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Examining the Psychometric Properties of the Farsi Version of the Body Image Scale for Breast Cancer Survivors. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2023; 21:3. [PMID: 36466117 PMCID: PMC9702771 DOI: 10.1007/s40944-022-00680-7] [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: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/28/2022]
Abstract
Background Mastectomy as a surgical treatment in women with breast cancer causes a change in their body image due to the loss of femininity and body integrity, decreased sense of sexual attractiveness, and dissatisfaction with the presence of surgical scars. The present study was conducted to evaluate the psychometric properties of the Farsi version of the body image scale for breast cancer survivors. Methods This cross-sectional study was conducted on 204 women with a mastectomy referred to Kermanshah's surgery and oncology office in 2021. Face and content validity were evaluated qualitatively. Construct validity was evaluated by exploratory factor analysis (with maximum likelihood and Promax rotation) and confirmatory factor analysis. Cronbach's alpha and McDonald's omega coefficients were used to verify internal consistency. Results The mean age of the participants was 46.57 (SD = 9.47). One factor was extracted that explained 46.56% of the total variance of body image. The factor load of the items varied between 0.561 and 0.801. The results of CFA also showed that the final model has a perfect fit: CMIN = 20.931; DF = 13; CMIN/FD = 1.610; p = 0.074; GFI = 0.972; AGFI = 0.939; IFI = 0.985; CFI = 0.985; TLI = 0.975; PNFI = 0.595; PCFI = 0.610; RMSEA = 0.055. internal consistency based on Cronbach's alpha and McDonald's omega coefficients was 0.856 and 0.861, respectively. Conclusion The Farsi version of the body image scale for breast cancer survivors has good construct validity and may be used in various studies in clinical and research settings.
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Mason TB, Smith KE. Delineating the role of binge eating in cancer research. Eat Weight Disord 2021; 26:2109-2116. [PMID: 33201393 DOI: 10.1007/s40519-020-01066-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship. CONCLUSIONS It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis. LEVEL OF EVIDENCE Level V: narrative review.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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The psychometric properties of the Persian version of the body image after breast Cancer questionnaire: A second- order confirmatory factor analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01741-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Associated Factors and Survival Outcomes for Breast Conserving Surgery versus Mastectomy among New Zealand Women with Early-Stage Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052738. [PMID: 33800387 PMCID: PMC7967454 DOI: 10.3390/ijerph18052738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/29/2022]
Abstract
This study aimed to investigate type of loco-regional treatment received, associated treatment factors and mortality outcomes in New Zealand women with early-stage breast cancer who were eligible for breast conserving surgery (BCS). This is a retrospective analysis of prospectively collected data from the Auckland and Waikato Breast Cancer Registers and involves 6972 women who were diagnosed with early-stage primary breast cancer (I-IIIa) between 1 January 2000 and 31 July 2015, were eligible for BCS and had received one of four loco-regional treatments: breast conserving surgery (BCS), BCS followed by radiotherapy (BCS + RT), mastectomy (MTX) or MTX followed by radiotherapy (MTX + RT), as their primary cancer treatment. About 66.1% of women received BCS + RT, 8.4% received BCS only, 21.6% received MTX alone and 3.9% received MTX + RT. Logistic regression analysis was used to identify demographic and clinical factors associated with the receipt of the BCS + RT (standard treatment). Differences in the uptake of BCS + RT were present across patient demographic and clinical factors. BCS + RT was less likely amongst patients who were older (75+ years old), were of Asian ethnicity, resided in impoverished areas or areas within the Auckland region and were treated in a public healthcare facility. Additionally, BCS + RT was less likely among patients diagnosed symptomatically, diagnosed during 2000–2004, had an unknown tumour grade, negative/unknown oestrogen and progesterone receptor status or tumour sizes ≥ 20 mm, ≤50 mm and had nodal involvement. Competing risk regression analysis was undertaken to estimate the breast cancer-specific mortality associated with each of the four loco-regional treatments received. Over a median follow-up of 8.8 years, women who received MTX alone had a higher risk of breast cancer-specific mortality (adjusted hazard ratio: 1.38, 95% confidence interval (CI): 1.05–1.82) compared to women who received BCS + RT. MTX + RT and BCS alone did not have any statistically different risk of mortality when compared to BCS + RT. Further inquiry is needed as to any advantages BCS + RT may have over MTX alternatives.
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The role of loco-regional treatment in long-term quality of life in de novo stage IV breast cancer patients: protocol MF07-01Q. Support Care Cancer 2020; 29:3823-3830. [PMID: 33242163 DOI: 10.1007/s00520-020-05905-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/18/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVE Since more solid evidence has emerged supporting the effectiveness of loco-regional treatment (LRT), clinicians consider LRT a treatment option for selected de novo stage IV breast cancer (BC) patients. This is the first report on long-term quality of life (QoL) in a cohort of patients who were randomized to receive either LRT and then systemic treatment (ST) or ST alone in the protocol MF07-01. We aimed to evaluate QoL in patients living at least 3 years since randomization using scores from the SF-12 health survey. METHODS SF-12 (V2) forms were completed during visits of patients who were living 36 months after the randomization. We first calculated PCS-12 (Physical Health Composite Scale) and MCS-12 (Mental Health Composite Scale) scores from de novo stage IV BC patients and compared them with the scores of patients diagnosed with stage I-III BC who lived more than 3 years. Further, PCS-12 and MCS-12 scores were compared between the LRT and ST groups with de novo stage IV BC. Additionally, general health, physical functioning, role functioning, bodily pain, vitality, mental health, and social functioning were evaluated and compared between the groups. Considering age-related changes in QoL, we also compared PCS-12 and MCS-12 scores of patients below or above 55 and 65 years of age. Responses to four additional questions (compare your physical health, mental health, daily activities, and energy currently vs. at diagnosis of BC) were recorded, considering cultural differences. RESULTS There were 81 patients in this analysis; 68% of patients (n = 55) had LRT, and 32% (n = 26) received ST. General health was good or very good in 62% (n = 34) in the LRT group and 66% (n = 17) in the ST-only group (p = 0.63). Mean PCS-12 score was 40.8 + 1.6, and mean MCS-12 score was 43.4 + 2.0 (p = 0.34 and p = 0.54, respectively). PCS-12 and MCS-12 score difference was lower than that of the general Turkish population (PCS-12 = 49.3 + 12.8 and MCS-12 = 46.8 + 13.0) and stage I-III BC patients (PCS-12 = 51.1 ± 0.5, MCS-12 = 45.7 ± 0.6). PCS-12 and MCS-12 scores were similar between the LRT and ST-only groups in patients younger and older than 55 and 65, but QoL scores were much better in stage I-III BC patients younger than 65 when compared to the scores of those with de novo stage IV BC. Although treatment with or without LRT did not affect physical health, mental health, daily activities, and energy at 3 years vs. at diagnosis of BC in de novo stage IV BC patients (p > 0.05), these variables were significantly better in stage I-III BC patients (p < 0.001). CONCLUSION The current MF07-01Q study demonstrates that patient who had LRT has similar physical and mental health outcomes compared to ST only in a cohort of patients who lived longer than 3 years. Trial registration This study is registered on clinicaltrials.gov with identifier number NCT00557986.
