was significantly associated only with better mental well-being (β ranged from − 0.40 to − 0.33, p < 0.001). The association between body image and mental well-being was much stronger in urban subjects (b = − 0.38, p < 0.001) than in rural subjects (b = − 0.20, p < 0.001). Conclusions Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our results indicate that incorporating interventions that address body image issues would be advantageous for survivorship care to enhance QoL in breast cancer survivors. Furthermore, rural–urban differences should be considered in the strategic design of survivorship care programs in rural and urban settings.
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Affiliation(s)
- Jinghua An
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Kaina Zhou
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Central Ave, Shatin, Hong Kong, SAR
| | - Xiaomei Li
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China.
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Goyal N, Day A, Epstein J, Goodman J, Graboyes E, Jalisi S, Kiess AP, Ku JA, Miller MC, Panwar A, Patel VA, Sacco A, Sandulache V, Williams AM, Deschler D, Farwell DG, Nathan C, Fakhry C, Agrawal N. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2022; 7:70-92. [PMID: 35155786 PMCID: PMC8823162 DOI: 10.1002/lio2.702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To provide a consensus statement describing best practices and evidence regarding head and neck cancer survivorship. METHODS Key topics regarding head and neck cancer survivorship were identified by the multidisciplinary membership of the American Head and Neck Society Survivorship, Supportive Care & Rehabilitation Service. Guidelines were generated by combining expert opinion and a review of the literature and categorized by level of evidence. RESULTS Several areas regarding survivorship including dysphonia, dysphagia, fatigue, chronic pain, intimacy, the ability to return to work, financial toxicity, lymphedema, psycho-oncology, physical activity, and substance abuse were identified and discussed. Additionally, the group identified and described the role of key clinicians in survivorship including surgical, medical and radiation oncologists; dentists; primary care physicians; psychotherapists; as well as physical, occupational, speech, and respiratory therapists. CONCLUSION Head and neck cancer survivorship is complex and requires a multidisciplinary approach centered around patients and their caregivers. As survival related to head and neck cancer treatment improves, addressing post-treatment concerns appropriately is critically important to our patient's quality of life. There continues to be a need to define effective and efficient programs that can coordinate this multidisciplinary effort toward survivorship.
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Affiliation(s)
- Neerav Goyal
- Department of Otolaryngology—Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Andrew Day
- Department of Otolaryngology—Head and Neck SurgeryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Joel Epstein
- Department of SurgeryCedars SinaiLos AngelesCaliforniaUSA
- City of HopeCaliforniaDuarteUSA
| | - Joseph Goodman
- Ear, Nose and Throat CenterGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Evan Graboyes
- Department of Otolaryngology—Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Scharukh Jalisi
- Department of OtolaryngologyBeth Israel DeaconessBostonMassachusettsUSA
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Jamie A. Ku
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Matthew C. Miller
- Department of OtolaryngologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Aru Panwar
- Department of Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaNebraskaUSA
| | - Vijay A. Patel
- Department of OtolaryngologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Assuntina Sacco
- Department of Medical OncologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Vlad Sandulache
- Department of Otolaryngology—Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amy M. Williams
- Department of Otolaryngology—Head and Neck SurgeryHenry Ford Health SystemDetroitMichiganUSA
| | - Daniel Deschler
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - D. Gregory Farwell
- Department of Otolaryngology—Head and Neck SurgeryUniversity of California DavisDavisCaliforniaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology—Head and Neck SurgeryLouisiana State UniversityShreveportLouisianaUSA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology—Head and Neck SurgeryUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA
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Bowie J, Brunckhorst O, Stewart R, Dasgupta P, Ahmed K. Body image, self-esteem, and sense of masculinity in patients with prostate cancer: a qualitative meta-synthesis. J Cancer Surviv 2022; 16:95-110. [PMID: 33963973 PMCID: PMC8881246 DOI: 10.1007/s11764-021-01007-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs. METHODS A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs. RESULTS Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity. CONCLUSIONS Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment. IMPLICATIONS FOR CANCER SURVIVORS This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
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Affiliation(s)
- Jessica Bowie
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.
- Department of Urology, King's College Hospital, London, UK.
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59
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Ivziku D, Gualandi R, Pesce F, De Benedictis A, Tartaglini D. Adult oncology patients' experiences of living with a central venous catheter: a systematic review and meta-synthesis. Support Care Cancer 2022; 30:3773-3791. [PMID: 35031831 DOI: 10.1007/s00520-022-06819-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The incidence of cancer is increasing globally, and a greater number of patients will receive treatments though central vascular access devices (CVADs). Only a few qualitative studies describe the experience of adult oncology patients living with CVADs, and no systematic review of literature has been published on this topic. We therefore aimed to systematically synthesize the evidence of the qualitative studies on the experience of adult oncology patients with CVADs to report the implications of living with this device, and to inform healthcare professionals (HCPs) about problematic aspects of care for this population. METHODS A comprehensive literature review was conducted on PUBMED, MEDLINE, SCOPUS, COCHRANE, and WEB OF SCIENCE, and was updated on May 25, 2021. Nine studies fulfilled the inclusion criteria. The evidence was synthesized using the meta-aggregation approach proposed by the Joanna Briggs Institute. RESULTS Four themes emerged: During catheter implantation oncology patients typically experience reluctance, apprehension and acceptance; The nature of the information, knowledge transmission and HCPs' competence all influence the patient's confidence; How the presence of a catheter impacts the patient's daily life, their self-perception and their social behavior; The catheter is a symbol of disease, a friend that helps prevent problems, and its removal is perceived as physical and psychological liberation. CONCLUSION This systematic review evidenced some problematic aspects related to patient information, education and device management, and gaps in nursing skills on handling the device. The results of this review should be used as a framework for improvement interventions.
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Affiliation(s)
- Dhurata Ivziku
- Department of Nursing Innovation and Development, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - Raffaella Gualandi
- Department of Health Professions, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | | | - Anna De Benedictis
- Department of Clinical affairs, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Daniela Tartaglini
- Department of Health Professions, Campus Bio-Medico of Rome University Hospital, Via Alvaro del Portillo, 200, 00128, Rome, Italy
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Abdelhadi OA, Pollock BH, Joseph JG, Keegan THM. Psychological distress and associated additional medical expenditures in adolescent and young adult cancer survivors. Cancer 2022; 128:1523-1531. [PMID: 35001391 DOI: 10.1002/cncr.34064] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/19/2021] [Accepted: 11/13/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer survivors experience psychological distress often because of cancer and its treatment. However, no prior studies have evaluated the additional medical expenditures and health care utilization associated with psychological distress in AYA cancer survivors. METHODS AYA cancer survivors and a comparison matched group of adults with no history of cancer were identified from 2011-2016 Medical Expenditure Panel Survey data. Medical expenditures and health care utilization were evaluated with multivariable regression models. RESULTS AYA cancer survivors were more likely to have psychological distress (11.5% of 1757) than adults with no history of cancer (5.8% of 5227). The prevalence of psychological distress was found to be high many years after the diagnosis, with 11.2% reporting distress ≥20 years after their cancer diagnosis. AYA cancer survivors with psychological distress were more likely to smoke and have chronic conditions and were less likely to exercise regularly in comparison with AYAs with no history of psychological distress. AYA cancer survivors with psychological distress had additional annual medical expenses ($4415; 95% CI, $993-$9690), office visits (2.80; 95% CI, 0.23-6.15), and use of prescription medications/medication renewals (11.58; 95% CI, 5.70-19.47) in comparison with AYA cancer survivors without psychological distress. Additional annual medical expenses of psychological distress were $2600 higher in AYA cancer survivors than adults without a history of cancer ($1802; 95% CI, $440-$3791). CONCLUSIONS These results highlight the substantial economic burden associated with psychological distress in AYA cancer survivors. This research could inform survivorship care plans and interventions addressing the psychological needs of AYA cancer survivors.
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Affiliation(s)
- Ola A Abdelhadi
- Graduate Group of Epidemiology, University of California Davis, Davis, California
| | - Brad H Pollock
- Graduate Group of Epidemiology, University of California Davis, Davis, California.,Department of Public Health Sciences, University of California Davis, Sacramento, California
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California
| | - Theresa H M Keegan
- Graduate Group of Epidemiology, University of California Davis, Davis, California.,Department of Public Health Sciences, University of California Davis, Sacramento, California.,Center for Oncology Hematology Outcomes Research and Training and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California
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Wu SY, Sun MH, Yen CH, Tsai YJ, Liao YL. Fabrication of a facial prosthesis for a 13-year-old child by using a point-and-shoot three-dimensional scanner and CAD/CAM technology. Taiwan J Ophthalmol 2022; 12:219-222. [PMID: 35813808 PMCID: PMC9262021 DOI: 10.4103/tjo.tjo_49_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/16/2021] [Indexed: 11/04/2022] Open
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Weingarden H, Laky ZE, Ladis I, Austen WG, Wilhelm S. Body Image After Mastectomy Scale: A New Measure of Body Image Behaviors and Beliefs in Women Following Mastectomy. J Womens Health (Larchmt) 2022; 31:47-54. [PMID: 34449252 PMCID: PMC8785764 DOI: 10.1089/jwh.2021.0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Body image distress is frequently reported by women after mastectomy and is associated with negative health outcomes, such as reduced quality of life, elevated depression and anxiety symptoms, and impaired sexual functioning. To reduce body image distress after mastectomy, we must first understand the factors that contribute to its development and maintenance. We therefore developed a new measure, the Body Image after Mastectomy Scale (BIMS), to comprehensively assess maladaptive appearance-related beliefs and behaviors (e.g., avoidance and rituals) that may trigger and maintain body image distress after mastectomy. Materials and Methods: Forty-seven female patients undergoing mastectomy with breast reconstruction completed the BIMS and other measures 3 months after breast reconstruction. Results: Evaluation of the BIMS' initial psychometric properties showed that the overall scale has good internal consistency and strong construct validity. Domain-specific subscales ranged in reliability from good to poor. Conclusions: The BIMS can be used clinically to identify cognitive and behavioral psychotherapy targets to reduce body image distress resulting from mastectomy. It can also be used in research to identify factors that contribute to the development and maintenance of body image distress after mastectomy. ClinicalTrials.gov identifier: NCT03428399.
