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Hou TC, Tian YF, Lee KT, Wang YM, Fang SY. Relationship between dyadic communication and body image among women with breast cancer. Support Care Cancer 2024; 32:516. [PMID: 39014258 DOI: 10.1007/s00520-024-08727-5] [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: 03/20/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Dyadic communication positively affects marital relationships, good relationships help restore body image, and this study explores the relationship between dyadic communication and body image of breast cancer patients. METHODS Cross-sectional correlation design with convenience sampling was used to recruit participants from two outpatient medical centers. Demographic information, medical records, and two questionnaires, dyadic communicative resilience scale (DCRS) and body image scale (BIS), were administered. Participants comprised women with breast cancer and their partners. Multiple regression analysis was performed to control related factors to understand the association between the DCRS of the women with breast cancer and their partners and the women's body image. Analysis of variance (ANOVA) was performed to analyze between three categories of couple's communication status (consistent and good, consistent and poor, and inconsistent) and body image of women with breast cancer. RESULTS Data were obtained from 162 women with breast cancer and 90 partners. The study found (1) significant correlation between the women's perception of their communication and body image, (2) humor in partner's perception of their communication was significantly associated with women's body image, and (3) dyadic communication that both patients and partners were consistent and good in the domain of keeping pre-cancer routines and attractiveness was associated with women's body image. CONCLUSION The correlation between dyadic communication and the body image of women with breast cancer is significant. Improving communication specific on keeping pre-cancer routines and attractiveness between women with breast cancer and their partners could enhance the women's body image.
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Affiliation(s)
- Tai-Chun Hou
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Feng Tian
- Department of General Surgery, Chi-Mei Foundation Medical Center, Tainan, Taiwan
| | - Kuo-Ting Lee
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ming Wang
- Department of Psychology, Chung Shan Medical University, and Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
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Shekhar N, Jaiswal R, Joseph L, Jain S, Jain S, Kr A, Yashas N, Fernandes A, G C, S V, Reddy T, Reddy L, Kumar R. An Overview of Psychological Analysis of Breast Cancer Patients undergoing Modified Radical Mastectomy and Breast Conservation Surgery and its impact on Objectified Body Consciousness at a Tertiary Care Cancer Centre in South India. Clin Breast Cancer 2023; 23:e394-e400. [PMID: 37400311 DOI: 10.1016/j.clbc.2023.05.017] [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: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/27/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer among females, and surgery plays a central role in its treatment. Surgical treatments may have a negative psychological impact on women's mental health regarding their body image. The purpose of this study was to compare the psychological health insights pertaining to objectified body consciousness scores before and after the surgery and also to observe whether these scores were comparable across the surgery types. MATERIALS AND METHODS This retrospective analysis of prospectively maintained data included 706 breast carcinoma patients who underwent either Breast Conservation Surgery or Modified Radical Mastectomy at tertiary care Cancer Centre, between the years 2020 to 2021. A validated questionnaire of Objectified Body Consciousness was used to obtain responses at diagnosis and at 6 months postsurgery and final scores were calculated for both instances. Two sample t-tests/analysis of variance and Chi-square tests were used to compare continuous and categorical variables respectively. RESULTS Out of total 706 breast cancer patients, 402 patients underwent Breast Conservation Surgery and 304 underwent Modified radical mastectomy procedure. A statistically significant change was seen in the mean Objectified Body Consciousness Score (14.22 ± 15.44) for all patients when compared preoperatively(72.72 ± 11.38) and postoperatively(60.15 ± 17.58). This change was higher in the Modified Radical Mastectomy group(29.38 ± 11.53). Also, statistically significant rise in scores was seen with increasing age. CONCLUSION We could affirmatively conclude in our study that younger breast cancer patients and all patients who underwent a Modified Radical Mastectomy, had more psychological apprehension with the body image postsurgery, signifying these groups should be encouraged by healthcare professionals to reach out for counselling at the earliest.
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Affiliation(s)
- Neha Shekhar
- Department of Psychology, Vidyashilp Academy, Bengaluru, Karnataka, India
| | - Richa Jaiswal
- Department of Surgical Oncology, Manipal Hospitals, Bengaluru, Karnataka, India.