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Matteucci V, Bai D, Fregoli L, Papini P, Aghababyan A, Docimo G, Miccoli P, Materazzi G. The effect of robot-assisted transaxillary thyroidectomy (RATT) on body image is better than the conventional approach with cervicotomy: a preliminary report. Updates Surg 2020; 73:1169-1175. [PMID: 32399594 DOI: 10.1007/s13304-020-00785-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/02/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cosmetic satisfaction is not only based on the patient's perception of the scar itself but is also related to body image self-evaluation. Cosmetic superiority of Robot-assisted transaxillary thyroidectomy (RATT) over conventional thyroidectomy (CT) has not yet been clearly demonstrated. Aim of our study was to compare body image in patients undergoing CT versus RATT. METHODS The study included 160 (80 CT and 80 RATT) patients undergoing thyroidectomy between August 2014 and March 2018 at the Endocrine Surgery Department. The inclusion criteria were age 18 to < 60 years, female sex, thyroid volume < 30 mL, and nodule diameter < 5 cm. Scar length, operative time, and complications were analyzed. The body image questionnaire (BIQ) was used 3 months postoperatively. The Student t test was used for statistical analysis. RESULTS Age was lower in RATT group (38.2 vs 41.4 years) (P < 0.0001). The nodule diameter was larger in RATT group (27.1 vs 23.1 mm) (P = 0.028). Operative time was longer in RATT group (93.7 vs 47.6 min) (P < 0.0001). The scar was longer in RATT group (59.9 vs 37.7 mm) (P < 0.0001). The groups had similar complication rates. BIQ showed that RATT patients answered more favorably to question 2, "Do you feel the operation has damaged your body?" (P = 0.042) and to question 3, "Do you feel less attractive as a result of your treatment?" (P = 0.024). Also self-global satisfaction was better in RATT group (P = 0.019). CONCLUSIONS In our experience, RATT has a significantly better impact on body image than the conventional approach.
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Affiliation(s)
- Valeria Matteucci
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy
| | - Dan Bai
- College of Clinical Medicine, Xi'an Medical University, Xi'an, China
| | - Lorenzo Fregoli
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy
| | - Piermarco Papini
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy
| | - Aleksandr Aghababyan
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy
| | - Giovanni Docimo
- Department of Advanced Medical and Surgical Sciences, University L. Vanvitelli, Naples, Italy
| | - Paolo Miccoli
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy
| | - Gabriele Materazzi
- Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, Pisa Hospital, University of Pisa, Via Paradisa 2, Edificio 30 J, 56100, Pisa, Italy.
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Kapoor A, Nambisan P. Personal decision support for survivor engagement: formulation and feasibility evaluation of a conceptual framework for implementing online cancer survivorship care plans. BMC Med Inform Decis Mak 2020; 20:59. [PMID: 32293436 PMCID: PMC7092430 DOI: 10.1186/s12911-020-1073-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/16/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although cancer survivorship care plans have been in use for several years, they have been shown to not be effective in meeting the long-term needs of cancer survivors, in addition being generic and passive in nature. Interactive survivorship care plans in the form of a personal decision support aid could provide an opportunity to not only engage survivors in their health care, but also capture meaningful treatment-related outcomes to use as a rich data source as the basis for making informed decisions. The objective of this research is to formulate an evidence-based model framework for implementing breast cancer survivorship guidelines via an online breast cancer survivorship care plan (SCP). METHODS The study was completed in three steps. In the first step, or the requirements gathering phase, we conducted personal interviews of breast cancer survivors to determine their use of the survivorship care plan (SCP) and related needs to determine core SCP functions and formulate an implementation framework for an online SCP. In the second step, we used the framework as a guide to design and develop the online SCP tool. Finally, in the third step, we conducted preliminary testing to determine the feasibility of the developed tool among online users. RESULTS Fifteen breast cancer survivors were consulted, who reported several issues from their use of the traditional paper-based SCP. Four themes were identified that represent the SCP's core desired functions. Eight features were matched to implement these core functions. Using a personal decision approach, an online SCP tool called ACESO that incorporates these features and functions was developed. Preliminary feasibility testing yielded overall positive responses from breast cancer survivors (n = 51). CONCLUSION Our study demonstrated that survivors face challenges from their use of a traditional paper-based SCP. The online SCP we developed is technically feasible and has the potential to effectively engage breast cancer survivors in self-management and shared decision-making with their clinicians and caregivers. Further testing is required to assess its usability and long-term impact.
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Affiliation(s)
- Akshat Kapoor
- Health Services and Information Management, East Carolina University, 600 Moye Blvd. (Mail Stop 668), Greenville, NC, 27834, USA.
| | - Priya Nambisan
- Department of Health Informatics and Administration, Social Media and Health Research & Training Lab, College of Health Sciences, University of Wisconsin - Milwaukee, Northwest Quadrant Building B, Rm #6410, 2025 East Newport Avenue, Milwaukee, WI, 53201-0413, USA
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Psychometric properties of the German version of the Self-Image Scale (SIS-D). PLoS One 2020; 15:e0230331. [PMID: 32176730 PMCID: PMC7075632 DOI: 10.1371/journal.pone.0230331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Self-Image Scale is a self-report measure originally developed for use in women with cancer. Two subscales assess appearance satisfaction (self-acceptance) and perceptions of partners’ acceptance of their appearance (partner-acceptance). This study aimed to increase the Self-Image Scale’s utility by 1) confirming the two-factor structure of the German version of the Self-Image Scale, 2) testing measurement invariance across sex and age groups and validity, and 3) gathering general population normative data. Methods Confirmatory factor analysis methods were used to examine the proposed two-factor model in a random sample of adults from the general German population (N = 1367). Measurement invariance, scale reliability, and validity were assessed. Results The original factor structure and measurement invariance across sexes and age groups were supported. Women showed significantly lower self-acceptance than men. Adolescent and young adult women showed higher self-acceptance than senior women. For both sexes, partner-acceptance lowered across successive age cohorts. Internal consistencies were good. Conclusions Results support the use of the German version of the Self-Image Scale in research and clinical practice. Research directions include validation in further diseases, collecting normative data across countries, and dyadic research, particularly exploring partner-acceptance across the life span.
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Chang YC, Hu WY, Chang YM, Chiu SC. Changes in sexual life experienced by women in Taiwan after receiving treatment for breast cancer. Int J Qual Stud Health Well-being 2020; 14:1654343. [PMID: 31526246 PMCID: PMC6758685 DOI: 10.1080/17482631.2019.1654343] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
As the number of breast cancer survivors increases, these patients with sexual problems also increase. For breast cancer survivors, sexual problems are a common and painful experience. Although breast cancer survivors often encounter sexual problems, Taiwanese women are culturally conservative and patients rarely discuss sex problems with clinicians. In this study, we used qualitative methods to better understand the changes in sexual life and related care strategies for breast cancer survivors. Twenty interviews were conducted on clinical patients enrolled in hospitals that received breast cancer treatment. The data were analysed by performing a constant comparative analysis. Three themes emerged: the causes of changes in sexual life, internal response strategies and external response strategies. Ten subthemes were identified. Changes in sexual life in patients with breast cancer in this study included changes related to body image, influence of friends and family, age, genital problems, and illegal love of a partner. Breast cancer survivors can tolerate and regulate sexual life changes by adopting internal and external response strategies. Medical staff must be sensitive and must understand strategies for dealing with sexual life changes that may occur during cancer adjustment and how these strategies can help women’s well-being in the rest of their lives.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University , Taipei , Taiwan.,Cancer Center, Hsinchu Mackay Memorial Hospital , Hsinchu , Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University , Taipei , Taiwan.,Department of Nursing, National Taiwan University Hospital , Taipei , Taiwan
| | - Yuh-Ming Chang
- Department of Neurology, Hsinchu Mackay Memorial Hospital , Hsinchu , Taiwan.,Institute of Biochemistry, Microbiology, and Immunology, Chung Shan Medical University , Taichung , Taiwan
| | - Shih-Che Chiu
- Cancer Center, Hsinchu Mackay Memorial Hospital , Hsinchu , Taiwan
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Valpey R, Kucherer S, Nguyen J. Sexual dysfunction in female cancer survivors: A narrative review. Gen Hosp Psychiatry 2019; 60:141-147. [PMID: 31030966 DOI: 10.1016/j.genhosppsych.2019.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/25/2019] [Accepted: 04/01/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Due to improvements in earlier detection and expansions in available treatments, the number of individuals surviving with cancer is steadily increasing. Sexual dysfunction is a common and often persistent complication for cancer survivors, affecting >60% of women diagnosed with cancer. Although highly prevalent, issues related to sexual health are often not addressed among survivors, with women reporting less discussion with providers compared to men. METHODS In this narrative review, we present a case series of three women seen in a psycho-oncology clinic who experienced sexual dysfunction following a cancer diagnosis. We then review existing literature on the presentation and management of sexual issues associated with cancer and its treatment. RESULTS The three cases highlight different mechanisms of sexual dysfunction after cancer, including anatomic changes, hormonal alterations, psychiatric conditions and medication side effects. The literature review includes discussion of the prevalence and course of sexual dysfunction in female cancer survivors. Tools for screening and assessment are then reviewed, as well as contributing factors and common presenting symptoms. We conclude with a discussion of both pharmacologic and non-pharmacologic approaches to management. CONCLUSIONS Despite its high prevalence and considerable impact on quality of life, the complication of sexual dysfunction after cancer diagnosis and treatment is still under recognized and undertreated. Improving awareness, communication, and screening, as well as appropriate referral to treatment, could have a profound impact on the ever growing number of women surviving with cancer with sexual health concerns.
