Impaired Body Image Research Articles

Brassiere-Wearing Practices and Issues among Post-mastectomy Women: A Systematic Review

This systematic review was carried out to appraise the evidence regarding the brassiere-wearing practices and problems faced by breast cancer survivors. An electronic search was carried out across eight databases such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Embase, CINAHL and ProQuest. Two researchers independently screened the studies for their eligibility and study quality. A total of 309 studies were assessed for eligibility. After conflict resolution by the third reviewer, five studies were selected for systematic review. All study outcomes in terms of the pattern of brassieres/prostheses, issues and challenges faced by women post-mastectomy were reviewed. It was observed that very few studies were published from various countries all over the world. All the studies were of descriptive type except one, which adopted a prospective randomised crossover design. The brassieres or prostheses, the survivors preferred were homemade made of cotton, cloth, wool, rice, sponge or commercially silicon-made. Weight of the brassiere/prostheses, discomfort, displacement while doing activities of daily living and impaired body image were common issues identified, while the unavailability of size or fit of the brassieres or requirement of alteration in clothes to meet clothing styles were common challenges faced by post-mastectomy women. It was concluded that the post- mastectomy used varied types of brassieres or prostheses with various associated issues and challenges.

Patient and Caregiver Perspectives on Gender Disparity in CKD: An Interview Study.

Chronic kidney disease (CKD) affects more women than men worldwide, however, men comprise the majority of patients who receive kidney replacement therapy. We aimed to describe the perspectives of patients and their caregivers regarding gender disparities in CKD. Semi-structured interviews were conducted with 45 patients with CKD (20 women) and 14 caregivers (12 women) from seven clinics in Austria. The interviews were analyzed thematically. Five themes were identified in this study. Participants perceived that women were "disadvantaged and vulnerable" (silent and intimidated, single mother predicament, impeded access to care and support due to socioeconomic disadvantage, had to fend for themselves); "fulfilling gender roles and norms" (primarily responsible for childcare, pressure to perform well as homemakers, put others' needs before their own, encouraging husband's treatment adherence), and "protecting their own health" (self-disciplined, vigilant, confronted health challenges, advocated for their needs). Men were seen to "place the onus of care on others" (expected help from family, relied on others for decisions). Both men and women experienced a "disease-related identity crisis and distress" (women: impaired body image, mental distress; men: denial and self-destruction, emasculated by sickness). Women with CKD felt vulnerable and were inclined to fulfill gender norms and responsibilities as caregivers but were also vigilant about protecting their own health. Men tended to be reluctant to accept CKD and appeared to depend on others for disease management. Better awareness and addressing these concerns can inform strategies to minimize gender disparities in access to care and outcomes in CKD.

Coping style and psychopathological morbidity in patients with advanced melanoma: differences between cancer therapy, metastatic location and staging.

The incidence of melanoma has been steadily increasing in recent years and remains one of the most frequent cancers in adolescents and young adults. The literature shows how a high percentage of melanoma patients present with high anxiety and depression scores and a correlation between worsening quality of life and impaired body image has been shown. The present study aimed to investigate the relationship between cutaneous and visceral metastasis in a group of 73 patients with advanced melanoma in relation to body image, anxiety, depression, and coping style. Hospital Anxiety and Depression Scale, Body Image Scale and Mini-Mac questionnaires were administered to a sample of 73 subjects with advanced melanoma (stage III and IV); Analyses were performed with SPSS version 28.01 and a P value <0.05 was considered significant. Emerging results indicated greater body image impairment in patients with skin metastasis, no significant difference in anxiety and depression by staging. Patients receiving target therapy showed a reduction in anxiety and depression compared with patients receiving immunotherapy. In line with the literature, cutaneous metastatic involvement negatively affected body image, a prevalence rate of anxiety and depression of 28,8% and 19.2%, respectively, emerged in the sample, while 17.8% reported significant body image impairment, suggesting how melanoma impacts in patient's quality of life.

The mediating effect of self-efficacy on family functioning and psychological resilience in prostate cancer patients.