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Affiliation(s)
- Hilary Weingarden
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Zoë E. Laky
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Ilana Ladis
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - William Gerald Austen
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Sabine Wilhelm
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Body Schema Self-Awareness and Related Dream Content Modifications in Amputees Due to Cancer. Brain Sci 2021; 11:brainsci11121625. [PMID: 34942926 PMCID: PMC8699339 DOI: 10.3390/brainsci11121625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE the evaluation of body image perception, pain coping strategies, and dream content, together with phantom limb and telescoping phenomena in patients with sarcoma who underwent surgery for limb amputation. MATERIAL AND METHODS consecutive outpatients were evaluated at T0 (within 3 weeks after surgery) and T1 (4-6 months after surgery) as follows: demographic and clinical data collection; the Groningen Questionnaire Problems after Arm Amputation; the West Haven-Yale Multidimensional Pain Inventory; the Body Image Concern Inventory, a clinical trial to identify telescoping; and a weekly diary of dreams. Dream contents were coded according to the Hall and Van de Castle coding system. RESULTS Twenty patients completed the study (15 males and 5 females, mean age: 53.9 ± 24.6, education: 7.8 ± 3.4). All subjects experienced phantom limb and 35% of them experienced telescoping soon after surgery, and 25% still after 4-6 months. Both at T0 and T1, that half of the subjects reported dreams about still having their missing limbs. At T1 the patients' perceptions of being able to deal with problems were lower, and pain and its interference in everyday life were higher yet associated with significant engagement in everyday activities and an overall good mood. The dream content analysis highlighted that males were less worried about health problems soon after amputation, and women showed more initial difficulties that seemed to be resolved after 4-6 months after surgery. CONCLUSIONS The dream content analysis may improve clinicians' ability to support their patients during their therapeutic course.
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Fiser C, Crystal JS, Tevis SE, Kesmodel S, Rojas KE. Treatment and Survivorship Interventions to Prevent Poor Body Image Outcomes in Breast Cancer Survivors. BREAST CANCER: TARGETS AND THERAPY 2021; 13:701-709. [PMID: 34938117 PMCID: PMC8687859 DOI: 10.2147/bctt.s321721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Caroline Fiser
- Dewitt Daughtry Department of Surgery, University of Miami/Miller School of Medicine, Miami, FL, USA
| | - Jessica S Crystal
- Dewitt Daughtry Department of Surgery, University of Miami/Miller School of Medicine, Miami, FL, USA
| | - Sarah E Tevis
- Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Susan Kesmodel
- Dewitt Daughtry Department of Surgery, University of Miami/Miller School of Medicine, Miami, FL, USA
| | - Kristin E Rojas
- Dewitt Daughtry Department of Surgery, University of Miami/Miller School of Medicine, Miami, FL, USA
- Correspondence: Kristin E Rojas Dewitt Daughtry Department of Surgery, University of Miami, 1295 NW 14th Street, Miami, FL, 33136, USATel +1 305 243-0783 Email
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Brederecke J, Heise A, Zimmermann T. Body image in patients with different types of cancer. PLoS One 2021; 16:e0260602. [PMID: 34843586 PMCID: PMC8629249 DOI: 10.1371/journal.pone.0260602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/12/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer can cause physical changes and affect satisfaction with a persons' physical appearance, which in turn can affect overall quality of life. Previous studies have primarily focused on women with breast cancer and few is known about body image in patients with other cancers and especially men. The present study compares satisfaction with body image of patients with different types of cancer with the general population and across sexes and identifies risk factors for diminished body image. Additionally, patients that were diagnosed within the last year and those living with cancer for longer are compared. METHODS In this cross-sectional study, N = 531 cancer patients answered the German Self-Image Scale to assess body image. One sample t-tests are utilized to compare the body image of cancer patients with the general population. Stepwise regression analyses were used to identify factors associated with body image and ANOVAs with posthoc tests as well as t-tests were used to examine group differences. RESULTS Cancer patients showed diminished body image compared to the general population. For men, higher relationship satisfaction and lower cancer-specific distress were associated with more positive body self-acceptance (SA), whereas younger age, higher relationship satisfaction, and lower cancer-specific distress resulted in better perceived partner-acceptance of one's body (PA). In women, higher education, lower anxiety and cancer-specific distress were associated with more positive SA. Female cancer patients with breast/gynecological cancer reported better SA than those with visceral cancers. Higher relationship satisfaction and lower cancer-specific distress were found to be associated with more satisfactory PA in females. Time since diagnosis did not affect body image in this study. CONCLUSIONS Results indicate that cancer patients regardless of sex tend to have decreased body image satisfaction. Future research directions include examination of additional entities of cancer, deeper research in men and the role of time since diagnosis.
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Affiliation(s)
- Jan Brederecke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anja Heise
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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66
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Sullivan-Myers C, Sherman KA, Beath AP, Duckworth TJ, Cooper MJW. Delineating sociodemographic, medical and quality of life factors associated with psychological distress in individuals with endometriosis. Hum Reprod 2021; 36:2170-2180. [PMID: 34166496 DOI: 10.1093/humrep/deab138] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION What is the relationship between specific quality of life domains and depression, anxiety and stress in the endometriosis population? SUMMARY ANSWER Psychosocial domains of quality of life, such as a perception of social support and self-image, are more strongly associated with depression, anxiety and stress than pain and medical factors. WHAT IS KNOWN ALREADY Prior research indicates a high prevalence of anxiety and depression in individuals with endometriosis. Pain is thought to be critical in the development of psychological distress, however prior research has investigated this association without consideration of psychosocial quality of life domains such as social functioning, perceived social support and self-image. STUDY DESIGN, SIZE, DURATION This study is a cross-sectional analysis of baseline data collected in a longitudinal study exploring psychological distress in endometriosis (n = 584). PARTICIPANTS/MATERIALS, SETTING, METHODS Individuals living with endometriosis participated in this study and were recruited via online platforms of community organizations and support groups. Demographic and medical information concerning endometriosis treatment and diagnosis was self-reported. Psychological distress and quality of life was measured using the Depression, Anxiety and Stress Scale (DASS-21), Endometriosis Health Profile-30 (EHP-30) and the Short Form Survey (SF-36v2). A series of linear regression analyses explored the relationship between specific quality of life domains and the primary outcomes of depression, anxiety and stress. MAIN RESULTS AND THE ROLE OF CHANCE Approximately half of the participants in this sample reported moderate to severe anxiety, depression and stress. Quality of life domains, particularly perceived social support, social functioning and self-image, were more strongly associated with psychological distress than medical or demographic factors. Pain was associated with anxiety, but not depression or stress. A greater number of endometriosis symptoms was only associated with depression. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional and, therefore, causality cannot be inferred from this analysis. Information about endometriosis diagnosis and treatment was self-reported, and not verified against medical records. WIDER IMPLICATIONS OF THE FINDINGS This study indicates that psychosocial factors may be more salient factors underlying depression, anxiety and stress in the endometriosis population than pain and medical factors. There is a need for interventions that target psychological distress in this population with a focus on the broader impact of endometriosis beyond pain and physical symptomatology. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Research Training Program (RTP) Scholarship awarded to C.S.M. by Macquarie University. The remaining authors have nothing to declare. TRIAL REGISTRATION NUMBER ACTRN12619001508167.
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Affiliation(s)
- C Sullivan-Myers
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - K A Sherman
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - A P Beath
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - T J Duckworth
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia.,Applied Cognition and Experimental Psychology (ACEP) Research Group, Faculty of Health and Medical Sciences, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - M J W Cooper
- Department of Obstetrics and Gynaecology, The University of Sydney, Sydney, NSW, Australia
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67
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Yang HY, Lee YH, Wu JM, Lai IR, Shun SC. Relationship Between Symptom Distress and Fatigue Characteristics in Patients with Gastric Cancer During 1 Month after Gastrectomy. Clin Nurs Res 2021; 31:463-472. [PMID: 34353134 DOI: 10.1177/10547738211035284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study's purpose was to describe changes in symptom distress and fatigue characteristics identifying which symptoms significantly impacted fatigue characteristics of patients with Gastric Cancer (GC) within 1 month after gastrectomy. A prospective longitudinal study was conducted. Patients with GC who were scheduled for gastrectomy were recruited from surgical outpatient clinics and surgery wards in northern Taiwan. Data were collected using a set of questionnaires before (T0) and 7 (T1) and 28 days (T2) after gastrectomy. Over all, 86 patients experienced mild levels of fatigue and symptom distress. The changes in worst fatigue and fatigue interference were greatest at T1. Anxiety had a significant negative effect on both worst fatigue and fatigue interference. Dry mouth, pain, and body image had significant deleterious effects on worst fatigue. The co-occurring symptoms affecting fatigue for patients with GC in the acute phase after gastrectomy should be actively assessed to ensure optimal fatigue management.