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Affiliation(s)
- Robin Valpey
- University of Pittsburgh Medical Center, United States of America.
| | - Shelly Kucherer
- University of Pittsburgh Medical Center, United States of America
| | - Julia Nguyen
- University of Pittsburgh School of Medicine, United States of America
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Biederman E, Cohee A, Monahan P, Stump T, Champion V. Psychometric development of a new body image scale for breast cancer survivors. Health Care Women Int 2019; 41:397-411. [PMID: 31237491 DOI: 10.1080/07399332.2019.1615916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to psychometrically test a body image scale for breast cancer survivors (BCS). Data (n = 1127 BCSs) were obtained via telephone and mailed questionnaires. Psychometric testing was conducted using Cronbach's alpha, item-total correlations, factor analysis, linear regression, and Pearson's correlations. Data demonstrated a unidimensional seven-item scale with Cronbach's alpha = 0.88 and item-total correlations ranging from 0.367 to 0.829. Construct validity was demonstrated with 48% of the variance in well-being explained by constructs in the conceptual model [F(14,784) = 48.35, p < .001]. The body image scale demonstrated high internal consistency reliability, unidimensionality, and construct validity.
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Affiliation(s)
- Erika Biederman
- Department of Community Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Andrea Cohee
- Department of Community Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Patrick Monahan
- Department of Biostatistics, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Timothy Stump
- Department of Biostatistics, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Victoria Champion
- Department of Community Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, USA
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Avis NE, Johnson A, Canzona MR, Levine BJ. Sexual functioning among early post-treatment breast cancer survivors. Support Care Cancer 2018; 26:2605-2613. [PMID: 29455301 PMCID: PMC6019113 DOI: 10.1007/s00520-018-4098-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 02/07/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2 years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors. METHODS Longitudinal observational study of breast cancer survivors recruited within 8 months of cancer diagnosis and followed for 18 months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale. RESULTS At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18 months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems. CONCLUSIONS Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.
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Affiliation(s)
- Nancy E Avis
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1063, USA.
| | - Aimee Johnson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1063, USA
- Department of Health Sciences, James Madison University, 235 Martin Luther King Jr Way, Harrisburg, VA, 22807, USA
| | - Mollie Rose Canzona
- Department of Communication, Wake Forest University, P.O. Box 7347, Winston-Salem, NC, 27109, USA
| | - Beverly J Levine
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1063, USA
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Alicikus ZA, Gorken IB, Sen RC, Kentli S, Kinay M, Alanyali H, Harmancioglu O. Psychosexual and Body Image Aspects of Quality of Life in Turkish Breast Cancer Patients: A Comparison of Breast Conserving Treatment and Mastectomy. TUMORI JOURNAL 2018; 95:212-8. [DOI: 10.1177/030089160909500213] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Assessing psychosexual and body image aspects of quality of life in Turkish breast cancer patients treated by either mastectomy or breast conserving treatment (BCT). Methods The study group consisted of 112 patients who had undergone all treatment at a single institution under the care of a multidisciplinary breast team. Following surgery all patients underwent adjuvant radiotherapy with or without chemotherapy and hormone therapy. At the time of this study all patients were disease free with at least 2 years' follow-up. Twenty percent of the patients were premenopausal and 80% postmenopausal. The patients completed a questionnaire consisting of 42 questions related to their sexual relations and body image. Results Forty-one percent of sexually active patients had experienced a deterioration of sexual functioning after treatment. This was mainly due to loss of libido (80%), loss of interest in partner (54%), and sexual dissatisfaction (59%). Problems tended to develop early in the course of treatment. Decreased sexual desire was significantly more frequent in patients undergoing mastectomy versus BCT (80% vs 61%; P = 0.043) and in premenopausal versus postmenopausal patients (P= 0.024). Although 80% of patients were satisfied with their apperance as a whole, only 54% liked their naked bodies. There was no significant difference in body image scores between patients undergoing mastectomy or BCT apart from a general feeling of physical unattractive-ness in mastectomy patients (3.4 vs 2.8; P = 0.03). Conclusions Significant, similar psychosexual and body image problems occur in patients treated for breast cancer with either mastectomy or BCT. Problems arise early in the course of the disease and therefore detection and treatment of these problems should be addressed during the patients' initial assessment and at the start of treatment. These findings are similar to those reported on similar groups of treated women in American and European populations.
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Affiliation(s)
- Zumre Arican Alicikus
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - Ilknur Bilkay Gorken
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - Rachel Cooper Sen
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
- Leeds Cancer Centre, Cookridge Hospital, Leeds, West Yorkshire, United Kingdom
| | - Suleyman Kentli
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - Munir Kinay
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - Hilmi Alanyali
- Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - Omer Harmancioglu
- Department of Surgery, Dokuz Eylul University Medical School, Izmir, Turkey
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Kapoor A, Nambisan P. Usability and acceptance evaluation of ACESO: a Web-based breast cancer survivorship tool. J Cancer Surviv 2018; 12:316-325. [DOI: 10.1007/s11764-017-0670-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/13/2017] [Indexed: 12/25/2022]
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15
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Yang Y, Wen Y, Bedi C, Humphris G. The relationship between cancer patient's fear of recurrence and chemotherapy: A systematic review and meta-analysis. J Psychosom Res 2017; 98:55-63. [PMID: 28554373 DOI: 10.1016/j.jpsychores.2017.05.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The study aim was to provide an overview of the current evidence available on the link between chemotherapy (CTX) and fear of cancer recurrence (FoR). METHODS PubMED, Medline, Embase, PsycINFO and Web of Science databases were searched to identify relevant studies. Two authors independently selected and assessed the studies regarding eligibility criteria. Meta-analysis of suitable studies was conducted, and quality rated. RESULTS Forty eligible studies were included in the systematic review and twenty-nine of them were included in further meta-analysis. Meta-analysis of the available data confirmed a weak relationship between CTX and FoR (29 studies, 30,176 patients, overall r=0.093, 95% CI: 0.062, 0.123, P˂0.001). CONCLUSIONS The meta-analysis demonstrates a weak but significant relationship between cancer patient's FoR and the receipt of chemotherapy. However, these results should be interpreted with caution. Further investigation is warranted to explore possible mechanisms of FoR increase in patients who receive chemotherapy. Longitudinal studies assessing the trajectory of FoR during chemotherapy are also warranted.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry and Psychology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Yunhong Wen
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Carolyn Bedi
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - Gerry Humphris
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK; School of Medicine, University of St Andrews, St Andrews, UK.
