Body image mediates the effect of cancer‐related stigmatization on depression: A new target for intervention

Esser, Peter; Mehnert, Anja; Johansen, Christoffer; Hornemann, Beate; Dietz, Andreas; Ernst, Jochen

doi:10.1002/pon.4494

Cited by 37 publications

(58 citation statements)

References 34 publications

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“…Rarely seen in other cultures, smoking in China is still a socially acceptable behavior, and cigarettes are well accepted and pervasive as a social currency 27. This is consistent with previous studies that identified visibility as an important predictor of stigmatization that can affect interpersonal interactions and psychosocial well-being 30,31. First, although China has medical insurance that provides partial compensation for healthcare services, most lung cancer patients often experience high levels of financial burden for their treatments, which likely makes patients feel that they are burdens to their families, further deepening their guilt and shame 29.…”

supporting

confidence: 86%

“…This is consistent with previous studies that identified visibility as an important predictor of stigmatization that can affect interpersonal interactions and psychosocial well-being. 30,31 In addition, close family members play an important role in providing tangible and emotional support as well as enjoyment for patients throughout their cancer journey. Negative changes in the family relationship, which are significantly associated with stigma, can bring more distress and loneliness to patients.…”

Section: Factors Associated With Stigma Among Lung Cancer Patientsmentioning

confidence: 99%

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Stigma and its correlates in people living with lung cancer: A cross‐sectional study from China

et al. 2019

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Objectives: This study aimed to examine the level of stigma and identify the correlates of stigma among lung cancer patients in China.Methods: In total, 283 lung cancer patients were recruited from a tertiary cancer center in China by the convenience sampling method and completed a demographic, disease-related information and situational characteristics questionnaire and selfreported measures assessing stigma, state self-esteem, and coping self-efficacy.Results: The mean stigma score was moderate (2.38 ± 0.45). Stigma was significantly and negatively associated with state self-esteem (r = -0.607, P < .001) and coping self-efficacy (r = -0.424, P < .001). Multivariable linear regression showed that age, cancer stage, negative changes (ie, in financial burden, body image, and family relationship), cancer disclosure, perceived blame, state self-esteem, and coping selfefficacy accounted for 49.9% of the variance in stigma.Conclusions: Stigma is a widespread psychosocial phenomenon among patients with lung cancer in China. Health care policy-makers and professionals should pay more attention to this issue and take effective measures to address stigma among lung cancer patients by improving their state self-esteem and coping self-efficacy, encouraging cancer disclosure and providing support for adjusting to negative changes after diagnosis.

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supporting

confidence: 86%

Section: Factors Associated With Stigma Among Lung Cancer Patientsmentioning

confidence: 99%

Stigma and its correlates in people living with lung cancer: A cross‐sectional study from China

et al. 2019

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“…The possibility that there are other mediators of this association needs to be clarified in future studies. Previous studies have shown that body image can mediate the relationship between stigmatization and depression, suggesting that body image could be a new target for interventions to reduce psychological distress in stigmatized patients . One review study supports the use of cognitive‐behavioral therapy interventions to address body image disturbances in cancer patients .…”

Section: Discussionmentioning

confidence: 95%

“…Stoma presence also predicts QOL in CRC patients . One study showed that body image mediates the relationship between stigmatization and depressive symptomatology . Greater body image distress is associated with worse psychosocial outcomes over time .…”

