Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction.
Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction.
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DOI：
10.1002/pon.3952
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发表时间：
2016-09
期刊：
影响因子：
3.6
通讯作者：
Fingeret MC
中科院分区：
文献类型：
--
作者：
Teo I;Reece GP;Christie IC;Guindani M;Markey MK;Heinberg LJ;Crosby MA;Fingeret MC
与癌症相关的乳房重建过程通常是多阶段的，可能需要数月至数年才能完成，但很少有研究在重建过程中检查患者的心理社会健康状况。我们研究了乳房重建时间和重建阶段对乳房重建过程中特定时间点的身体形象和生活质量的影响。在这项横断面研究中，216名患者被分为四个重建阶段：重建前阶段、完成阶段1、完成阶段2和最终阶段。多元回归分析检验了重建时间（即时重建与延迟重建）和重建阶段的作用，以及它们在预测身体形象和生活质量、控制患者年龄、BMI、重建类型、化疗、放疗和主要并发症方面的相互作用。在整个重建阶段，身体形象模式的差异被观察到，接受延迟重建的人与接受立即重建的人相比，对身体形象的不满程度显著降低。在重建前，等待延迟重建的患者报告的社会幸福感明显低于等待立即重建的患者。重建阶段显著预测情绪幸福感，在那些已经开始重建的人中观察到更高的情绪幸福感。在检查乳腺癌患者接受重建的社会心理结果时，重建的时间和阶段是重要的考虑因素。那些等待开始延迟重建的人在身体形象、情感和社交方面的风险尤其大。我们讨论了心理社会治疗的意义，以最大限度地提高身体形象和生活质量的患者接受癌症相关乳房重建。
The process of cancer-related breast reconstruction is typically multi-staged and can take months to years to complete, yet few studies have examined patient psychosocial well-being during the reconstruction process. We investigated the effects of reconstruction timing and reconstruction stage on body image and quality of life at specific time points during the breast reconstruction process. In this cross-sectional study, 216 patients were grouped into four reconstructive stages: pre-reconstruction, completed stage 1, completed stage 2, and final stages. Multiple regression analyses examined the roles of reconstruction timing (immediate vs. delayed reconstruction) and reconstruction stage as well as their interaction in predicting body image and quality of life, controlling for patient age, BMI, type of reconstruction, chemotherapy, radiation therapy, and major complication(s). Across the reconstructive stages, differences in patterns of body image were observed with those receiving delayed reconstruction showing significant decrease in body image dissatisfaction compared to those with immediate reconstruction. At pre-reconstruction, patients awaiting delayed reconstruction reported significantly lower social well-being compared to those awaiting immediate reconstruction. Reconstruction stage significantly predicted emotional well-being, with higher emotional well-being observed in those who had commenced reconstruction. Timing and stage of reconstruction are important to consider when examining psychosocial outcomes of breast cancer patients undergoing reconstruction. Those waiting to initiate delayed reconstruction appear at particular risk for body image, emotional, and social distress. We discuss the implications for delivery of psychosocial treatment to maximize body image and quality of life of patients undergoing cancer-related breast reconstruction.