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Kang SJ, Choi GE. Cross-Cultural Adaptation and Validation of the Korean Version of the Body Image After Mastectomy Scale. Semin Oncol Nurs 2024; 40:151576. [PMID: 38262849 DOI: 10.1016/j.soncn.2023.151576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE This study aimed to evaluate the psychometric properties and validity of the Korean version of the Body Image After Mastectomy Scale (K-BIMS). METHODS This validation study was divided into two phases. Phase 1 included the translation of the K-BIMS according to the World Health Organization recommendations, investigation of content validity by five experts, and a pilot study involving 10 participants for the final list of K-BIMS items. The study participants included 156 women who met the inclusion and exclusion criteria to verify the validity-reliability of the K-BIMS. Phase 2 included a validity-reliability analysis of the K-BIMS. This included convergent validity, known-group validity, construct validity assessed by confirmatory factor analysis, and item-total score correlation. We assessed internal consistency using the Cronbach α. RESULTS The K-BIMS confirmatory factor analysis demonstrated good fitness of indices and validity including content validity, convergent validity, and known-group validity was satisfactory. Internal consistency reliability was satisfying with a Cronbach α reliability of .89. CONCLUSIONS The results revealed that the K-BIMS is a valid and reliable instrument for assessing appearance-based behaviors and beliefs about body image distress among women who underwent reconstructive surgery after mastectomy. IMPLICATIONS FOR NURSING PRACTICE To identify individuals who exhibit maladaptive symptoms and are at risk of developing long-term body image problems, the K-BIMS can be used as a point-of-care screening tool. Therefore, the K-BIMS can be used as an early screening tool to proactively offer accessible and affordable solutions.
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Affiliation(s)
- Sook Jung Kang
- College of Nursing/ Associate Professor, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea
| | - Goh Eun Choi
- College of Nursing/PhD student, Clinical Instructor, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea.
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2
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Devarakonda SK, Timman R, Bouvy PF, Oemrawsingh A, Apon I, Mureau MAM, Koppert LB, Kranenburg LW. Trends in emotional functioning and psychosocial wellbeing in breast cancer survivors: a prospective cohort study using patient-reported outcome measures. BMC Womens Health 2023; 23:153. [PMID: 36997924 PMCID: PMC10064532 DOI: 10.1186/s12905-023-02243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND A breast cancer diagnosis can threaten every aspect of a woman's wellbeing, including her mental health. With the growing number of breast cancer survivors, studies addressing mental health in this population are of increasing importance now more than ever. Therefore, the current study investigated trends in emotional functioning and psychosocial wellbeing of breast cancer survivors, and the demographic and treatment characteristics that may influence these trends. METHODS Prospectively collected data of women treated for breast cancer at the Erasmus MC were analyzed in this study using a cohort study design. Emotional functioning was measured using the EORTC-QLQ-C30, while psychosocial wellbeing was measured using the BREAST-Q. Type of surgery, age, family status and employment status of study participants were retrieved, and multilevel analyses were performed to identify trends in emotional functioning and psychosocial wellbeing and to determine the relationship between aforementioned characteristics and these outcomes. RESULTS Three hundred thirty-four cancer survivors were analyzed. Psychosocial wellbeing declined, but emotional functioning showed a steady improvement over time. Women who underwent breast reconstruction showed a steeper increase in their emotional functioning, and women with no partner or children showed a marginal decline in psychosocial wellbeing between baseline and 12 months after surgery. CONCLUSIONS These findings can be utilized by healthcare teams to identify breast cancer patients at risk for emotional problems and to provide adequate psychological support to those women who need help dealing with their emotions and self-concept in order to optimize clinical treatment.
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Affiliation(s)
- Sri K Devarakonda
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - Paul F Bouvy
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands
| | - Arvind Oemrawsingh
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Inge Apon
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marc A M Mureau
- Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Linetta B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands.
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3
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Velasco L, Gutiérrez L, Alcocer N, Sánchez S, Catalá P, Peñacoba C. Exploring the moderated role of two psychological programs on sexual pleasure from physical symptoms, body image distortion and emotional problems of Hispanic women with breast cancer. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:643-658. [PMID: 36735842 DOI: 10.1080/0092623x.2023.2173111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Decreased sexual pleasure is a common problem in women with breast cancer. The aim of this study was to evaluate the effect of psychoeducation vs. acceptance and commitment therapy to improve sexual pleasure according to the predictive role of physical, cognitive and emotional factors. Results of 139 Hispanic women (Mexico and Spain) diagnosed with breast cancer reveal that only the emotional factor of depression predicts decreased sexual pleasure. Although women who participated in the psychoeducation program presented greater physical symptomatology, body image distortions and emotional distress, the results seem to indicate that psychoeducational guidelines are relevant to improve sexual pleasure in those women who manifest higher levels of previous depression. Future research is required to clarify these issues.
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Affiliation(s)
- Lilian Velasco
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Lorena Gutiérrez
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Natasha Alcocer
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de México, México
| | - Sofía Sánchez
- Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de México, México
| | - Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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4
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McDonald S, Sharpe L, MacCann C, Blaszczynski A. The Role of Body Image on Psychosocial Outcomes in People With Diabetes and People With an Amputation. Front Psychol 2021; 11:614369. [PMID: 33505341 PMCID: PMC7829667 DOI: 10.3389/fpsyg.2020.614369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/09/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Research indicates that body image disturbance is associated with poorer psychosocial outcomes for individuals with physical health conditions, with poorest body image reported for individuals with visible bodily changes. Using White's (2000) theoretical model of body image the present paper aimed to examine the nature of these relationships in two distinct groups: individuals with an amputation and individuals with diabetes. It was hypothesized that body image disturbance would be associated with psychosocial outcomes and would mediate the relationships between self-ideal discrepancy and personal investment in psychosocial outcomes. Methods Individuals with diabetes (N = 212) and individuals with an amputation (N = 227) provided details regarding their medical condition, and completed measures assessing body image, investment, self-ideal discrepancy, depression, anxiety, and quality of life. Structural equation and invariance modeling were used to test the model paths and the invariance of the model. Results As hypothesized, body image disturbance was found to mediate the relationships between personal investment and psychosocial outcome, and between self-ideal discrepancy and psychosocial outcome. The predicted paths were invariant across groups, although the model accounted for more variance in people with an amputation than people with diabetes. Conclusion Body image disturbance, personal investment, and self-ideal discrepancy are important factors contributing to psychosocial outcome for individuals with diabetes and individuals with an amputation. These findings not only confirm the validity of the model in these two groups, but they emphasize the importance of targeting body image in future psychological interventions for individuals with a health condition.
