头颈部癌症（HNC）患者体像评估工具的系统评价。
A systematic review of body image measures for people diagnosed with head and neck cancer (HNC).
机构信息
Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.
Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia.
出版信息
Support Care Cancer. 2019 Oct;27(10):3657-3666. doi: 10.1007/s00520-019-04919-6. Epub 2019 Jun 15.
PURPOSE
Head and neck cancer (HNC) is a relatively common cancer which causes a significant health burden, impacting individuals physically and psychologically. HNC treatment may result in facial disfigurement, eating and communication difficulties, and body image disturbances. We aimed to (1) identify HNC-specific patient-reported outcome measures (PROMs) used to assess body image, (2) evaluate their conceptual coverage, (3) appraise their development process and psychometric properties, and (4) determine appropriate body image PROM(s) for use in the HNC setting.
METHODS
Online databases were searched (July 2007-July 2017) for studies that assessed body image in patients with HNC. Studies were screened for eligibility. In addition, we searched three PROM databases for relevant PROMs. From available body image frameworks, we compiled a conceptual schema consisting of 18 clinically relevant body image issues important in the HNC setting, against which PROMs were assessed. Selected measures were appraised for psychometric characteristics, content, and readability.
RESULTS
A total of 245 records were retrieved. 18 studies with PROMs met our inclusion criteria, reporting eight PROMs. The PROM databases searched yielded 62 measures. After screening, eleven measures were short-listed and appraised. The Derriford Appearance Scale (DAS)-59, DAS-24, and body image scale (BIS) cover > 55% of issues within the body image conceptual schema; were developed based on literature, patient interviews, and clinician opinions; and have evidence of internal consistency (Cronbach alpha > 0.7), validity, and responsiveness.
CONCLUSIONS
We recommend the DAS-24 and BIS as having adequate coverage of HNC-related issues, and suitable for use in future research.
目的
头颈部癌症（HNC）是一种较为常见的癌症，它会给患者带来沉重的健康负担，在身体和心理上都对患者造成影响。HNC 的治疗可能导致面部畸形、进食和沟通困难以及身体形象障碍。我们旨在：（1）确定用于评估身体形象的 HNC 特定的患者报告结局测量（PROM）；（2）评估其概念覆盖范围；（3）评估其开发过程和心理测量特性；（4）确定适合在 HNC 环境中使用的适当的身体形象 PROM。
方法
在线数据库（2007 年 7 月至 2017 年 7 月）中搜索评估 HNC 患者身体形象的研究。对研究进行了筛选以确定其是否符合入选标准。此外，我们还在三个 PROM 数据库中搜索了相关的 PROM。根据现有的身体形象框架，我们编制了一个概念框架，其中包含 18 个在 HNC 环境中重要的临床相关身体形象问题，根据该框架评估了 PROM。选择的测量方法用于评估心理测量特性、内容和可读性。
结果
共检索到 245 条记录。符合纳入标准的 18 项研究报告了 8 项 PROM。搜索 PROM 数据库共获得 62 项措施。经过筛选，有 11 项措施被列入短名单并进行了评估。Derriford 外观量表（DAS）-59、DAS-24 和身体形象量表（BIS）涵盖了身体形象概念框架中>55%的问题；是基于文献、患者访谈和临床医生意见开发的；具有内部一致性（Cronbach α>0.7）、有效性和反应性的证据。
结论
我们建议使用 DAS-24 和 BIS，因为它们涵盖了 HNC 相关问题，并且适合在未来的研究中使用。
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