Media images,body dissatisfaction,and disordered eating in adolescent women

This article examines the literature related to the media, body image, and diet/weight issues in children and young women. The media holds an awesome power to influence young women, bombarding them with images of abnormally thin models who seem to represent the ideal. When the majority of adolescents inevitably fail to achieve the extremely thin image they crave, body dissatisfaction results, and disordered eating can begin. Emerging research in the pediatric and adolescent literature demonstrates that children as young as 5 are already anxious about their bodies, and want to be thinner. This obsessive interest in body weight is only fueled by a dramatic increase in the number of Internet Web sites devoted to disordered eating. Unfortunately many of the Web sites are "pro-ana" (pro anorexia) and "pro-mia" (pro bulimia); these Web sites encourage young people at risk to begin starving themselves, or to begin binge-purging. As nurses know, each of these scenarios can lead to serious illness, and sometimes to death.     

Assessing altered body image

Assessing altered body image.
Like pain, altered body image remains highly personal, abstract and difficult to describe. It has taken nearly a century to define the concept of body image, and to construe a reasonable working definition of altered body image (ABI). During this time, the assessment of body image has focused upon the researcher and his/her needs, rather than the professional nurse, who must arrive at a practical means to understanding patients' distress, and identify possible solutions. In this paper the author suggests parameters for the assessment of ABI in the practical arena, based both upon ongoing asthma care research and the experience of practitioners developing body image counsellor roles. It is suggested that altered body image should be assessed as part of an integrated approach, and that the complicated risk or cathexis scales developed for psychological research have limited use within the clinical setting.     

Dialysis access and the impact on body image: role of the nephrology nurse

End-stage renal disease is a chronic condition, without cure, requiring dialysis therapy to maintain life or transplantation for those fortunate enough to receive a kidney. To commence dialysis (peritoneal dialysis or haemodialysis), access is required in the form of a fistula, vascular catheter or peritoneal catheter, and changes in body image will ensue, no matter what treatment option is selected. Renal transplantation, the treatment of choice for many patients, is also associated with body image issues. Despite these problems, the role of the nurse in managing body image problems in the renal population is rarely discussed. The aim of this article is to outline the concepts of dialysis and body image, and discuss the role of the nephrology nurse at the authors' current place of work. It highlights suggestions on how renal nurses can prepare and educate patients regarding changes in body image following a diagnosis of end-stage renal disease, and emphasizes the need for future research in this area.     

Changes in body image experienced by adolescents with cancer.

Cancer and its treatments affect adolescents' body image. However, it is not known what factors impinge on adolescents' perception of their body image. This multiple case study explored how 5 adolescents with cancer perceived their body image and the impact of this perception on their daily life. Adolescents described their body image as "I don't look normal," a theme that comprised 2 dimensions: "I look ugly" and "I look sick." For the adolescent with cancer, these 2 dimensions evoked feelings of being vulnerably exposed: "People look at me." Consequently, adolescents adopted a new set of coping strategies to help them manage their physical appearance and social interactions: "avoiding," "maintaining normality," "testing the waters," and "peer-shield" themes. Although the adolescents perceived their body image as altered, coping mechanisms enabled adolescents to think of themselves as normal and re-establish their social lives. The results of this small study suggest 2 potential nursing approaches to facilitate adolescents' adaptation to their new body image.     

Body image in older adults: a review of the literature

Body image is not a new concept. Most of the research conducted on body image has been with neurologically or psychiatrically impaired patients or with college-age students. The study of the body image of older adults and how they respond to alterations in their body image has not been studied extensively. Therefore, this paper is to summarize study findings concerning body-image perception in older adults.     

Psychological aspects of breast reconstruction: a review of the literature

AIM: This paper critically examines the research literature relating to the psychological aspects of breast reconstruction. Particular attention is given to the role of specialist breast care nurses in supporting women faced with the decision of whether or not to opt for reconstructive surgery. BACKGROUND: Breast reconstruction is intended to offer psychological benefits (e.g. improvements to quality of life, body image, anxiety and depression) to women treated by mastectomy following diagnosis of breast cancer. METHODS: A literature search was carried out on the PSYCHINFO, MEDLINE and CINAHL databases using the terms "breast reconstruction", "mastectomy", "reconstructive surgery", "breast surgery", "breast implants", "transverse rectus adominis myocutaneous (TRAM) flap" and "Lat-dorsi". Further relevant articles were identified from the reference lists of papers detected by this literature search. Finally, proceedings of recent psychological and surgical meetings were scrutinized to identify any conference papers on this topic. FINDINGS: A thorough search of the existing literature revealed a lack of theoretically based studies examining breast reconstruction in terms of relevant psychological constructs, especially in relation to coping and decision-making. This review highlights the methodological flaws with much of the existing research in this area, in particular the reliance upon retrospective designs and the inappropriate use of randomised controlled trials. Suggestions are given for further research in this topical area. CONCLUSIONS: Existing research into the psychological aspects of breast reconstruction is limited and not sufficiently conclusive to inform changes to policy and the provision of care. More methodologically rigorous research is needed.     