Prostate cancer patients face impaired body image and psychological distress during the diagnosis and treatment of the disease, which leads to changes in mood, cognition and behavior. Psychological resilience has been shown to buffer shocks and stresses from the disease. Therefore, this study investigates the relationship between family functioning and psychological resilience in prostate cancer patients and the mediating role of self-efficacy between family functioning and psychological resilience to provide a relevant theoretical basis for improving patients' psychological status by providing relevant theoretical basis. Using a cross-sectional design, participants were 215 patients with prostate cancer admitted to and treated in a tertiary hospital in Jiangsu province, China. Questionnaires were administered using the general information questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Family Adaptation, Partnership, Growth, Affection, and Resolution Index (APGAR), and the General Self-efficacy Scale (GSES). Data were analyzed using descriptive and correlational analyses and the bootstrap mediation test was used to test the effect relationship between the variables. Family functioning, self-efficacy and psychological resilience were significantly and positively correlated (r = 0.526, P < 0.01; r = 0.378, P < 0.01; r = 0.358, P < 0.01). The mediating effect of psychological resilience between family functioning and psychological resilience was significant, accounting for 42.56%. Family function and self-efficacy have been shown to increase the level of psychological resilience in prostate cancer patients. Attention should be paid to the mental health problems of prostate cancer patients, early screening and intervention, and the use of patients' family resources to improve their confidence in recovering from the disease, thus increasing their psychological resilience and improving their mental health.

P391 A not so innocent bystander: The prevalence and burden of anaemia at IBD onset

Abstract Background Anaemia is the most common systemic complication of Inflammatory Bowel Disease (IBD). Contemporary studies linking its prevalence with symptom burden at disease onset are limited. We present the prevalence and disability associated with anaemia in a large new onset adult IBD cohort. Methods Demographic, clinical and biochemical indices were collected prospectively in patients referred with suspected IBD between January 2021 - April 2023. Anaemia was defined as haemoglobin (Hb) of &amp;lt;115g/L in women and &amp;lt;130g/L in men. Iron deficiency was defined as Ferritin &amp;lt;30ug/L (&amp;lt;100ug/L if active inflammation – CRP &amp;gt;5mg/L, Faecal Calprotectin [FCP] &amp;gt;200ug/g) or Iron saturations &amp;lt;15%. IBD disk scores were collected in a subgroup of patients. For two groups, non-parametric Mann-Whitney U tests were utilised, with a pairwise Dunn test and holm corrected p values for more than two. Results Hb results were available for 586 patients (182 CD, 170 UC, 234 non-IBD). Of these, an IBD disk score was available for 245 (84 CD, 71 UC, 90 non-IBD). Hb levels were significantly lower in CD than non-IBD (Table 1). Overall, a significantly larger proportion of patients with CD were anaemic than UC (X2 10.2 p=0.001, odds ratio 2.4 [95% CI 1.39-4.16]). Whilst most anaemic patients in both groups were iron deficient, many without anaemia also had demonstrable iron deficiency (Figure 1). In CD, Hb levels were significantly lower in ileocolonic disease than either isolated ileal (median Hb 125vs135.5g/L, p=0.002) or isolated colonic (125vs139g/L, p=0.002). Across IBD, Hb significantly correlated with Harvey Bradshaw Index (n=142, Spearman’s Rho [SR] -0.23 p=0.007), Partial Mayo (n=143, SR -0.23 p=0.006), Simple endoscopic score for CD (n=130, SR -0.29 p&amp;lt;0.001) and FCP (n=314, SR -0.23 p&amp;lt;0.001). Regarding overall disease burden, Hb correlated with overall disability as determined by the IBD disk (n=155, -0.23 p=0.004). Anaemic patients had higher overall disability (total disk score 62.5vs49 p=0.007). Using individual disk domains, those with anaemia had higher fatigue (median 9vs8, p=0.012), disruption of education or work (7vs4, p&amp;lt;0.001), impairment of body image (7vs4, p=0.019) and reduced sexual function (5.5vs1, p=0.004). When compared in a linear regression alongside age, body mass index, ethnicity, IBD type and baseline FCP, Hb was the second strongest predictor of overall disk score (Model fit R=0.515, BMI t=3.05 p=0.003, Hb t=-2.41 p=0.019). Conclusion Anaemia is frequently present at IBD onset, particularly in CD. Nearly half of those without anaemia have demonstrable iron deficiency. Severity of anaemia is associated with overall disease activity but influences symptom burden and disability beyond that which is attributable to mucosal inflammation alone.