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Affiliation(s)
| | | | | | - I-Rue Lai
- National Taiwan University Hospital, Taipei
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68
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Donegan B, Kingston L. Quality of life following formation of an ileal conduit due to urinary bladder neoplasm: A systematic review. Int J Nurs Pract 2021; 28:e12988. [PMID: 34313369 DOI: 10.1111/ijn.12988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 11/28/2022]
Abstract
AIM To present the findings of a systematic review on reported quality of life following the formation of a urinary diversion as a result of cystectomy due to urinary bladder neoplasm. BACKGROUND Bladder cancer is the most commonly occurring cancer of the urological system. Treatment often involves undergoing a radical cystectomy with an ileal conduit formation. Quality of life issues associated with this surgery are complex and varied. DESIGN A systematic review using thematic synthesis. DATA SOURCES A comprehensive search, using The Cochrane Library, CINAHL, PubMed and PsycInfo databases, focusing on the years from 2007 to 2020. REVIEW METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was the chosen checklist used. Studies were critically appraised using the Crowe Critical Appraisal Tool. RESULTS The formation of an ileal conduit negatively affects respondent's quality of life particularly regarding body image, social distress, reduced sexual activity and employment. Poor research focus on the impact of ileal conduit formation on sexual well-being postoperatively was apparent. CONCLUSIONS Further research using qualitative methodologies is needed to gain a deeper understanding of how this life-changing procedure impacts quality of life.
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Affiliation(s)
- Breege Donegan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Zebolsky AL, Patel N, Heaton CM, Park AM, Seth R, Knott PD. Patient-Reported Aesthetic and Psychosocial Outcomes After Microvascular Reconstruction for Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2021; 147:1035-1044. [PMID: 34292310 DOI: 10.1001/jamaoto.2021.1563] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Aesthetic outcomes are key determinants of psychosocial functioning among surgically treated patients with head and neck cancer (HNC); however, long-term aesthetic outcomes after microvascular free tissue transfer (MFTT) are not well described. Objective To examine risk factors for impaired long-term aesthetic satisfaction and appearance-related psychosocial functioning after HNC ablation with MFTT. Design, Setting, and Participants A cross-sectional, web-based survey was conducted at an academic tertiary care center. A total of 228 individuals who underwent MFTT between January 1, 2015, and December 31, 2019, for treatment of HNC were included. The study was conducted from November 1, 2020, through January 15, 2021. Exposures Head and neck cancer ablation with MFTT. Main Outcomes and Measures Patient-reported outcomes were assessed via Aesthetic FACE-Q scales. The primary objective was aesthetic satisfaction determined by the Satisfaction With Facial Appearance scale. Secondarily, the Appearance-Related Psychosocial Distress, Psychological Function, and Social Function scales were used to assess appearance-related psychosocial functioning. Patients were stratified by demographic, disease, surgical, and postoperative characteristics. Survey scores on a 100-point scale were compared and subjected to univariable and multivariable linear regression. Results A total of 124 of 228 patients (54.4%) completed surveys a median of 34.4 months after MFTT (interquartile range, 22.6-48.8). Most responders (79 [63.7%]) were men with advanced cancer of the oral cavity or skin, reconstructed with anterolateral thigh or osteocutaneous fibula free flaps. Nonresponders had no significant differences in baseline characteristics. The Satisfaction With Facial Appearance score was independently lower among patients who received osteocutaneous flaps (regression coefficient, -10.6 points, 95% CI, -20.4 to -0.8 points) and/or adjuvant (chemo)radiotherapy (regression coefficient, -6.9 points; 95% CI, -13.8 to -0.1 points). Impaired appearance-related psychosocial functioning was independently associated with female sex, a history of anxiety or depression, osteocutaneous flaps, prolonged tube feeding requirements, and any recurrent or persistent disease. After adjustment for covariates, each 1-point increase in the Satisfaction With Facial Appearance score independently estimated improved appearance-related psychosocial functioning as determined by the Appearance-Related Psychosocial Distress scale (regression coefficient, -0.5 points; 95% CI, -0.7 to -0.4 points), Psychological Function scale (regression coefficient, 0.4 points; 95% CI, 0.3 to 0.5 points), and Social Function scale (regression coefficient, 0.4 points; 95% CI, 0.3 to 0.6 points). Conclusions and Relevance The findings of this cross-sectional, web-based survey study suggest that osteocutaneous reconstruction and adjuvant therapy independently increase the risk of poor patient-reported long-term aesthetic satisfaction, which correlated with impaired appearance-related psychosocial functioning. Aesthetic outcomes appear to be a priority to address in patients with HNC undergoing MFTT.
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Affiliation(s)
- Aaron L Zebolsky
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| | - Neil Patel
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, San Francisco
| | - Chase M Heaton
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| | - Andrea M Park
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| | - Rahul Seth
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
| | - P Daniel Knott
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
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Harbeck E, Chambers S, Porter-Steele J, Anderson D, Sanmugarajah J, Hughes F, Nehill C, Seib C. Screening for distress in women with gynaecological cancer: Adaptation of the distress thermometer for gynaecological oncology patients. Eur J Cancer Care (Engl) 2021; 30:e13486. [PMID: 34258811 DOI: 10.1111/ecc.13486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Generic distress screening tools may not recognise the unique concerns reported in some cancer populations. The face and content validity of a screening tool derived from the National Cancer Comprehensive Network distress thermometer and problem list and adapted specifically for women with gynaecological cancer is presented. METHODS Building on existing work, panels of clinicians and researchers, and focus groups with women treated for gynaecological cancer, developed a nuanced distress screening tool. RESULTS The clinical reference group used an iterative process to reduce 54 items to 22 across four domains (practical/family/psychological/physical). These items were included in the draft tool, which was reviewed by two focus groups of long-term cancer survivors. Participants unanimously thought the tool was necessary though several changes were recommended. The final draft tool contained a global distress score and 25 items across the four domains. CONCLUSIONS This measure provides a structured screening tool tailored to the concerns of women with gynaecological cancer, enhancing communication between clinicians and their patients about potentially identified and unrecognised sources of distress. Future research will focus on establishing sensitivity and specificity of this tool and further assessing its utility in clinical settings for all gynaecological cancers (including rare cancers like vulvar cancer).
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Affiliation(s)
- Emma Harbeck
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Janine Porter-Steele
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Choices Cancer Support Program, Wesley Hospital, Brisbane, Queensland, Australia
| | - Debra Anderson
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jasotha Sanmugarajah
- Director for Medical Oncology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | | | | | - Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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Tarutani K, Takaki H, Igeta M, Fujiwara M, Okamura A, Horio F, Toudou Y, Nakajima S, Kagawa K, Tanooka M, Yamakado K. Development and Accuracy Evaluation of Augmented Reality-based Patient Positioning System in Radiotherapy: A Phantom Study. In Vivo 2021; 35:2081-2087. [PMID: 34182483 DOI: 10.21873/invivo.12477] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIM To develop and evaluate the accuracy of augmented reality (AR)-based patient positioning systems in radiotherapy. MATERIALS AND METHODS AR head-mounted displays (AR-HMDs), which virtually superimpose a three-dimensional (3D) image generated by the digital imaging and communications in medicine (DICOM) data, have been developed. The AR-based positioning feasibility was evaluated. Then, the setup errors of three translational axes directions and rotation angles between the AR and the conventional laser-based positioning were compared. RESULTS The AR-based pelvic phantom positioning was feasible. The setup errors of AR-based positioning were comparable to laser-based positioning in all translational axis directions and rotation angles. The time necessary for AR-based positioning was significantly longer than that for laser-based positioning (171.0 s vs. 47.5 s, p<0.001). CONCLUSION AR-based positioning for radiotherapy was feasible, and showed comparable positioning errors to those of conventional line-based positioning; however, a markedly longer setup time was necessary.
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Affiliation(s)
- Kazuo Tarutani
- Department of Radiology, Hyogo College of Medicine, Hyogo, Japan.,Japan Organization of Occupational Health and Safety Kansai Rousai Hospital, Hyogo, Japan
| | - Haruyuki Takaki
- Department of Radiology, Hyogo College of Medicine, Hyogo, Japan;
| | - Masataka Igeta
- Department of Biostatistics, Hyogo College of Medicine, Hyogo, Japan
| | | | - Ayako Okamura
- Japan Organization of Occupational Health and Safety Kansai Rousai Hospital, Hyogo, Japan
| | - Futo Horio
- Kobe Digital Labo Incorporated, Hyogo, Japan
| | - Yuki Toudou
- Japan Organization of Occupational Health and Safety Kansai Rousai Hospital, Hyogo, Japan
| | - Satoshi Nakajima
- Japan Organization of Occupational Health and Safety Kansai Rousai Hospital, Hyogo, Japan
| | - Kazufumi Kagawa
- Japan Organization of Occupational Health and Safety Kansai Rousai Hospital, Hyogo, Japan
| | - Masao Tanooka
- Department of Radiotherapy, Takarazuka City Hospital, Hyogo, Japan
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Sayer-Jones K, Sherman KA. Body image concerns in individuals diagnosed with benign gynaecological conditions: scoping review and meta-synthesis. Health Psychol Behav Med 2021; 9:456-479. [PMID: 34104570 PMCID: PMC8158251 DOI: 10.1080/21642850.2021.1920949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Benign gynaecological conditions (BCGs) and body image-related concerns are commonly experienced by reproductive-aged female-identified individuals. Qualitative evidence from cancer populations identifies a link between diseases of the sexual organs and body image distress encompassing appearance, sensory and functional aspects. Most BCGs and the impacts on body image have been studied separately. However, commonalities exist between these conditions including chronicity, diagnostic delays, and menstrual-related social stigma. This systematic scoping review and meta-synthesis aimed to compare and contrast the experience of body image in the benign conditions of endometriosis, polycystic ovarian cysts, uterine fibroids, and vulvar intraepithelial neoplasia. Method Electronic databases (MEDLINE, PsycINFO, Scopus, CINAHL, Embase, and Allied and Complementary Medicine) were searched in February 2020 and relevant articles were examined to identify papers that qualitatively explored the relationship between body image and BCGs. Meta-synthesis was used to analyse the 17 papers that met the inclusion criteria. Results Six main themes evolved from this iterative analysis: loss of control; regained control; silence – menstrual concealment; cultural differences; feeling abnormal, and functional impairment. Body image concerns were widespread although impacts on individual’s lives were dependent on the unique symptom profile of each disease which interacted with socio-cultural factors, daily functioning, and feminine identity. Body image concerns were a common, but hidden, experience rarely screened in routine clinical settings despite causing significant distress. Conclusions The chronicity and severity of individuals unique symptom profile often determined the intensity and type of body image concerns individuals described. Across conditions, body image concerns were often left untreated, were concealed, and were associated with reduced quality of life.
