Sherman K A, Woon S, French J, Elder E
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia.
Psychooncology. 2017 Mar;26(3):337-345. doi: 10.1002/pon.4138. Epub 2016 May 11.
Women with breast cancer face threats to body image following surgery. Nipple-sparing mastectomy with immediate breast reconstruction (NSM + IBR) may minimise body image disturbance as this preserves the woman's skin and areola complex. We assessed levels of body image disturbance and psychological distress in women undergoing NSM + IBR. To further understand the body image-distress relationship, we investigated the potential moderating effect of self-compassion and appearance investment on this relationship.
Women diagnosed with breast cancer (N = 75) who had undergone NSM + IBR completed online questionnaires including the Body Image Scale, general (Depression, Anxiety and Stress Scales) and cancer-specific (Impact of Event Scale) psychological distress and Self-Compassion Scale and Appearance Schemas Inventory - Revised.
Mean general and cancer-specific psychological distress scores were within normal ranges, and body image disturbance was moderately low. Body image was positively correlated with depression, stress, Impact of Event Scale scores and appearance investment and negatively correlated with self-compassion. MANCOVA analyses indicated a significant moderating effect of self-compassion and appearance investment on the body image disturbance-distress relationship (for depression, stress and intrusion), such that participants with high self-compassion and low appearance investment experienced lower distress than individuals with low self-compassion and high appearance investment.
Moderately low levels of psychological distress and body image disturbance suggest NSM + IBR may minimise adverse psychological impacts of mastectomy. Increased body image disturbance was associated with psychological distress and moderated by self-compassion and appearance investment, suggesting a potential role for these characteristics as the focus of psychological interventions to minimise the negative impacts of mastectomy. Copyright © 2016 John Wiley & Sons, Ltd.
乳腺癌女性患者术后面临身体形象受损的威胁。保留乳头的乳房切除术并即刻乳房重建术（NSM + IBR）或许能将身体形象干扰降至最低，因为该手术保留了女性的皮肤和乳晕复合体。我们评估了接受NSM + IBR手术的女性的身体形象干扰程度和心理困扰情况。为进一步了解身体形象与困扰之间的关系，我们调查了自我同情和外表投入对这种关系的潜在调节作用。
75名接受NSM + IBR手术的乳腺癌确诊女性完成了在线问卷，包括身体形象量表、一般心理困扰量表（抑郁、焦虑和压力量表）、癌症特异性心理困扰量表（事件影响量表）、自我同情量表以及修订后的外表模式量表。
一般心理困扰和癌症特异性心理困扰的平均得分均在正常范围内，身体形象干扰程度为中度偏低。身体形象与抑郁、压力、事件影响量表得分及外表投入呈正相关，与自我同情呈负相关。多变量协方差分析表明，自我同情和外表投入对身体形象干扰与困扰之间的关系具有显著调节作用（针对抑郁、压力和侵入感），即自我同情程度高且外表投入低的参与者比自我同情程度低且外表投入高的个体所经历的困扰更少。
心理困扰和身体形象干扰程度为中度偏低表明NSM + IBR可能将乳房切除术的不良心理影响降至最低。身体形象干扰增加与心理困扰相关，并受到自我同情和外表投入的调节，这表明这些特征作为心理干预的重点，在将乳房切除术的负面影响降至最低方面可能发挥潜在作用。版权所有© 2016约翰·威利父子有限公司。
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