Psychosocial Adjustment Experiences Among Nasopharyngeal Carcinoma Survivors: A Qualitative Study.

Nasopharyngeal carcinoma (NPC) has serious effects on the daily lives and psychosocial adjustment of survivors. In particular, psychosocial problems are a prominent concern. The aim of this study was to understand the lived experiences of NPC survivors regarding psychosocial adjustment. A qualitative design using individual semistructured interviews was conducted with 20 NPC survivors. Each participant was asked open-ended questions about their lived experience with psychosocial adjustment. The data were then subjected to thematic analysis. The following 4 themes, which had subthemes, were identified from the data: (1) grappling with discomforts (symptoms distress of late toxicities, impaired body image, and returning-to-work restrictions), (2) struggling with uncertainty (disease attribution with self-blame, contradictory rehabilitation information, fear of cancer recurrence, and distance from medical staff), (3) changing social patterns (special favors, social isolation, and social discrimination), and (4) cultivating positive change (healthy lifestyle and positive mindset). Nasopharyngeal carcinoma survivors experience many obstacles, as well as positive changes, during psychosocial adjustment. This study highlights the pressing need to consider NPC survivors' concerns about their psychosocial adjustment. Medical staff should provide NPC survivors with sufficient rehabilitation information to help them deal with possible late toxicities and mitigate their uncertainty and misunderstanding. Effective public education measures are needed to address misunderstandings about cancer in Chinese cultural settings.

A follow-up and treatment model for pediatric eating disorders: examination of the clinical variables of a child and adolescent psychiatry eating disorder outpatient clinic.

Anorexia nervosa and other eating disorders are common in children and adolescents and are characterized by symptoms such as food restriction, efforts to lose weight, fear of gaining weight and impaired body image. Anorexia nervosa is a life-threatening psychiatric disorder and its management in the outpatient setting can be challenging for clinicians. The aim of this study was to introduce the subunit service model developed for the multidisciplinary diagnosis and management of eating disorders in the outpatient setting and to evaluate the clinical follow-up of patients. The medical records of 37 patients who were followed up by the eating disorders team at our clinic between 2018 and 2022 were reviewed. The study was designed as retrospective case study. A diagnosis was made according to DSM-5 and a treatment plan was developed for each case. Body mass index (BMI), Clinic Global Impression (CGI) scale scores, duration of follow-up, number of interviews and other scale scores (The Turgay Attention Deficit Hyperactivity Disorder Scale and the Autism Spectrum Screening Questionnaire Scale) of 37 patients aged 12-17 years diagnosed with an eating disorder and followed up in our clinic were statistically compared. The Eating Disorder Follow-up Model developed and applied in our clinic had a positive effect on patients BMI scores, a significant improvement in CGI scores was observed. Conclusion: We believe that this multidisciplinary system will serve as a model for other mental health centers by raising awareness and guiding mental health professionals in the follow-up and treatment of eating disorders.

The Experiences of Children with Primary Immunodeficiency Who Receive Immunoglobulin Subcutaneously Instead of Intravenously

Children with primary immunodeficiency disorder have begun receiving subcutaneous immunoglobulin (SCIg) instead of intravenous immunoglobulin (IVIg). So, we aim to explore the experiences of primary immunodeficiency children with regard to receiving SCIg instead of IVIg. We adopted a phenomenological approach in 2022 in Turkey using semi-structured interviews. We recruited 15 participants using the purposive sampling method. The main theme was the sweetness and bitterness of living with SCIg. The first subtheme was sweetness (sense of freedom, having a normal life, saving time, ease of use, and feeling better). The second subtheme was bitterness (worries about taking responsibility for injection, impaired body image due to abdominal edema, and minimal tolerable complications). The results show these children had more sweet experiences than bitter ones. Being flexible in choosing a method, teaching patients to apply it correctly, and providing enough time to cope are as reasons for this.