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Affiliation(s)
- Katherine Sayer-Jones
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
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73
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Song L, Pang Y, Zhang J, Tang L. Body image in colorectal cancer patients: A longitudinal study. Psychooncology 2021; 30:1339-1346. [PMID: 33797154 DOI: 10.1002/pon.5688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/02/2021] [Accepted: 02/16/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess changes in body image distress (BID) over time, identify factors associated with BID, and explore the mediating role of body image on the longitudinal association between stoma status (permanent stoma, temporary stoma, or nonstoma) and psychological distress in postoperative colorectal cancer (CRC) patients in China. METHODS Participants (N = 255) 1-2 weeks postsurgery completed self-report questionnaires assessing BID (Body Image Scale) and psychosocial distress (Distress Thermometer, Hospital Anxiety and Depression Scale); 212 (83%) completed 6-month follow-up surveys. Generalized estimating equations were used to identify factors associated with BID for longitudinal data analysis. RESULTS A total of 46.7% of participants reported BID at follow-up. Prevalence of BID and BID scores did not significantly change over time in the total sample. Body image scores decreased in patients whose temporary stoma was removed during follow-up (p < 0.05). Prevalence of BID decreased in nonstoma patients at follow-up (p < 0.05). There were significant decreases in the prevalence and scores of distress, anxiety, and depression between baseline and follow-up (p < 0.001). Stoma presence, later clinical stages, greater distress, anxiety, and depression were risk factors for poorer body image. Body image had partial mediating effects on the longitudinal association between stoma status and distress. CONCLUSIONS Our findings indicate that BID remains stable even as psychological distress decreases. BID should be addressed early postoperation to avoid persistent impairment in CRC patients.
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Affiliation(s)
- Lili Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jie Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department 3 of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital and Institute, Beijing, China
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Zhang X, Pennell ML, Bernardo BM, Clark J, Krok-Schoen JL, Focht BC, Crane TE, Shadyab AH, Paskett ED. Body image, physical activity and psychological health in older female cancer survivors. J Geriatr Oncol 2021; 12:1059-1067. [PMID: 33967023 DOI: 10.1016/j.jgo.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/08/2021] [Accepted: 04/29/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To determine the association of physical activity and body image with psychological health outcomes and whether body image mediates the association of physical activity with psychological health among older female cancer survivors. MATERIALS AND METHODS Data from the Women's Health Initiative (WHI) Life and Longevity after Cancer (LILAC) Study were used. Surveys assessed body image (appearance, attractiveness, scars), moderate-strenuous physical activity (min/week), and psychological health (depression, anxiety, distress). A mediation analysis was conducted to estimate the percentage of the total effect of physical activity on psychological health mediated by body image concerns. RESULTS Among 4567 female cancer survivors aged 66-98 years, the average time since cancer diagnosis was 9.2 years. Approximately 50% reported no moderate-strenuous physical activity; 15% reported depressive symptoms, 6% reported anxiety, and 5% reported psychological distress; 3% had concerns with appearance, 20% had concerns with attractiveness, and 21% had concerns with scars. When unadjusted for body image concerns, every 30 min/week increase in physical activity was associated with lower risk of depressive symptoms (RR = 0.93, 95%CI: 0.90-0.96), anxiety (RR = 0.92, 95%CI: 0.87-0.97), and distress (RR = 0.92, 95%CI: 0.87-0.98). Body image concerns with appearance mediated 7%, 8.8%, and 14.5% of the association between physical activity and depressive symptoms, anxiety, and distress, respectively. CONCLUSION Older female cancer survivors reported body image concerns, which were associated with both physical activity and psychological health. Our findings suggest that interventions designed to address body image concerns in older female cancer survivors could serve to improve the benefit of physical activity on psychological health.
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Affiliation(s)
- Xiaochen Zhang
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
| | - Michael L Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Brittany M Bernardo
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
| | - Justin Clark
- Department of Mathematics and Statistics, Kenyon College, Gambier, OH, United States of America
| | - Jessica L Krok-Schoen
- Division of Health Sciences and Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States of America
| | - Brian C Focht
- Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, United States of America
| | - Tracy E Crane
- Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, United States of America
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, United States of America
| | - Electra D Paskett
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America.
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Prevalence of erectile dysfunction in male survivors of cancer: a systematic review and meta-analysis of cross-sectional studies. Br J Gen Pract 2021; 71:e372-e380. [PMID: 33926885 PMCID: PMC8087306 DOI: 10.3399/bjgp20x714197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background Prevalence of erectile dysfunction (ED) in male survivors of cancer across cancer types has not been systematically analysed. Aim To estimate the prevalence of ED in all types of cancer and identify characteristics associated with ED in survivors of cancer. Design and setting Systematic review and meta-analysis (MA) of cross-sectional studies. Method MEDLINE, CINAHL, PsycINFO, and EMBASE were searched, targeting reports published from inception to 1 February 2020. All retrospective or prospective studies reporting prevalence of ED in male patients with cancer and using a validated tool for detection of ED were included. A random-effects MA model was used to pool prevalence of ED as absolute estimates at three different stages, that is, ‘healthy’, ‘at diagnosis’, and ‘after treatment’. A univariate MA regression including the three-level group variable as the only independent variable was used to assess the difference in ED prevalence across the three groups. Further MAs were conducted for studies involving patients at diagnosis and after treatment, and statistical inferences were made with setting for multiple testing controlling for a false discovery rate (FDR) <0.05. Results In total, 1301 studies were assessed for inclusion. Of these, 141 were potentially eligible and subsequently scrutinised in full text. Finally, 43 studies were included with a total of 13 148 participants. Overall, pooled data of the included studies showed an ED prevalence of 40.72% (95% confidence interval [CI] = 31.80 to 50.29) in patients with cancer, with prevalences of 28.60% (95% CI = 12.10 to 53.83) at time of diagnosis and 42.70% (95% CI = 32.97 to 53.03) after treatment, with significant difference between these two stages and across cancer locations, controlling for an FDR <0.05. Conclusion Erectile dysfunction was particularly high in male survivors of cancer and was associated with cancer treatment, cancer site, and age.
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Cyr MP, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. A Prospective Single-Arm Study Evaluating the Effects of a Multimodal Physical Therapy Intervention on Psychosexual Outcomes in Women With Dyspareunia After Gynecologic Cancer. J Sex Med 2021; 18:946-954. [PMID: 33931347 DOI: 10.1016/j.jsxm.2021.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/08/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dyspareunia affects most women after treatment for gynecologic malignancies. However, to date, evidence-based interventions remain limited and no study has examined the effects of multimodal physical therapy on psychosexual outcomes in these patients. AIM To assess the effects of multimodal physical therapy on psychosexual outcomes including sexual distress, body image concerns, pain anxiety, pain catastrophizing, pain self-efficacy and depressive symptoms in women with dyspareunia after treatment for gynecologic malignancies. METHODS Thirty-one gynecologic cancer survivors with dyspareunia enrolled in this prospective single-arm interventional study. The participants undertook 12 weekly sessions of physical therapy incorporating education, pelvic floor muscle exercises with biofeedback, manual therapy and home exercises. Outcome measures were evaluated pre- and post-treatment. Paired t-tests were conducted to investigate the changes from pre-treatment (P-value ˂ 0.05) while effect sizes (Cohen's d) were calculated to measure the magnitude of the change. MAIN OUTCOME MEASURES Sexual distress (Female Sexual Distress Scale-Revised), body image concerns (Body Image Scale), pain anxiety (Pain Anxiety Symptoms Scale), pain catastrophizing (Pain Catastrophizing Scale), pain self-efficacy (Painful Intercourse Self-Efficacy Scale) and depressive symptoms (Beck Depression Inventory-II). RESULTS Significant changes were found from pre- to post-treatment for all psychosexual outcomes. Women reported reductions in sexual distress (P ˂ 0.001, d = 1.108), body image concerns (P ˂ 0.001, d = 0.829), pain anxiety (P ˂ 0.001, d = 0.980), pain catastrophizing (P ˂ 0.001, d = 0.968) and depression symptoms (P = 0.002, d = 0.636) with an increase in pain self-efficacy (P ˂ 0.001, d ≥ 0.938) following the intervention. CLINICAL IMPLICATIONS The results suggest that multimodal physical therapy significantly improves sexual distress, body image concerns, pain anxiety, pain catastrophizing, pain self-efficacy and depressive symptoms in our sample of women with dyspareunia after treatment for gynecologic malignancies. The medium to large effect sizes obtained with the high proportion of women presenting meaningful changes according to the known minimal clinically important difference or clinical cut-off underlines the significance of these effects. STRENGTHS & LIMITATIONS The current study used validated questionnaires to assess the psychosexual outcomes of a well-designed physical therapy intervention using multiple modalities to address the multifaceted aspect of dyspareunia in cancer survivors. This study did not include a control group, which may limit drawing definitive conclusions. CONCLUSION Findings showed that multimodal physical therapy yielded significant improvements in psychosexual outcomes in gynecologic cancer survivors with dyspareunia. A randomized controlled trial is indicated to confirm these results. Cyr M-P, Dumoulin C, Bessette P, et al. A Prospective Single-Arm Study Evaluating the Effects of a Multimodal Physical Therapy Intervention on Psychosexual Outcomes in Women With Dyspareunia After Gynecologic Cancer. J Sex Med 2021;18:946-954.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada; Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annick Pina
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Walter Henry Gotlieb
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada; Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
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77
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The psychometric properties of the Persian version of the body image after breast Cancer questionnaire: A second- order confirmatory factor analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01741-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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78
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Saeed S, Asim M, Sohail MM. Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan. BMC WOMENS HEALTH 2021; 21:151. [PMID: 33853583 PMCID: PMC8045297 DOI: 10.1186/s12905-021-01293-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Background Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment. Methods In this process 45 women (age = 18–50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan. Results An inductive approach was used to analyze the data which resulted in the emergence of eight subthemes under the umbrella of three major themes that delineate individual, socio-cultural and structural barriers to seek screening and treatment of breast cancer in Punjab. Individual barriers included lack of awareness, hesitance in accepting social support, and spiritual healing. The identified socio-cultural factors included feminine sensitivity, stigmatization, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hinder screening and treatment. Conclusions These barriers can be addressed through raising awareness and community mobilization about breast-self exam and treatment. The healthcare system should also pay attention to socio-psychological and cultural factors impeding women's access to available health facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01293-6.
