Vanderbilt University School of Nursing, Nashville, TN 37240, USA.
Oral Oncol. 2013 Aug;49(8):753-60. doi: 10.1016/j.oraloncology.2013.04.005. Epub 2013 May 14.
Patients with head and neck cancer have a high potential for body image disturbance due to highly visible disfigurement resulting from both the primary cancer and its treatment. The purpose of this review is to examine the conceptual framework for understanding body image in patients treated for head and neck cancer, present the current state of the science, discuss measurement issues, and identify areas for future investigation. A novel hypothetical model based on ongoing work is proposed, and it asserts that head and neck cancer therapy results in two main tumor/treatment related physical effects: (1) disfigurement and (2) dysfunction. In this model, personal, social and environmental factors moderate the effect of dysfunction and disfigurement on body image.
A search of the empirical literature revealed a paucity of data on body image in head and neck cancers including a lack of longitudinal data as well as a lack of data on the relationship between body image disturbance and other psychosocial variables such as depression, anxiety, and social isolation over the course of treatment and throughout recovery. Additionally, the need for measurement tools specifically developed for the assessment of body image in head and neck cancer patients was identified.
Prospective longitudinal studies that define the trajectory of body image issues and the mediating and moderating factors associated with body image will allow researchers to design targeted interventions to limit body image disturbance and thereby improve quality of life in patients with head and neck cancer.
由于头颈部癌症原发肿瘤及其治疗导致的明显毁容,患者存在较高的体像障碍风险。本综述旨在检验头颈部癌症患者体像理解的概念框架,呈现该领域的现有研究状况,讨论测量问题,并确定未来研究方向。本研究提出了一个基于现有研究的新的假设模型,该模型认为头颈部癌症治疗会导致两种主要的与肿瘤/治疗相关的躯体效应:(1)毁容和(2)功能障碍。在该模型中,个人、社会和环境因素调节了功能障碍和毁容对体像的影响。
对头颈部癌症体像的文献检索结果显示,相关数据非常有限,包括缺乏纵向数据,以及缺乏体像障碍与其他心理社会变量(如治疗过程中和康复期间的抑郁、焦虑和社会隔离)之间关系的数据。此外,还需要专门用于评估头颈部癌症患者体像的测量工具。
前瞻性纵向研究可以明确体像问题的轨迹,以及与体像相关的中介和调节因素,从而使研究人员能够设计有针对性的干预措施,限制体像障碍,从而改善头颈部癌症患者的生活质量。