Assessing attitudes towards insulin pump therapy in adults with type 1 diabetes: Italian validation of the Insulin Pump Attitudes Questionnaire (IT-IPA questionnaire)

AimsThe aim of the study was to adapt the German version of the insulin pump therapy (IPA) questionnaire to Italian (IT-IPA) and to evaluate its psychometric properties in adults with type 1 diabetes.MethodsWe conducted a cross-sectional study, data were collected through an online survey. In addition to IT-IPA, questionnaires evaluating depression, anxiety, diabetes distress, self-efficacy, and treatment satisfaction were administered.The six factors identified in the IPA German version were assessed using confirmatory factor analysis; psychometric testing included construct validity and internal consistency.ResultsThe online survey was compiled by 182 individuals with type 1 diabetes: 45.6% continuous subcutaneous insulin infusion (CSII) users and 54.4% multiple daily insulin injection users.The six-factor model had a very good fit in our sample. The internal consistency was acceptable (Cronbach’s α = 0.75; 95% IC [0.65–0.81]).Diabetes treatment satisfaction was positively correlated with a positive attitude towards CSII therapy (Spearman’s rho = 0.31; p < 0.01), less Technology Dependency, higher Ease of Use, and less Impaired Body Image. Furthermore, less Technology Dependency was associated with lower diabetes distress and depressive symptoms.ConclusionsThe IT-IPA is a valid and reliable questionnaire evaluating attitudes towards insulin pump therapy. The questionnaire can be used for clinical practice during consultations for shared decision-making to CSII therapy.

P761 Negative Body Image in Inflammatory Bowel Disease persists despite Modern IBD care

Abstract Background Body image dissatisfaction (BID) is prevalent in patients with Inflammatory Bowel Disease (IBD). Historically female sex, previous IBD surgery, impaired QoL have been associated with negative body image. The introduction of biologic therapies and modern IBD care in Australia in 2007 has improved disease control and endoscopic outcomes, but it is unclear if body image has improved in parallel with this. We aimed to determine whether body image and QoL have improved amongst IBD patients with modern IBD car Methods Tertiary IBD service patients were offered inclusion in the study in 2006 by postal survey (pre-biologic era), and in 2021 by electronic survey (biologic era). Surveys included demographics and history of IBD surgery. In the pre-biologic era (PBE) body image dissatisfaction (BID) and QoL were assessed using a patient reported yes/no question, followed by an open question about how IBD or treatment has changed the way they view their body’s appearance. In the biologic era (BE) the validated modified Body Image Scale and Short Inflammatory Bowel Disease Questionnaire were used. Results The BE included 135 patients, 59% female, mean age 45.9. The PBE included 215 patients, 66% female and mean age 35.5. PBE had 40% reporting IBD surgery vs 36% in BE (P=0.489). BID was observed in 67% vs 39% of the PBE and BE respectively (p&amp;lt;0.01). In the PBE free text responses elicited themes of dissatisfaction with medication or steroid-related appearance changes (41%), bloating (30%), weight gain (28%), weight loss (12%), and specific appearance changes. The link between body image and QoL was mentioned by 33% of patients, with 8% specifically mentioning its impact on their mental health. Females were affected to a greater extent in both PBE (75% vs 52% p&amp;lt;0.01), and BE (50.5% versus 22% p&amp;lt;0.01). In the PBE patients with surgical intervention for IBD had higher rates of BID than those without surgery (81% vs 58%, p&amp;lt;0.01). This association between surgery and BID was not observed in the BE (47% vs 34.9%, p=0.168). In the PBE those with BID were significantly more likely to report impaired QoL(97% vs 71%, p&amp;lt;0.01). This association persisted with time with BE patients with BID also having higher rates of QoL impairment (85% vs 45% p&amp;lt;0.01). Conclusion Whilst the rate of BID has decreased with modern IBD treatment; it remains highly prevalent and is associated with impaired QoL. Whilst females remain disproportionately affected, the historically observed association between IBD surgery and impaired body image was not demonstrated in the BE. This may reflect improved surgical techniques and biologic down staging prior to surgery. However, body image remains an important Patient Reported Outcome in IBD and warrants further attention.