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16
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Ogle JP, Ullstrup K. Breast Cancer as an Embodied Life Event: A Synthesis of Research and Theory and Directions for Intervention and Future Work. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/105413730601400302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the present work, we reviewed literature exploring breast cancer and body image and invoked this synthesis as a platform from which to develop (a) theoretical applications for understanding the embodied experience of breast cancer, (b) implications for counseling interventions, and (c) recommendations for continued research. Of particular relevance to our analyses was theory related to the social construction of the female body and also theories related to meaning-making, illness, and loss. Based upon our synthesis, we suggest a counseling approach in which professionals treating breast cancer patients listen for and attend to breast cancer patients' attributions of meaning and consider the varied influences that may contribute to those meanings. Additionally, we propose that researchers invoke qualitative approaches and social constructionist/meaning-making perspectives to build understanding about the ways in which a woman's social roles, embodied history, world views, and other contextual factors shape her embodied experience of breast cancer.
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Schlebusch L, van Oers HM. Psychological Stress, Adjustment and Cross-Cultural Considerations in Breast Cancer Patients. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2016. [DOI: 10.1177/008124639902900105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a dearth of information regarding the psychological experience of breast cancer in the South African context, particularly within the black population. Existing psychological studies have focused mainly on the healthy breast or instances of non-malignant disease, largely within the white population from a Western perspective. This study addressed some of these concerns and examined and compared the nature and degree of psychological distress with reference to specific variables experienced by South African black and white breast cancer patients. Fifty women, comprising two equal groups of 25 black and white breast cancer patients were assessed and compared in terms of their levels of depression, body image dysphoria and styles of psychological adjustment during the course of their post-surgical chemotherapy treatment. There were several differences in the psychological experiences of black and white breast cancer patients. Most of the black patients were found to experience greater levels of somatisation, depression and body image dysphoria and tended to utilise less adaptive styles of adjustment to their disease. The only measure on which both groups more closely resembled each other was that of anxiety. The greater levels of psychological distress reported by most of the black patient group may be due to traditional cultural reasons which possibly predispose them to suppress emotions or somatise them rather than display these outwardly, and because of a lack of knowledge and of psycho-oncological services for this group. These patients could be regarded as being at high risk for elevated distress levels requiring psychological intervention.
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Affiliation(s)
- Lourens Schlebusch
- Department of Medically Applied Psychology, Medical School, University of Natal, Durban, Private Bag 7, Congella 4013, South Africa
| | - Helena M. van Oers
- Department of Medically Applied Psychology, Medical School, University of Natal, Durban, Private Bag 7, Congella 4013, South Africa
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Abstract
Worldwide, approximately 1 in 11 women have breast cancer at some time in their lifetime. The majority are successfully treated with surgery, then radiotherapy and/or chemo-therapy. Survival brings its own problems, however, including an underlying ontological problem: What is the part of the body left after a mastectomy? Women talking about their experiences of mastectomy are faced with complex referential tasks with regard to their bodies at different stages of the past and present, within different discourses (medical, sexual, maternal), and from different perspectives (the individual and the generic, their own perspective and that of their medical professionals). Drawing on anthropological research conducted among Australian women, we illustrate how women resolve difficulties of reference to the site of the mastectomy, and examine the shifts in perspective that are marked by different lexical choices.
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Affiliation(s)
- Lenore Manderson
- School of Psychology, Psychiatry and Psychological Medicine, Monash
University, Melbourne, Australia,
| | - Lesley Stirling
- School of Languages and Linguistics, The University of Melbourne,
Australia,
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19
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Quality of life and symptom burden in patients with breast cancer treated with mastectomy and lumpectomy. Support Care Cancer 2015; 24:2191-2199. [DOI: 10.1007/s00520-015-3027-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
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20
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Jeffery DD, Barbera L, Andersen BL, Siston AK, Jhingran A, Baron SR, Reese JB, Coady DJ, Carter J, Flynn KE. Self-Reported Sexual Function Measures Administered to Female Cancer Patients: A Systematic Review, 2008-2014. J Psychosoc Oncol 2015; 33:433-66. [PMID: 25997102 DOI: 10.1080/07347332.2015.1046012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A systematic review was conducted to identify and characterize self-reported sexual function (SF) measures administered to women with a history of cancer. Using 2009 PRISMA guidelines, we searched electronic bibliographic databases for quantitative studies published January 2008-September 2014 that used a self-reported measure of SF, or a quality of life (QOL) measure that contained at least 1 item pertaining to SF. Of 1,487 articles initially identified, 171 were retained. The studies originated in 36 different countries with 23% from US-based authors. Most studies focused on women treated for breast, gynecologic, or colorectal cancer. About 70% of the articles examined SF as the primary focus; the remaining examined QOL, menopausal symptoms, or compared treatment modalities. We identified 37 measures that assessed at least one domain of SF, eight of which were dedicated SF measures developed with cancer patients. Almost one third of the studies used EORTC QLQ modules to assess SF, and another third used the Female Sexual Function Inventory. There were few commonalities among studies, though nearly all demonstrated worse SF after cancer treatment or compared to healthy controls. QOL measures are better suited to screening while dedicated SF questionnaires provide data for more in depth assessment. This systematic review will assist oncology clinicians and researchers in their selection of measures of SF and encourage integration of this quality of life domain in patient care.
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21
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Kim YS, Do H, Lee JW, Jeong J, Shin YW, Yi K, Kim J, Lee SB, Sohn G, Yang N, Oh Y, Kim L, Kim Y, Yu JH, Ko BS, Kim HJ, Son BH, Ahn SH. Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer. Psychooncology 2015; 25:308-15. [DOI: 10.1002/pon.3919] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Yoo Seok Kim
- Department of Surgery; Chosun University College of Medicine; Gwangju Korea
| | - Hyuigyung Do
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Won Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jaesim Jeong
- Department of Nursing; University of Ulsan College of Medicine; Ulsan Korea
| | - Yong Wook Shin
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Kikyoung Yi
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jisun Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sae Byul Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Guiyun Sohn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Nuri Yang
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Youngkyung Oh
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Leeyoung Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Yeonhee Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Han Yu
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Beom Seok Ko
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Hee Jeong Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Byung Ho Son
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sei Hyun Ahn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
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Akça M, Ata A, Nayır E, Erdoğdu S, Arıcan A. Impact of Surgery Type on Quality of Life in Breast Cancer Patients. THE JOURNAL OF BREAST HEALTH 2014; 10:222-228. [PMID: 28331675 DOI: 10.5152/tjbh.2014.1919] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 07/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Breast cancer can lead to alterations in quality of life of the patients. The aim of this study is to evaluate the changes in quality of life of the female patients who had undergone surgical treatment for breast cancer. MATERIALS AND METHODS A total of 250 female patients (breast-preserving surgery (BPS), n=27, 11%; modified radical mastectomy (MRM), n=194, 77%, and simple mastectomy (SM), n=29; 11%) aged between 28-55 years (47.4±6.4 yrs) were included in the study. Patient information, demographic characteristics, income, and treatment modalities applied were recorded. Validated Turkish versions of EORTC QLQ-C30, and EORTC-BR23 questionnaires were used for all patients. RESULTS Breast-preserving surgery has a more favorable impact on general well-being, physical role, cognitive, psychological, and social functions, and symptom scale scores. When the identical parameters were taken into consideration, relatively favorable outcomes of BPS on the patients were observed relative to mastectomized patients. Besides, though not statistically significant, BPS has more patient-friendly effects on sexual function and sexual satisfaction in comparison with mastectomy. Patients with advanced stage disease and elder patients had more unfavorable health related quality of life (HRQoL) scores than younger patients, and those in their early stages of breast cancer. CONCLUSION Quality of life of BPS patients is less adversely affected relative to mastectomized patients. In the decision-making process, quality of life should be taken into consideration.
