A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

Melissant, Heleen C.; Jansen, Femke; Eerenstein, Simone E. J.; Cuijpers, Pim; Lissenberg‐Witte, Birgit I.; Sherman, Kerry A.; Laan, Ellen; Leemans, C. René; Leeuw, Irma M. Verdonck‐de

doi:10.1007/s00520-021-06114-y

Cited by 13 publications

(17 citation statements)

References 46 publications

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“…Despite the high prevalence of BID in patients with HNC, evidencebased interventions to manage HNC-related BID are lacking (Ellis et al, 2019a;Richardson et al, 2019). Preliminary data from a few recent small studies highlight the promise of a virtually delivered cognitive behavioral intervention (Graboyes et al, 2020b) or a structured expressive writing activity as novel treatments for HNC-related BID (Melissant et al, 2021b). Future research should utilize validated measures of HNC-related BID (e.g., IMAGE-HN) to test interventions aimed at reducing BID in patients with HNC.…”

Section: Clinical and Research Implications Of An Inventory To Measure And Assess Image Disturbance -Head And Neck Cutoff Scorementioning

confidence: 99%

Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

et al. 2021

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Objective: The Inventory to Measure and Assess imaGe disturbance – Head and Neck (IMAGE-HN) is a validated patient-reported outcome measure of head and neck cancer-related body image-related distress (BID). However, the IMAGE-HN score corresponding to clinically relevant BID is unknown. The study objective is to determine the IMAGE-HN cutoff score that identifies head and neck cancer patients with clinically relevant BID.Methods: We conducted a cross-sectional study at six academic medical centers. Individuals ≥18 years old with a history of head and neck cancer treated with definitive intent were included. The primary outcome measure was the IMAGE-HN. A Receiver Operating Characteristic curve analysis was performed to identify the IMAGE-HN score that maximized sensitivity and specificity relative to a Body Image Scale score of ≥10 (which indicates clinically relevant BID in a general oncology population). To confirm the validity of the IMAGE-HN cutoff score, we compared the severity of depressive [Patient Health Questionnaire-9 (PHQ-9)] and anxiety symptoms [Generalized Anxiety Disorder-7 (GAD-7)], and quality of life [University of Washington-QOL (UW-QOL)] in patients with IMAGE-HN scores above and below the cutoff.Results: Of the 250 patients, 70.4% were male and the mean age was 62.3 years. An IMAGE-HN score of ≥22 was the optimal cutoff score relative to a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related BID. Relative to those with an IMAGE-HN score of <22, patients with IMAGE-HN scores of ≥22 had a clinically meaningful increase in symptoms of depression (mean PHQ-9 score difference = 5.8) and anxiety (mean GAD-7 score difference = 4.1) as well as worse physical (mean UW-QOL score difference = 18.9) and social-emotional QOL (mean UW-QOL score difference = 21.5). Using an IMAGE-HN cutoff score ≥22, 28% of patients had clinically relevant BID.Conclusion: An IMAGE-HN score of ≥22 identifies patients with clinically relevant head and neck cancer-related BID. This score may be used to detect patients who could benefit from strategies to manage their distress, select patients for studies evaluating interventions to manage head and neck cancer-related BID, and improve our understanding of the underlying epidemiology of the disorder.

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Section: Clinical and Research Implications Of An Inventory To Measure And Assess Image Disturbance -Head And Neck Cutoff Scorementioning

confidence: 99%

Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

et al. 2021

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“…Melissant et al [20] found in their intervention study that expressive writing, an exercise that performed well in people with breast cancer, had no effect on body image disturbance in people with HNC.…”