P280 Quality of life in military patients with Inflammatory Bowel Disease

Abstract Background Inflammatory Bowel Disease (IBD), represented by Crohn's disease (CD) and Ulcerative Colitis (UC), are chronic conditions that can impair quality of life (HRQOL). Active military personnel are particularly at risk, given the strain of their work and military missions. The aim of our study was to evaluate the HRQOL of active military patients with IBD and to search for factors related to its alteration. Methods This was a prospective cross-sectional study, over a period of 5 months [February 2022 - June 2022], including male military patients that were still serving. The HRQOL of these patients was assessed by the IBD-Disk, which is a visual scale that consists of 10 items (Abdominal pain, diarrhea, social behavior, education and work, sleep, energy, emotions, body image, sexual activity, joint pain). It is validated for the assessment of HRQOL in IBD patients. Each dimension is scored from 0 to 10, with a total score of 0 to 100. The higher the score, the more impaired the HRQOL. The overall IBD-Disk score was considered impaired if it was higher than 40. Results We included 30 patients. The most represented age range was from 31 to 40 years. Ten patients were smokers. Twenty-four patients had CD and 6 had UC. The majority of CD was isolated ileal (n=16) with an upper gastrointestinal tract involvement in one patient and anoperineal manifestations in 5 patients. UC was distal in 3 patients and extensive in the other 3. Nine patients had extra-intestinal involvement, principally rheumatological (n=8). The mean overall IBD-Disk score was 21.6 [6 - 66]. We noted that CD was associated with the alteration of the dimensions related to urgent stools (p=0.001), social life (0.002) and sleep (p=0.004). The presence of anoperineal lesions during CD was associated with impairment of the social (p=0.002) and energy (p=0.006) dimensions. The presence of extra-intestinal manifestations was associated with elevated social dimension score (p=0.002). Azathioprine treatment was associated with impaired sleep dimension (p=0.048). Patients with a disease that had been evolving for more than 5 years had an alteration in the dimension related to urgent stools (diarrhea) (p=0.036), energy (p=0.048) as well as the dimension of sexual life (p=0.042). History of hospitalization for IBD was associated with impaired body image (p=0.030). History of surgical resection was associated with impaired energy (p=0.029), sexuality (p=0.015) and overall quality of life (p=0.02). Conclusion In our active military patients, HRQOL was not impaired overall, but several factors, related to severe forms, were associated with lower HRQOL.

An Attempt to Understand the Biology of Gender and Gender Dysphoria: A Christian Approach

The recent rise in the number of transgender individuals has perplexed many. A study of possible biological origins of gender dysphoria presents a complex picture. In some cases, prenatal hormonal imbalance may cause early-onset and persistent gender dysphoria. In contrast, late-onset cases are associated with a high incidence of comorbidities such as trauma, depression, and autism. In such cases, social isolation and an impaired body image may make individuals susceptible to social media suggestions of gender dysphoria. Moreover, affirmative counseling without addressing underlying comorbidities can strengthen this misperception, further moving these individuals along a trajectory toward transition. Care must be taken when considering early transition, given the fact that childhood gender dysphoria frequently desists. One must balance sparing a child from the distressing sexual changes of puberty with beginning transition in someone who might otherwise have desisted. Recent studies of perception suggest that it is a top-down predictive, "best guess" process. Although these "guesses" are continuously modified by sensory experience, they can persist; they might also apply to some cases of gender dysphoria. While some people have managed to detransition back to their natal gender, we should not assume that this is possible with everyone. As Christians, we need to examine each case individually, removing the stigma and supporting them through this distressing condition.

Do Tooth Loss and Dentures Cause Body Image Disturbance?

To investigate the psychologic morbidities associated with tooth loss despite treatment with technically successful dentures. This cross-sectional questionnaire-based study compared the psychologic disturbance and functional difficulties in two groups: individuals with tooth loss who wore optimal-quality removable dentures (test group), and individuals with tooth loss who did not wear dentures (control group). The questionnaire used was developed and validated previously. The short-form revised Eysenck personality questionnaire was also used to assess the relationship with personality traits. A total of 138 participants were recruited (denture group = 70; control group = 68). There was a significant difference in body image dissatisfaction between the groups (χ2 = 7.72, P value = .005). The denture group had 5.75-times higher probability than the control group of suffering from body image disturbance. Older patients were predicted to have 75% less probability of body image disturbance (OR = 0.25), and men were predicted to have up to 70% less disturbance (OR = 0.3). As for psychologic morbidities, participants in both groups presented with somatic symptoms related to depression or anxiety, which were nearly double that expected in the general population (15.7% and 7.8%, respectively). Furthermore, participants who complained about body image impairment were more likely to have higher scores on the neuroticism scale (OR = 3.64). Tooth loss and dentures could be associated with body image dissatisfaction and psychologic morbidity. Planning for patient-centered care is paramount prior to extracting any teeth and providing replacement options.