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Affiliation(s)
- Mustafa Akça
- Department of Internal Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Alper Ata
- Clinic of Medical Oncology, Mersin State Hospital, Mersin, Turkey
| | - Erdinç Nayır
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Süleyman Erdoğdu
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Ali Arıcan
- Department of Medical Oncology, Mersin University, Faculty of Medicine, Mersin, Turkey
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23
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Rhondali W, Chisholm GB, Filbet M, Kang DH, Hui D, Cororve Fingeret M, Bruera E. Screening for body image dissatisfaction in patients with advanced cancer: a pilot study. J Palliat Med 2014; 18:151-6. [PMID: 25188590 DOI: 10.1089/jpm.2013.0588] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cancer and its treatment can significantly affect appearance and body integrity. A number of studies have explored the impact of cancer and its treatment on body image, primarily in head and neck and breast cancer. The aim of this pilot study was to examine the construct of body image dissatisfaction and its measurement using a single question in patients with advanced cancer. METHODS Outpatients with advanced cancer were recruited (n=81). Assessments included Body Image Scale (BIS), Appearance Schema Inventory (ASI-R), Edmonton Symptom Assessment System (ESAS) with a total symptom distress score (TSDS) and two subscales scores (physical distress [PHS] and psychological distress [PSS]), Hospital Anxiety Depression Scale (HADS), and one question assessing the overall appearance satisfaction from the Multidimensional Body-Self Relations Questionnaire (MBSRQ). We also asked patients to rate the body image changes importance compared with five symptoms (pain, fatigue, depression, insomnia, lack of appetite). RESULTS Forty-seven (58%) patients had a BIS score >10 (body image dissatisfaction) with a median of 11 (first-third quartiles, Q1-Q3; 5-16) and a median ASI-R of 3.1 (Q1-Q3; 2.8-3.5). Sensitivity and specificity of ≤3 for body image dissatisfaction in the single overall appearance question using the BIS as a standard was 0.70 and 0.71, respectively. BIS score was significantly correlated with ASI-R (r=0.248; p=0.025), age (r=-0.225; p=0.043), HADS-A (r=0.522, p<0.001), HADS-D (r=0.422, p<0.001), PSS score (r=0.371, p=0.001), PHS score (r=0.356, p=0.001), TSDS score (r=0.416, p<0.001), and the overall appearance question (MBSRQ; r=-0.449, p<0.001). CONCLUSION Body image dissatisfaction was frequent and associated with symptom burden. A single item ≤3 has a sensitivity of 70% for body image satisfaction screening.
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Affiliation(s)
- Wadih Rhondali
- 1 Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas
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24
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Gómez-Campelo P, Bragado-Álvarez C, Hernández-Lloreda MJ, Sánchez-Bernardos ML. The Spanish version of the Body Image Scale (S-BIS): psychometric properties in a sample of breast and gynaecological cancer patients. Support Care Cancer 2014; 23:473-81. [PMID: 25135839 DOI: 10.1007/s00520-014-2383-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/31/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study is to develop a Spanish version of the Body Image Scale (Hopwood et al. Eur J Cancer 37(2):189-197, 2001) and to analyze its psychometric properties in a sample of women with breast or gynaecological cancer. METHODS The Spanish version of the Body Image Scale was developed using a forward and backward translation technique. A total sample of 100 women who had undergone radical surgery for breast (n = 50) or gynaecological cancer (n = 50) completed the scale. RESULTS Factor analysis resulted in a single-factor solution, both in the total sample and in the two subgroups, accounting for >76 % variance. Internal consistency (Cronbach's alpha) was 0.960. The Spanish version of the Body Image Scale correlated negatively with self-esteem (r = -0.733), quality of life (r = -0.632) and age (r = -0.643) and positively with depression (r = 0.832) and anxiety (r = 0.564); all p values < 0.01. CONCLUSIONS To our knowledge, this is the first study that provides a Spanish version of the Body Image Scale. Our results show a stable factorial structure between samples with a single-factor solution and good psychometric properties, suggesting that it is a suitable tool for measuring body image concerns among Spanish-speaking cancer patients. Its brevity and comprehensibility allow a quick assessment both in clinical and research settings.
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Affiliation(s)
- Paloma Gómez-Campelo
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPaz), Aging and Fragility in the Elderly Group, Hospital Universitario La Paz, Edificio Escuela de Enfermeras, 4ª Planta, Paseo de la Castellana, 261, 28046, Madrid, Spain,
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25
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Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors. Qual Life Res 2014; 24:205-12. [PMID: 24996392 DOI: 10.1007/s11136-014-0749-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The end of primary treatment for cancer patients is increasingly recognized as an important time of adjustment that may impact quality of life (QoL). A psychometrically sound QoL instrument that assesses the mix of acute and longer-term concerns present during this unique time has not yet been identified. This article evaluates the Quality of Life in Adult Cancer Survivors (QLACS) scale, originally developed for long-term (>5 years) cancer survivors, as an appropriate QoL measure for this transition period. METHODS Psychometric properties of the QLACS were evaluated in a sample of post-treatment breast cancer survivors 18-24 months post-diagnosis. This observational study consisted of women (n = 552) aged 25 years and older (mean = 55.4 years) who were diagnosed with stage I, II, or III breast cancer. The 47 items of the QLACS comprise 12 domains: seven domains are generic, and five are cancer specific. RESULTS The QLACS demonstrated adequate internal consistency (Cronbach's alpha for the 12 domains ranged from 0.79 to 0.91) and good convergent and divergent validity (assessed by comparison with the Functional Assessment of Cancer Therapy and other measures). CONCLUSIONS The QLACS appears to be consistent with other widely accepted measures in capturing QoL, while also allowing for more inclusive measurement of specific issues relevant to post-treatment cancer survivors. These data, in addition to previous data supporting use of the QLACS across different cancer sites, suggest that the QLACS is a promising comprehensive QoL measure appropriate for breast cancer survivors transitioning off active treatment.
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DeSnyder SM, Teo I, Fingeret MC. Body image struggles and breast cancer care: an under-recognized and undertreated issue with important implications for all patients. BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.14.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Body image encompasses the relationship between perceptions, cognitions, behaviors and emotions regarding the body and its functions. Breast cancer treatment can have a profound impact on body image, with body image issues occurring throughout diagnosis, treatment and survivorship. Despite this, a potential disconnect exists between breast cancer care providers and patients with respect to understanding and addressing body image difficulties. This article provides an overview of body image issues related to breast cancer treatment and offers recommendations that will enable healthcare providers to assist patients who are struggling with body image issues. More emphasis must be placed on the importance of body image as a means of improving the quality of care for all breast cancer patients.
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Affiliation(s)
- Sarah M DeSnyder
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
| | - Irene Teo
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
| | - Michelle Cororve Fingeret
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
- Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA
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Rhoten BA, Murphy B, Ridner SH. Body image in patients with head and neck cancer: A review of the literature. Oral Oncol 2013; 49:753-60. [DOI: 10.1016/j.oraloncology.2013.04.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/13/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022]
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Bezerra KB, Silva DSMD, Chein MBDC, Ferreira PR, Maranhão JKP, Ribeiro NL, Mochel EG. Qualidade de vida de mulheres tratadas de câncer de mama em uma cidade do nordeste do Brasil. CIENCIA & SAUDE COLETIVA 2013; 18:1933-41. [DOI: 10.1590/s1413-81232013000700008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/30/2012] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi avaliar a qualidade de vida de mulheres tratadas cirurgicamente de câncer de mama no Hospital de Referência Estadual em Oncologia de São Luís (MA). A qualidade de vida foi avaliada pelo Functional Assessment of Cancer Therapy-Breast (FACT-B). As variáveis foram expressas em média e desvio padrão; e a análise estatística constou da Anova ou Kruskal Wallis e Teste t de Student ou Mann-Whitney. O nível de significância foi α < 5%. Na estatística foram usados o Stata 9.0 e o BioEstat 5.0. Participaram 197 mulheres com idade média de 53,0 ± 11,7 anos. Os valores médios do FACT-B demonstraram tendência para boa qualidade de vida, sendo o domínio Emocional o mais comprometido e a Subescala Câncer a mais favorável. O tipo de cirurgia influenciou os domínios Social, Emocional e Subescala câncer do questionário. A cirurgia não conservadora apresentou piores níveis de qualidade de vida. Viu-se relação estatística significante entre o tempo de cirurgia e os domínios Físico, Emocional e Funcional, bem como entre tempo de cirurgia e os escores do FACT-B. O tratamento adjuvante influenciou todos os domínios do FACT-B. A qualidade de vida encontrada foi relativamente boa, mas influenciada negativamente pela cirurgia não conservadora, pelo menor tempo desde a cirurgia e pelas terapias adjuvantes.
