Teo Irene, Reece Gregory P, Christie Israel C, Guindani Michele, Markey Mia K, Heinberg Leslie J, Crosby Melissa A, Fingeret Michelle Cororve
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Psychooncology. 2016 Sep;25(9):1106-12. doi: 10.1002/pon.3952. Epub 2015 Sep 10.
The process of cancer-related breast reconstruction is typically multi-staged and can take months to years to complete, yet few studies have examined patient psychosocial well-being during the reconstruction process. We investigated the effects of reconstruction timing and reconstruction stage on body image and quality of life at specific time points during the breast reconstruction process.
In this cross-sectional study, 216 patients were grouped into four reconstructive stages: pre-reconstruction, completed stage 1, completed stage 2, and final stages. Multiple regression analyses examined the roles of reconstruction timing (immediate vs delayed reconstruction) and reconstruction stage as well as their interaction in predicting body image and quality of life, controlling for patient age, BMI, type of reconstruction, chemotherapy, radiation therapy, and major complication(s).
A difference in pattern of body image was observed across the reconstructive stages, with those receiving delayed reconstruction showing significant decrease in body image dissatisfaction compared with those with immediate reconstruction. At pre-reconstruction, patients awaiting delayed reconstruction reported significantly lower social well-being compared with those awaiting immediate reconstruction. Reconstruction stage predicted emotional well-being, with higher emotional well-being observed in those who had commenced reconstruction.
Timing and stage of reconstruction are important to consider when examining psychosocial outcomes of breast cancer patients undergoing reconstruction. Those waiting to initiate delayed reconstruction appear at particular risk for body image, emotional, and social distress. Our findings have implications for delivery of psychosocial treatment to maximize body image and quality of life of patients undergoing cancer-related breast reconstruction.Copyright © 2015 John Wiley & Sons, Ltd.
与癌症相关的乳房重建过程通常分多个阶段，可能需要数月至数年才能完成，但很少有研究考察重建过程中患者的心理社会幸福感。我们调查了重建时机和重建阶段对乳房重建过程中特定时间点的身体形象和生活质量的影响。
在这项横断面研究中，216名患者被分为四个重建阶段：重建前、完成第一阶段、完成第二阶段和最后阶段。多元回归分析考察了重建时机（即刻重建与延迟重建）和重建阶段及其相互作用在预测身体形象和生活质量方面的作用，同时控制患者年龄、体重指数、重建类型、化疗、放疗和主要并发症。
在各重建阶段观察到身体形象模式存在差异，与即刻重建的患者相比，延迟重建的患者身体形象不满意程度显著降低。在重建前，等待延迟重建的患者报告的社会幸福感显著低于等待即刻重建的患者。重建阶段可预测情绪幸福感，开始重建的患者情绪幸福感更高。
在检查接受重建的乳腺癌患者的心理社会结果时，重建时机和阶段是需要考虑的重要因素。等待开始延迟重建的患者在身体形象、情绪和社交困扰方面似乎面临特别风险。我们的研究结果对提供心理社会治疗以最大限度提高接受与癌症相关乳房重建患者的身体形象和生活质量具有启示意义。版权所有©2015约翰·威利父子有限公司。