| | - Leesha Joseph
- Department of Psychology, Vidyashilp Academy, Bengaluru, Karnataka, India
| | - Shraddha Jain
- Department of We Can Team, Manipal Hospitals Bengaluru, Karnataka, India
| | - Salil Jain
- Department of We Can Team, Manipal Hospitals Bengaluru, Karnataka, India
| | - Ashwin Kr
- Department of Surgical Oncology, Aster CMI Hospitals, Bangalore, Karnataka, India
| | - Nitin Yashas
- Department of Medical Oncology, Manipal Hospitals, Bengaluru, Karnataka, India
| | - Aaron Fernandes
- Department of Surgical Oncology, Manipal Hospitals, Bengaluru, Karnataka, India
| | - Chandana G
- Department of Surgical Oncology, Manipal Hospitals, Bengaluru, Karnataka, India
| | - Vanitha S
- Department of Surgical Oncology, Manipal Hospitals, Bengaluru, Karnataka, India
| | - Trupthi Reddy
- Department of Surgery, Manipal University, Tiger Circle Road, Manipal, Karnataka, India
| | - Lavanya Reddy
- Department of Surgery, St. Johns College Hospital, Bangalore, Karnataka, India
| | - Rohit Kumar
- Department of Surgical Oncology, Aster CMI Hospitals, Bangalore, Karnataka, India
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Konara Mudiyanselage SP, Wu YL, Kukreti S, Chen CC, Lin CN, Tsai YT, Ku HC, Fang SY, Wang JD, Ko NY. Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up. Breast Cancer 2023; 30:226-240. [PMID: 36319889 DOI: 10.1007/s12282-022-01413-6] [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: 02/21/2022] [Accepted: 10/27/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. METHODS Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. RESULTS After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. CONCLUSION The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
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Affiliation(s)
- Sriyani Padmalatha Konara Mudiyanselage
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Operation Theatre Department, The National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Yi-Lin Wu
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Chang-Chun Chen
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Chia-Ni Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Yi-Tseng Tsai
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Han-Chang Ku
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Su-Ying Fang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Gender Socialization as a Predictor of Psychosocial Well-Being in Young Women with Breast Cancer. Curr Oncol 2022; 29:8121-8132. [PMID: 36354701 PMCID: PMC9689583 DOI: 10.3390/curroncol29110641] [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: 09/30/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 01/14/2023] Open
Abstract
This study aimed to explore the relationship between gender socialization and psychosocial well-being among young women diagnosed with and treated for breast cancer. A total of 113 women between the ages of 18-49 completed a one-time questionnaire package. Four key measures of gender socialization were included: Gender Role Socialization Scale (GRSS), Objectified Body Consciousness Scale (OBCS), Mental Freedom Scale (MFS), and Silencing the Self Scale (SSS). Two measures of psychosocial well-being were included: Functional Assessment of Cancer Therapy-Breast (FACT-B) and Experience of Embodiment Scale (EES). Correlational and regression analyses were conducted to assess the relationship between gender socialization variables and well-being. In multiple regression models, GRSS and MFS added significant increments to the prediction of variance of the FACT-B (R2 = 23.0%). In contrast, the OBCS and MFS added significant increments to the prediction of variance of the EES (R2 = 47.0%). Findings suggested that women with greater endorsements to proscribed gender socialization were associated with poor well-being scores. Women who endorsed a critical stance, resisting traditional gender-role expectations, objectification pressures, and other social discourses, were associated with greater well-being scores. Future studies are needed to examine the impact of gender socialization on the well-being of young people with breast cancer.
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The indirect effect of body image on distress in women with breast cancer undergoing chemotherapy. HEALTH PSYCHOLOGY REPORT 2022. [DOI: 10.5114/hpr.2022.113381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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6
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Fang SY, Lin PJ, Kuo YL. Long-Term Effectiveness of a Decision Support App (Pink Journey) for Women Considering Breast Reconstruction Surgery: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e31092. [PMID: 34890354 PMCID: PMC8709911 DOI: 10.2196/31092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/10/2021] [Accepted: 10/27/2021] [Indexed: 01/22/2023] Open
Abstract
Background Various kinds of breast reconstruction (BR) options, including implants and autologous, and surgery techniques, including traditional and endoscope assisted, can be used to perform surgery. All options have their own advantages and disadvantages. Women decide on an option depending on the values and preferences they emphasize. Lacking knowledge about BR or having decision difficulties during the treatment decision process makes women experience more decision regret, psychological distress, and poor body image. Delivering decision support with a values clarification exercise using eHealth approaches would be beneficial for patient outcomes. Objective This study aims to examine the effects of a decision support app on decision-making quality and psychological morbidity for women considering BR surgery. Methods This randomized controlled trial included women who were over 20 years of age and were newly diagnosed with breast cancer and candidates