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Sohl SJ, Levine B, Case LD, Danhauer SC, Avis NE. Trajectories of illness intrusiveness domains following a diagnosis of breast cancer. Health Psychol 2013; 33:232-41. [PMID: 23668843 DOI: 10.1037/a0032388] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To identify trajectories of illness intrusiveness over the first 2 years after a breast cancer diagnosis and describe associated patient and treatment characteristics. Illness intrusiveness, or how much an illness disrupts life domains, has been shown to be highly related to quality of life. METHODS Women recruited within 8 months of a breast cancer diagnosis (n = 653) completed questionnaires at baseline and 6, 12, and 18 months postbaseline. Group-based trajectory modeling was used to identify trajectories in three established domains of illness intrusiveness: instrumental, intimacy, and relationships and personal development. Bivariate analyses identified contextual, disease/treatment, psychological, and social characteristics of women in trajectory groups. RESULTS Forty-one percent of women fell into a trajectory of consistently low illness intrusiveness (Low) across all three domains. Other women varied such that some reported illness intrusiveness that decreased over time on at least one domain (9-34%), and others reported consistently high intrusiveness on at least one domain (11-17%). A fourth trajectory of increased illness intrusiveness emerged in the relationship and personal development domain (9%). Characteristics of women in the Low group were being older; being less likely to have children at home; and having stage I cancer, fewer symptoms, and better psychosocial status. CONCLUSIONS Women experienced different patterns of illness intrusiveness in the first 2 years after a diagnosis of breast cancer with a high percentage reporting Low intrusiveness. However, women differentially followed the other trajectory patterns by domain, suggesting that the effect of breast cancer on some women's lives may be specific to certain areas.
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Affiliation(s)
- Stephanie J Sohl
- Department of Medicine, Vanderbilt University School of Medicine & Public Health
| | - Beverly Levine
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - L Douglas Case
- Department of Biostatistical Sciences, Wake Forest School of Medicine
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
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An exploratory analysis of fear of recurrence among African-American breast cancer survivors. Int J Behav Med 2013; 19:280-7. [PMID: 21915625 DOI: 10.1007/s12529-011-9183-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Fear of recurrence (FOR) is a psychological concern that has been studied extensively in cancer survivors but has not been adequately examined in African-American breast cancer survivors. PURPOSE This exploratory study describes the extent and nature of FOR in African-American breast cancer survivors. FOR is examined in relation to socio-demographic characteristics, treatment-related characteristics, psychological distress, and quality of life (QOL). METHODS Participants completed questionnaires assessing FOR, psychological distress, QOL, and demographic and treatment characteristics. Pearson r correlations, t tests, and ANOVAs were used to determine the association between FOR and demographic and treatment-related characteristics. Hierarchical multiple regression models were performed to investigate the degree to which FOR dimensions account for the variance in QOL and psychological distress. RESULTS Fifty-one African-American breast cancer survivors participated in this study. The mean age of participants was 64.24 (SD = 12.3). Overall fears as well as concerns about death and health were rated as low to moderate. Role worries and womanhood worries were very low. Inverse relationships were observed between age and FOR dimensions. FOR was positively correlated with measures of psychological distress and negatively correlated with QOL. FOR significantly accounted for a portion of the variance in QOL and distress after controlling for other variables. CONCLUSIONS This study suggests that African-American women in this sample demonstrated some degree of FOR. Results indicate that FOR among African-American breast cancer survivors decreases with age and time since diagnosis and co-occurs with psychological distress as well as diminished quality of life.
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Avis NE, Levine B, Naughton MJ, Case DL, Naftalis E, Van Zee KJ. Explaining age-related differences in depression following breast cancer diagnosis and treatment. Breast Cancer Res Treat 2012; 136:581-91. [PMID: 23053661 DOI: 10.1007/s10549-012-2277-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/24/2012] [Indexed: 11/25/2022]
Abstract
Younger women with breast cancer consistently show greater psychological distress than older women. This study examined a range of factors that might explain these age differences. A total of 653 women within 8 months of a first-time breast cancer diagnosis provided data on patient characteristics, symptoms, and psychosocial variables. Chart reviews provided cancer and treatment-related data. The primary outcome was depressive symptomatology assessed by the Beck Depression Inventory. A succession of models that built hierarchically upon each other was used to determine which variables could account for age group differences in depression. Model 1 contained age group only. Models 2-5 successively added patient characteristics, cancer-related variables, symptoms, and psychosocial variables. As expected, in the unadjusted analysis (Model 1) younger women were significantly more likely to report depressive symptomatology than older women (p < 0.0001). Age remained significantly related to depression until Model 4 which added bodily pain and vasomotor symptoms (p = 0.24; R (2) = 0.27). The addition of psychosocial variables in Model 5 also resulted in a model in which age was nonsignificant (p = 0.49; R (2) = 0.49). Secondary analyses showed that illness intrusiveness (the degree that illness intrudes on specific areas of life such as work, sex life, recreation, etc.) was the only variable which, considered individually with age, made the age group-depression association nonsignificant. Age differences in risk of depression following a breast cancer diagnosis can be explained by the impact of cancer and its treatment on specific areas of a woman's life.
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Affiliation(s)
- Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
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Crist JV, Grunfeld EA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psychooncology 2012; 22:978-86. [DOI: 10.1002/pon.3114] [Citation(s) in RCA: 235] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 04/25/2012] [Accepted: 04/28/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Jade V. Crist
- Department of Psychology; King's College London; London UK
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Bokor T, Kiffner E, Kotrikova B, Billmann F. Cosmesis and Body Image after Minimally Invasive or Open Thyroid Surgery. World J Surg 2012; 36:1279-85. [DOI: 10.1007/s00268-012-1563-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Annunziata MA, Giovannini L, Muzzatti B. Assessing the body image: relevance, application and instruments for oncological settings. Support Care Cancer 2011; 20:901-7. [PMID: 22160547 DOI: 10.1007/s00520-011-1339-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE Body image is the sum of physical, cognitive, emotional, and relational elements that, when integrated, allow the development of a whole, healthy self-identity. Even though body image is normally studied in relation to eating disorders, it can also be influenced by other pathologies, including cancer. In oncology, an effective body image assessment is fundamental. The physical effects of cancer and cancer treatments are important and frequently irreversible also on a functional and emotional level; however, only few surveys have investigated body image in this peculiar context. METHODS An extensive literature review was carried out in PubMed and PsycINFO. We considered articles published from 1990 to 2010. RESULTS Two hundred sixty-three papers matched the search criteria. Assessment methodologies included clinical interviews, self-report measures, questionnaires, symptom check lists, and graphic tests and projective techniques. After excluding the instruments that referred to eating disorders, validated only for adolescents, and/or projective and graphic tests, we found 81 articles with six questionnaires specifically dedicated to body image assessment in oncology. CONCLUSIONS From our systematic review, we could identify six instruments specifically designed for assessing body image in the oncological area. In this paper, we discuss their general characteristics, psychometrics properties and the clinical implications, and body image relevance on the quality of life in cancer patients.
