Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2013 Jun;45(6):1039-49. doi: 10.1016/j.jpainsymman.2012.06.013. Epub 2012 Oct 26.
No prospective studies have dealt with the impact of cachexia-related weight loss on patients' body image as well as the impact of patients' body image changes on the level of patient and family distress.
Our aim was to examine associations between body mass index (BMI), weight loss, symptom distress, and body image for patients with advanced cancer and their caregivers.
Outpatients with advanced cancer and different levels of BMI, along with their caregivers, were recruited. Patient assessments included BMI, precancer weight, Body Image Scale (BIS; 0-30), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), and sexual interest and enjoyment as measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck Cancer Module 35. Caregivers were asked to assess the patient's body image, using the BIS; rate their own quality of life, using the Caregiver Quality of Life Index-Cancer; and rate their overall distress and distress regarding the patient's weight, using the Distress Thermometer (DT).
We included 81 patients and 30 caregivers. Forty-eight patients (59%) experienced weight loss of at least 10%. The mean BIS score was 11.23 (SD = 7.24). Body image dissatisfaction was correlated with weight loss (r = 0.31, P = 0.006), anxiety (HADS-A; r = 0.39, P < 0.001), depression (HADS-D; r = 0.46, P < 0.001), decreased sexual interest (r = 0.37, P = 0.001), decreased sexual enjoyment (r = 0.33, P = 0.004), ESAS score for pain (r = 0.25, P = 0.026), fatigue (r = 0.28, P = 0.014), drowsiness (r = 0.28, P = 0.014), shortness of breath (r = 0.27, P = 0.016), sleep disorders (r = 0.24, P = 0.036), and well-being (r = 0.29, P = 0.011). We found a significant association between the caregivers' evaluation of patients' body image dissatisfaction and patients' BIS score (r = 0.37, P = 0.049) and caregivers' distress regarding the patients' weight (DT; r = 0.58; P = 0.001).
Body image dissatisfaction was strongly associated with patients' weight loss and with psychosocial distress among patients and their caregivers. More research is necessary to better understand the association between the severity of body image dissatisfaction and the severity of other problems in patients with cancer.
没有前瞻性研究涉及恶病质相关体重减轻对患者身体形象的影响，以及患者身体形象变化对患者和家属痛苦程度的影响。
我们旨在检查晚期癌症患者及其照顾者的体重指数（BMI）、体重减轻、症状困扰与身体形象之间的关联。
招募了不同 BMI 水平的晚期癌症患者及其照顾者。患者评估包括 BMI、癌症前体重、身体形象量表（BIS；0-30）、埃德蒙顿症状评估系统（ESAS）、医院焦虑和抑郁量表（HADS），以及欧洲癌症研究与治疗组织生活质量问卷-头颈部癌症模块 35 中测量的性兴趣和性享受。要求照顾者使用 BIS 评估患者的身体形象；使用照顾者生活质量指数-癌症（Caregiver Quality of Life Index-Cancer）评估自己的生活质量；使用痛苦温度计（Distress Thermometer，DT）评估他们对患者体重的整体痛苦和痛苦程度。
我们纳入了 81 名患者和 30 名照顾者。48 名患者（59%）经历了至少 10%的体重减轻。平均 BIS 评分为 11.23（标准差[SD]=7.24）。身体形象不满意与体重减轻（r=0.31，P=0.006）、焦虑（HADS-A；r=0.39，P<0.001）、抑郁（HADS-D；r=0.46，P<0.001）、性兴趣降低（r=0.37，P=0.001）、性享受降低（r=0.33，P=0.004）、ESAS 疼痛评分（r=0.25，P=0.026）、疲劳（r=0.28，P=0.014）、嗜睡（r=0.28，P=0.014）、呼吸困难（r=0.27，P=0.016）、睡眠障碍（r=0.24，P=0.036）和幸福感（r=0.29，P=0.011）相关。我们发现照顾者对患者身体形象不满意的评估与患者的 BIS 评分（r=0.37，P=0.049）以及照顾者对患者体重的担忧（DT；r=0.58；P=0.001）之间存在显著关联。
身体形象不满意与患者体重减轻以及患者及其照顾者的心理社会困扰密切相关。需要进一步研究以更好地理解身体形象不满意的严重程度与癌症患者其他问题严重程度之间的关系。