for mastectomy. Women having an option for breast conservation were excluded. After being referred from the outpatient physician, the women provided consent and completed the baseline assessment. Women allocated to the control group (CG) received usual care and were provided with a pamphlet with information about types of surgery and the advantages and disadvantages of different surgery types. Women allocated to the intervention group (IG) were given the same pamphlet and guided to use the Pink Journey app to support their decision. Then they were also prompted to discuss the opinions with their significant others. Finally, the decision-making process of using the app was printed out for women that they could take home. Decision conflict, anxiety, and depression were measured at baseline. At 1 week after the intervention (T1) and at 1 month (T2), 8 months (T3), and 12 months (T4) after surgery, the women completed decision conflict, decision regret, anxiety, depression, and body image scales. An intention-to-treat analysis was performed. Results From February 2018 to July 2019, 96 women were randomly assigned to the CG (n=48) or the IG (n=48). Results revealed that body image distress declined significantly for the IG but increased for the CG. The interaction of time and group also reached significance, indicating a significant decrease in body image distress from baseline in the IG compared with the CG after the 12th month (T4) follow-up (β=–2.25, standard error=1.01, P=.027). However, there was no significant difference in decision conflict (P=.21-.87), decision regret (P=.44-.55), anxiety (P=.26-.33), and depression (P=.20-.75), indicating that the decrease in these outcomes in the IG was not greater than those in the CG. Conclusions Although we found no effect on decision conflict, decision regret, anxiety, and depression, a decision aid that combines surgery information and values clarification can help women reduce their body image distress. Trial Registration ClinicalTrials.gov NCT04190992; https://clinicaltrials.gov/ct2/show/NCT04190992
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pin-Jun Lin
- Department of Nursing, DaYeh University, Changhua, Taiwan
| | - Yao-Lung Kuo
- Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
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Nikoloudi M, Thanasko F, Parpa E, Kostopoulou S, Mystakidou K. The Experience of Living With Breast Cancer and the Assessment of Needs and Expectations. J Patient Exp 2021; 8:23743735211049663. [PMID: 34646940 PMCID: PMC8504255 DOI: 10.1177/23743735211049663] [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: 11/11/2022] Open
Abstract
Living with a chronic disease constitutes a biographical reversal characterized by change and loss. The aims of this study are to conceptualize the meaning of breast cancer, of its burden, to explore the patient's needs and expectations while being admitted to a palliative care unit, and to evaluate the fulfillment of those expectations. Two semistructured interviews were conducted, audio taped, transcribed verbatim, and subjected to the qualitative method of Interpretative Phenomenological Analysis. The first interview was conducted at the first visit of the patient to the palliative care unit, and the second after 2 weeks of receiving palliative care services. Qualitative findings indicated that the meaning of cancer can be interpreted as a transition of fading away. The transition began with redefining cancer from "my difficult moment" to "fortunately to its final destination"; struggling with the paradox of "the will to see the development of yourself and your child" and "wishing to die" while being able to "adapt" to "a balanced" day to day leaving and preparing for death. The need for interdisciplinarity is expressed.
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Affiliation(s)
- Maria Nikoloudi
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Florjan Thanasko
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Efi Parpa
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Sotiria Kostopoulou
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Aretaieion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
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8
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Gorven A, du Plessis L. Corporeal Posttraumatic Growth As a Result of Breast Cancer: An Interpretative Phenomenological Analysis. JOURNAL OF HUMANISTIC PSYCHOLOGY 2021. [DOI: 10.1177/0022167818761997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women’s traumatic experience of breast cancer (BC) can result in posttraumatic growth (PTG). Women’s embodied experiences of BC seem particularly pertinent to their experiences of both difficulty and growth. While PTG is usually conceptualized as having five domains, it seems that BC survivors experience a sixth domain—corporeal PTG (CPTG). CPTG was recently defined as a “reclaiming” and renewed connection to the body through increased appreciation of the physical self, a new sense of bodily responsibility, positive health changes, and a new sense of positive identification with the body. This study’s aim was to explore how women experience CPTG due to BC. In-depth interviews were conducted with female BC survivors. Interpretative phenomenological analysis extracted three themes: losing, regaining, and relinquishing ultimate control over the body, reconstructing embodied identity, and a newfound appreciation for the body. Participants spoke of a complicated journey from distress, loss, and fragmentation to a reshaping of their assumptions about their bodies. The findings suggest that the body plays a vital role in women’s traumatic and growth-related experiences of BC. Future research on the embodied experience of BC is recommended as it forms a crucial part of BC recovery.