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Affiliation(s)
- Sarah McDonald
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Louise Sharpe
- Clinical Psychology Unit, University of Sydney, Sydney, NSW, Australia.,School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Carolyn MacCann
- School of Psychology, University of Sydney, Sydney, NSW, Australia
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5
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Favez N, Antonini T, Delaloye JF, Notari SC. From breast cancer surgery to survivorship: Insecure attachment tendencies predict negative psychological outcomes. Health Psychol Open 2021; 8:2055102920987463. [PMID: 33598303 PMCID: PMC7863168 DOI: 10.1177/2055102920987463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Little is known about the variables explaining individual variability in the long-term adaptation of breast cancer survivors. Attachment tendencies have, however, been shown to explain negative psychological outcomes in the postsurgical period. The present study aimed to assess the continuing influence of attachment tendencies in the survivorship period. A sample of 28 women were surveyed 2 weeks, 3 months, 12 months, and 5 to 7 years after surgery. Attachment tendencies and psychological outcomes (distress, body image, sexuality) were assessed through questionnaires, and medical and sociodemographic data collected. Results show that insecure attachment tendencies predict negative body image and elevated distress.
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6
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Ream ME, Pester MS, Goodman ZT, Bainter SA, Antoni MH. Elucidating mechanisms of quality-of-life disparities in Hispanic women with breast cancer: An examination of disease stage, coping, and affect. Psychooncology 2020; 30:623-631. [PMID: 33300657 DOI: 10.1002/pon.5611] [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: 07/07/2020] [Revised: 10/26/2020] [Accepted: 11/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Compared to non-Hispanic white (NHW) women, Hispanic women with breast cancer (BCa) are more likely to be diagnosed at later stages of disease and experience reduced quality of life (QOL) following diagnosis. We hypothesized that the demands of later-stage disease results in a perceived inability to cope and greater distress for Hispanic women, resulting in decreased QOL. METHODS Hispanic (51%) and NHW (49%) women (N = 198) with newly diagnosed stage 0-3 BCa in Miami were enrolled in two trials between 2006 and 2019. In this cross-sectional analysis, a multiple-group structural equation modeling approach was applied to baseline measures of coping confidence (Measure of Current Status Scale), negative and positive affect (Affect Balance Scale), QOL (Functional Assessment of Cancer Therapy - Breast), and disease stage. RESULTS In our model, later-stage disease was not associated with worse QOL for Hispanic or NHW women. However, there were differences between Hispanic and NHW women on the path from disease stage to (1) coping confidence, (2) positive affect, and (3) negative affect, such that later disease stage was associated with lower coping confidence (b[SE] = -1.75[0.59], p = 0.002), less positive affect (b[SE] = -0.21[0.10], p = 0.026), and greater negative affect (b[SE] = 0.15[0.08], p = 0.052) among Hispanic, but not NHW, women. In addition, an indirect effect was found from greater stage to poorer QOL via less positive affect among Hispanic women only (b[SE] = -0.49[0.24], p = 0.041). CONCLUSIONS This data supports our theory that Hispanic women experience worse emotional distress at later-stage disease than do NHW women, in turn impacting QOL.
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Affiliation(s)
- Molly E Ream
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Mollie S Pester
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Zachary T Goodman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sierra A Bainter
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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7
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Gutiérrez Hermoso L, Velasco Furlong L, Sánchez-Román S, Salas Costumero L. The Importance of Alexithymia in Post-surgery. Differences on Body Image and Psychological Adjustment in Breast Cancer Patients. Front Psychol 2020; 11:604004. [PMID: 33391123 PMCID: PMC7775299 DOI: 10.3389/fpsyg.2020.604004] [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] [Received: 09/08/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022] Open
Abstract
Breast cancer is a disease that is difficult to face and that often hinders body acceptance. Body changes due to surgery can be very emotionally challenging for those who experience them. The aim of this study is to explore the differences on body image and psychological adjustment on women with breast cancer with high and low alexithymia according to the type of surgery. In this cross-sectional study, 119 women diagnosed with breast cancer (stages I, II, and III) were evaluated with different self-report questionnaires. Afterward, patients were divided into two groups (high and low levels of alexithymia) to analyze dependent variables (body image and psychological adjustment) according to the type of surgery (radical mastectomy or breast conserving therapy). The results of the General Linear Model suggest that when patients show high alexithymia combined with having undergone a radical mastectomy, they show higher levels of Hopelessness. Furthermore, in patients with high alexithymia, higher scores of maladaptive coping styles and greater distortion of body image were found. Alexithymia seems to play an important role in the way in which women cope with their disease, especially in those with radical mastectomy.