Body Image disturbance in patients with cancer

IntroductionCancer and its treatments have been shown to have a negative psychological effect on many cancer patients. One of these effects is often described as body image disturbance.ObjectivesTo assess body image in cancer patients and its association with clinical variables.MethodsThis was a cross-sectional study, conducted over 1 month, involving 100 cancer patients followed in the oncology department at the Habib Bourguiba University Hospital in Sfax (Tunisia). All participants completed a 10-item Body Image Scale (BIS) questionnaire to assess body image dissatisfaction.Results These results showed that half of the patients were female, and 70% of them were married. Their mean age was 51.96 years with extremes ranging from 41 to 60 years. Their level of education did not exceed primary school in 61% of cases, and 68% of them were unemployed. A total of 58% of patients received chemotherapy and 44%, 25%, and 11% of persons were affected by breast, digestive and cavum cancer, respectively. Impaired body image was noted in 81% of cases with an average BIS score of 15.39. An altered body image was statistically correlated with female sex (p = 0.005), absence of professional activity (p = 0.032), and the presence of anxiety-depressive symptoms (p = 0.008).ConclusionsIn this study most of the cancer patients had body image disturbances. Therefore, it is to the health team and nurses that take the concept of body image more serious and make use of some interventions to minimize the possible side effects.DisclosureNo significant relationships.

Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis.

Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.

Internalized skin bias: validation study to explore the impact of the internalization of social stigma on those with hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a chronic auto-inflammatory disease that is highly associated with adverse psychopathology and impaired body image. Previous studies show that patients with HS are also impacted by social stigma associated with their skin disease. Over time, these experiences can influence the way in which patients feel about themselves, leading to internalized skin bias (ISB). To evaluate the validity and reliability of the Internalized Skin Bias Questionnaire (ISBQ) in an HS population and to determine the association of this instrument with markers of HS severity. A cross-sectional survey with 72-h retest was sent to adult patients with HS from March to November 2021. Reliability for the ISBQ was evaluated using Cronbach's alpha and the Concordance Correlation Coefficient (CCC). Construct validity was evaluated using Pearson Correlation Coefficients with similar measures. Internal consistency for the ISBQ instrument was 0.89 with a CCC of 0.88. The ISBQ had moderate correlation (r = 0.63) with the experienced skin stigma questionnaire as well as the BDI-II (r = 0.66) and the psychosocial subscale of the HiSQOL (r = 0.65). ISBQ scores differed significantly across different stages of disease severity (P = 0.04). There was no significant difference between those with different durations of disease (P = 0.47). This study shows that the ISBQ is a valid and reliable instrument that can be used to assess the psychosocial construct of ISB especially in a population of HS patients. Further, ISB places a prevalent negative impact on the psychopathology of patients with HS.

Body image and perception among adults with and without phantom limb pain.

Following lower-limb amputation, phantom limb pain (i.e., pain perceived as coming from the amputated portion of the limb) is common. Phantom limb pain may be associated with impaired body image and perception, which may be targets for rehabilitative intervention. To compare measures of body image and perception between adults with and without phantom limb pain post amputation and evaluate associations between measures of body image and perception and phantom limb pain. Survey. Online, remote assessment. Seventy-two adults ≥1 year post unilateral lower-limb loss (n=42 with phantom limb pain, n=30 without phantom limb pain or pain in the remaining portion of the limb). Not applicable. Self-reported outcome measures assessing body image (i.e., Amputee Body Image Scale-Revised), perceptual disturbances associated with the phantom limb (i.e., a modified Bath Complex Regional Pain Syndrome Body Perception Disturbance Scale), and prosthesis satisfaction (i.e., Trinity Amputation and Prosthesis Experience Scale) were administered; participants with phantom limb pain reported pain interference via the Brief Pain Inventory-Short Form. Between-group comparisons of self-reported outcome measure scores were conducted using Mann Whitney U or chi-square tests, as appropriate (a=.05). Compared to peers without phantom limb pain, adults with phantom limb pain reported more negative body image; increased phantom limb ownership, attention, and awareness; and reduced prosthesis satisfaction and embodiment (U=175.50-364.00, p < .001 to .034). Disturbances in phantom limb perception (i.e., size, weight, pressure, temperature) were similar between groups (p=.086 to >.999). More negative body image was associated with increased phantom limb pain interference (τb =.25, p=.026). Adults with phantom limb pain demonstrate more negative body image and hypervigilance of the phantom limb as compared to peers with nonpainful phantom sensations. Mind-body treatments that target impaired body image and perception may be critical interventions for adults with phantom limb pain.