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Affiliation(s)
- Amy Gorven
- University of Johannesburg, Johannesburg, Gauteng, South Africa
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Padmalatha S, Tsai YT, Ku HC, Wu YL, Yu T, Fang SY, Ko NY. Higher Risk of Depression After Total Mastectomy Versus Breast Reconstruction Among Adult Women With Breast Cancer: A Systematic Review and Metaregression. Clin Breast Cancer 2021; 21:e526-e538. [PMID: 33541834 DOI: 10.1016/j.clbc.2021.01.003] [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: 06/28/2020] [Revised: 11/03/2020] [Accepted: 01/05/2021] [Indexed: 12/24/2022]
Abstract
This systematic review with a meta-regression was conducted to determine the risk of depression after mastectomy compared to breast reconstruction among women with breast cancer 1 year after surgery. A literature search was conducted according to PRISMA guidelines using 4 databases: Medline (Ovid), Embase, Cinahl, and the Cochrane Library for the period January 2000 to March 2019. Studies that measured the status of depression within 1 year and immediately after surgery were included. Outcomes related to depression were analyzed by using a pool of event rates and a risk ratio of 95% confidence interval (CI), P value, and a fitting model based on the results of a heterogeneity test of mastectomy and BR. The statistical analysis was conducted using Comprehensive Meta-analysis 3.0 software. Nine studies met the inclusion criteria. There were 865 cases of mastectomy only, with a 22.2% risk of depression (95% CI, 12.4-36.2). In 869 women who underwent BR, the risk of depression was 15.7% (95% CI, 8.8-26.2). The depression risk ratio for mastectomy compared to BR was 1.36 (95% CI, 1.11-1.65). Patients with delayed reconstruction exhibited lower levels of depression (risk ratio 0.96, 95% CI 0.57-1.01). The Beck Depression Inventory (BDI) scale showed high sensitivity, and the Hospital Anxiety Depression Scale (HADS) with a cutoff of > 7 could measure even low to moderate depressive symptoms. One in 4 women with breast cancer had symptoms of depression after mastectomy; both surgeries were associated with depression in women 1 year after surgery. Our results will permit the development of proactive treatment plans before and after surgery to mitigate risk and prevent depression through the use of sensitive depression scales like BDI.
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Affiliation(s)
- Sriyani Padmalatha
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Tseng Tsai
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Han-Chang Ku
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Lin Wu
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan.
| | - Su-Ying Fang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Barba D, León-Sosa A, Lugo P, Suquillo D, Torres F, Surre F, Trojman L, Caicedo A. Breast cancer, screening and diagnostic tools: All you need to know. Crit Rev Oncol Hematol 2020; 157:103174. [PMID: 33249359 DOI: 10.1016/j.critrevonc.2020.103174] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/18/2020] [Accepted: 11/05/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer is one of the most frequent malignancies among women worldwide. Methods for screening and diagnosis allow health care professionals to provide personalized treatments that improve the outcome and survival. Scientists and physicians are working side-by-side to develop evidence-based guidelines and equipment to detect cancer earlier. However, the lack of comprehensive interdisciplinary information and understanding between biomedical, medical, and technology professionals makes innovation of new screening and diagnosis tools difficult. This critical review gathers, for the first time, information concerning normal breast and cancer biology, established and emerging methods for screening and diagnosis, staging and grading, molecular and genetic biomarkers. Our purpose is to address key interdisciplinary information about these methods for physicians and scientists. Only the multidisciplinary interaction and communication between scientists, health care professionals, technical experts and patients will lead to the development of better detection tools and methods for an improved screening and early diagnosis.
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Affiliation(s)
- Diego Barba
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Instituto de Investigaciones en Biomedicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Mito-Act Research Consortium, Quito, Ecuador
| | - Ariana León-Sosa
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Instituto de Investigaciones en Biomedicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Mito-Act Research Consortium, Quito, Ecuador
| | - Paulina Lugo
- Hospital de los Valles HDLV, Quito, Ecuador; Fundación Ayuda Familiar y Comunitaria AFAC, Quito, Ecuador
| | - Daniela Suquillo
- Instituto de Investigaciones en Biomedicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Mito-Act Research Consortium, Quito, Ecuador; Ingeniería en Procesos Biotecnológicos, Colegio de Ciencias Biológicas y Ambientales COCIBA, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Fernando Torres
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Hospital de los Valles HDLV, Quito, Ecuador
| | - Frederic Surre
- University of Glasgow, James Watt School of Engineering, Glasgow, G12 8QQ, United Kingdom
| | - Lionel Trojman
- LISITE, Isep, 75006, Paris, France; Universidad San Francisco de Quito USFQ, Colegio de Ciencias e Ingenierías Politécnico - USFQ, Instituto de Micro y Nanoelectrónica, IMNE, USFQ, Quito, Ecuador
| | - Andrés Caicedo
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Instituto de Investigaciones en Biomedicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador; Mito-Act Research Consortium, Quito, Ecuador; Sistemas Médicos SIME, Universidad San Francisco de Quito USFQ, Quito, Ecuador.
