Anxiety and Depression Symptoms, Self-Esteem and Body Image Among Patients with Gynecological Cancers: A Cross-Sectional Study

Abstract

Aim: Gynecological cancers are among the most important health problems of women, with high rates of morbidity and mortality.
These patients also have high rates of anxiety and depression symptoms which can affect the quality of life, self-care, self-esteem,
body image, adherence, response to treatment and prognosis of the cancer. This study aimed to investigate the anxiety and depression symptoms, self-esteem and body image among patients with gynecological cancers. 
Material and Method: In this study, anxiety and depression symptoms, self-esteem, body image satisfaction, and the effect of cancer
on these parameters were investigated in eighty-one patients with gynaecological cancer who underwent surgery and have been taking chemotherapy currently. After obtaining the informed consent, a socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Body Image Scale (BIS) and Coopersmith Self- Esteem Scale (CSES) were applied to all participants.
Results: HADS-anxiety score was positively correlated with HAD depression score (p<0.001) and negatively correlated with CSES
(p≤0.01) score. HADS-depression score was negatively correlated with BIS score (p<0.01). HADS-anxiety score predicted the decrease in self-esteem weakly. HADS-depression score predicted the decrease in self-esteem and deterioration in body image as
close to statistically significant. Increased symptoms of anxiety and depression as well as declined self-esteem and impaired body image were observed in patients treated for gynecological cancers.
Conclusion: In patients with gynecological cancers, the existence of possible anxiety and depression symptoms, impairment in selfesteem and body image should be screened; if detected, the treatment should be performed for the health of the patients.

Keywords

• Cancer,gynecology,anxiety,depression

Jinekolojik Kanserli Hastalarda Anksiyete ve Depresyon Semptomları, Benlik Saygısı ve Beden Algısı: Kesitsel Bir Çalışma

Abstract

Amaç: Jinekolojik kanserler yüksek morbidite ve mortalite ile kadınların en önemli sağlık sorunlarından biridir. Bu hastalar aynı zamanda hayat kalitelerini, öz bakımlarını, benlik saygılarını, beden algılarını uyumlarını, tedaviye yanıtlarını ve kanser prognozlarını
etkileyebilen yüksek oranlarda anksiyete ve depresyon semptomlarına sahiptirler. Bu çalışma jinekolojik kanserli hastalarda anksiyete ve depresyon semptomlarını, benlik saygısını ve beden algısını araştırmayı amaçlamıştır.
Materyal ve Metot: Bu çalışmada cerrahi operasyon geçiren ve halen kemoterapi almakta olan 81 jinekolojik kanserli hastada anksiyete ve depresyon semptomları, benlik saygısı, beden algısı memnuniyeti ve kanserin bu parametreler üzerine etkisi araştırıldı. Aydınlatılmış onam formu alındıktan sonra tüm katılanlara birer sosyodemografik bilgi formu, Hastane Anksiyete ve Depresyon Ölçeği (HAD), Beden Algısı Ölçeği (BAÖ) ve Coopersmith Benlik Saygısı Ölçeği uygulandı (CBSÖ).
Bulgular: HAD Anksiyete skoru, HAD Depresyon skoru ile pozitif yönde (p<0,001) ve CBSÖ skoru ile negatif yönde (p≤0,01) ilişkiliydi.
HAD Depresyon skoru BAÖ skoru ile negatif yönde ilişkiliydi. HAD anksiyete skoru ile benlik saygısındaki azalmayı zayıf olarak
öngördü. HAD Depresyon skoru benlik saygısındaki azalmayı ve beden algısındaki bozulmayı istatistiksel olarak anlamlıya yakın olarak öngördü. Jinekolojik kanserler için tedavi edilmiş hastalarda artmış anksiyete ve depresyon semptomları gibi azalmış benlik saygısı ve bozulmuş beden algısı gözlendi.
Sonuç: Jinekolojik kanserli hastalarda olası anksiyete ve depresyon semptomlarının, bozulmuş benlik saygısının ve beden algısının
varlığı takip edilmelidir. Eğer varlıkları tespit edilirse hastaların sağlığı için tedavi uygulanmalıdır.

Keywords

• Kanser,jinekoloji,anksiyete,depresyon

References

1. 1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics. CA Cancer J Clin 2010;60(5):277–300.
2. 2. American Cancer Society Cancer Facts and Figures. Annual Report. California Division and Public Health Ins 2007: www. cancer. org/docroot/CRI.
3. 3. Berard RM. Depression and anxiety in oncology: the psychiatrist’s perspective. J Clin Psychiatry 2001;62(8):58–63.
4. 4. Kutlu R, Çivi S, Börüban MC, Demir A. Depression and the Factors Affecting the Quality of Life in Cancer Patients Selçuk Üniv Tıp Derg 2011;27(3):149–53.
5. 5. Manne SL, Andrykowski MA. Are psychological interventions effective and accepted by cancer patients? II. Using empirically supported therapy guidelines to decide. Ann Behav Med 2006;32(2):98–103.
6. 6. Andrykowski MA, Manne SL. Are psychological interventions effective and accepted by cancer patients? I. Standards and levels of evidence. Ann Behav Med 2006;32(2):93–7.
7. 7. Seven M, Akyüz A, Sever N, Dinçer Ş. [Studying the Physical and Psychological Symptoms of Patients with Cancer] TAF Prev Med Bull 2013;12(3):219–24.
8. 8. Lee JI, Kim SH, Tan AH, Kim HK, Jang HW, Hur KY, et al. Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea. Health Qual Life Outcomes 2010;15(8):101.

