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

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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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Acknowledgments

We appreciate the efforts of our research assistants on this project: Michelle Majcen, Jackie Wan, Colleen Simpson, Vivian Tsung, and Ka Ming Fong. We extend our gratitude to the members of the UHN Quality of Life Manuscript-Review Seminar for their invaluable feedback and suggestions on earlier versions of this manuscript.

Funding

This research was supported in part by the Canadian Institutes of Health Research through a Postdoctoral Fellowship to Sophie Lebel, a Senior Investigator Award to Gerald M. Devins, and a grant from the Psychosocial Oncology and Palliative Care Program (Princess Margaret Cancer Centre) to Sophie Lebel.

Author information

Authors and Affiliations

  1. Department of Supportive Care, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada

    Kenneth Mah & Gerald M. Devins

  2. School of Psychology, University of Ottawa, Ottawa, Ontario, Canada

    Sophie Lebel

  3. Department of Surgical Oncology, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada

    Jonathan Irish

  4. Department of Medicine, University of Toronto, Toronto, Ontario, Canada

    Jonathan Irish & Andrea Bezjak

  5. Ontario Cancer Institute, Toronto, Ontario, Canada

    Jonathan Irish, Andrea Bezjak & Gerald M. Devins

  6. Department of Radiation Oncology, Princess Margaret Cancer Centre (University Health Network), Toronto, Ontario, Canada

    Andrea Bezjak

  7. Cancer Care Ontario, Toronto, Ontario, Canada

    Ada Y. M. Payne

  8. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

    Gerald M. Devins

Authors
  1. Kenneth Mah
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  2. Sophie Lebel
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  6. Gerald M. Devins
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Corresponding author

Correspondence to Kenneth Mah.

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The authors declare that they have no conflicts of interest.

Appendix: Disrupted Body Integrity Scale

Appendix: Disrupted Body Integrity Scale

When people have cancer and go through cancer treatments, they may experience distressing changes in (a) how their body feels and (b) the thoughts they have about their body. We would like to understand these kinds of changes.

Below are items describing these kinds of changes people might experience as a result of the cancer and cancer treatment. For each item, please fill in the circle that best matches how well that item describes how your body feels right now or what you think about your body (“not at all” to “perfectly”). Please note that there is no right or wrong answer; we are only interested in knowing the kinds of changes you yourself have experienced.

How well does each item describe how your body feels or what you think about your body?

figure a
figure b
figure c

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Mah, K., Lebel, S., Irish, J. et al. A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer. Support Care Cancer 26, 3365–3377 (2018). https://doi.org/10.1007/s00520-018-4187-0

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  • DOI: https://doi.org/10.1007/s00520-018-4187-0

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