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Affiliation(s)
| | | | - Sofía Sánchez-Román
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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8
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Mah K, Lebel S, Irish J, Bezjak A, Payne AYM, Devins GM. A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer. Support Care Cancer 2018; 26:3365-3377. [PMID: 29651597 DOI: 10.1007/s00520-018-4187-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 03/28/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE This cross-sectional study presents an initial psychometric evaluation of a two-dimensional (perceptual and evaluative) conceptualization and measure of disrupted body integrity (DBI)-illness-related disruption of the sense of the body as an integrated, smoothly functioning whole. METHODS Male and female head and neck cancer (HNC) outpatients (N = 98) completed a questionnaire package prior to outpatient visits. MAIN OUTCOME MEASURES The Disrupted Body Integrity Scale (DBIS) was developed to measure the perceptual and evaluative facets of DBI. Self-report measures of disfigurement, stigma, depressive symptoms, and negative affect were also completed. RESULTS Almost all DBIS subscales demonstrated good internal consistency. Results largely supported the DBIS's construct validity. The majority of subscales correlated within the predicted range of r's = .40-.70. Almost all DBIS constructs were positively linked with either depressive symptoms or disfigurement. None correlated with positive affect, and only two subscales, abnormal sensations (perceptual) and physical vulnerability (evaluative), correlated with negative affect. DBIS constructs showed little relation with stigma, once disfigurement effects were controlled for. CONCLUSIONS Findings offer preliminary evidence for the DBIS and the relevance of DBI in HNC. Further evaluation of DBI in disease adaptation and the DBIS's factor structure is warranted.
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Affiliation(s)
- Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada.
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jonathan Irish
- Department of Surgical Oncology, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Ontario Cancer Institute, Toronto, Ontario, Canada
| | - Andrea Bezjak
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Ontario Cancer Institute, Toronto, Ontario, Canada.,Department of Radiation Oncology, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada
| | | | - Gerald M Devins
- Department of Supportive Care, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada.,Ontario Cancer Institute, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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9
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Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis. J Clin Psychol Med Settings 2018; 25:335-355. [DOI: 10.1007/s10880-017-9526-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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10
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Favez N, Cairo Notari S, Charvoz L, Notari L, Ghisletta P, Panes Ruedin B, Delaloye JF. Distress and body image disturbances in women with breast cancer in the immediate postsurgical period: The influence of attachment insecurity. J Health Psychol 2016; 21:2994-3003. [DOI: 10.1177/1359105315589802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The aim of this study was to assess, in the immediate postsurgical period, the influence of attachment avoidance and anxiety on distress and body image disturbances in women facing breast cancer. Seventy-five women participated in the study 3 weeks after surgery. Questionnaires were used to assess study variables. To predict distress and body image disturbances, we controlled for several variables known to influence adjustment to the stress of breast cancer. The results of hierarchical regression analyses show that attachment explains the outcomes above and beyond other influential variables. Insecurely attached women are especially vulnerable to the stress of the disease.
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Affiliation(s)
- Nicolas Favez
- University of Geneva, Switzerland
- Distance Learning University, Switzerland
| | | | | | | | - Paolo Ghisletta
- University of Geneva, Switzerland
- Distance Learning University, Switzerland
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11
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McClelland SI, Holland KJ, Griggs JJ. Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis. Qual Life Res 2015; 24:2939-43. [PMID: 26038224 DOI: 10.1007/s11136-015-1034-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 01/08/2023]
Abstract
PURPOSE Too little is understood about the quality of life (QoL) concerns of patients diagnosed with advanced disease. While body image has been found to be consistently important for women with early-stage breast cancer, the impact of body image on women with metastatic breast cancer (MBC) is less frequently studied. This cross-sectional study aimed to identify factors affecting QoL in a sample of patients diagnosed with MBC, with particular attention to body image, disease site, and time since diagnosis. METHODS In total, 113 women diagnosed with MBC completed two QoL scales (EORTC QLQ30; EORTC BR23) as part of a larger study. Clinical characteristics were obtained via medical record review. Demographics, disease characteristics, and clinical factors were examined. RESULTS Time since diagnosis and location of metastases were found to affect patients' QoL, and most strikingly, this effect often differed for those with higher and lower body image. Body image appears to remain highly influential even for those living with a shortened life expectancy. CONCLUSIONS These findings indicate that the development of QoL support should more carefully consider patients diagnosed with MBC and the unique sets of body concerns that affect this population.
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Affiliation(s)
- Sara I McClelland
- Departments of Psychology and Women's Studies, University of Michigan, 204 South State St., Ann Arbor, MI, 48109, USA.
| | - Kathryn J Holland
- Departments of Psychology and Women's Studies, University of Michigan, 204 South State St., Ann Arbor, MI, 48109, USA
| | - Jennifer J Griggs
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School and Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
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12
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Devins GM, Wong JC, Payne AYM, Lebel S, Lee RNF, Mah K, Irish J, Rodin G. Distancing, self-esteem, and subjective well-being in head and neck cancer. Psychooncology 2015; 24:1506-13. [DOI: 10.1002/pon.3760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 12/15/2014] [Accepted: 12/23/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Gerald M. Devins
- Princess Margaret Cancer Center and University of Toronto; Canada
| | | | | | | | - Ruth N. F. Lee
- McMaster University Medical Centre and McMaster University; Canada
| | | | - Jonathan Irish
- Princess Margaret Cancer Center and University of Toronto; Canada
| | - Gary Rodin
- Princess Margaret Cancer Center and University of Toronto; Canada
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13
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Teo I, Novy DM, Chang DW, Cox MG, Fingeret MC. Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer. Psychooncology 2015; 24:1377-83. [DOI: 10.1002/pon.3745] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 10/28/2014] [Accepted: 12/10/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Irene Teo
- Department of Behavioral Science; The University of Texas MD Anderson Cancer Center; Houston TX USA
- Department of Plastic Surgery; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Diane M. Novy
- Department of Pain Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - David W. Chang
- Department of Surgery; University of Chicago Medicine & Biological Sciences; Chicago IL USA
| | - Matthew G. Cox
- Department of Behavioral Science; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Michelle Cororve Fingeret
- Department of Behavioral Science; The University of Texas MD Anderson Cancer Center; Houston TX USA
- Department of Plastic Surgery; The University of Texas MD Anderson Cancer Center; Houston TX USA
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14
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Wimberly SR, Carver CS, Antoni MH. Effects of optimism, interpersonal relationships, and distress on psychosexual well-being among women with early stage breast cancer. Psychol Health 2014; 23:57-72. [PMID: 25159907 DOI: 10.1080/14768320701204211] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined associations between optimism, social support, and distress as they relate to psychosexual well-being among 136 women with Stage 0, I, and II breast cancer. Women were assessed immediately post-surgery and 3, 6, and 12 months post-surgery. Results support two cross-sectional mediation models. The first model indicates that patients who are more optimistic experience greater psychosexual well-being (i.e., feel more feminine, attractive, and sexually desirable) partly because they perceive themselves as having more social support available. The second model indicates that patients who are more optimistic experience greater psychosexual well-being partly because they experience less emotional distress related to the disease. When the two models were tested simultaneously, distress no longer contributed uniquely to the model at any time point except for 12 months follow-up.