Section: Changes In Body Image After Head and Neck Cancermentioning

confidence: 99%

“…The general characteristics of the studies included in the review (n = 9) can be found in Table 2. The articles were published from 2018 to 2021 in a variety of scientific journals with different aims and scopes: Indian journal of palliative care [19], Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer [20], Sexual Medicine [21], Psycho-oncology [22], Otolaryngology-head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery [23], Indian journal of palliative care [24], Psycho-oncology [25], Surgery [26], Medicina oral, patología oral y cirugía bucal [27]. All the records were written in English.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Study 1 [19] included 60 HNC patients (46 males/14 females), the average mean age of the patients was 43 years, who were divided into a total of 8 HNC localization groups: carcinoma of buccal mucosa (n = 24), carcinoma of tongue (n = 14), carcinoma of maxilla (n = 3), hard palate (n = 3), carcinoma postcricoid/supraglottic (n = 5), carcinoma of central arch /mandible (n = 6), carcinoma esophagus (n = 4) and carcinoma of lip (n = 1) in the Department of Pain and Palliative Medicine, Gujarat Cancer and Research Institute, India. Study 2 [20] included 87 patients, with a mean age of 66 years, divided into a total of 5 groups: oral cavity (n = 17), oropharynx (n = 20), hypopharynx (n = 5), larynx (n = 29) and others (n = 16), from the Department of Otolaryngology-Head and Neck Surgery at Amsterdam UMC, location VUmc. Study 3 [21] consisted of 134 HNC survivors (males = 44/females = 23), with a mean age of 66 years, who were divided into a total of 3 HNC localizations: lip/oral/cavity/oropharynx (n = 29), hypopharynx/larynx (n = 21), other head and neck cancers (n = 17), randomized to investigate differences in the course of sexual interest and sexual pleasure between a care program targeting psychological distress compared to usual care and a control, at the clinic of Amsterdam University Medical Centers (Amsterdam UMC), location VU University medical center.…”

Section: Participants and Regroupingmentioning

confidence: 99%

“…My Changed Body (MyCB) is an exercise of expressive writing pre-and post-treatment which showed an improvement in self-esteem, but no effect on body image distress, measured on Body Image Scale [20].…”

Section: Specific Interventionsmentioning

confidence: 99%

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The Psychosocial Role of Body Image in the Quality of Life of Head and Neck Cancer Patients. What Does the Future Hold?—A Review of the Literature

et al. 2021

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Background and Objectives: It is well known that among all cancers, cancers of the head and neck (HNC) have a major impact on patients’ quality of life. Disfigurement, anxiety and disabling physical and psychological symptoms affect people with HNC to such an extent that the suicide rate in this category of patients is exceeded only by that of patients with pancreatic cancer. The aim of this review was to summarize the published literature describing the severity of body image and quality of life impairment in patients with HNC over time, and to examine the psychosocial and functional associations and interventions implemented to improve body image and quality of life. Materials and Methods: We conducted a literature search from 1 January 2018 to June 2021 that included electronic searches of six major databases (PubMed, ScienceDirect, ProQuest, PsycINFO, PsychArticles and Scopus) and review of references of articles screened. Of 620 records, only 9 articles met the eligibility criteria. Results: Numerous studies have been conducted to analyze various psychological variables, but there is still a lack of standardization in the assessment of body image perception (BI) and quality of life, resulting in small-scale testing of interventions with poor results. Conclusions: Expected longitudinal studies describing the flow of body image problems and the mediation and balance factors associated with body image will allow researchers to design methods aimed at limiting body image disorders and thus improving quality of life of patients with head and neck cancer.

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Factors Associated With Risk of Body Image–Related Distress in Patients With Head and Neck Cancer

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et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Body image-related distress (BID) is common among head and neck cancer (HNC) survivors and associated with significant morbidity. Risk factors for HNC-related BID remain poorly characterized because prior research has used outcome measures that fail to fully capture BID as experienced by HNC survivors.OBJECTIVE To assess the association of demographic and oncologic characteristics with HNC-related BID using the Inventory to Measure and Assess imaGe disturbancE-Head & Neck (IMAGE-HN), a validated, multidomain, patient-reported outcome measure of HNC-related BID. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study assessed 301 adult survivors of surgically managed HNC at 4 academic medical centers. MAIN OUTCOMES AND MEASURESThe primary outcome measure was IMAGE-HN scores, for which higher scores reflect more severe HNC-related BID. Multivariable linear regression analyses were performed to evaluate the association of patient characteristics with IMAGE-HN global and 4 subdomain (other-oriented appearance concerns, personal dissatisfaction with appearance, distress with functional impairments, and social avoidance) scores. RESULTSOf the 301 participants (212 [70.4%] male; mean [SD] age, 65.3 [11.7] years), 181 (60.1%) underwent free flap reconstruction. Graduation from college (β = −9.6; 95% CI, −17.5 to −1.7) or graduate school (β = −12.6; 95% CI, −21.2 to −3.8) was associated with lower IMAGE-HN social avoidance scores compared with less than a high school education.

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A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

Cited by 13 publications

References 46 publications

Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

The Psychosocial Role of Body Image in the Quality of Life of Head and Neck Cancer Patients. What Does the Future Hold?—A Review of the Literature

Factors Associated With Risk of Body Image–Related Distress in Patients With Head and Neck Cancer

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