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Affiliation(s)
- Sidra Saeed
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | - Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.
| | - Malik Muhammad Sohail
- Department of Sociology, Institute of Arts and Sciences, Government College University Faisalabad, Chiniot Campus, Chiniot, Pakistan
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79
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Aquil A, El Kherchi O, El Azmaoui N, Mouallif M, Guerroumi M, Benider A, Elgot A. Predictors of mental health disorders in women with breast and gynecological cancer after radical surgery: A cross-sectional study. Ann Med Surg (Lond) 2021; 65:102278. [PMID: 33948163 PMCID: PMC8080456 DOI: 10.1016/j.amsu.2021.102278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction In lower-middle-income countries, significant progress has been made in the therapeutic management of cancers. However, mental health disorders related to these diseases are usually underestimated by the health system. The aim of this study is to investigate the predictive factors for mental health disorders in Moroccan women with breast or gynecological cancer treated by radical surgery. Material and methods A cross-sectional study was carried out on Moroccan women treated by radical surgery for breast or gynecological cancer (N = 200). For each cancer type, patients were divided into two groups following age criteria. Hospital Anxiety and Depression Scale and Body image scale were used. Results Age had a significant effect on mental health disorders but not the type of cancer. Younger women showed significantly greater mental health disorders than older women (p ≤ 0.001). The predictive model for high anxiety and depression included the effect of the following variables: Being younger, having lower income, and advanced tumor stage. For higher body image dissatisfaction, the variables are as follows: being younger, having fewer children, lower-income, and advanced tumor stage. Conclusion The association of mental health disorders in patients with breast or gynecological cancer increases their distress. The establishment of management protocols for these disorders is strongly recommended in oncology departments. Age has an effect on mental disorders linked to breast and gynecological cancer. Cancer type does not have a significant effect on mental disorders. Young Age, lower income and advanced tumor stage are predictors of mental disorders.
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Affiliation(s)
- Amina Aquil
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
| | - Ouassil El Kherchi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
| | - Naoual El Azmaoui
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
| | - Mustapha Mouallif
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
| | - Maroua Guerroumi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
| | - Abdellatif Benider
- Ibn Rochd University Hospital Center, Mohammed VI Center for the Treatment of Cancers, Casablanca, Morocco
| | - Abdeljalil Elgot
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Morocco
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80
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Facchin F, Scarfone G, Tamanza G, Ravani S, Francini F, Peccatori FA, Di Loreto E, Dell'Acqua A, Saita E. "Lights and Shadows": An Interpretative Phenomenological Analysis of the Lived Experience of Being Diagnosed With Breast Cancer During Pregnancy. Front Psychol 2021; 12:620353. [PMID: 33868088 PMCID: PMC8049111 DOI: 10.3389/fpsyg.2021.620353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Cancer diagnosed during pregnancy is a rare event. The most common type of malignancy diagnosed in pregnant women is breast cancer, whose incidence is expected to raise in the next future due to delayed childbirth, as well as to the increased occurrence of the disease at young age. Pregnant women diagnosed with breast cancer are exposed to multiple sources of stress, which may lead to poorer obstetric outcomes, such as preterm birth and low birth weight. In addition, pregnancy involves physiological changes in the breasts that may blur the signs of cancer, with delayed diagnosis and poor prognosis. However, the lived experience of these women was investigated in very few studies. Given this scenario, we conducted this qualitative study to describe and understand women’s subjective experience of being diagnosed with breast cancer during pregnancy. The study was conducted following the principles of Interpretative Phenomenological Analysis. Participants were five women with breast cancer diagnosed during pregnancy, purposefully recruited at a public hospital during medical visits and interviewed at treatment initiation. The interview transcripts were analyzed using thematic analysis. The textual analysis led to the identification of three main themes related to: (1) the emotional storm experienced after cancer diagnosis, and the importance of receiving appropriate information and being focused on treatment decisions; (2) physical changes and comparisons with healthy women, associated with feelings of sadness and inadequacy; (3) being positive, feeling free to disclose all kinds of emotions, religion and spirituality as sources of strength. The paradoxical coexistence of pregnancy and cancer represents a stressful experience for women and their loved ones. Adopting a systemic perspective may be important to understand the effects of such a complex condition, also considering its impact on healthcare workers.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giovanna Scarfone
- Gynecology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giancarlo Tamanza
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Silvia Ravani
- Faculty of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Federica Francini
- Faculty of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Fedro Alessandro Peccatori
- Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Eugenia Di Loreto
- Gynecology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Dell'Acqua
- Gynecology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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81
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Dinapoli L, Colloca G, Di Capua B, Valentini V. Psychological Aspects to Consider in Breast Cancer Diagnosis and Treatment. Curr Oncol Rep 2021; 23:38. [PMID: 33709235 PMCID: PMC7952347 DOI: 10.1007/s11912-021-01049-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Breast cancer (BC) is the most common cancer diagnosed in women in the West World. Coping with cancer is cause of extreme stress for patients and their family. The purpose of this review is to evaluate possible approaches to follow to control those situations that can impact on quality of life (QoL) and compliance to treatments. RECENT FINDINGS Anxiety, distress, depression, and posttraumatic stress disorder are the most frequent psychological disorders in BC patients. Cognitive disorders and sexual dysfunction can also be important in affecting QoL both in younger and older patients. Younger and older patients show different characteristics of these disorders and different strategies of managing them. Several psychotherapeutic and supportive approaches have proven effective in managing psychological disorders in BC patients. Every BC patient should be supported with these techniques during her entire oncological history, in order to increase QoL and compliance to treatments.
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Affiliation(s)
- Loredana Dinapoli
- Dipartimento di diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Giuseppe Colloca
- Dipartimento di diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. .,Catholic University of the Sacred Heart, Rome, Italy.
| | - Beatrice Di Capua
- Dipartimento di diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Vincenzo Valentini
- Dipartimento di diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore Istituto di Radiologia, Roma, Italy
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82
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Sebri V, Durosini I, Triberti S, Pravettoni G. The Efficacy of Psychological Intervention on Body Image in Breast Cancer Patients and Survivors: A Systematic-Review and Meta-Analysis. Front Psychol 2021; 12:611954. [PMID: 33732184 PMCID: PMC7957010 DOI: 10.3389/fpsyg.2021.611954] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
The experience of breast cancer and related treatments has notable effects on women's mental health. Among them, the subjective perception of the body or body image (BI) is altered. Such alterations deserve to be properly treated because they augment the risk for depression and mood disorders, and impair intimate relationships. A number of studies revealed that focused psychological interventions are effective in reducing BI issues related to breast cancer. However, findings are inconsistent regarding the dimension of such effects. This meta-analysis synthesizes and quantifies the efficacy of psychological interventions for BI in breast cancer patients and survivors. Additionally, since sexual functioning emerged as a relevant aspect in the BI distortions, we explored the efficacy of psychological interventions on sexual functioning related to BI in breast cancer patients and survivors. The literature search for relevant contributions was carried out in March 2020 through the following electronic databases: Scopus, PsycINFO, and ProQUEST. Only articles available in English and that featured psychological interventions for body image in breast cancer patients or survivors with controls were included. Seven articles with 17 dependent effect sizes were selected for this meta-analysis. Variables were grouped into: Body Image (six studies, nine dependent effect sizes) and Sexual Functioning Related to the Body Image in breast cancer patients and survivors (four studies, eight dependent effect sizes). The three-level meta-analysis showed a statistically significant effect for Body Image [g = 0.50; 95% CI (0.08; 0.93); p < 0.05] but no significant results for Sexual Functioning Related to Body Image [g = 0.33; 95% CI (−0.20; 0.85); p = 0.19]. These results suggest that psychological interventions are effective in reducing body image issues but not in reducing sexual functioning issues related to body image in breast cancer patients and survivors. Future review efforts may include gray literature and qualitative studies to better understand body image and sexual functioning issues in breast cancer patients. Also, high-quality studies are needed to inform future meta-analyses.
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Affiliation(s)
- Valeria Sebri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
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83
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Cole SF, Skaczkowski G, Wilson C. The role of illness perceptions and exercise beliefs in exercise engagement during treatment for cancer. Support Care Cancer 2021; 29:5065-5073. [PMID: 33594512 DOI: 10.1007/s00520-021-06055-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/07/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study examined whether exercise beliefs and illness perceptions were associated with changes in exercise behaviour following a cancer diagnosis. DESIGN This study uses a cross-sectional survey of 366 adults with a diagnosis of cancer, who were currently receiving treatment. MAIN OUTCOME MEASURES The main outcome measures are symptom severity, pre- and post-morbid exercise levels, exercise beliefs, and illness perceptions. RESULTS The majority of participants decreased their level of exercise after diagnosis (Decreasers; 58.1%). Approximately a third increased participation (Increasers; 30.4%) and a small group maintained (Maintainers; 9.2%) their pre-diagnosis exercise levels. After controlling for symptom severity and time since cancer diagnosis, Decreasers reported lower Self-Efficacy for exercise, higher levels of belief in the Negative Impact on Cancer of exercise, lower levels of Personal Control, and less Emotional Representation of their illness, than Increasers. Decreasers also reported lower levels of Self-Efficacy for exercise than Maintainers. CONCLUSION The results suggest that identifying unhelpful beliefs about the relationship between exercise and illness during cancer treatment and improving confidence and control of exercise through psycho-educational intervention could be an effective strategy for preventing cancer patients decreasing exercise following their diagnosis.