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Affiliation(s)
- Sarah R Wimberly
- a Department of Psychology , University of Miami , 5665 Ponce De Leon Blvd. , Coral Gables , FL , USA
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15
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Ramirez M, Altschuler A, McMullen C, Grant M, Hornbrook M, Krouse R. "I didn't feel like I was a person anymore": realigning full adult personhood after ostomy surgery. Med Anthropol Q 2014; 28:242-59. [PMID: 24782269 PMCID: PMC5023005 DOI: 10.1111/maq.12095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer in the United States. For some CRC patients, cancer treatment involves creating a permanent or temporary intestinal ostomy. Having an ostomy often results in complex social and physical concerns-including unpredictable and at times publicly noticeable bowel output. In this article, we discuss findings from 30 in-depth interviews with female CRC survivors with ostomies in the western United States. We highlight how having an ostomy disrupts culturally sanctioned practices of continence that mark the attainment of full-adult personhood. We discuss how survivors reclaim a sense of full personhood after ostomy surgery through a process of realignment that entails both learning how to manage ostomy equipment to conceal bowel activity and reappraising their illness and suffering. We suggest that the anthropological categories of personhood and personhood realignment be incorporated into research and interventions aimed at increasing support among cancer survivors living with bodily impairments.
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16
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Rowland E, Metcalfe A. A systematic review of men's experiences of their partner's mastectomy: coping with altered bodies. Psychooncology 2014; 23:963-74. [DOI: 10.1002/pon.3556] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 02/10/2014] [Accepted: 03/20/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Emma Rowland
- Florence Nightingale School of Nursing and Midwifery; King's College London; London UK
| | - Alison Metcalfe
- Florence Nightingale School of Nursing and Midwifery; King's College London; London UK
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17
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18
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Exploring the influence of gender-role socialization and objectified body consciousness on body image disturbance in breast cancer survivors. Psychooncology 2013; 22:2177-85. [DOI: 10.1002/pon.3271] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 01/26/2013] [Accepted: 02/04/2013] [Indexed: 11/07/2022]
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19
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Roy M, Payette H. The body image construct among Western seniors: A systematic review of the literature. Arch Gerontol Geriatr 2012; 55:505-21. [DOI: 10.1016/j.archger.2012.04.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 04/16/2012] [Accepted: 04/17/2012] [Indexed: 10/28/2022]
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20
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Wong JC, Payne AYM, Mah K, Lebel S, Lee RNF, Irish J, Rodin G, Devins GM. Negative cancer stereotypes and disease-specific self-concept in head and neck cancer. Psychooncology 2012; 22:1055-63. [PMID: 22692968 DOI: 10.1002/pon.3109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 04/19/2012] [Accepted: 04/24/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Life-threatening diseases, such as head and neck cancer (HNCa), can stimulate the emergence of a new disease-specific self-concept. We hypothesized that (i) negative cancer-stereotypes invoke distancing, which inhibits the adoption of a disease-specific self-concept and (ii) patient characteristics, disease and treatment factors, and cancer-related stressors moderate the phenomenon. METHODS Head and neck cancer outpatients (N = 522) completed a semantic-differential measure of disease-specific self-concept (perceived similarity to the 'cancer patient') and other self-report measures in structured interviews. Negative cancer-stereotypes were represented by the number of semantic-differential dimensions (0-3) along which respondents evaluated the stereotypic 'cancer patient' negatively (i.e., negative valence). We tested the two-way interactions between negative valence and hypothesized moderator variables. RESULTS We observed significant negative valence × moderator interactions for the following: (i) patient characteristics (education, employment, social networks); (ii) disease and treatment factors (cancer-symptom burden); and (iii) cancer-related stressors (uncertainty, lack of information, and existential threats). Negative cancer stereotypes were consistently associated with distancing of self from the stereotypic 'cancer patient,' but the effect varied across moderator variables. All significant moderators (except employment and social networks) were associated with increasing perceived similarity to the 'cancer patient' when respondents maintained negative stereotypes; perceived similarity decreased when people were employed or had extensive social networks. Moderator effects were less pronounced when respondents did not endorse negative cancer stereotypes. DISCUSSION When they hold negative stereotypes, people with HNCa distance themselves from a 'cancer patient' identity to preserve self-esteem or social status, but exposure to cancer-related stressors and adaptive demands may attenuate these effects.
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Affiliation(s)
- Janice C Wong
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Abstract
Cancer and its treatments induce important physical transformations, which could be source of psychological and social difficulties. Since about 15 years, interest for cancer and treatments consequences on body image had grown in oncology. Nevertheless studying body image remains complex because of conceptual and methodological limits. This article aims at a clarification about the methods employed in the field of cancer to assess body image, in order to make accessible reference marks about adapted instruments for every person who would like to study this theme.
