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Supportive Care in Cancer
Published in: Supportive Care in Cancer 10/2018

01-10-2018 | Original Article

A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer

Authors: Kenneth Mah, Sophie Lebel, Jonathan Irish, Andrea Bezjak, Ada Y. M. Payne, Gerald M. Devins

Published in: Supportive Care in Cancer | Issue 10/2018

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Abstract

Purpose

This cross-sectional study presents an initial psychometric evaluation of a two-dimensional (perceptual and evaluative) conceptualization and measure of disrupted body integrity (DBI)—illness-related disruption of the sense of the body as an integrated, smoothly functioning whole.

Methods

Male and female head and neck cancer (HNC) outpatients (N = 98) completed a questionnaire package prior to outpatient visits.

Main outcome measures

The Disrupted Body Integrity Scale (DBIS) was developed to measure the perceptual and evaluative facets of DBI. Self-report measures of disfigurement, stigma, depressive symptoms, and negative affect were also completed.

Results

Almost all DBIS subscales demonstrated good internal consistency. Results largely supported the DBIS’s construct validity. The majority of subscales correlated within the predicted range of r’s = .40–.70. Almost all DBIS constructs were positively linked with either depressive symptoms or disfigurement. None correlated with positive affect, and only two subscales, abnormal sensations (perceptual) and physical vulnerability (evaluative), correlated with negative affect. DBIS constructs showed little relation with stigma, once disfigurement effects were controlled for.