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Suchocka-Capuano A, Bungener C. Peur de la récidive et/ou progression du cancer et prévention en santé mentale. PSYCHO-ONCOLOGIE 2010. [DOI: 10.1007/s11839-010-0283-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Effects of breast cancer surgery and surgical side effects on body image over time. Breast Cancer Res Treat 2010; 126:167-76. [PMID: 20686836 DOI: 10.1007/s10549-010-1077-7] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 07/17/2010] [Indexed: 10/19/2022]
Abstract
We examined the impact of surgical treatments (breast-conserving surgery [BCS], mastectomy alone, mastectomy with reconstruction) and surgical side-effects severity on early stage (0-IIA) breast cancer patients' body image over time. We interviewed patients at 4-6 weeks (T1), six (T2), 12 (T3), and 24 months (T4) following definitive surgical treatment. We examined longitudinal relationships among body image problems, surgery type, and surgical side-effects severity using the Generalized Estimating Equation approach, controlling for demographic, clinical, and psychosocial factors. We compared regression coefficients of surgery type from two models, one with and one without surgical side-effects severity. Of 549 patients enrolled (mean age 58; 75% White; 65% BCS, 12% mastectomy, 23% mastectomy with reconstruction), 514 (94%) completed all four interviews. In the model without surgical side-effects severity, patients who underwent mastectomy with reconstruction reported poorer body image than patients who underwent BCS at T1-T3 (each P < 0.02), but not at T4. At T2, patients who underwent mastectomy with reconstruction also reported poorer body image than patients who underwent mastectomy alone (P = 0.0106). Adjusting for surgical side-effects severity, body image scores did not differ significantly between patients with BCS and mastectomy with reconstruction at any interview; however, patients who underwent mastectomy alone had better body image at T2 than patients who underwent mastectomy with reconstruction (P = 0.011). The impact of surgery type on body image within the first year of definitive surgical treatment was explained by surgical side-effects severity. After 2 years, body image problems did not differ significantly by surgery type.
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Auler JOC, Torres MLA, Cardoso MM, Tebaldi TC, Schmidt AP, Kondo MM, Zugaib M. Clinical evaluation of the flotrac/Vigileo system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study. Clinics (Sao Paulo) 2010; 65:793-8. [PMID: 20835557 PMCID: PMC2933127 DOI: 10.1590/s1807-59322010000800009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Accepted: 05/25/2010] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo system in patients undergoing spinal anesthesia for elective cesarean section. METHODS A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.
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Affiliation(s)
- José Otavio Costa Auler
- Department of Anesthesia and Critical Care, Heart Institute, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil, SP.
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Härtl K, Engel J, Herschbach P, Reinecker H, Sommer H, Friese K. Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psychooncology 2010; 19:160-9. [DOI: 10.1002/pon.1536] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Dalton EJ, Rasmussen VN, Classen CC, Grumann M, Palesh OG, Zarcone J, Kraemer HC, Kirshner JJ, Colman LK, Morrow GR, Spiegel D. Sexual Adjustment and Body Image Scale (SABIS): a new measure for breast cancer patients. Breast J 2009; 15:287-90. [PMID: 19645784 DOI: 10.1111/j.1524-4741.2009.00718.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to develop and validate a self-report measure of body image and sexual adjustment in breast cancer patients: the Sexual Adjustment and Body Image Scale (SABIS). Three hundred and fifty three women diagnosed with primary breast cancer that had completed initial surgical treatment completed the SABIS and five measures of psychological, psychosocial, and sexual functioning. Psychometric properties of the SABIS were examined and it was found to be a reliable and valid means of assessing body image and sexuality in breast cancer patients following surgery.
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Affiliation(s)
- E Jane Dalton
- Women's Mental Health Program, Women's College Hospital, Ontario, Canada
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Daniels C, Rubinsky B. Electrical field and temperature model of nonthermal irreversible electroporation in heterogeneous tissues. J Biomech Eng 2009; 131:071006. [PMID: 19640131 DOI: 10.1115/1.3156808] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nonthermal irreversible electroporation (NTIRE) is a new minimally invasive surgical technique that is part of the emerging field of molecular surgery, which holds the potential to treat diseases with unprecedented accuracy. NTIRE utilizes electrical pulses delivered to a targeted area, producing irreversible damage to the cell membrane. Because NTIRE does not cause thermal damage, the integrity of all other molecules, collagen, and elastin in the targeted area is preserved. Previous theoretical studies have only examined NTIRE in homogeneous tissues; however, biological structures are complex collections of diverse tissues. In order to develop electroporation as a precise treatment in clinical applications, realistic models are necessary. Therefore, the purpose of this study was to refine electroporation as a treatment by examining the effect of NTIRE in heterogeneous tissues of the prostate and breast. This study uses a two-dimensional finite element solution of the Laplace and bioheat equations to examine the effects of heterogeneities on electric field and temperature distribution. Three different heterogeneous structures were taken into account: nerves, blood vessels, and ducts. The results of this study demonstrate that heterogeneities significantly impact both the temperature and electrical field distribution in surrounding tissues, indicating that heterogeneities should not be neglected. The results were promising. While the surrounding tissue experienced a high electrical field, the axon of the nerve, the interior of the blood vessel, and the ducts experienced no electrical field. This indicates that blood vessels, nerves, and lactiferous ducts adjacent to a tumor treated with electroporation will survive, while the cancerous lesion is ablated. This study clearly demonstrates the importance of considering heterogeneity in NTIRE applications.
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Affiliation(s)
- Charlotte Daniels
- Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA 94720, USA.
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Shoma AM, Mohamed MH, Nouman N, Amin M, Ibrahim IM, Tobar SS, Gaffar HE, Aboelez WF, Ali SE, William SG. Body image disturbance and surgical decision making in egyptian post menopausal breast cancer patients. World J Surg Oncol 2009; 7:66. [PMID: 19678927 PMCID: PMC2739851 DOI: 10.1186/1477-7819-7-66] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 08/13/2009] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In most developing countries, as in Egypt; postmenopausal breast cancer cases are offered a radical form of surgery relying on their unawareness of the subsequent body image disturbance. This study aimed at evaluating the effect of breast cancer surgical choice; Breast Conservative Therapy (BCT) versus Modified Radical Mastectomy (MRM); on body image perception among Egyptian postmenopausal cases. METHODS One hundred postmenopausal women with breast cancer were divided into 2 groups, one group underwent BCT and the other underwent MRM. Pre- and post-operative assessments of body image distress were done using four scales; Breast Impact of Treatment Scale (BITS), Impact of Event Scale (IES), Situational Discomfort Scale (SDS), and Body Satisfaction Scale (BSS). RESULTS Preoperative assessment showed no statistical significant difference regarding cognitive, affective, behavioral and evaluative components of body image between both studied groups. While in postoperative assessment, women in MRM group showed higher levels of body image distress among cognitive, affective and behavioral aspects. CONCLUSION Body image is an important factor for postmenopausal women with breast cancer in developing countries where that concept is widely ignored. We should not deprive those cases from their right of less mutilating option of treatment as BCT.
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Affiliation(s)
| | | | | | - Mahmoud Amin
- Surgery Department, Mansoura University Hospital, Egypt
| | | | - Salwa S Tobar
- Psychiatric Department, Mansoura University Hospital, Egypt
| | - Hanan E Gaffar
- Psychiatric Department, Mansoura University Hospital, Egypt
| | | | - Salwa E Ali
- Medical Surgical Department, Alexandria Faculty of Nursing, Egypt
| | - Soheir G William
- Medical Surgical Department, Alexandria Faculty of Nursing, Egypt
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The Differences in Body Image Between Patients with and Without Lymphedema Following Breast Cancer Treatment. ACTA ACUST UNITED AC 2008. [DOI: 10.1300/j004v15n02_04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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44
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Quality of life over 5 years in women with breast cancer after breast-conserving therapy versus mastectomy: a population-based study. J Cancer Res Clin Oncol 2008; 134:1311-8. [DOI: 10.1007/s00432-008-0418-y] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Accepted: 05/08/2008] [Indexed: 01/22/2023]
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Scarpa M, Erroi F, Ruffolo C, Mollica E, Polese L, Pozza G, Norberto L, D'Amico DF, Angriman I. Minimally invasive surgery for colorectal cancer: quality of life, body image, cosmesis, and functional results. Surg Endosc 2008; 23:577-82. [PMID: 18389312 DOI: 10.1007/s00464-008-9884-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 01/23/2008] [Accepted: 02/11/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aims of this cross-sectional study were to assess the long-term quality of life, the body image, and the cosmetic and functional results in patients who had laparoscopic-assisted for colorectal cancer. METHODS Forty-two patients were enrolled in this study: 21 consecutive patients who had undergone laparoscopic-assisted colonic resection and 21 patients who had open colonic resection, selected according to stage, gender, age, cancer site, and type of resection. The patients answered four questionnaires about their quality of life, body image, functional, and cosmetic results. Nonparametric tests were used for statistical analysis. RESULTS Postoperative hospital stay was shorter in patients who had laparoscopic-assisted resection. The cosmetic score was significantly better in the laparoscopic-assisted group than in the open group (p < 0.01). In spite of similar overall body image score, patients who had a laparoscopic-assisted resection reported a significantly better satisfaction with their own body (p = 0.05). Quality-of-life and functional results were similar in both groups. CONCLUSIONS The cosmetic results and the consequent satisfaction with the body were significantly better after laparoscopic assisted resection compared to equivalent open procedure. These effects seemed to be temporary but they could help patients to accept the burden of surgery.