Section: Introductionmentioning

confidence: 99%

Body image mediates the effect of stoma status on psychological distress and quality of life in patients with colorectal cancer

et al. 2020

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Objective:We investigated the effect of stoma status (permanent stoma, temporary stoma, or non-stoma) on psychological distress and quality of life (QOL) in Chinese patients with colorectal cancer (CRC) in the early postoperative stage. We also investigated whether body image mediated the association between stoma status and psychological distress and QOL. Methods: A convenience sample of 282 CRC patients 1 to 2 weeks postsurgery participated in an observational, cross-sectional study. Participants completed the following self-report measures: Body Image Scale, Distress Thermometer, Hospital Anxiety and Depression Scale, and Core Quality of Life Questionnaire. Results: The temporary stoma group (TS) and the permanent stoma group (PS) reported worse body image and higher levels of anxiety and depression than the non-stoma group (P < .05). PS reported worse body image than TS (P < .01). Depression and significant body image problems were more prevalent in PS than in TS (P < .05). Stoma status was the strongest factor associated with body image, distress, and depression (P < .05). CRC patients who were younger or in later clinical stages had poorer body image. Body image fully mediated the effect of stoma status on anxiety, depression, and global QOL in PS and TS, but mediated the effect on distress only in PS. Conclusions: Body image problems are common in stoma patients in the early postoperative stage and require early assessment. This study helps to elucidate the role of body image as a mediator. Longitudinal studies are needed to further explore body image distress trajectories. K E Y W O R D S anxiety, body image, cancer, China, colorectal, depression, distress, oncology, quality of life

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“…Therefore, the group BPT aimed at supporting patients in learning to cope with untoward bodily sensations, feelings, and disturbances, such as changes in overt body image 46, 47 , as well as changes in attitudes toward and perceptions of their own body 48 , including feelings of insecurity and vulnerability 49– 51 , stigmatization 52 , impaired functioning 51, 53 , and feelings of disconnectedness from one’s own body 50 .…”

Section: Methodsmentioning

confidence: 99%

A case series report of cancer patients undergoing group body psychotherapy

2017

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Background: Disturbances in bodily wellbeing represent a key source of psychosocial suffering and impairment related to cancer. Therefore, interventions to improve bodily wellbeing in post-treatment cancer patients are of paramount importance. Notably, body psychotherapy (BPT) has been shown to improve bodily wellbeing in subjects suffering from a variety of mental disorders. However, how post-treatment cancer patients perceive and subjectively react to group BPT aiming at improving bodily disturbances has, to the best of our knowledge, not yet been described. Methods: We report on six patients undergoing outpatient group BPT that followed oncological treatment for malignant neoplasms. The BPT consisted of six sessions based on a scientific embodiment approach, integrating body-oriented techniques to improve patients’ awareness, perception, acceptance, and expression regarding their body. Results: The BPT was well accepted by all patients. Despite having undergone different types of oncological treatment for different cancer types and locations, all subjects reported having appreciated BPT and improved how they perceived their bodies. However, individual descriptions of improvements showed substantial heterogeneity across subjects. Notably, most patients indicated that sensations, perceptions, and other mental activities related to their own body intensified when proceeding through the group BPT sessions. Conclusion: The findings from this case series encourage and inform future studies examining whether group BPT is efficacious in post-treatment cancer patients and investigating the related mechanisms of action. The observed heterogeneity in individual descriptions of perceived treatment effects point to the need for selecting comprehensive indicators of changes in disturbances of bodily wellbeing as the primary patient-reported outcome in future clinical trials. While increases in mental activities related to their own body are commonly interpreted as important mechanisms of therapeutic action in BPT, follow-up assessments are needed to evaluate intended and unintended consequences of these changes in cancer patients.

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Body image mediates the effect of cancer‐related stigmatization on depression: A new target for intervention

Abstract: Perceived stigmatization is an important and generalizable risk factor for depressive symptomatology among cancer patients. Apart from interventions addressing stigmatization, improving body image could additionally help to reduce the psychological burden in stigmatized patients.

Cited by 37 publications

References 34 publications

Stigma and its correlates in people living with lung cancer: A cross‐sectional study from China

Stigma and its correlates in people living with lung cancer: A cross‐sectional study from China

Body image mediates the effect of stoma status on psychological distress and quality of life in patients with colorectal cancer

A case series report of cancer patients undergoing group body psychotherapy

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