Evaluation of women with breast disease using body image drawing analysis.
Evaluation of women with breast disease using body image drawing analysis.
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发表时间：
2010-06
影响因子：
2
通讯作者：
M. Eskelinen;Paula Ollonen
中科院分区：
文献类型：
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作者：
M. Eskelinen;Paula Ollonen
Wirsching等人引入了一种心理社会风险量表（PRS），用于在活检前对乳腺癌患者进行心理鉴定，发现癌症女性比良性肿瘤女性倾向于绘制更大的图纸。据我们所知，在前瞻性研究中，很少考虑身体图像绘图分析与乳腺癌风险之间的关联。患者和方法本研究是Kuopio乳腺癌研究的延伸。有乳腺症状的女性由医生转诊至库奥皮奥大学医院（芬兰），并被要求参加本研究。这些女性（n=115）接受了采访，所有的研究变量都是在进行任何诊断程序之前获得的，因此研究者和参与者在采访时都不知道乳房症状的最终诊断。研究方法为半结构式深度访谈法。研究者使用Montgomery-Asberg抑郁评定量表（MADRS）评估研究参与者的抑郁。所有参与者还被要求完成标准化问卷（贝克抑郁量表和Spielberger特质量表）。身体意象绘画的整体内容使用3分制进行评估：象征性的，部分象征性的，或类人的。两名评分员分别对身体意象图进行评分，通过比较两名评分员的评分形成最终评分。评分员在评分过程中以5分制评估评分的难度。结果34例患者经临床检查和活检证实为乳腺癌（BC），53例为乳腺良性病变（BBD），28例为健康人（HSS）。结果表明，乳腺癌患者倾向于使一个更大的尺寸，并绘制一个不太积极的身体形象比BBD和HSS组。BC组在乳腺区的体像绘制也较其他组差，分化差。结论：本研究结果支持身体图像绘画的大小与乳腺癌风险之间的弱相关性。然而，对这种关联的生物学解释尚不清楚，心理因素对与乳腺癌发展相关的各种激素的确切影响目前还不清楚。
BACKGROUND Wirsching et al. introduced a psychosocial risk scale (PRS) for psychological identification of breast cancer patients before biopsy and found that women with cancer had a tendency create bigger drawings than the women with a benign tumour. To our knowledge, the associations between body image drawing analysis and the risk of breast cancer have rarely been considered together in a prospective study. PATIENTS AND METHODS This study is an extension of the Kuopio Breast Cancer Study. Women with breast symptoms were referred by physicians to the Kuopio University Hospital (Finland) and were asked to participate in this study. These women (n=115) were interviewed, and all study variables were obtained before any diagnostic procedures were carried out, so neither the investigator nor the participants knew the final diagnosis of breast symptoms at the time of the interview. The research method used was the semistructured in-depth interview method. The investigator used the Montgomery-Asberg depression rating scale (MADRS) to evaluate the depression of the study participants. All participants were also asked to complete standardized questionnaires (Beck depression inventory and Spielberger trait inventory). The overall content of the body image drawing was estimated using a 3-point scale: symbolistic, partly symbolistic, or humanlike. Two raters scored the body image drawings independently and the final scores were formed by comparing the separate scores of the two raters. The raters evaluated the difficulty of giving a score on a 5-point scale during scoring. RESULTS The clinical examination and biopsy showed breast cancer (BC) in 34 patients, benign breast disease (BBD) in 53 patients, and 28 individuals were shown to be healthy (HSS). The results indicated that breast cancer patients tended to make a body image drawing of a bigger size, and to draw a less positive body image than did those in the BBD and HSS groups. The BC group also made a less differentiated and less complete body image drawing in the area of the breast than did those in the other groups. CONCLUSION The results of this study support a weak association between the size of the body image drawing and breast cancer risk. However, the biological explanation for such an association is unclear and the exact effects of psychological factors on the various hormones relevant to the development of breast cancer are at present poorly defined.