Prospective examination of psychological risk and maintenance factors for body image distress after mastectomy with immediate breast reconstruction.
Prospective examination of psychological risk and maintenance factors for body image distress after mastectomy with immediate breast reconstruction.
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DOI：
10.1016/j.bodyim.2022.05.014
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发表时间：
2022-09
期刊：
影响因子：
5.2
通讯作者：
Colwell, Amy S.
中科院分区：
文献类型：
--
作者：
Weingarden, Hilary;Wilhelm, Sabine;Jacobs, Jamie M.;Carrellas, Julia;Cetrulo, Curtis;Austen, William Gerald, Jr.;Colwell, Amy S.
乳房重建手术旨在改善乳房切除术后的身体形象，但许多妇女经历持续的身体形象困扰（BID）。乳房切除术中，乳房重建手术的美学结果与BID之间的关系尚未得到充分研究。本研究旨在评估乳房切除术后的重建结果是否与术后BID相关，并检查BID高于重建结果的潜在心理风险和维持因素。在49名接受乳房切除术并立即乳房再造的女性中，我们前瞻性地评估了假设的术前心理风险因素和术后BID的术后维持因素。重建结果通过手术后照片的盲外科医生评级进行评估。外科医生评定的重建结果与BID或患者对手术结果的评定无关。较高的术前抑郁症状和较低的术前患者重建的期望预测更大的术后BID，以上重建的结果。术后身体检查也预测了更大的BID，高于重建结果。结果表明，医疗团队不能假设他们对重建结果的看法与患者的观点或BID程度相匹配。如果重复，结果指出潜在的心理风险和维护因素是重建后BID的更强预测因子，突出了轻触预防和干预的机会，以减少乳房切除术后乳房重建的BID。
Reconstructive breast surgery aims to improve body image following mastectomy, yet many women experience ongoing body image distress (BID). The relationship between the aesthetic outcome of reconstructive surgery with BID has been underexplored in mastectomy. This study aimed to assess whether reconstruction outcome following mastectomy is associated with post-surgery BID, and to examine potential psychological risk and maintenance factors for BID above reconstruction outcome. In 49 women undergoing mastectomy with immediate breast reconstruction, we prospectively assessed hypothesized pre-surgery psychological risk factors and post-surgery maintenance factors for post-surgery BID. Reconstruction outcome was assessed via blind surgeon ratings of post-surgery photographs. Surgeon-rated reconstruction outcome was uncorrelated with BID, or with patients’ ratings of surgical outcome. Higher pre-surgery depressive symptoms and lower pre-surgery patient expectations for reconstruction predicted greater post-surgery BID, above reconstruction outcome. Post-surgery body checking also predicted greater BID, above reconstruction outcome. Results suggest that the medical team cannot assume their perception of reconstruction outcome matches the patient’s view or degree of BID. If replicated, results point to potential psychological risk and maintenance factors that are stronger predictors of post-reconstruction BID, highlighting opportunities for light-touch prevention and intervention to reduce BID after mastectomy with breast reconstruction.
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