Testing a model of body image in the bariatric surgery patient

PurposeThe purpose was to test a published model of body image in the bariatric surgery patient in the clinical office setting.BackgroundA model was created based on clinical observations during field work and the literature. It focuses on five concepts of body image: body attitude, body checking, appearance orientation, perceived body size, and perceived body space. Testing this model 3 months after surgery is important because morphology changes rapidly influencing early changes in body image, yet there is a paucity of research at this time point.MethodsFor this study of 67 bariatric surgery patients, sequential sampling was used. Body image and anthropometric measures (body mass index and other weight loss indicators) were obtained at baseline and 3-months postoperatively. Established model testing criteria were used.ResultsOver 3 months, mean body mass index was significantly reduced. Mean body image was significantly improved regarding all concepts in the model, except body checking. Body image improvement varied widely when individual responses were examined.ConclusionsThe model was successfully tested. Data on the five concepts in the model provided a body image profile at 3 months indicating individuals' degree of improvement. Areas of non-improvement in the early postoperative phase may signal the need for interventions, like support or psychological counseling, for patients who might be struggling with views of themselves after surgery. Preliminary recommendations are made regarding several of the instruments and their use clinically. Researchers should take into consideration the study's short 3-month time frame when designing future studies.     

Corporeality: women's experiences of a body with rheumatoid arthritis

The purpose of this research report is to describe women's experiences living with rheumatoid arthritis (RA). Twenty women diagnosed with RA participated in semistructured interviews that were analyzed using qualitative content analysis. Findings indicated that how women with RA experience life in their physical bodies is fundamentally important. Corporeality, the name we chose for this phenomenon, is quite literally being one's body. This experience of the reality of being in or being of a body or corpus was central, not only to participants' perceptions of well-being but also to the impact rheumatoid arthritis was having on their lives and the actions they took to contend with the illness. The authors identified three themes that described what corporeality was for women with RA: relating to a noncompliant body, body out of synch, and private body made public. These results are discussed in light of other research about embodied experience in persons living with chronic illness.     

Measuring dimensions of body connection: body awareness and bodily dissociation

OBJECTIVE: This study aimed to test the preliminary psychometric properties of the Scale of Body Connection (SBC), a 20-item self-report measure, designed to assess body awareness and bodily dissociation in mind-body intervention research. METHODS: The SBC items were based on common expressions of awareness in body therapy. Content validity was established by a panel of experts. The validity and reliability of the scale was examined with an undergraduate sample. To assess the scale's discriminant validity, the respondents were asked to indicate exposure to specific traumas. RESULTS: Confirmatory factor analysis, used to examine the scale's construct validity, indicated acceptable goodness-of-fit indices, and revealed uncorrelated subscales, reflecting independent dimensions. Cronbach's alpha revealed equal internal consistency reliability for each subscale for both men and women. Body awareness scores did not differ between individuals with and without reported trauma exposure. Bodily dissociation scores differed between individuals with and without past experience with physical trauma, suggesting the applicability of this subscale for use with populations with trauma histories. CONCLUSIONS: The results provide preliminary evidence of the construct validity and internal consistency reliability of the SBC.     

'The reflections you get': an exploration of body image and cachexia

BACKGROUND: cachexia has a detrimental effect on quality of life and is an indicator of poor prognosis. The meanings people attach to their lived experiences of cachexia are unknown. AIMS: to explore the impact of cachexia on body image of people with advanced cancer, their emotions, relationships and social functioning. DESIGN: qualitative study using face-to-face in-depth interviews of a conversational style. Rich narrative data analysed by thematic content analysis. PARTICIPANTS: 12 participants recruited from two community palliative care teams in south east England. RESULTS: altered body image impacts on other aspects of embodiment: the emotions, spirituality, relationships and social functioning. Lives were restricted and isolated, which was compounded by emotional distancing by carers and health care professionals. Participants discussed their repeated attempts to re-adapt to disruptions of self caused by an altered body image. CONCLUSIONS: the key study implications focus on the need for (i) improved holistic care and support, and advice; (ii) training and awareness raising of care professionals; (iii) further research on the lived experiences of the condition and the development of effective measures of cachexia.     

Body-image therapy

Body image is a complex interplay of factors resulting in a sense of the body perceived by that individual. In eating-disorder clients, there is a distortion between their perceived image of their body and its actuality. This is combined with a sense of dissatisfaction and alienation of mind and body. Cognitive, right-brain, and kinesthetic strategies are described that seek to decrease distortion and dissatisfaction and facilitates individuation-separation and a reintegration of the self. These strategies are both therapeutic and evaluative. Cultural expectations of women have had a profound impact on the proliferation of eating disorders, and they account for the fact that body distortion is found in both normal and eating-disordered women.     