Conclusions

Findings offer preliminary evidence for the DBIS and the relevance of DBI in HNC. Further evaluation of DBI in disease adaptation and the DBIS’s factor structure is warranted.
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Literature
1.
Andrykowski MA, Brady MJ, Greiner CB, Altmaier EM, Burish TG, Antin JH, Gingrich R, McGarigle C, Henslee-Downey PJ (1995) “Returning to normal” following bone marrow transplantation: outcomes, expectations and informed consent. Bone Marrow Transplant 15:573–581PubMed
2.
3.
Baxter NN, Goodwin PJ, Mcleod RS, Dion R, Devins G, Bombardier C (2006) Reliability and validity of the body image after breast cancer questionnaire. Breast J 12:221–232CrossRefPubMed
4.
Blanke O (2012) Multisensory brain mechanisms of bodily self-consciousness. Nat Rev Neurosci 13:556–571CrossRefPubMed
5.
Bradburn NM (1969) The structure of psychological well-being. Aldine, Chicago
6.
Callahan C (2004) Facial disfigurement and sense of self in head and neck cancer. Soc Work Health Care 40:73–87CrossRefPubMed
7.
Carver CS, Pozo-Kaderman C, Price AA, Noriega V, Harris SD, Derhagopian RP, Robinson DS, Moffat FL Jr (1998) Concern about aspects of body image and adjustment to early stage breast cancer. Psychosom Med 60:168–174CrossRefPubMed
8.
Cash TF (2000) The multidimensional body-self relations questionnaire users’ manual. Old Dominion University, Norfolk
9.
Charmaz K (2002) The self as habit: the reconstruction of self in chronic illness. OTJR 22:31S–41S
10.
Crowne DP, Marlowe D (1960) A new scale of social desirability independent of psychopathology. J Consult Psychol 24:349–354CrossRefPubMed
11.
de Boer MF, Pruyn JFA, van den Borne B, Knegt PP, Ryckman RM, Verwoerd CDA (1995) Rehabilitation outcomes of long-term survivors treated for head and neck cancer. Head Neck 17:503–515CrossRefPubMed
12.
13.
Devins GM, Orme CM, Costello CG, Binik YM, Frizzell B, Stam HJ, Pullin WM (1988) Measuring depressive symptoms in illness populations: psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale. Psychol Health 2:139–156CrossRef
14.
Ervik B, Asplund K (2012) Dealing with a troublesome body: a qualitative interview study of men's experiences living with prostate cancer treated with endocrine therapy. Eur J Oncol Nurs 16:103–108CrossRefPubMed
15.
Fabbri S, Kapur N, Wells A, Creed F (2001) Emotional, cognitive, and behavioral characteristics of medical outpatients: a preliminary analysis. Psychosomatics 42:74–77CrossRefPubMed
16.
Fingeret MC, Yuan Y, Urbauer D, Weston J, Nipomnick S, Weber R (2012) The nature and extent of body image concerns among surgically treated patients with head and neck cancer. Psychooncology 21:836–844CrossRefPubMed
17.
Fuchs T, Schlimme JE (2009) Embodiment and psychopathology: a phenomenological perspective. Curr Opin Psychiatry 22:570–575CrossRefPubMed
18.
Gallagher S (2005) How the body shapes the mind. Oxford University, New YorkCrossRef
19.
Gardner RM (2012) Perceptual measures of body image for adolescents and adults. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 146–153
20.
Heathcote LC, Eccleston C (2017) Pain and cancer survival: a cognitive-affective model of symptom appraisal and the uncertain threat of disease recurrence. Pain 158:1187–1191CrossRefPubMed
21.
Helgeson VS, Snyder P, Seltman H (2004) Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol 23:3–15CrossRefPubMed
22.
Henry M, Ho A, Lambert SD, Carnevale FA, Greenfield B, MacDonald C, Mlynarek A, Zeitouni A, Rosberger Z, Hier M, Black M, Kost K, Frenkiel S (2014) Looking beyond disfigurement: the experience of patients with head and neck cancer. J Palliat Care 30:5–15PubMed
23.
Janoff-Bulman R, Frieze IH (1983) A theoretical perspective for understanding reactions to victimization. J Soc Issues 39:1–17CrossRef
24.
Jim HS, Jacobsen PB (2008) Posttraumatic stress and posttraumatic growth in cancer survivorship: a review. Cancer J 14:414–419CrossRefPubMed
25.
Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ (2000) Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients. Head Neck 22:132–141CrossRefPubMed
26.
Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ (2003) Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender and social support. Head Neck 25:103–112CrossRefPubMed
27.
Lang H, France E, Williams B, Humphris G, Wells M (2013) The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 22:2648–2663CrossRefPubMed
28.
Lebel S, Castonguay M, Mackness G, Irish J, Bezjak A, Devins GM (2013) The psychosocial impact of stigma in people with head and neck or lung cancer. Psychooncology 22:140–152CrossRefPubMed
29.
Lindwall L, Bergbom I (2009) The altered body after breast cancer surgery. Int J Qual Stud Health Well-being 4:280–287CrossRef
30.
Longo MR, Azanon E, Haggard P (2010) More than skin deep: body representation beyond primary somatosensory cortex. Neuropsychologia 48:655–668CrossRefPubMed
31.
Lundgren H, Bolund C (2007) Body experience and reliance in some women diagnosed with cancer. Cancer Nurs 30:16–23CrossRefPubMed
32.
Mahlo L, Tiggemann M (2016) Yoga and positive body image: a test of the embodiment model. Body Image 18:135–142CrossRefPubMed
33.
McDowell I, Newell C (1996) Measuring health: a guide to rating scales and questionnaires. Oxford University, New York
34.
Meng X-L, Rosenthal R, Rubin DB (1992) Comparing correlated correlation coefficients. Psychol Bull 111:72–175CrossRef
35.
Merleau-Ponty M (1978) Phenomenology of perception. Routledge & Kegan Paul, London
36.
Murray CD (2004) An interpretative phenomenological analysis of the embodiment of artificial limbs. Disabil Rehabil 26:963–973CrossRefPubMed
37.
Nunnally JC (1978) Psychometric theory. McGraw-Hill, New York
38.
Parton CM, Ussher JM, Perz J (2015) Women’s construction of embodiment and the abject sexual body after cancer. Qual Health Res 26:490–503CrossRefPubMed
39.
40.
Pedersen B, Groenkjaer M, Falkmer U, Mark E, Delmar C (2016) “The ambiguous transforming body”—a phenomenological study of the meaning of weight changes among women treated for breast cancer. Int J Nurs Stud 55:15–25CrossRefPubMed
41.
Petronis VM, Carver CS, Antoni MH, Weiss S (2003) Investment in body image and psychosocial well-being among women treated for early stage breast cancer: partial replication and extension. Psychol Health 18:1–13CrossRef
42.
Price MJ (1993) Exploration of body listening: health and physical self-awareness in chronic illness. Adv Nurs Sci 15:37–52CrossRef
43.
Rabinor JR, Bilich M (2012) Experiential approaches to body image change. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 424–433
44.
Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401CrossRef
45.
Raguram R, Weiss MG, Channabasavanna SM, Devins GM (1996) Stigma, depression and somatization in South India. Am J Psychiatry 153:1043–1049CrossRefPubMed
46.
Röing M, Hirsch J-M, Holmström I (2007) The uncanny mouth–a phenomenological approach to oral cancer. Patient Educ Couns 67:301–306CrossRefPubMed
47.
Schmidt NB, Lerew DR, Trakowski JH (1997) Body vigilance in panic disorder: evaluating attention to bodily perturbations. J Consult Clin Psychol 65:214–220CrossRefPubMed
48.
Senkowski D, Heinz A (2016) Chronic pain and distorted body image: implications for multisensory feedback interventions. Neurosci Biobehav Rev 69:252–259CrossRefPubMed
49.
Silvia PJ, Duval TS (2001) Objective self-awareness theory: recent progress and enduring problems. Personal Soc Psychol Rev 5:230–241CrossRef
50.
Slatman J (2011) The meaning of body experience evaluation in oncology. Health Care Anal 19:295–311CrossRefPubMed
51.
Smolak L, Cash TF (2012) Future challenges for body image science, practice, and prevention. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 471–478
52.
Teo I, Novy DM, Chang DW, Cox MG, Fingeret MC (2015) Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer. Psychooncology 24:1377–1383CrossRefPubMed
53.
Thomas R, Quinlan E, Kowalski K, Spriggs P, Hamoline R (2014) Beyond the body: insights from an iyengar yoga program for women with disability after breast cancer. Holist Nurs Pract 28:353–361CrossRefPubMed
54.
Weber CS, Fliege H, Arck PC, Kruezer K-A, Rose M, Klapp BF (2004) Patients with haematological malignancies show a restricted body image focusing on function and emotion. Eur J Cancer Care 14:155–165CrossRef
55.
Weiss MG, Doongaji DR, Siddhartha S, Wypij D, Pathare S, Bhatawdekar M, Bhave A, Sheth A, Fernandes R (1992) The explanatory model interview catalogue (EMIC): Contribution to cross-cultural research methods from a study of leprosy and mental health. Br J Psychiatry 160:819–830CrossRefPubMed
56.
Weiss MG, Ramakrishna J, Somma D (2006) Health-related stigma: rethinking concepts and interventions. Psychol Health Med 11:277–287CrossRefPubMed
Metadata
Title
A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer
Authors
Kenneth Mah
Sophie Lebel
Jonathan Irish
Andrea Bezjak
Ada Y. M. Payne
Gerald M. Devins
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4187-0

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