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Affiliation(s)
- Marco Scarpa
- Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy.
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Christensen S, Zachariae R, Jensen AB, Vaeth M, Møller S, Ravnsbaek J, von der Maase H. Prevalence and risk of depressive symptoms 3-4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer. Breast Cancer Res Treat 2008; 113:339-55. [PMID: 18278553 DOI: 10.1007/s10549-008-9920-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 01/28/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Elevated levels of depressive symptoms are generally found among cancer patients, but results from existing studies vary considerably with respect to prevalence and proposed risk factors. PURPOSE To study the prevalence of depressive symptoms and major depression 3-4 months following surgery for breast cancer, and to identify clinical risk factors while adjusting for pre-cancer sociodemographic factors, comorbidity, and psychiatric history. PATIENTS AND METHODS The study cohort consists of 4917 Danish women, aged 18-70 years, receiving standardized treatment for early stage invasive breast cancer during the 2 1/2 year study period. Of these, 3343 women (68%) participated in a questionnaire study 12-16 weeks following surgery. Depressive symptoms (Beck's Depression Inventory II) and health-related behaviors were assessed by questionnaire. The Danish Breast Cancer Cooperative Group (DBCG) and the surgical departments provided disease-, treatment-, and comorbidity data for the study cohort. Information concerning sociodemographics and psychiatric history were obtained from national longitudinal registries. RESULTS The results indicated an increased prevalence of depressive symptoms and major depression (13.7%) compared to population-based samples. The pre-cancer variables: Social status, net-wealth, ethnicity, comorbidity, psychiatric history, and age were all independent risk factors for depressive symptoms. Of the clinical variables, only nodal status carried additional prognostic information. Physical functioning, smoking, alcohol use, and BMI were also independently associated with depressive symptoms. CONCLUSION Risk factors for depressive symptoms were primarily restricted to pre-cancer conditions rather than disease-specific conditions. Special attention should be given to socio-economically deprived women with a history of somatic- and psychiatric disease and poor health behaviors.
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Affiliation(s)
- Søren Christensen
- Psychooncology Reseach Unit, Aarhus University Hospital, Nobelparken, Bygn. 1483, 8000, Aarhus C, Denmark.
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Ohsumi S, Shimozuma K, Shimozumai K, Kuroi K, Ono M, Imai H. Quality of life of breast cancer patients and types of surgery for breast cancer--current status and unresolved issues. Breast Cancer 2007; 14:66-73. [PMID: 17244998 DOI: 10.2325/jbcs.14.66] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Since standard radical mastectomy was established by Halsted for breast cancer, surgical procedures for breast cancer have been changed according to the results of randomized controlled trials. Breast-conserving treatment is now regarded as a standard local treatment for early breast cancer. More recently, sentinel node biopsy is becoming popular as an alternative procedure to axillary node dissection for nodal staging. These new procedures have been believed to be better in terms of patients' quality of life in comparison with previous surgical procedures without impairing prognosis. Many studies regarding the quality of life (QOL) of patients after such procedures have been reported. Here we review those data, especially of studies comparing quality of life of patients after mastectomy and breast-conserving treatment, and of those after axillary node dissection and sentinel node biopsy. Viewpoints and issues on surgical treatment-related QOL are discussed.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
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Romanek KM, McCaul KD, Sandgren AK. Age Differences in Treatment Decision Making for Breast Cancer in a Sample of Healthy Women: The Effects of Body Image and Risk Framing. Oncol Nurs Forum 2007; 32:799-806. [PMID: 15990909 DOI: 10.1188/05.onf.799-806] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the effects of age, body image, and risk framing on treatment decision making for breast cancer using a healthy population. DESIGN An experimental 2 (younger women, older women) X 2 (survival, mortality frame) between-groups design. SETTING Midwestern university. SAMPLE Two groups of healthy women: 56 women ages 18-24 from undergraduate psychology courses and 60 women ages 35-60 from the university community. METHODS Healthy women imagined that they had been diagnosed with breast cancer and received information regarding lumpectomy versus mastectomy and recurrence rates. Participants indicated whether they would choose lumpectomy or mastectomy and why. MAIN RESEARCH VARIABLES Age, framing condition, treatment choice, body image, and reasons for treatment decision. FINDINGS The difference in treatment selection between younger and older women was mediated by concern for appearance. No main effect for risk framing was found; however, older women were somewhat less likely to select lumpectomy when given a mortality frame. CONCLUSIONS Age, mediated by body image, influences treatment selection of lumpectomy versus mastectomy. Framing has no direct effect on treatment decisions, but younger and older women may be affected by risk information differently. IMPLICATIONS FOR NURSING Nurses should provide women who recently have been diagnosed with breast cancer with age-appropriate information regarding treatment alternatives to ensure women's active participation in the decision-making process. Women who have different levels of investment in body image also may have different concerns about treatment, and healthcare professionals should be alert to and empathetic of such concerns.
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Lam WWT, Chan M, Ka HW, Fielding R. Treatment decision difficulties and post-operative distress predict persistence of psychological morbidity in Chinese women following breast cancer surgery. Psychooncology 2007; 16:904-12. [PMID: 17221942 DOI: 10.1002/pon.1147] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The patterns and determinants of longer-term psychological morbidity in women following breast cancer surgery have not been described for Chinese populations. METHODS Chinese women were assessed at 3-days, 4-months and 8-months following breast surgery, on treatment decision-making difficulty (TDMD), satisfaction with treatment outcome (E-OI), self efficacy (GSeS), optimism (C-LOT-R), consultation satisfaction (C-MISS-R), physical symptom distress (PSD) and psychological morbidity (CHQ-12) and compared using polynomial logistic models. RESULTS Of 303/405 women providing complete data, 33% received chemotherapy and 26% radiotherapy. GSeS, CLOTR and TDMD scores were moderate. Though the proportion of women meeting psychological morbidity case-criteria declined from 78% (95% Confidence Interval 73-83%) at Baseline to 64% (59-69%) at 8-months, almost 50% (44-54%) of women remained distressed over the 8-month period. After adjustment for demographic and clinical factors, severity of psychological morbidity at 4-months was predicted by PSD, disappointment and higher Baseline CHQ12, and among moderate/severe cases only, greater TDMD and pessimistic outlook. At 8-months, CHQ12 scores were predicted by PSD, Baseline CHQ-12, and difficulties with TDM. CONCLUSION TDM difficulties, early post-surgical psychological and physical symptom distress indicate risk for prolonged distress in Chinese women following breast cancer surgery.
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Affiliation(s)
- Wendy W T Lam
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
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Fobair P, Stewart SL, Chang S, D'Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psychooncology 2006; 15:579-94. [PMID: 16287197 DOI: 10.1002/pon.991] [Citation(s) in RCA: 479] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. BACKGROUND Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. METHODS A multi-ethnic population-based sample of 549 women aged 22-50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. RESULTS Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. CONCLUSIONS Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer.
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