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Affiliation(s)
- Siân F Cole
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Australia.
- School of Psychology, Charles Sturt University, Bathurst, Australia.
- , Heidelberg, Australia.
| | - Gemma Skaczkowski
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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84
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Brunet J, Price J. A scoping review of measures used to assess body image in women with breast cancer. Psychooncology 2021; 30:669-680. [PMID: 33480160 DOI: 10.1002/pon.5619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 12/21/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The emergence of body image studies in the oncology setting has led to the use of numerous measures to assess different dimensions of body image. The present study is a scoping review of the literature on body image in women with breast cancer to describe: measures used to assess body image in women with breast cancer, dimensions the measures used tap into, and gaps and issues needing attention going forward. METHODS Three databases were searched for peer-reviewed original studies that had: (1) full-texts available in English; (2) focused on women with breast cancer; and (3) assessed body image. RESULTS The search yielded 3,729 peer-reviewed articles; after screening, 562 articles met inclusion criteria. Of the 88 measures used, 28 were used in more than two studies and analyzed herein. The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire constituted the most frequently used measure. Most measures used focused on the affective dimension of body image (n = 24/28, 85.7%), followed by the cognitive (n = 20/28, 71.4%), behavioral (n = 13/28, 46.4%), and perceptual dimensions (n = 13/28, 46.4%). CONCLUSIONS This review provides a current summary of measures used to assess body image in women with breast cancer. Although some further development and refinement of body image measures could benefit the field, depending on the questions researchers or clinicians seek to answer, there are many available for use. Future research should use these measures to assess the effectiveness of interventions aimed at improving body image in women with breast cancer across the lifespan.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Cancer Therapeutics Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada.,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
| | - Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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85
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Jones JK, Evans JF, Barfield RC. The Utility of Verbal Therapy for Pediatric Cancer Patients and Survivors: Expressive Writing, Video Narratives, and Bibliotherapy Exercises. Front Pediatr 2021; 9:579003. [PMID: 33614548 PMCID: PMC7889798 DOI: 10.3389/fped.2021.579003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/04/2021] [Indexed: 11/13/2022] Open
Abstract
Childhood cancer is a stressful experience. No pediatric patient, however, should be made to feel as if their concerns and feelings about their cancer experience must be bottled up inside. Importantly, talking and writing about one's illness has myriad implications for young cancer patients and survivors. The most salient of these may include increased understanding of one's condition as well as improved physical and cognitive symptoms (e.g., lowered depression, decreased anxiety, and an enhanced quality of life overall). This literature review explores three promising avenues for verbal therapy in the pediatric oncology setting: expressive writing, video narratives, and bibliotherapy exercises. Several recent studies, covering verbal therapy methods from illness blogging to book interventions, are referenced and discussed. Ultimately, we conclude that expressive writing, video narratives, and bibliotherapy exercises are valuable, feasible, inexpensive, and acceptable tools for patients and survivors of childhood cancer to facilitate self-expression-and to find meaning in the uncertainty and anxiety that cancer inherently fosters. We recommend that future studies investigate this theme so that we may improve quality of life and mental health for pediatric cancer patients and survivors worldwide.
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Affiliation(s)
- Jill K Jones
- Trinity College of Arts & Sciences, Duke University, Durham, NC, United States.,Duke Integrative Medicine, Durham, NC, United States
| | - John F Evans
- Duke Integrative Medicine, Durham, NC, United States
| | - Raymond C Barfield
- Memorial Health University Medical Center (Palliative Care), Savannah, GA, United States
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86
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Kang D, Kim IR, Choi HJ, Jung CW, Yoon SS, Kim JS, Lee CH, Jang JH, Cho J. Association between body image dissatisfaction and poor quality of life and depression among patients with hematopoietic stem cell transplantation. Support Care Cancer 2020; 29:3815-3822. [PMID: 33241506 DOI: 10.1007/s00520-020-05884-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/05/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aims to evaluate the association between body image dissatisfaction and quality of life and depression among patients after hematopoietic stem cell transplantation (HSCT). METHODS We conducted a cross-sectional survey at three university-based HSCT outpatient clinics and the Korea Blood Cancer Association. We assessed the body image using the body image scale; quality of life and depression were measured using the World Health Organization Quality of Life-BREF and the Patient Health Questionnaire 9, respectively. Univariate and multivariate linear regression models were used to find an association between body image, quality of life, and depression. RESULTS Among 163 study participants, 71.8% were male, and the mean age of the participants was 48.3 (SD = 11.2). Over 70% of the participants reported that they felt less physically and sexually attractive due to HSCT, and 39.3% of the patients were dissatisfied with their body image. In fully adjusted models, patients with dissatisfied body image had significantly poorer quality of life (- 13.68, 95% confidence interval [CI] = - 18.16, - 9.21). Moreover, patients with body image dissatisfaction were 8.59 times (95% CI = 3.79, 19.48) more likely to have depressive symptoms than patients without it. CONCLUSION The majority of HSCT patients experienced body image dissatisfaction, which was significantly associated with poor quality of life and depression. It would be essential to evaluate body image after HSCT and provide appropriate interventions for preventing further psychological consequences.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im-Ryung Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Jin Choi
- Department of Nursing (Cancer center), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chul Won Jung
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Soo Yoon
- Division of Hematology/Oncology, Department of Internal Medicine, Seoul National University School of Medicine, Seoul, South Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | | | - Jun Ho Jang
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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87
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Abstract
PURPOSE OF REVIEW Body image is a critical psychosocial issue for patients with cancer, because of the profound effects the disease and its treatment can have on appearance and bodily functioning. Adverse psychological effects of body image changes associated with cancer include debilitating levels of anxiety, social avoidance, depression, problems with intimacy and impaired sexuality, and feelings of shame/inadequacy. The construct of body image is increasingly recognized as complex and multifaceted from an embodied lens, creating more meaningful and efficacious interventions. Although there is some evidence now for in-person interventions, more research is needed in online and in-person interventions, particularly beyond what has been demonstrated in breast cancer. There is also need to address concerns around the practical and psychosocial barriers that can diminish access to, and participation in such individual or group interventions. Internet-based interventions offer opportunity for greater access to tailored psychosocial care. RECENT FINDINGS An emerging conceptualization of body image for cancer patients is discussed. Internet-delivered interventions targeting body image are outlined; the majority are pilot trials and those developed for breast cancer patients. Challenges found in online interventions are also discussed. SUMMARY Internet-delivered body image interventions would benefit from a broader conceptualization of body image, greater methodological rigor, and investigations focused on a broader range of cancer populations, beyond patients with breast cancer. Future research is needed to develop, test, and identify who can benefit from online interventions within cancer care.
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Lestuzzi C, Annunziata MA, Nohria A, Muzzatti B, Bisceglia I, Ewer MS. Cancer patients in cardiology: how to communicate with patients with special psychological needs and manage their cardiac problems in daily clinical practice. J Cardiovasc Med (Hagerstown) 2020; 21:286-291. [PMID: 31977538 DOI: 10.2459/jcm.0000000000000936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
: Cancer patients are increasingly referred for cardiology evaluations. These patients differ from those routinely seen in cardiology clinics because of their psychological burden and because the therapies and cancer itself can cause cardiac symptoms. A humane approach is critical to managing these patients. Cardiologists may see patients who are newly diagnosed with cancer or are in various phases of treatment; these patients may or may not have preexisting cardiac disease, and may develop cardiotoxicity from chemoimmunotherapy or radiotherapy. Each of these situations presents unique communication challenges for cardiologists. Although some oncology centers provide training in communication skills for their personnel, including cardiologists, this training is not widely available to physicians in general hospitals or private practice. This article examines the psychological aspects of cardio-oncology. It offers practical suggestions on how to best communicate with cancer patients in different phases of oncology care, and discusses when professional psychological help is needed.
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Affiliation(s)
- Chiara Lestuzzi
- Cardiology and Cardio-Oncology Rehabilitation Unit, Cardiology Department, AAS5
| | | | - Anju Nohria
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital.,Cardio-Oncology Program, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Barbara Muzzatti
- Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Irma Bisceglia
- Cardiovascular Department, San Camillo Forlanini Hospital, Rome, Italy
| | - Michael S Ewer
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Brederecke J, Zimmermann T. Psychometric properties of the German version of the Self Image Scale (SIS-D) in a sample of cancer patients. PLoS One 2020; 15:e0240619. [PMID: 33052971 PMCID: PMC7556474 DOI: 10.1371/journal.pone.0240619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A cancer disease can affect the satisfaction with the physical appearance, so that the standardized assessment of the body image is important in cancer patients. The German version of the Self-Image Scale is a self-report measure that uses two subscales to assess appearance satisfaction (self-acceptance) and perceptions of partners' acceptance of their appearance (partner-acceptance). The present study aimed to validate the Self-Image Scale's two-factor structure in a sample of cancer patients with a variety of different diagnoses to further increase its utility. METHODS Confirmatory factor analysis methods were used to examine the two-factor model in a sample of cancer patients (N = 278). Scale reliability and validity were then assessed through internal consistency measures and correlations with external criteria such as depressiveness, anxiety, distress, and relationship satisfaction. RESULTS The proposed factor structure was supported by the results and the internal consistencies were good with α = .83 for the self-acceptance scale and α = .88 for the partner-acceptance scale while additional correlations with external criteria were observed as expected. CONCLUSIONS The results support the use of the German version of the Self-Image Scale in cancer patients in general. Future research directions include validation across further entities of cancer, the in-depth investigation of sex differences, and research in other diseases that might impact body image.