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11
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Cong W, Wu Y, Liu L, Hu M, Zhou C. A Chinese version of the chemotherapy-induced alopecia distress scale based on reliability and validity assessment in breast cancer patients. Support Care Cancer 2020; 28:4327-4336. [PMID: 31912364 DOI: 10.1007/s00520-019-05284-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/23/2019] [Indexed: 01/23/2023]
Abstract
PURPOSE Chemotherapy-induced alopecia is a common and emotionally traumatic side effect on breast cancer patients. In order to make up for the deficiency of measuring tools in China, our study aims at translating the chemotherapy-induced alopecia distress scale (CADS) into Chinese and evaluating the psychometric properties of the Chinese version of CADS (CADS-C) in breast cancer patients. METHODS The validity and reliability of CADS-C were measured by a questionnaire survey among 301 breast cancer patients from Chinese mainland. Construct validity was assessed through factor analysis and contrasted group comparisons. The validity of the content was examined by an experts group. The internal consistency and test-retest reliability were evaluated by calculating Cronbach's alpha and the intraclass correlation coefficient. RESULTS The content validity index was 0.94; a structure with three factors was revealed by exploratory factor analysis which explained 65.40% of the variance and proved by confirmatory factor analysis. The contrasted group comparisons showed significant differences among different degrees of alopecia. The average variance extracted and composite reliability and correlations between CADS and body image, quality of life and self-esteem proved the convergent validity. The Cronbach's alpha and the intraclass correlation coefficient of the total scale were 0.90 and 0.89 respectively, indicating satisfactory internal consistency and time stability. CONCLUSION The scale appears to be a reliable and valid tool to measure chemotherapy-induced alopecia distress among breast cancer patients in China.
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Affiliation(s)
- WeiLian Cong
- Department of Nursing, Nanfang Hospital, Southern Medical University, NO. 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - YanNi Wu
- Department of Nursing, Nanfang Hospital, Southern Medical University, NO. 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - LiPing Liu
- Department of Nursing, Nanfang Hospital, Southern Medical University, NO. 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - MingYu Hu
- Department of Nursing, Nanfang Hospital, Southern Medical University, NO. 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - ChunLan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, NO. 1838 Guangzhou Avenue North, Guangzhou, 510515, China.
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Qiu J, Tang L, Huang L, Hou S, Zhou J. Physical and psychological effects of different temperature-controlled breast prostheses on patients with breast cancer during rehabilitation: a randomized controlled study (CONSORT). Medicine (Baltimore) 2020; 99:e19616. [PMID: 32221086 PMCID: PMC7220261 DOI: 10.1097/md.0000000000019616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Breast loss causes negative influence on women physically, psychologically, and socially. Breast prosthesis can improve patient's figure externally, increase self-confidence, thus improving quality of life (QOL). Prospective study of different breast prostheses has not yet been performed in China. Our objective was to evaluate the QOL of patients wearing different types of breast prostheses and to compare the physical and psychological effects of different temperature-controlled breast prostheses on patients. METHODS Thirty patients with breast cancer were recruited through the Yankang E-follow-up Platform at the Department of Breast Surgery of Fudan University, Shanghai Cancer Center and were randomized into either intervention or control group. Random number tables were used in this study for randomization. In the first 6 weeks of the study, self-adhesive breast prostheses and conventional breast prostheses had been used in the intervention and control group, respectively. In the later 6 weeks, the breast prostheses used were switched into another kind. Several dimensional parameters including skin conditions, breast prosthesis knowledge, breast prosthesis knowledge, QOL, and body image were examined by different questionnaires in the end of both 6th and 12th week. RESULTS There were no significant difference in QOL and body image between the 2 groups during 6th and 12th week. At the 6th week of the study, patients of the intervention group preferred to the self-adhesive breast prosthesis, indicating that the self-adhesive breast prosthesis seemed more likely to feel like part of their body, while prosthesis cleaning remaining their biggest concern. At the end of 12th week, in comparison with the number at 6th week, more patients in both groups were willing to choose self-adhesive breast prosthesis. CONCLUSIONS We conclude that women are satisfied with the temperature-controlled breast prosthesis and are more willing to choose self-adhesive breast prostheses although cleaning remains a problem. In China, patients still lack information about breast prostheses. Therefore, specialist breast nurses should provide comprehensive information about breast prostheses, assist patients in selecting suitable breast prostheses, collect feedback about the prostheses, and reduce each patient's physical and mental discomfort.