9. 9. Valente SM, Saunders JM. Diagnosis and treatment of major depression among people with cancer. CancerNurs 1997;20(3):168–77.
10. 10. Norum J, Wist EA. Quality of Life in Survivors of Hogkins’ Disease. Quality of Life Research 1996;5(3);367–74.
11. 11. Teixeira RJ, Pereira MG. Psychological morbidity, burden, and the mediating effect of social support in adult children caregivers of oncological patients undergoing chemotherapy. Psychooncology 2013;22(7):1587–93.
12. 12. D’Antonio LL, Long SA, Zimmerman GJ, Peterman AH, Petti GH, Chonkich GD. Relationship between quality of life and depression in patients with head and neck cancer. Laryngoscope 1998;108(6):806–11.
13. 13. Hardman A, Maguire P, Crowther D. The recognition of psychiatric morbidity on a medical oncology ward. J Psycosom Res 1989;33(2):235–9.
14. 14. Ozkan B, Mentes S, Ozturk A, Soyuer S. Effects of Follow-up by Phone Interview and Anger Management Training Provided to Patients with Breast Cancer Undergoing Radiotherapy on Levels of Self-Esteem, Anger and Depression. International Journal of Hematology and Oncology 2014;4(24):260–9.
15. 15. Cam O, Gümüs AB. Breast cancer screening behavior in Turkish women: Relationships with health beliefs and self-esteem, bodyperception and hopelessness. Asian Pac J Cancer Prev 2009;10(1):49–56.
16. 16. Harter S. Developmental differences in the nature of selfrepresentations: implications for the understanding, assessment and treatment of maladaptive behaviour. Cognitive Therapy and Research 1990;14(2):113–42.
17. 17. Ramachandran VS, Brang D, McGeoch PD, Rosar W. Sexual and food preference in apotemnophilia and anorexia: interactions between ‘beliefs’ and ‘needs’ regulated by twoway connections between body image and limbic structures. Perception 2009;38(5):775–7.
18. 18. Gümüş AB, Çam O. Relationships Between Early Diagnosis Attitudes In Cervical Cancer Of Women And Levels Of SelfEsteem, Body Perception And Hopelessness. Nobel Med 2011;7(3):46–52.
19. 19. Zigmond AS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70.
20. 20. Aydemir O. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 1997;8:280–7.
21. 21. Secord PF, Jourard SM The appraisal of body-cathexis: bodycathexis and the self. J Consult Psychol 1953;17(5):343–7.
22. 22. Hovardaoğlu S. Body Image Scale 3P Dergisi 1993;1:26.
23. 23. Coopersmith S. Self Esteem Inventories. Consulting Psychologist Press: California; 1967.
24. 24. Turan N, Tufan B. Coopersmith benlik saygısı envanteri’nin geçerlik-güvenirlik çalışması. [The study of reliability and validity for the Coopersmith sef-esteem scale] 23. National conference of psychiatry and neurological Sciences: İstanbulTürkiye; 1987.
25. 25. Moses-Kolko EL, Roth EK. Antepartum And Postpartum Depression: Healthy Mom, Healthy Baby. J Am Med Womens Assoc 2004;59:181–91.
26. 26. Myers JK, Weissman MM, Tischler GL, Holzer CE 3rd, Leaf PJ, Orvaschel H, et al. Six month prevalence of psychiatric disorders in three communities 1980 to 1982. Arch Gen Psychiatry 1984;41:959–70
27. 27. Schiffer RB. Psychiatric Disorders In Medical Practice Cecil Texbook of Medicine, 21th ed, Philadelphia: W. B. Saunders Company 2000;2047–56
28. 28. Pınar R. Depression, Self-Esteem and Body Image in Obese People: a Comparative Study C. Ü. Hemşirelik Yüksekokulu Dergisi 2002;6(1):30–41.
29. 29. Tahmasebi M, Yarandi F, Eftekhar Z, Montazeri A, Namazi H. Quality of life in gynecological cancer patients. Asian Pac J Cancer Prev 2007;8(4):591–2.
30. 30. Kızılcı S. The factors effected quality of life of people with cancer and their relatives. C. Ü. Hemşirelik Yüksekokulu Dergisi 1999;3(2):18–25.
31. 31. Mishel M, Sorenson DS. Uncertainty in gynecological cancer: A test of the mediating functions of mastery and coping Nurs Res 1991;40(3):167–71