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Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, Ng W, King MT. Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol 2011; 12:1240-8. [PMID: 21996168 DOI: 10.1016/s1470-2045(11)70212-1] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Ethnic minority is associated with higher cancer incidence and poorer survival than is being in the majority group. We did a systematic review and meta-analysis to assess whether psychological morbidity and health-related quality of life (HRQoL) were affected by minority status. METHODS We searched Medline, AMED, PsycINFO, Embase, CENTRAL, CINAHL, PubMed, Sociological Abstracts, and Web of Science for English-language articles published between Jan 1, 1995, and October, 2009. Articles were eligible if they reported original data on anxiety, depression, distress (for psychological morbidity), or HRQoL in minority and majority cancer patients or survivors. Minority status was defined as being an immigrant or having an ethnic, linguistic, or religious background different to the majority of the population in the country where the research was done. We excluded African Americans and indigenous groups. Eligible articles were rated for quality of reporting, external validity, internal validity, sample size, and power. Each quality criterion was rated independently by two reviewers until inter-rater reliability was achieved. In a meta-analysis we compared mean scores adjusted for socioeconomic status and other sociodemographic and clinical variables, where available. Effect sizes greater than 0·5 and 95% CI that included 0·5 or -0·5 were deemed clinically important, with negative values indicating worse outcomes in minority patients. We assessed publication bias by estimating the number of potential unpublished studies and the number of non-signficant studies with p=0·05 required to produce a non-significant overall result. FINDINGS We identified 21 eligible articles that included 18 datasets collected in the USA and one in each of Canada, Romania, and the UK. Ethnic minority groups were Hispanic, Asian or Pacific Islander, or Hungarian (one dataset). Overall, we found minority versus majority groups to have significantly worse distress (mean difference -0·37, 95% CI -0·46 to -0·28; p<0·0001), depression (-0·23, -0·36 to -0·11; p=0·0003), and overall HRQoL (-0·33, -0·58 to -0·07; p=0·013). Further analyses found disparities to be specific to Hispanic patients in the USA, in whom poorer outcomes were consistent with potentially clinically important differences for distress (effect size -0·37, 95% CI -0·54 to -0·20; p<0·0001), social HRQoL (-0·45, -0·87 to -0·03; p=0·035), and overall HRQoL (-0·49, -0·78 to -0.20; p=0·0008). Results were significantly heterogeneous for overall HRQoL and all domains. Tests for interaction, for adjusted versus unadjusted and comparisons of high-quality, medium-quality, and low-quality articles, were generally non-significant, which suggests no bias. We found no evidence of any substantive publication bias. INTERPRETATION Hispanic cancer patients in the USA, but not other ethnic minority groups, report significantly worse distress, depression, social HRQoL, and overall HRQoL than do majority patients, of which all but depression might be clinically important. Heterogeneous results might, however, have limited the interpretation. Data for other minority groups and for anxiety are scarce. More studies are needed from outside the USA. Future reports should more clearly describe their minority group samples and analyses should control for clinical and sociodemographic variables known to predict outcomes. Understanding of why outcomes are poor in US Hispanic patients is needed to inform the targeting of interventions. FUNDING Prince of Wales Hospital, Sydney, Australia.
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Affiliation(s)
- Tim Luckett
- Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, NSW, Australia.
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Yanez B, Thompson EH, Stanton AL. Quality of life among Latina breast cancer patients: a systematic review of the literature. J Cancer Surviv 2011; 5:191-207. [PMID: 21274649 PMCID: PMC3096762 DOI: 10.1007/s11764-011-0171-0] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 01/07/2011] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The Latino population is the most rapidly growing ethnic minority in the United States and Latinas have higher rates of advanced breast cancer and more rigorous treatments than White women. However, the literature lacks reviews on quality of life among this population of breast cancer patients. METHODS A systematic review of the breast cancer quality of life (QOL) literature was conducted among studies that provided a comparison of mental, physical, social, or sexual QOL between Latinas and other racial/ethnic groups. Of the 375 studies reviewed, 20 quantitative studies and two qualitative studies met criteria for inclusion. RESULTS Latinas were more likely to report poor mental, physical, and social QOL, relative to non-Latinas. Only four studies assessed sexual QOL, making it difficult to draw any conclusions. Of these four QOL domains, the largest disparity was found in the area of mental health in which Latinas reported poorer QOL compared to non-Latina Whites and Blacks. DISCUSSION/CONCLUSIONS Most quantitative studies revealed either that Latinas consistently evidenced significantly lower QOL than non-Latinas on all measures (6 studies) or reported mixed findings in which Latinas generally demonstrated significantly worse QOL on most, but not all, measures (12 studies) included in the study. Explanatory mechanisms including socio-demographic, treatment-related, and culturally-relevant factors are discussed. Implications for research design, measurement, and clinical work are also included. IMPLICATIONS FOR CANCER SURVIVORS Although not entirely consistent, data suggest that Latina breast cancer survivors on average experience worse QOL than non-Latina Whites. Understanding ethnic differences in QOL among breast cancer survivors can inform interventions targeted at improving health status for Latinas.
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Affiliation(s)
- Betina Yanez
- Department of Psychology, University of California, Los Angeles, USA
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Mah K, Bezjak A, Loblaw DA, Gotowiec A, Devins GM. Do ongoing lifestyle disruptions differ across cancer types after the conclusion of cancer treatment? J Cancer Surviv 2010; 5:18-26. [DOI: 10.1007/s11764-010-0163-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 12/04/2010] [Indexed: 11/28/2022]
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Christie KM, Meyerowitz BE, Maly RC. Depression and sexual adjustment following breast cancer in low-income Hispanic and non-Hispanic White women. Psychooncology 2010; 19:1069-77. [PMID: 20014073 PMCID: PMC2891209 DOI: 10.1002/pon.1661] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Hispanics are the largest and fastest growing ethnic minority group in the United States and breast cancer is the most commonly diagnosed cancer in Hispanic women. However, Hispanics are underrepresented in the psychosocial breast cancer literature. METHODS This study included 677 low-income women (425 Hispanic, 252 non-Hispanic White) enrolled in the Medi-Cal Breast and Cervical Cancer Treatment Program. Data were gathered through phone interviews conducted in English or Spanish 6 and 18 months following breast cancer diagnosis. We focus on three variables that the literature indicates are salient for breast cancer survivors: sexual function, body image and depression. RESULTS Results of an ANCOVA indicated worse sexual function for Hispanic women, even after controlling for significant covariates. Hispanics reported significantly less sexual desire, greater difficulty relaxing and enjoying sex, and greater difficulty becoming sexually aroused and having orgasms than non-Hispanic White women. Both Hispanic and non-Hispanic White women endorsed a lack of sexual desire more frequently than problems with sexual function. Body image did not differ between Hispanic and non-Hispanic White women. In all, 38% of Hispanic and 48% of non-Hispanic White women scored above cut-off scores for depressive symptoms. While there was no ethnic difference in depressive symptoms, single women reported more depressive symptoms than partnered women. CONCLUSIONS Findings suggest that low-income breast cancer survivors may experience symptoms of depression more than a year following diagnosis, and that sexual dysfunction may be particularly salient for low-income Hispanic women.
