Henry Melissa, Albert Justine G, Frenkiel Saul, Hier Michael, Zeitouni Anthony, Kost Karen, Mlynarek Alex, Black Martin, MacDonald Christina, Richardson Keith, Mascarella Marco, Morand Gregoire B, Chartier Gabrielle, Sadeghi Nader, Lo Christopher, Rosberger Zeev
Department of Oncology, McGill University, Montreal, QC, Canada.
Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada.
Front Psychol. 2022 Mar 24;13:816587. doi: 10.3389/fpsyg.2022.816587. eCollection 2022.
Head and neck cancer (HNC) treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: (1) the prevalence, level, and course of body image concerns; (2) correlates of upon cancer diagnosis (pre-treatment) body image concerns; (3) predictors of immediate post-treatment body image concerns; and (4) association between body image concerns and levels of anxiety, depression, suicidal ideation, support (i.e., satisfaction with support from physician, social/family wellbeing, and unmet support needs), and alcohol and drug misuse.
Two hundred and twenty-three (participation rate = 72%), newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model.
Sixty-eight percent of patients with HNC ( = 148 of 218) presented some level of body image concerns. Body image concerns at baseline (i.e., upon cancer diagnosis, pre-treatment) and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment (i.e., at 3 month follow-up), 89% ( = 132 of 148) presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism.
This longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions.
已知头颈癌（HNC）治疗会显著影响功能和外观，导致身体形象障碍风险增加。然而，很少有纵向研究来考察这些患者的身体形象。基于一个概念模型，本研究旨在确定新诊断为头颈癌的患者：（1）身体形象担忧的患病率、程度和病程；（2）癌症诊断（治疗前）时身体形象担忧的相关因素；（3）治疗后即刻身体形象担忧的预测因素；以及（4）身体形象担忧与焦虑、抑郁、自杀意念、支持（即对医生支持的满意度、社会/家庭幸福感以及未满足的支持需求）以及酒精和药物滥用水平之间的关联。
223名（参与率 = 72%）新诊断为原发性头颈癌的患者在诊断后3个月和6个月时使用结构化临床访谈和心理测量方法进行评估。主要结局是3个月时的情况，因为这对身体形象障碍最为突出。基于该模型，对潜在的身体形象预测因素进行了多元线性回归分析。
68%的头颈癌患者（218名中的148名）存在一定程度的身体形象担忧。基线（即癌症诊断时，治疗前）和治疗后的身体形象担忧显著相关，且从治疗前到治疗后显著增加。治疗后即刻（即3个月随访时），89%（148名中的132名）存在一定程度的身体形象担忧。头颈癌患者基线时身体形象担忧的相关因素包括：身体症状负担、沟通和进食困难、使用否认方式应对癌症诊断、自杀意念以及过去曾有焦虑诊断。在控制社会人口统计学和医学变量后，头颈癌患者治疗后即刻的身体形象担忧由以下因素预测：基线身体形象、身体症状负担和神经质。
这项纵向研究有助于识别出头颈癌后更容易出现身体形象障碍的患者。临床医生应特别关注癌症诊断时的身体形象担忧、身体症状负担和神经质，并可能希望在未来的预防性干预中针对这些因素。