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Affiliation(s)
- Jan Brederecke
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
- * E-mail:
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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Tahir K, Khan N. Mediating role of body image between sexual functioning and marital intimacy in Pakistani women with breast cancer. Psychooncology 2020; 30:260-266. [PMID: 33002257 DOI: 10.1002/pon.5563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The current study aimed to explore the mediating role of body image (dissatisfaction) between sexual functioning (SF) and marital intimacy in Pakistani women with breast cancer. DESIGN/PARTICIPANTS Correlation research design was used. One hundred and eighteen women suffering from breast cancer with age (M = 39.58, SD = 11.06) were taken from both Government and Private Hospitals of Lahore, Pakistan. The participants were asked to fill out a set of questionnaires including a Demographic Form, Female Sexual Function Index, Body Image Scale, and Marital Intimacy Questionnaire (MIQ). FINDINGS Correlation analysis revealed that there was a significant positive relationship between higher SF and positive determinants of marital intimacy (consensus, openness, affection, and commitment). Body image dissatisfaction had a negative relationship with positive determinants of marital intimacy and positive relationship with intimacy problems (dimension of MIQ). SPSS (Process) revealed that SF came out to be a positive predictor of marital intimacy while body image (dissatisfaction) came out to be a negative predictor of positive dimensions of marital intimacy. There was a mediational role of body image (dissatisfaction) between SF and all dimensions of marital Intimacy. CONCLUSION It was concluded that women who perceived their bodies positively had better marital intimacy, which lead to a healthy marital life.
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Affiliation(s)
- Khola Tahir
- Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan
| | - Nashi Khan
- Rashid Latif Medical Complex (RLMC), Department of Psychology, Lahore, Pakistan
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Ghaffari F, Ghahramanian A, Zamanzadeh V, Onyeka TC, Davoodi A, Mazaheri E, Asghari-Jafarabadi M. Patient-centred communication for women with breast cancer: Relation to body image perception. J Clin Nurs 2020; 29:4674-4684. [PMID: 32956571 DOI: 10.1111/jocn.15508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/26/2020] [Accepted: 09/06/2020] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to determine the predictive values of patient-centred communication (PCC) and patient's characteristics on the body image (BI) perception in postmastectomy patients. BACKGROUND Patient-centred communication has been touted as a means of addressing BI issues, especially for postmastectomy patients. DESIGN AND METHODS This predictive correlational study was conducted on 275 surgically treated breast cancer patients admitted to the Oncology Departments of two hospitals in Tabriz, Iran. These patients were selected using a convenience sampling method. The Body Image after Breast Cancer Questionnaire (BIBCQ) and patient-centred communication questionnaire (PCCQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data. Reporting was in accordance with the STROBE guideline. RESULTS A multivariable model significantly predicted BI perception in participants using surgery type and time elapsed following surgery. Participants' limitations were significantly affected by surgery type and participants' perception of the nurses' PCC skills. Arm concern was significantly affected by surgery type and nurses' PCC skills. CONCLUSION Patient-centred skills in nurse-patient communication are critical for resolving BI difficulties such as arm concerns and limitations regarding the disease and its treatment. RELEVANCE TO CLINICAL PRACTICE Patient-centred communication skills can be taught nurses in the clinical setting to help alleviate patients' BI problems.
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Affiliation(s)
- Fariba Ghaffari
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Medical Surgical Department, Nursing and Midwifery Faculty, Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Arefeh Davoodi
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Effat Mazaheri
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Huang MM, Schwen ZR, Biles MJ, Alam R, Gabrielson AT, Patel HD, Day J, Pierorazio PM, Pavlovich CP. A Comparative Analysis of Surgical Scar Cosmesis Based on Operative Approach for Radical Prostatectomy. J Endourol 2020; 35:138-143. [PMID: 32731747 DOI: 10.1089/end.2020.0649] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Recent developments in minimally invasive approaches to radical prostatectomy (RP) for localized prostate cancer have improved oncological outcomes, but may also affect surgical scar cosmesis, an important component of survivorship and patient quality of life. Our aim was to evaluate surgical scar appearance based on operative approach to RP using a validated tool for evaluating psychosocial impact of scar appearance. Methods: Men between the ages of 45 and 80 were surveyed on an online crowdsourcing platform. Well-healed surgical scars after open, multiport (MP) robotic (transperitoneal and extraperitoneal), and single-port (SP) robotic RP were digitally rendered on stock photos to control for patient appearance. Respondents evaluated images using the SCAR-Q© psychosocial impact domain. Additionally, different RP scars were ranked by appearance and assigned 10-point appearance scores. Results: Two hundred thirty-four surveys were included for analysis (completion rate 84.2%). The median age was 54 (IQR: 49-61) and 35% (85/234) had previous abdominal surgery, of which 45% (38/85) was robotic or laparoscopic. SP scars had better psychosocial impact scores (median 100 out of 100 vs 69 and 58) than MP and open, respectively (both p < 0.001). SP scars were consistently ranked higher by appearance (median rank 1, IQR: 1-1) than MP (2, IQR: 2-3) and open (3, IQR: 3-4) (p < 0.001). SP without assistant port had the highest appearance score (median 9, IQR: 7-9) among all scars (p < 0.001). Conclusion: SP scars scored highest on psychosocial impact and were consistently ranked highest in appearance. These findings may be informative for optimizing both cosmetic appearance and quality of life for patients undergoing RP.
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Affiliation(s)
- Mitchell M Huang
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zeyad R Schwen
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael J Biles
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ridwan Alam
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew T Gabrielson
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hiten D Patel
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Phillip M Pierorazio
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christian P Pavlovich
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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93
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Body image in men with prostate or laryngeal cancer and their female partners. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2020; 66:287-301. [PMID: 32876551 DOI: 10.13109/zptm.2020.66.3.287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives: The study examines body image of male cancer patients and their female partners as well as factors influencing body image. Methods: N = 73 heterosexual couples in which the male partner was diagnosed with prostate (PC; n = 52) or laryngeal cancer (LC; n = 21) completed questionnaires on body image acceptance (Self Image Scale), relationship satisfaction (Quality of Marriage Questionnaire), and cancer-related distress (Questionnaire on Stress in Cancer Patients). The body image was assessed from two perspectives: self-acceptance (which measures a person's satisfaction or acceptance of the body) and partner-acceptance (which assesses a person's perception of the partners' appraisals of the body). Results: No differences occurred in body image acceptance between men with PC or LC. Patients with PC rated the perceived partner-acceptance lower than did their female partners. In couples with LC, women rated the self-acceptance of their partners higher than did the patients themselves. Multiple regression analysis revealed that for survivors of PC, cancer-related distress, relationship satisfaction and partner-acceptance emerged as significant predictors of self-acceptance. The only significant predictor of partner-acceptance was men's self-acceptance. Conclusions: The dissatisfaction with physical appearance is found in PK and LK patients and seems to persist for a long time. Impairment of patients' body image should be identified and addressed to prevent the negative effects on psychosocial stress for patients and relationship satisfaction.
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Reese JB, Sorice KA, Zimmaro LA, Lepore SJ, Beach MC. Communication about Sexual Health in Breast Cancer: What Can We Learn from Patients' Self-Report and Clinic Dialogue? PATIENT EDUCATION AND COUNSELING 2020; 103:1821-1829. [PMID: 32349896 PMCID: PMC7423724 DOI: 10.1016/j.pec.2020.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 03/13/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Research assessing clinical communication about sexual health is limited. We compared clinical communication about sexual health across patients' self-reports and coded dialogue in breast cancer outpatients. METHODS 134 patients had clinic visits audio-recorded and coded for sexual health communication and completed self-report questionnaires immediately after the visit. Associations between the self-report and dialogue were assessed using Phi coefficient. Agreements (present/absent) and discrepancies (omissions, commissions) about discussed topics were classified and discrepancies analyzed for themes. RESULTS Sexual health was discussed in 61 of 134 patient visits (46%). Associations were significant (p < .01) but differed by topic (φ = .27-.76). 37 women (23%) had ≥ 1 self-report error. Discrepancies were common (19 omissions, 29 commissions). Patients often omitted communication about sexual concerns when such concerns were not problematic, and interpreted non-specific discussions as including specific topics of concern, even when not explicitly stated. Omissions were more common for women with lower education. CONCLUSIONS Patients' reports of whether sexual health communication occurs does not always align with observed dialogue, and may vary by personal relevance of the topic. PRACTICE IMPLICATIONS There are limitations in determining the prevalence of clinical communication about sexual health through patient self-report. Explaining sexual health terms might enhance shared understanding.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA; Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA.
| | - Kristen A Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Lauren A Zimmaro
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Stephen J Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA; Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA
| | - Mary Catherine Beach
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
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95
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Banerjee SC, Pottenger E, Petriccione M, Chou JF, Ford JS, Sklar CA, Robison LL, Kleinerman RA, Oeffinger KC, Francis JH, Abramson DH, Dunkel IJ, Friedman DN. Impact of enucleation on adult retinoblastoma survivors' quality of life: A qualitative study of survivors' perspectives. Palliat Support Care 2020; 18:322-331. [PMID: 31699178 PMCID: PMC7205583 DOI: 10.1017/s1478951519000920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Retinoblastoma is the most common primary intraocular tumor of childhood with >95% survival rates in the US. Traditional therapy for retinoblastoma often included enucleation (removal of the eye). While much is known about the visual, physical, and cognitive ramifications of enucleation, data are lacking about survivors' perception of how this treatment impacts overall quality of life. METHODS Qualitative analysis of an open-ended response describing how much the removal of an eye had affected retinoblastoma survivors' lives and in what ways in free text, narrative form. RESULTS Four hundred and four retinoblastoma survivors who had undergone enucleation (bilateral disease = 214; 52% female; mean age = 44, SD = 11) completed the survey. Survivors reported physical problems (n = 205, 50.7%), intrapersonal problems (n = 77, 19.1%), social and relational problems (n = 98, 24.3%), and affective problems (n = 34, 8.4%) at a mean of 42 years after diagnosis. Three key themes emerged from survivors' responses; specifically, they (1) continue to report physical and intrapersonal struggles with appearance and related self-consciousness due to appearance; (2) have multiple social and relational problems, with teasing and bullying being prominent problems; and (3) reported utilization of active coping strategies, including developing more acceptance and learning compensatory skills around activities of daily living. SIGNIFICANCE OF RESULTS This study suggests that adult retinoblastoma survivors treated with enucleation continue to struggle with a unique set of psychosocial problems. Future interventions can be designed to teach survivors more active coping skills (e.g., for appearance-related issues, vision-related issues, and teasing/bullying) to optimize survivors' long-term quality of life.