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Affiliation(s)
- Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center
- Department of Oncology, Shanghai Medical College
| | - Lichen Tang
- Department of Oncology, Shanghai Medical College
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Lijin Huang
- Department of Nursing Administration, Shanghai Cancer Center
- Department of Oncology, Shanghai Medical College
| | - Shengqun Hou
- Department of Nursing Administration, Shanghai Cancer Center
- Department of Oncology, Shanghai Medical College
| | - Jie Zhou
- Department of Nursing Administration, Shanghai Cancer Center
- Department of Oncology, Shanghai Medical College
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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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Esplen MJ, Warner E, Boquiren V, Wong J, Toner B. Restoring body image after cancer (ReBIC): A group therapy intervention. Psychooncology 2020; 29:671-680. [PMID: 31984589 DOI: 10.1002/pon.5304] [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: 09/12/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Body image (BI) remains a significant survivorship challenge among breast cancer (BC) survivors. We describe an 8-week group intervention-restoring body image after cancer (ReBIC)-developed to target BI distress for BC survivors. METHODS The intervention was informed by interviews with BC survivors and by a descriptive, exploratory approach which adapted guided imagery exercises to address BI. Educational material was selected to address sociocultural factors that may contribute to BI distress and affect adjustment. Videotape reviews and content analyses further refined the intervention. RESULTS The intervention incorporates three active components: psychotherapeutic group principles; guided imagery exercises to address BI; and psychoeducation on relevant socialization factors and gender-based messages internalized by women in Western society. The therapeutic group was a supportive and effective way to assist BC survivors to gain insight on BI impacts, their histories, and relevant sociocultural factors contributing to BI distress. The group also facilitated the working through of grief over multiple losses. Guided imagery was well-received, and appeared to help survivors identify negative and emerging self-schema, as well as facilitate new self-views. Specific themes included negative emotions associated with an altered body and self, grief and loss, isolation, difficulties with sexual intimacy, relationship challenges, and uncertainty around sense of self and future. CONCLUSION An empirically tested group therapy intervention is described and has implications for survivorship programs to help address BI-related challenges. Future work could consider testing a similar approach tailored for other cancer populations.
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Affiliation(s)
- Mary Jane Esplen
- de Souza Institute, University Health Network, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ellen Warner
- Division of Medical Oncology, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Jiahui Wong
- de Souza Institute, University Health Network, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brenda Toner
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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15
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Depression and marital satisfaction: the mediating role of sexual satisfaction and perceived partner acceptance in women after mastectomy. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.84213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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The influence of partner involvement in the decision-making process on body image and decision regret among women receiving breast reconstruction. Support Care Cancer 2018; 27:1721-1728. [PMID: 30132239 DOI: 10.1007/s00520-018-4416-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study examines the influence of partner involvement in decision-making for breast reconstruction (BR) on women's body image and post-BR decision regret. METHODS A cross-sectional and correlational approach was used in a convenience sample of 105 women in Taiwan who had breast cancer (BC) whose partners were involved in decision-making for BR. A structured questionnaire including the Involvement in the Breast Reconstruction Decision-Making Process Scale, the Body Image Scale, and the Decision Regret Scale was administered. Pearson's r and path analysis were used to examine the relationships among the dyadic BR decision-making process, women's body image, and decision regret. RESULTS The greater the amount of medical information women had, the better their body image and the less decision regret they experienced. Moreover, partner involvement was not related to women's body image, though it was inversely related to women's decision regret. The final path model showed that the amount of medical information women obtained was directly related to body image and decision regret, while body image also directly influenced decision regret. Overall, the amount of medical information women obtained and their body image explained 45% of the variance in decision regret. CONCLUSIONS Medical teams should provide female BC patients with complete medical information, and through partner involvement, women can be supported to make an appropriate decision regarding BR to achieve optimal levels of body image and lower levels of decision regret.
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Castonguay AL, Wrosch C, Pila E, Sabiston CM. Body-Related Shame and Guilt Predict Physical Activity in Breast Cancer Survivors Over Time. Oncol Nurs Forum 2018. [PMID: 28632240 DOI: 10.1188/17.onf.465-475] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To test body-related shame and guilt as predictors of breast cancer survivors' (BCS') moderate to vigorous intensity physical activity (MVPA) during six months and to examine motivational regulations as mediators of this association.
. DESIGN Prospective study.
. SETTING Survivors were recruited through advertisements and oncologist referrals from medical clinics and hospitals in Montreal, Quebec, Canada.
. SAMPLE 149 female BCS.
. METHODS Self-reports of body-related shame and guilt, motivational regulations, and MVPA were measured among BCS at baseline. MVPA was assessed a second time six months later. Residual change scores were used.
. MAIN RESEARCH VARIABLES Body-related shame and guilt; external, introjected, and autonomous (identified and intrinsic) motivational regulations; MVPA.
. FINDINGS In the multiple mediation models, body-related shame was associated with low levels of MVPA, as well as external, introjected, and autonomous motivational regulations. Guilt was related to high levels of MVPA and introjected and autonomous motivational regulations. Indirect effects linked shame, guilt, and MVPA via autonomous motivation. Only body-related shame was a significant predictor of six-month changes in MVPA.
. CONCLUSIONS Based on these results, the specific emotions of shame and guilt contextualized to the body differentially predict BCS' health motivations and behavior over time.
. IMPLICATIONS FOR NURSING Survivorship programs may benefit from integrating intervention strategies aimed at reducing body-related shame and helping women manage feelings of guilt to improve physical activity.