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Affiliation(s)
- Kysa M Christie
- Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA
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Moreira H, Canavarro MC. A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease. Eur J Oncol Nurs 2010; 14:263-70. [DOI: 10.1016/j.ejon.2010.04.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 03/22/2010] [Accepted: 04/04/2010] [Indexed: 10/19/2022]
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Traditional and non-traditional male college students' attitudes on muscularity. Eat Weight Disord 2010; 15:e90-2. [PMID: 20571328 DOI: 10.1007/bf03325285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Body dissatisfaction has been studied widely in women, and is now receiving considerable attention in men, particularly in terms of muscularity dissatisfaction. The present study found that traditional students display higher levels of drive for muscularity (DFM) than do non traditional students. In addition, in traditional students, DFM is predicted by appearance orientation, whereas in non traditional students DFM is predicted by investment in appearance and body type dissatisfaction. Future research implications are discussed.
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Bakht S, Najafi S. Body image and sexual dysfunctions: comparison between breast cancer patients and healthy women. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.sbspro.2010.07.314] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moreira H, Silva S, Canavarro MC. The role of appearance investment in the adjustment of women with breast cancer. Psychooncology 2009; 19:959-66. [DOI: 10.1002/pon.1647] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
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Piot-Ziegler C, Sassi ML, Raffoul W, Delaloye JF. Mastectomy, body deconstruction, and impact on identity: a qualitative study. Br J Health Psychol 2009; 15:479-510. [PMID: 19840495 DOI: 10.1348/135910709x472174] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. DESIGN Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. METHOD Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. RESULTS Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. CONCLUSION With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.
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Affiliation(s)
- C Piot-Ziegler
- CerPsa - Centre of Research in Health Psychology - Psychology Institute, Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland.
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Knafo R, Thombs BD, Jewett L, Hudson M, Wigley F, Haythornthwaite JA. (Not) talking about sex: a systematic comparison of sexual impairment in women with systemic sclerosis and other chronic disease samples. Rheumatology (Oxford) 2009; 48:1300-3. [PMID: 19692458 DOI: 10.1093/rheumatology/kep240] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Sexual impairment in women with SSc has received little attention. The objective of this study was to compare levels of sexual impairment in women with SSc with samples of women with medical illnesses for which sexual impairment has been researched more extensively. METHODS SSc patients completed the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR). A systematic review was conducted to select comparison samples. Sexual Relationships subscale scores from SSc patients were compared with scores from comparison samples (breast or gynaecological cancer and HIV) using t-tests and Hedges's g to calculate effect sizes. RESULTS Samples from 138 female SSc patients were analysed (28.3% diffuse; mean age 52.1 +/- 12.3 years; mean time since diagnosis 9.0 +/- 8.3 years). Women with dcSSc (6.1 +/- 4.2) reported significantly greater sexual impairment (P < 0.05) than those with lcSSc (4.4 +/- 4.2), three breast cancer samples (1.8 +/- 0.1, 3.4 +/- 3.9, 1.6 +/- 0.6) and two samples of HIV-positive female patients (4.4 +/- 3.8, 4.5 +/- 3.9). Scores in dcSSc were similar to one sample of HIV-positive women (5.8 +/- 4.1) and gynaecological cancer patients (7.3 +/- 4.3). Scores in lcSSc were significantly higher than two breast cancer samples, similar to one breast cancer sample and two HIV-positive samples, and significantly lower (P < 0.05) than in one HIV sample and gynaecological cancer. CONCLUSION Women with SSc, particularly those with dcSSc, have high levels of sexual impairment compared with women with other chronic diseases, where sexual function has received greater attention. Further research is needed on sexual function among women with SSc.
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Affiliation(s)
- Ruby Knafo
- Department of Psychiatry, McGill University and General Hospital, Montreal, Quebec, Canada
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Kudel I, Edwards R, Raja S, Heinberg LJ, Haythornthwaite J. The association of perceived partner-related social support with self-reported outcomes in women post-mastectomy. J Health Psychol 2009; 13:1030-9. [PMID: 18987076 DOI: 10.1177/1359105308097968] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Marital satisfaction is an important indicator of adaptation in patients with cancer; however, its relationship to medium-to-long-term health-related outcomes is less well understood. Married women (N = 152) at least six months post-mastectomy were surveyed to determine whether marital satisfaction predicted non-weight-related body image distress (BID), pain impact, and mood, or whether the directionality of this association operated in reverse. Structural equation modeling indicated that the model predicting medium-to-long-term health-related outcomes from satisfaction better fit the data and that time influences mood.
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Affiliation(s)
- Ian Kudel
- Cincinnati VAMC and University of Cincinnati, Ohio 45220, USA.
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Abstract
Diagnosis and treatment of breast cancer affects women physically as well as psychologically. There are many obvious and real factors that are related to psychological distress in women coping with breast cancer, such as facing a life-threatening illness, painful and impairing treatments, and significant role changes. Although these factors are clearly important, issues related to body image in women faced with breast cancer can also add to psychological distress. Women, in general, are concerned with their appearance, their weight, and their body, with recent studies suggesting 89% of women reported concerns with weight. Such premorbid concerns are often deeply ingrained and can contribute to psychological distress in women treated for breast cancer. The present article is a summary of the literature that has examined body image issues and related psychological adjustment in women with breast cancer. Implications for clinical practice and recommendations for future investigations are discussed.