Psycho-social distress and disease specific treatment affecting quality of life in breast cancer patients: A brief report

Health-related quality of life (QOL) in breast cancer patients is very pertinent to assess due to advances in treatment leading to prolonged survival. Nevertheless, psycho-social distress and various treatment modalities used in breast cancer can have both acute and delayed complications which can significantly affect QOL of the patient. The diagnosis of the disease, impairment of body image, alopecia and alteration of femininity are some of the major factors causing psychological distress. Among the treatment related factors, fatigue, insomnia, lymphedema, premature menopause and pain are the prominent factors influencing QOL. Measures should be undertaken to timely diagnose and treat these symptoms. Physical activity such as yoga, tai-chi, aerobics, meditation can enhance QOl and reduce these symptoms. Also psychosocial education is an upcoming treatment which helps to improve overall QOL.

SENTIREC – The sentinel node mapping in women with cervical cancer study – Patient-reported early lymphedema and its impact on quality of life

ObjectiveTo evaluate patient-reported incidence and severity of early lymphedema and its impact on quality of life (QoL) after sentinel lymph node (SLN) mapping only and after SLN and pelvic lymphadenectomy (PL) in women undergoing surgery for early-stage cervical cancer. MethodsIn a national prospective multicenter study, we included women with early-stage cervical cancer from March 2017–January 2021 to undergo radical surgery including SLN mapping. Women with tumors >20 mm underwent completion PL. The incidence and severity of early lymphedema and its influence on QoL were evaluated using validated patient-reported outcome measures before surgery and three months postoperative. We investigated changes over time using linear regression. ResultsTwo hundred of 245 (81.6%) included women completed questionnaires at baseline and three months postoperatively. The incidence of early lymphedema was 5.6% (95% CI 2.1–11.8%) and 32.3% (95% CI 22.9–42.7%) in women who underwent SLN mapping only and SLN + PL, respectively. Lymphedema symptoms in the legs, genitals, and groins increased in both groups postoperatively but three times more in women who underwent PL. Lymphedema symptoms after SLN + PL significantly impaired physical performance (p = 0.001) and appearance (p = 0.007). Reporting lymphedema was significantly associated with impaired body image, physical-, role-, and social functioning, and a high level of fatigue. ConclusionsSLN mapping alone carries a low risk of lymphedema in women undergoing surgery for early-stage cervical cancer. In contrast, completion PL is associated with a high incidence of early lymphedema. Reporting lymphedema is associated with significant impairment of several physical, psychological, and social aspects of QoL.

In search of lost beauty: Experiences of Iranian women with melasma.

The skin condition called melasma affects patients' appearance significantly and affects them psychologically and emotionally, besides leading to an impaired body image. Since access to quality information in different cultural environments is necessary to understand the psychological problems associated with melasma, the aim of this qualitative study was to explore the experiences of 20 Iranian women with melasma. The content analysis method was employed for this study. Twenty participants were selected through purposive sampling, and data were collected through face-to-face in-depth interviews and then transcribed verbatim. After categorizing the initial codes, 14subthemes were identified, which were classified under five themes-camouflage, seeking treatment, lost beauty, grief, and others' reaction; these were then grouped under a general one, "in search of lost beauty." Melasma has a tremendous impact on the lives of the women it affects, and therapists should focus on the condition's social and psychological aspects, in addition to treatment.