Relationship between body image and chronic obstructive pulmonary disease

Abstract

T HE IMPACT OF A chronic illness may significantly alter how an individual views the self. Chronically ill individuals must cope with alterations in their health status which may lead to body image disturbance. For individuals with Chronic Obstructive Pulmonary Disease (COPD), rigorous therapeutic interventions such as respiratory therapy, medication regimes, and proper nutrition are focused on maximizing functional capabilities. The psychological well-being of individuals with COPD can be affected due to the physical changes and lifestyle alterations that result from this chronic condition. A change in the body can influence one's feelings of self-worth and self-esteem and further compromise functional abilities. The purpose of this study was to explore the relationship between body image and the presence of the chronic illness of COPD. This illness was chosen because it represented a chronic condition that may require integration of physical changes into the individual's view of the self. Assessment of changes in body image in individuals with COPD may be important in the planning and implementation of nursing care. Diekmann (1988) has suggested that both adaptation and quality of life may be inextricably related to the individual's view of his or her body. This study was conducted in a large urban hospital. All patients with a diagnosis of moderate (n = 37) or severe (n = 50) COPD who visited the pulmonary outpatient clinic during a l-year period were interviewed. Severe COPD was defined as the forced expiratory volume in 1 second divided by the forced vital capacity percentage predicted (FEV 1%) of less than 50%, which indicates severe airway obstruction. Moderate COPD was defined as an FEV 1% value between 50% and 60%, which indicates moderate airway obstruction. A comparison group of 49 healthy subjects was obtained from various departments and professional organizations within the hospital setting. Individuals who indicated they were in excellent or good health were included in the study. Body cathexis, the degree of feeling of satisfaction or dissatisfaction with various parts or processes of the body and the self, was measured by the Body Cathexis/Self Cathexis Scales originally developed by Secord and Jourard (1953). The Body Cathexis Scale (BCS) consists of 46 body parts and functions. Subjects indicate their feelings on each of the 46 items on a scale of 1 (have strong feelings and wish changes could be made) to 5 (consider myself fortunate). The Self Cathexis Scale (SCS) lists 55 items that represented various conceptual elements of the self. Subjects rate these aspects of the self on a scale of 1 (wish changes could be made) to 5 (consider myself fortunate). In the original study, Secord and Jourard (1953) found split-half reliability coefficients that ranged from .78 to .92 for the two scales. Healthy subjects and subjects in both COPD groups completed the BCS and SCS. The mean age for healthy subjects was 50 years (SD = 9.19). For the individuals with moderate COPD, mean age was 58 years (SD = 7.22), and mean age was 55 years (SD = 10.10) for individuals with severe COPD. Mean scores on the BCS and the SCS are presented in Table 1. After finding significant ANOVAs for the BCS and SCS, comparisons were made among healthy individuals, individuals with moderate COPD, and individuals with severe COPD using Bonferroni post-hoc analyses. Each of these three groups differed significantly from each other. Healthy subjects had the