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Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and Meta-analysis. World J Surg 2018; 42:2076-2085. [DOI: 10.1007/s00268-018-4477-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Esplen MJ, Wong J, Warner E, Toner B. Restoring Body Image After Cancer (ReBIC): Results of a Randomized Controlled Trial. J Clin Oncol 2018; 36:749-756. [PMID: 29356610 DOI: 10.1200/jco.2017.74.8244] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This study aimed to test a group psychosocial intervention focused on improving disturbances of body image (BI), sexual functioning, and quality of life in breast cancer (BC) survivors. Methods A prospective, randomized controlled trial was conducted to assess the efficacy of an 8-week group intervention in women after BC treatment. The manual-based intervention combined two powerful ingredients: expressive guided-imagery exercises integrated within a model of group-therapy principles. The intervention facilitates exploration of identity, the development of new self-schemas, and personal growth. In addition, the intervention included an educational component on the social and cultural factors affecting women's self-esteem and BI. The control condition included standard care plus educational reading materials. One hundred ninety-four BC survivors who had expressed concerns about negative BI and/or difficulties with sexual functioning participated in the study; 131 were randomly assigned to the intervention, and 63 were assigned to the control condition. Participants were followed for 1 year. Results Women in the intervention group reported significantly less concern/distress about body appearance ( P < .01), decreased body stigma ( P < .01), and lower level of BC-related concerns ( P < .01), compared with women in the control group. BC-related quality of life was also better in the intervention group compared with the control group at the 1-year follow-up ( P < .01). There was no statistically significant group difference in sexual functioning. Conclusion Restoring Body Image After Cancer (ReBIC), a group intervention using guided imagery within a group-therapy approach, is an effective method for addressing BI-related concerns and quality of life post-BC. The manual-based intervention can be easily adapted to both cancer centers and primary care settings.
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Affiliation(s)
- Mary Jane Esplen
- Mary Jane Esplen and Jiahui Wong, University Health Network and University of Toronto; Ellen Warner, Sunnybrook Health Sciences Centre and University of Toronto; and Brenda Toner, University of Toronto, Toronto, Canada
| | - Jiahui Wong
- Mary Jane Esplen and Jiahui Wong, University Health Network and University of Toronto; Ellen Warner, Sunnybrook Health Sciences Centre and University of Toronto; and Brenda Toner, University of Toronto, Toronto, Canada
| | - Ellen Warner
- Mary Jane Esplen and Jiahui Wong, University Health Network and University of Toronto; Ellen Warner, Sunnybrook Health Sciences Centre and University of Toronto; and Brenda Toner, University of Toronto, Toronto, Canada
| | - Brenda Toner
- Mary Jane Esplen and Jiahui Wong, University Health Network and University of Toronto; Ellen Warner, Sunnybrook Health Sciences Centre and University of Toronto; and Brenda Toner, University of Toronto, Toronto, Canada
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Wong CC, Warmoth K, Ivy S, Cheung B, Lu Q. Relation of social constraints on disclosure to adjustment among Chinese American cancer survivors: A multiprocesses approach. Psychooncology 2018; 27:977-982. [DOI: 10.1002/pon.4604] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 11/06/2017] [Accepted: 11/30/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Celia C.Y. Wong
- Culture and Health Research Center, Department of Psychology; University of Houston; Houston TX USA
| | | | - Shelby Ivy
- Culture and Health Research Center, Department of Psychology; University of Houston; Houston TX USA
| | - Bernice Cheung
- Culture and Health Research Center, Department of Psychology; University of Houston; Houston TX USA
| | - Qian Lu
- Culture and Health Research Center, Department of Psychology; University of Houston; Houston TX USA
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Staring at My Body: The Experience of Body Reconstruction in Breast Cancer Long-term Survivors. Cancer Nurs 2017; 41:E56-E61. [PMID: 28537953 DOI: 10.1097/ncc.0000000000000507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Breast cancer takes time for its survivors after a mastectomy to adjust to their changed bodies. There are limited studies about the process of how those survivors accept the changes of their bodies and how they reestablish their new selves. OBJECTIVE The aim of this study was to understand the perception of body from women diagnosed with breast cancer more than 5 years previously and whose treatment included a mastectomy. METHODS A phenomenological method was applied to this study. Women who received a mastectomy at least 5 years previously were invited to participate. Eight participants were recruited from southern Taiwan. RESULTS Twenty transcripts were obtained and analyzed using Colaizzi's method. Three themes were obtained from the data analysis: "restoration of the body image," "abandonment of objectification," and "redefinition of self." Subthemes were also identified and described. CONCLUSION The results indicate that women with breast cancer have embodied the recovering experience to a new self and have adapted to identify their new bodies. They overcome being a female body with an absent breast(s) by discovering the value of their existence and being free from self-objectification. IMPLICATIONS FOR PRACTICE This study contributes to the understanding of the perception of body in long-term breast cancer survivors, which reflects the process of adjusting to the loss of a breast/breasts to reconstructing a new body experience. Health professionals could help and encourage women undergoing a mastectomy to engage in self-recovery by searching for and affirming self-value.