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Cho HSM, Paek JU, Davis G, Fedric T. Expanding the comfort of postmastectomy patients using the Papilla Gown. J Nurs Scholarsh 2008; 40:26-31. [PMID: 18302588 DOI: 10.1111/j.1547-5069.2007.00202.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine whether the Papilla Gown designed specifically to meet the needs of postmastectomy patients with a closed drainage system in place is more comfortable than is a typical hospital gown. BACKGROUND The closed wound drainage system used for breast cancer patients immediately following mastectomy requires external drainage tubes that connect to a pouch. The pins that are usually used to attach the drains to a patient's gown create problems. The Papilla Gown (Papilla is the Latin term for breast) was designed with safety pouches for supporting the drains. METHODS A convenience sample of 13 postmastectomy patients participated in this preliminary study of the gown's use. Participants were taught how to properly wear the typical hospital gown and Papilla Gown before surgery. Patients were discharged with the gowns and two questionnaires that were to be returned approximately 1 week following surgery. Thirteen of the 38 (34%) who agreed to participate submitted usable forms. The Wilcoxon signed-ranks test was used for comparing the comfort scores of the Papilla with the hospital gown. FINDINGS Participants reported significantly higher scores (p<.003) for the Papilla Gown on all of Comfort Questionnaire's 10 items, except one (p=.337) related to fear of pulling out the drainage tubes. Specifically, patients felt more comfortable about their appearance in the gowns, their ability to move, and the support of the drainage tubes. CONCLUSION The newly designed Papilla Gown shows promise for meeting the purpose of increasing the comfort of postmastectomy patients with closed drainage systems. CLINICAL RELEVANCE The Papilla Gown was designed to address the comfort, mobility, and body image issues that patients face during the first week following a mastectomy, when they are dealing with such issues as the cancer diagnosis, loss of a breast, and managing drainage tubes. Preliminary results show that nurses can improve patient satisfaction by providing clothing that is comfortable, attractive, and supports the drainage system in place during this critical time.
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Molton IR, Siegel SD, Penedo FJ, Dahn JR, Kinsinger D, Traeger LN, Carver CS, Shen BJ, Kumar M, Schneiderman N, Antoni MH. Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: the role of interpersonal sensitivity. J Psychosom Res 2008; 64:527-36. [PMID: 18440406 PMCID: PMC2429960 DOI: 10.1016/j.jpsychores.2008.01.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 06/25/2007] [Accepted: 01/10/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Treatment for localized prostate carcinoma (PCa) is frequently associated with decrements in sexual functioning and satisfaction. Given the highly interpersonal nature of these decrements, interpersonal problems (such as interpersonal sensitivity) may affect recovery of sexual functioning after PCa treatment through interference with physician and partner communication and through distorted cognitions surrounding sexual dysfunction. The objective of the present study was to determine the effect of interpersonal sensitivity on several treatment indicators, including response to a group-based psychosocial intervention. METHODS Participants were 101 older men recovering from radical prostatectomy who were enrolled in a randomized controlled trial of a 10-week group-based cognitive-behavioral stress management (CBSM) intervention. Measures included the Inventory of Interpersonal Problems and the sexual functioning subscale of the University of California-Los Angeles quality-of-life measure. RESULTS At baseline, interpersonal sensitivity was related to a belief linking sexual dysfunction to core male identity (r=.29, P<.05). Using hierarchical regression, we found that (a) the CBSM intervention was effective in promoting sexual recovery in all participants, and (b) this effect was moderated by interpersonal sensitivity, such that individuals with higher levels of interpersonal sensitivity made larger improvements in sexual functioning in response to CBSM. CONCLUSIONS CBSM was effective in improving sexual function after radical prostatectomy. Individuals with higher levels of interpersonal sensitivity were more likely to perceive sexual dysfunction as a threat to masculine identity and made larger gains in the CBSM intervention. Results and relevance to the older male cancer patients are discussed from the perspective of interpersonal theory.
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Affiliation(s)
- Ivan R Molton
- Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA, USA
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36
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Ogden J, Lindridge L. The Impact of Breast Scarring on Perceptions of Attractiveness. J Health Psychol 2008; 13:303-10. [DOI: 10.1177/1359105307088132] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored whether breast scarring following a lumpectomy generated negative judgements using an experimental between subjects factorial design. Eight images of women varying in terms of breast scarring (present vs. absent), beauty (average vs. high) and celebrity (as a proxy for familiarity; present vs. absent) were rated by 232 participants. The results showed that scarring resulted in lower ratings of attractiveness and self esteem and higher ratings of femininity. Scarred celebrities were judged as particularly unattractive. Women's assumption that they will be judged more harshly following breast cancer surgery maybe reflected in the actual ratings of others.
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Hormes JM, Lytle LA, Gross CR, Ahmed RL, Troxel AB, Schmitz KH. The Body Image and Relationships Scale: Development and Validation of a Measure of Body Image in Female Breast Cancer Survivors. J Clin Oncol 2008; 26:1269-74. [DOI: 10.1200/jco.2007.14.2661] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PurposeA self-report measure of body image in female breast cancer survivors, the Body Image and Relationships Scale (BIRS), was developed to address attitudes about appearance, health, physical strength, sexuality, relationships, and social functioning following treatment.MethodsThe 32-item measure, generated by expert consensus and revised based on focus group feedback, was administered to 95 female breast cancer participants twice within 1 to 2 weeks. Test-retest reliability, internal consistency, and validity of the measure were assessed using standard-scale construction techniques. The structure of the proposed measure was evaluated using exploratory factor analysis. Associations of the resulting factors and other variables were assessed using extreme groups analyses.ResultsThe BIRS had satisfactory test-retest reliability and internal consistency. Principal axis factoring revealed three factors: (1) health and strength, (2) social barriers, and (3) appearance and sexuality. Correlations of the subscales with standardized measures of related constructs were significant and in the anticipated directions. Extreme groups analyses suggested associations between less physical activity and more impairment on factors 1 and 3, premenopausal status at first diagnosis and more impairment on factor 2, and younger age at the time of survey administration and more impairment on factor 3.ConclusionThe proposed scale demonstrated satisfactory reliability and internal consistency. Factor analysis revealed three subscales with coherent item content and differential associations with measures of activity level, menopause status, and age. Observed relationships with other measures support convergent and divergent validity. Results suggest that the proposed scale is useful for clinical and research applications.