A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease

PurposeThe research of body image among breast cancer patients is characterized by some limitations, such as the lack of longitudinal studies or the absence of a multidimensional perspective of body image. This study intends to overcome these limitations, by examining the evolution of body image dimensions (investment, emotions and evaluations) from the period of surgery (T1) to 6-months after the treatment’s ending (T2). It also aims to explore the predictors of body image at T2 and, simultaneously, the predictive role of initial body image to psychosocial adjustment at T2.MethodsA total of 56 breast cancer patients participated in both assessments and completed a battery of instruments that included measures of body image dimensions (appearance investment, self-consciousness of appearance, shame and appearance satisfaction) and psychosocial adjustment (quality of life and emotional distress).ResultsWithin the dimensions of body image, only shame increased over time. In general, initial levels of investment predicted subsequent body image dimensions and having a mastectomy done was associated with higher shame and lower appearance satisfaction at T2. Initial body image did not predict later adjustment, with the exception of depression, where appearance investment played a relevant role.ConclusionsOur findings contributed to the advance of knowledge in this area, providing relevant data about the evolution of body image dimensions, its predictors and its predictive role on psychosocial adjustment among breast cancer patients. This study also suggested some clinical implications that can assist health professionals to implement strategies focused on body image throughout the disease.     

Weight change, body image, and quality of life in HIV disease: A pilot study

Fat distribution alterations and lipodystrophy occur as part of a broad spectrum of body alterations in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Recent advances in HIV therapies, including highly active antiretroviral therapy, contribute to these fat distribution alterations. The purpose of this pilot study was to investigate the relationships of weight change, body image, length of time with HIV/AIDS diagnosis, and quality of life in HIV disease. The sample consisted of 23 men with mean age of 42.2 years (SD = 8.2) and 17 women with mean age of 36.8 years (SD = 5.2). Participants reported a net increase in weight from 3 months prior (M = 2.4 lb, SD = 12.9 lb) and 12 months prior (M = 10.9 lb, SD = 19.1 lb). They also reported that their weight was greater than their ideal weight (M = 9.2 lb, SD = 22.9 lb). Body image scores (0-100 scale) were found to be significantly (F((1, 37)) = 5.41, p = .03) higher for women (73.1 +/- 17.0) compared with men (60.2 +/- 17.0). Although HIV-positive participants had slightly higher body image scores (M = 68.0, SD = 17.0) compared with participants with AIDS (M = 60.5, SD = 18.8), there was no significant difference (F((1, 37)) = 1.56, p = .22) in body image scores between those with HIV and those with AIDS. Finally, weight change was related to three scales of the Medical Outcomes Study-HIV: mental health (r = .42, p = .03), vitality (r = .53, p = .006), and quality of life (r = .45, p = .02) for men. There were no significant correlations between weight change and quality of life domains for women. Education of clinicians and individuals living with HIV/AIDS should focus on the assessment, management, and evaluation of weight change during the course of HIV disease.     

Assessing the body image: relevance,application and instruments for oncological settings

Purpose  

Body image is the sum of physical, cognitive, emotional, and relational elements that, when integrated, allow the development of a whole, healthy self-identity. Even though body image is normally studied in relation to eating disorders, it can also be influenced by other pathologies, including cancer. In oncology, an effective body image assessment is fundamental. The physical effects of cancer and cancer treatments are important and frequently irreversible also on a functional and emotional level; however, only few surveys have investigated body image in this peculiar context.     

Psychological considerations in cosmetic breast augmentation.

Within the past decade, the popularity of cosmetic breast augmentation has surged and, with it, the interest in the psychological aspects of the procedure. Investigations of women who seek cosmetic breast augmentation have examined both their psychosocial characteristics and their motivations for surgery. Dissatisfaction both with body image and with breast size and/or shape are thought to be primary motivators for surgery. It is common for women seeking cosmetic breast augmentation to have some body image dissatisfaction. However, a considerable minority may suffer from excessive dissatisfaction consistent with the psychiatric diagnosis of body dysmorphic disorder, which is believed to contraindicate cosmetic surgery. Following breast augmentation, most women report satisfaction with the aesthetic result and improvements in body image. The impact of the procedure on other areas of functioning, such as self-esteem and quality of life, is less clear. These positive outcomes have been tempered by recent epidemiological studies that have identified a relationship between cosmetic breast implants and suicide. This article reviews this literature and provides recommendations to plastic surgical nurses regarding the psychological assessment and management of patients seeking breast augmentation.     

The body and physiotherapy

In recent years, physiotherapists have been increasingly interested in defining their professional identity. At the heart of this interest lies a fundamental question about the role that the body plays in defining physiotherapy practice. Given the importance of the body to physiotherapy, it is surprising how under-theorized the body is in existing physiotherapy literature. With a few notable exceptions, the body as a philosophical/theoretical construct has been almost entirely bypassed by the profession. In this paper the authors argue that a renewed interest in the meaning given to the body by physiotherapists is timely, and offer a sociohistorical critique of the role the body has played in defining physiotherapy practice. We challenge physiotherapists' longstanding affinity with a biomechanical view of the body, arguing that whilst this approach may have been critically important in the past, it is now increasingly clear that a more diverse and inclusive approach to the body will be needed in the future. The authors explore the notion of embodiment and suggest ways in which embodiment theory might be applied to physiotherapy practice.