Phung Van Du, Fang Su-Ying
Author Affiliations: Department of Nursing, College of Medicine, National Cheng Kung University (Drs Fang and Phung); Department of Nursing, National Cheng Kung University Hospital (Dr Fang), Tainan, Taiwan; and Department of Nursing, Hai Duong Medical Technical University (Dr Phung), Vietnam.
Cancer Nurs. 2023;46(3):233-247. doi: 10.1097/NCC.0000000000001085. Epub 2022 Dec 1.
Stomas in colorectal cancer (CRC) survivors lead to body image problems. Advances in treatment help reduce the rate of stoma formation, but body image distress is still frequently experienced in CRC survivors.
This review is aimed toward mapping and describing the state of knowledge regarding body image in patients with CRC.
A systematic literature search complying with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. Screening and data extraction were performed by 2 reviewers independently for all potentially eligible studies.
A total of 56 eligible articles were selected. The majority of these studies were quantitative studies (85%). The eligible studies were classified into 4 broad categories: instruments used to assess body image, prevalence of body image distress, factors related to body image, and impact of body image distress. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-CR38) colorectal questionnaire was the most common measurement tool found among the reviewed studies (70%), and body image distress was reported by 25.5% to 86% of participants. Excluding gender, age, type of surgery, adjuvant therapy, time from diagnosis, social support, and stoma status, changes in bowel habits was identified as affecting the body image of patients with CRC.
Changing bowel habits emerged as a significant factor causing body image distress for CRC survivors.
Clinicians should raise awareness about body image distress in patients with CRC, focus on finding effective measures and interventions intended to help alleviate symptoms of bowel dysfunction, and prepare patients to adapt to altered bowel functions.
结直肠癌（CRC）幸存者的造口会导致身体形象问题。治疗方法的进步有助于降低造口形成率，但CRC幸存者仍经常经历身体形象困扰。
本综述旨在梳理和描述CRC患者身体形象方面的知识状况。
按照系统评价和Meta分析的首选报告项目指南进行系统文献检索。由2名评审员独立对所有潜在合格研究进行筛选和数据提取。
共筛选出56篇合格文章。这些研究大多为定量研究（85%）。合格研究分为4大类：用于评估身体形象的工具、身体形象困扰的患病率、与身体形象相关的因素以及身体形象困扰的影响。欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-CR38）结直肠问卷是综述研究中最常用的测量工具（70%），25.5%至86%的参与者报告有身体形象困扰。排除性别、年龄、手术类型、辅助治疗、确诊时间、社会支持和造口状态后，排便习惯改变被确定为影响CRC患者身体形象的因素。
排便习惯改变是导致CRC幸存者身体形象困扰的一个重要因素。
临床医生应提高对CRC患者身体形象困扰的认识，专注于寻找有效的措施和干预手段以帮助缓解肠道功能障碍症状，并让患者做好适应肠道功能改变的准备。