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Affiliation(s)
- Julia M. Hormes
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
| | - Leslie A. Lytle
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
| | - Cynthia R. Gross
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
| | - Rehana L. Ahmed
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
| | - Andrea B. Troxel
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
| | - Kathryn H. Schmitz
- From the Department of Psychology; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; Division of Epidemiology and Community Health; and College of Pharmacy and School of Nursing, University of Minnesota, Minneapolis, MN
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Pinquart M, Fröhlich C, Silbereisen RK. Cancer patients' perceptions of positive and negative illness-related changes. J Health Psychol 2008; 12:907-21. [PMID: 17956970 DOI: 10.1177/1359105307082454] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We assessed perceived cancer-related change in 153 recently diagnosed patients. High levels of social support and optimism at the start of chemotherapy predicted higher numbers of perceived positive changes and lower numbers of negative changes nine months later. Higher numbers of perceived gains predicted an increase in positive affect, and higher numbers of negative changes predicted an increase in negative affect at follow-up. We conclude that finding positive consequences of cancer promotes psychological well-being, but patients with low levels of psychosocial resources are at risk for finding nothing beneficial in adversity.
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Affiliation(s)
- Martin Pinquart
- Department of Psychology, Philipps University, Marburg, Germany.
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Culver JL, Arena PL, Wimberly SR, Antoni MH, Carver CS. Coping among african-american, hispanic, and non-hispanic white women recently treated for early stage breast cancer. Psychol Health 2007. [DOI: 10.1080/08870440310001652669] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jenifer L. Culver
- a Department of Psychology , University of Miami , Coral Gables, FL 33124-2070
| | - Patricia L. Arena
- a Department of Psychology , University of Miami , Coral Gables, FL 33124-2070
| | - Sarah R. Wimberly
- a Department of Psychology , University of Miami , Coral Gables, FL 33124-2070
| | - Michael H. Antoni
- a Department of Psychology , University of Miami , Coral Gables, FL 33124-2070
| | - Charles S. Carver
- a Department of Psychology , University of Miami , Coral Gables, FL 33124-2070
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Tatrow K, Montgomery GH. Cognitive Behavioral Therapy Techniques for Distress and Pain in Breast Cancer Patients: A Meta-Analysis. J Behav Med 2006; 29:17-27. [PMID: 16400532 DOI: 10.1007/s10865-005-9036-1] [Citation(s) in RCA: 197] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2005] [Indexed: 10/25/2022]
Abstract
This meta-analysis is the first to examine cognitive behavioral therapy (CBT) techniques for distress and pain specifically in breast cancer patients. Twenty studies that used CBT techniques with breast cancer patients were identified and effect sizes were calculated to determine (1) whether CBT techniques have a significant impact on distress and pain, (2) if individual or group treatments are more effective, (3) whether severity of cancer diagnosis influences distress and pain outcomes, and, (4) if there is a relationship between CBT technique efficacy for distress and pain. Results revealed effect sizes of d = 0.31 for distress (p < 0.05) and .49 for pain (p < 0.05), indicating that 62 and 69% of breast cancer patients in the CBT techniques treatment groups had less distress and less pain (respectively) relative to the control groups. Studies with individual treatment approaches had significantly larger effects compared to studies that employed group approaches for distress (p = 0.04), but not for pain (p > 0.05). There were no significant differences in effects between those with or without metastases (p > 0.05). The correlation between effect sizes for distress and pain was not significant (p = 0.07). Overall, the results support the use of CBT techniques administered individually to manage distress and pain in breast cancer patients. However, more well-designed studies are needed.
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Affiliation(s)
- Kristin Tatrow
- Psychology Department, Good Shepherd Rehabilitation Hospital, Allentown, PA 18103, USA.
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Figueiredo MI, Cullen J, Hwang YT, Rowland JH, Mandelblatt JS. Breast Cancer Treatment in Older Women: Does Getting What You Want Improve Your Long-Term Body Image and Mental Health? J Clin Oncol 2004; 22:4002-9. [PMID: 15459224 DOI: 10.1200/jco.2004.07.030] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Little is known about the impact of surgical treatment on body image and health outcomes in older breast cancer patients. The purpose of this article is to evaluate whether concordance between treatment received and treatment preferences predicts posttreatment body image and whether body image, in turn, affects mental health in older women with breast cancer 2 years after treatment. Patients and Methods A longitudinal cohort of 563 women who were 67 years old or older and who had stages I and II breast cancer were surveyed by telephone at 3, 12, and 24 months after surgery. All women were clinically eligible for breast conservation. Body image was measured using questions adapted from the Cancer Rehabilitation Evaluation System–Short Form, and mental health was evaluated using a Medical Outcomes Study subscale. Results Body image was an important factor in treatment decisions for 31% of women. Women who received breast conservation had better body image 2 years after treatment than women who had mastectomies (P < .0001). Women who preferred breast conservation but received mastectomy had the poorest body image. Using generalized estimating equations, we found that body image, in turn, predicted 2-year mental health. Conclusion Body image is important for many older women, and receiving treatment consistent with preferences about appearance was important in long-term mental health outcomes. Health professionals should elicit preferences about appearance from women and provide treatment choices in concordance with these preferences. Enhancing shared decision making has the potential to improve mental health in older breast cancer survivors.
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Affiliation(s)
- Melissa I Figueiredo
- Department of Oncology, Cancer Control Program, Lombardi Cancer Center, Georgetown University Medical Center, 2233 Wisconsin Ave, Ste 317, Washington, DC 20007, USA
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