Phung Van Du, Fang Su-Ying
Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 70101, Taiwan.
Department of Nursing, Hai Duong Medical Technical University, No1 Vu Huu Str, Hai Duong, Vietnam.
Support Care Cancer. 2025 Feb 28;33(3):237. doi: 10.1007/s00520-025-09299-8.
Colorectal cancer (CRC) survivors commonly experience bowel dysfunction symptoms because of treatment, leading to psychological distress. While previous studies have focused on managing physical symptoms and the impact of a stoma on psychological outcomes, CRC patients without a stoma may also suffer from psychological distress, including body image distress due to their bowel dysfunction symptoms. Body image distress may mediate the relationship between bowel dysfunction symptoms and psychological outcomes in CRC patients.
This study aims to (1) identify bowel dysfunction symptoms, body image distress, and psychological outcomes in CRC survivors and (2) examine the mediating role of body image in the relationship between bowel dysfunction symptoms and psychological outcomes.
A cross-sectional and correlational design was employed, and CRC survivors completed the Low Anterior Resection Syndrome (LARS) Score, Body Image Scale (BIS), and Hospital Anxiety and Depression Scale (HADS) questionnaires. The mediated role of body image was examined using Hayes' PROCESS macro.
A total of 193 CRC patients provided data, with 65.8% reporting experiencing bowel dysfunction symptoms, 44.6% reporting body image distress, and 40.4% experiencing anxiety and depression. Body image was found to partially mediate the effect of bowel dysfunction symptoms on both anxiety (β = 0.0446, 95% CI = 0.0061, 0.0968) and depression (β = 0.0411, 95% CI = 0.0034, 0.0941).
The significant mediating role of body image underscores the importance of addressing both bowel dysfunction symptoms and body image distress. Healthcare professionals should integrate both physical and psychological aspects to promote psychological well-being.
由于治疗，结直肠癌（CRC）幸存者通常会出现肠道功能障碍症状，从而导致心理困扰。虽然先前的研究主要集中在管理身体症状以及造口对心理结果的影响，但没有造口的CRC患者也可能遭受心理困扰，包括因肠道功能障碍症状导致的身体形象困扰。身体形象困扰可能在CRC患者的肠道功能障碍症状与心理结果之间的关系中起中介作用。
本研究旨在（1）识别CRC幸存者的肠道功能障碍症状、身体形象困扰和心理结果，以及（2）检验身体形象在肠道功能障碍症状与心理结果之间关系中的中介作用。
采用横断面和相关性设计，CRC幸存者完成低位前切除综合征（LARS）评分、身体形象量表（BIS）和医院焦虑抑郁量表（HADS）问卷。使用海斯的PROCESS宏程序检验身体形象的中介作用。
共有193名CRC患者提供了数据，65.8%的患者报告有肠道功能障碍症状，44.6%的患者报告有身体形象困扰，40.4%的患者有焦虑和抑郁症状。发现身体形象在肠道功能障碍症状对焦虑（β = 0.0446，95%CI = 0.0061，0.0968）和抑郁（β = 0.0411，95%CI = 0.0034，0.0941）的影响中起部分中介作用。
身体形象的显著中介作用强调了同时解决肠道功能障碍症状和身体形象困扰的重要性。医疗保健专业人员应将身体和心理方面结合起来，以促进心理健康。