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Sherman KA, Woon S, French J, Elder E. Body image and psychological distress in nipple-sparing mastectomy: the roles of self-compassion and appearance investment. Psychooncology 2016; 26:337-345. [DOI: 10.1002/pon.4138] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 01/13/2023]
Affiliation(s)
- K. A. Sherman
- Centre for Emotional Health, Department of Psychology; Macquarie University; Sydney NSW Australia
- Westmead Breast Cancer Institute; Westmead Hospital; Sydney Australia
| | - S. Woon
- Centre for Emotional Health, Department of Psychology; Macquarie University; Sydney NSW Australia
| | - J. French
- Westmead Breast Cancer Institute; Westmead Hospital; Sydney Australia
| | - E. Elder
- Westmead Breast Cancer Institute; Westmead Hospital; Sydney Australia
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Grogan S, Mechan J. Body image after mastectomy: A thematic analysis of younger women’s written accounts. J Health Psychol 2016; 22:1480-1490. [DOI: 10.1177/1359105316630137] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated younger women’s body image after mastectomy. In all, 49 women, aged 29–53 years (mean age: 39 years) who had had bilateral ( n = 8) or unilateral ( n = 41) mastectomy responded to open-ended questions online. Inductive thematic analysis revealed that aesthetics were less important than survival between diagnosis and mastectomy. Following mastectomy, women negotiated new body identities. Treatment effects such as weight gain were significant concerns. However, impacts on body confidence varied, and some participants rejected mainstream body shape ideals and reported feeling proud of their scars. Implications for supporting younger women post-mastectomy, including promotion of body acceptance, are discussed.
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Affiliation(s)
- Sarah Grogan
- Department of Psychology, Manchester Metropolitan University, UK
| | - Jayne Mechan
- Department of Apparel, Manchester Metropolitan University, UK
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Fang SY, Chang HT, Shu BC. The moderating effect of perceived partner empathy on body image and depression among breast cancer survivors. Psychooncology 2015; 24:1815-22. [PMID: 26110591 DOI: 10.1002/pon.3868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 04/28/2015] [Accepted: 05/14/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE The aims of the study were the following: (1) to understand the relationship between women's perceptions of empathy from their partners and their depressive symptoms and body image and (2) to examine the moderating effects of women's perceptions of empathy from their partners on the relationship between body image and depressive symptoms. METHODS A cross-sectional and correlational design was used, in which a convenience sample of 151 women who completed surgery and the necessary chemotherapy/radiotherapy were recruited from southern Taiwan. A structured questionnaire including the Other Dyadic Perspective-Taking Scale, the Body Image Scale, and the Center for Epidemiologic Studies Depression scale were administered. Hierarchical regression was used to examine the moderating effects of empathy from partners between the women's body image and their level of depressive symptoms. RESULTS The results showed significant relationships between empathy from a partner and depressive symptoms (p < 0.001). However, there was no significant relationship between empathy from a partner and body image (p > 0.05). The moderating effect of empathy from a partner on the relationship between body image and depressive symptoms was also significant (p < 0.01). CONCLUSION The more empathy women perceived from partners, the fewer depressive symptoms women reported. Empathy from a partner could moderate the impact of body image changes on depressive symptoms. Women's depressive symptoms, resulting from a change in body image after breast cancer surgery, might be minimized if they perceived greater empathy from their partners.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Tai Chang
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Bih-Ching Shu
- Institute of Allied Health Sciences and Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Impact of marital coping on the relationship between body image and sexuality among breast cancer survivors. Support Care Cancer 2015; 23:2551-9. [PMID: 25617071 DOI: 10.1007/s00520-015-2612-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE The aims of the study were (1) to understand the relationship between women's marital coping efforts and body image as well as sexual relationships and (2) to test a hypothesized model suggesting that marital coping efforts have a mediating effect on the relationship between body image and sexual relationships among breast cancer survivors. METHODS A total of 135 breast cancer survivors who had finished cancer treatment completed a self-reported questionnaire concerning body image, marital coping efforts, and sexual relationship. RESULTS Body image, marital coping, and sexual relationship were found to be significantly correlated with each other. The final path model showed that negative marital coping efforts, including avoidance and self-blame, significantly mediated the effect of women's body image on their sexual relationships. Although a positive approach did not correlate with body image, it did significantly correlate with women's sexual relationships. CONCLUSIONS Our study demonstrated that negative marital coping using self-blame and avoidance mediated the association between body image and sexual relationship. Future interventions to address the body image and sexual life of breast cancer survivors should be considered using positive approaches that prevent disengaged avoidance or self-blame coping efforts intended to deal with marital stress.
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