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Affiliation(s)
- Smita C. Banerjee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | | | | | - Joanne F Chou
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York, New York, NY, USA
| | - Charles A Sklar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | | | | | | | | | - David H Abramson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Ira J Dunkel
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Danielle Novetsky Friedman
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Medical Dance/Movement Therapy in the Infusion Room: A Model for Individual Sessions with Adults in Active Treatment. AMERICAN JOURNAL OF DANCE THERAPY 2020. [DOI: 10.1007/s10465-020-09323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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97
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Psychometric properties of the German version of the Self-Image Scale (SIS-D). PLoS One 2020; 15:e0230331. [PMID: 32176730 PMCID: PMC7075632 DOI: 10.1371/journal.pone.0230331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Self-Image Scale is a self-report measure originally developed for use in women with cancer. Two subscales assess appearance satisfaction (self-acceptance) and perceptions of partners’ acceptance of their appearance (partner-acceptance). This study aimed to increase the Self-Image Scale’s utility by 1) confirming the two-factor structure of the German version of the Self-Image Scale, 2) testing measurement invariance across sex and age groups and validity, and 3) gathering general population normative data. Methods Confirmatory factor analysis methods were used to examine the proposed two-factor model in a random sample of adults from the general German population (N = 1367). Measurement invariance, scale reliability, and validity were assessed. Results The original factor structure and measurement invariance across sexes and age groups were supported. Women showed significantly lower self-acceptance than men. Adolescent and young adult women showed higher self-acceptance than senior women. For both sexes, partner-acceptance lowered across successive age cohorts. Internal consistencies were good. Conclusions Results support the use of the German version of the Self-Image Scale in research and clinical practice. Research directions include validation in further diseases, collecting normative data across countries, and dyadic research, particularly exploring partner-acceptance across the life span.
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98
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Rowe L, Vera E, Acquaye A, Crandon S, Shah V, Bryla C, Wu J, Wall K, Siegel C, Reyes J, Penas-Prado M, Leggiero N, Cordova C, Burton E, Antony R, Boris L, Aboud O, Vyas Y, Mathen P, Gilbert M, Camphausen K, Mendoza T, Armstrong T. The prevalence of altered body image in patients with primary brain tumors: an understudied population. J Neurooncol 2020; 147:397-404. [PMID: 32096067 PMCID: PMC7136178 DOI: 10.1007/s11060-020-03433-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/12/2020] [Indexed: 11/28/2022]
Abstract
Purpose Body image (BI) is an important issue for cancer patients, as patients with BI concerns are susceptible to depression, anxiety, difficulty coping, and poor quality of life (QoL). While this concern has been documented in patients with other malignancies, no data exists of this QoL issue in patients with primary brain tumors (PBT). Methods A cross-sectional survey of 100 PBT patients was conducted on an IRB approved prospective protocol using structured questionnaires. Participants completed the body image scale (BIS), Appearance Scheme Inventory Revised (ASI-R), MD Anderson Symptom Inventory Brain Tumor (MDASI-BT), and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Psychosocial Impact Positive measures. Results The prevalence of clinically significant body image dissatisfaction (BIS ≥ 10) was 28% (95% CI 19–37%), median BIS score was 5 (range 0–27). The median ASI-R composite score was 2.9 (range 1.5–4.7). BIS was significantly correlated with the ASI-R (r = 0.53, 95% CI 0.37 to 0.65). The mean PROMIS Depression score was 48.4 (SD = 8.9), PROMIS Anxiety score was 49.4 (SD = 9.9), and PROMIS Psychosocial Illness Impact Positive score was 48.9 (SD = 9.7). BIS was significantly correlated with age, and trended with BMI and sex. The PROMIS Psychosocial Illness Impact Positive and PROMIS Anxiety scores were the most strongly related to BIS. Conclusions This study, the first to explore altered body image in PBT patients, revealed clinically significant body image dissatisfaction in nearly 1/3 of patients, similar to other malignancies. These findings underscore the potential contribution of disease and treatment-related body image concerns on psychosocial wellbeing in patients with PBT. Electronic supplementary material The online version of this article (10.1007/s11060-020-03433-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lindsay Rowe
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alvina Acquaye
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sonja Crandon
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Veeraj Shah
- University of Maryland, College Park, MD, USA
| | - Christine Bryla
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jing Wu
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kathleen Wall
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christine Siegel
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Reyes
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marta Penas-Prado
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nicole Leggiero
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christine Cordova
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eric Burton
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ramya Antony
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Boris
- Leidos Biomedical Research, Frederick National Laboratory for Cancer Research Sponsored By the National Cancer Institute, Frederick, MD, USA
| | - Orwa Aboud
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yamini Vyas
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Peter Mathen
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Camphausen
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tito Mendoza
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Terri Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Song L, Han X, Zhang J, Tang L. Body image mediates the effect of stoma status on psychological distress and quality of life in patients with colorectal cancer. Psychooncology 2020; 29:796-802. [PMID: 32043668 DOI: 10.1002/pon.5352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 01/14/2020] [Accepted: 02/04/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We investigated the effect of stoma status (permanent stoma, temporary stoma, or non-stoma) on psychological distress and quality of life (QOL) in Chinese patients with colorectal cancer (CRC) in the early postoperative stage. We also investigated whether body image mediated the association between stoma status and psychological distress and QOL. METHODS A convenience sample of 282 CRC patients 1 to 2 weeks postsurgery participated in an observational, cross-sectional study. Participants completed the following self-report measures: Body Image Scale, Distress Thermometer, Hospital Anxiety and Depression Scale, and Core Quality of Life Questionnaire. RESULTS The temporary stoma group (TS) and the permanent stoma group (PS) reported worse body image and higher levels of anxiety and depression than the non-stoma group (P < .05). PS reported worse body image than TS (P < .01). Depression and significant body image problems were more prevalent in PS than in TS (P < .05). Stoma status was the strongest factor associated with body image, distress, and depression (P < .05). CRC patients who were younger or in later clinical stages had poorer body image. Body image fully mediated the effect of stoma status on anxiety, depression, and global QOL in PS and TS, but mediated the effect on distress only in PS. CONCLUSIONS Body image problems are common in stoma patients in the early postoperative stage and require early assessment. This study helps to elucidate the role of body image as a mediator. Longitudinal studies are needed to further explore body image distress trajectories.
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Affiliation(s)
- Lili Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xinkun Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jie Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
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Graboyes EM, Hill EG, Marsh CH, Maurer S, Day TA, Hornig JD, Lentsch EJ, Neskey DM, Skoner J, Sterba KR. Temporal Trajectory of Body Image Disturbance in Patients with Surgically Treated Head and Neck Cancer. Otolaryngol Head Neck Surg 2020; 162:304-312. [PMID: 31906788 DOI: 10.1177/0194599819898861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To characterize the temporal trajectory of body image disturbance (BID) in patients with surgically treated head and neck cancer (HNC). STUDY DESIGN Prospective cohort study. SETTING Academic medical center. SUBJECTS AND METHODS Patients with HNC who were undergoing surgery completed the Body Image Scale (BIS), a validated patient-reported outcome measure of BID, pretreatment and 1, 3, 6, 9, and 12 months posttreatment. Changes in BIS scores (ΔBIS) relative to pretreatment (primary endpoint) were analyzed with a linear mixed model. Associations between demographics, clinical characteristics, psychosocial attributes, and persistently elevated BIS scores and increases in BIS scores ≥5 points relative to pretreatment (secondary endpoints) were analyzed through logistic regression. RESULTS Of the 68 patients, most were male (n = 43), had oral cavity cancer (n = 37), and underwent microvascular reconstruction (n = 45). Relative to baseline, mean ΔBIS scores were elevated at 1 month postoperatively (2.9; 95% CI, 1.3-4.4) and 3 (3.2; 95% CI, 1.5-4.9) and 6 (1.8; 95% CI, 0.02-3.6) months posttreatment before returning to baseline at 9 months posttreatment (0.9; 95% CI, -0.8 to 2.5). Forty-three percent of patients (19 of 44) had persistently elevated BIS scores at 9 months posttreatment relative to baseline, and 51% (31 of 61) experienced an increase in BIS scores ≥5 relative to baseline. CONCLUSIONS In this cohort of patients surgically treated for HNC, BID worsens posttreatment before returning to pretreatment (baseline) levels at 9 months posttreatment. However, 4 in 10 patients will experience a protracted course with persistent posttreatment body image concerns, and half will experience a significant increase in BIS scores relative to pretreatment levels.
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Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.,Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth G Hill
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Courtney H Marsh
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Stacey Maurer
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Joshua D Hornig
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Eric J Lentsch
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David M Neskey
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.,Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Judith Skoner
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Katherine R Sterba
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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