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Supportive Care in Cancer

, Volume 27, Issue 10, pp 3657–3666 | Cite as

A systematic review of body image measures for people diagnosed with head and neck cancer (HNC)

  • Chindhu Shunmuga Sundaram
  • Haryana M. Dhillon
  • Phyllis N. Butow
  • Puma Sundaresan
  • Claudia RutherfordEmail author
Review Article

Abstract

Purpose

Head and neck cancer (HNC) is a relatively common cancer which causes a significant health burden, impacting individuals physically and psychologically. HNC treatment may result in facial disfigurement, eating and communication difficulties, and body image disturbances. We aimed to (1) identify HNC-specific patient-reported outcome measures (PROMs) used to assess body image, (2) evaluate their conceptual coverage, (3) appraise their development process and psychometric properties, and (4) determine appropriate body image PROM(s) for use in the HNC setting.

Methods

Online databases were searched (July 2007–July 2017) for studies that assessed body image in patients with HNC. Studies were screened for eligibility. In addition, we searched three PROM databases for relevant PROMs. From available body image frameworks, we compiled a conceptual schema consisting of 18 clinically relevant body image issues important in the HNC setting, against which PROMs were assessed. Selected measures were appraised for psychometric characteristics, content, and readability.

Results

A total of 245 records were retrieved. 18 studies with PROMs met our inclusion criteria, reporting eight PROMs. The PROM databases searched yielded 62 measures. After screening, eleven measures were short-listed and appraised. The Derriford Appearance Scale (DAS)-59, DAS-24, and body image scale (BIS) cover > 55% of issues within the body image conceptual schema; were developed based on literature, patient interviews, and clinician opinions; and have evidence of internal consistency (Cronbach alpha > 0.7), validity, and responsiveness.

Conclusions

We recommend the DAS-24 and BIS as having adequate coverage of HNC-related issues, and suitable for use in future research.

Keywords

Head and neck cancer Body image Patient-reported outcome measures Validation Content validity Systematic review 

Notes

Acknowledgements

We thank Rhiannon Ashleigh for her assistance with data extraction.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2019_4919_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 16 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of ScienceUniversity of SydneySydneyAustralia
  2. 2.Psycho-Oncology Cooperative Research GroupUniversity of SydneySydneyAustralia
  3. 3.Radiation Oncology NetworkWestern Sydney Local Health DistrictSydneyAustralia
  4. 4.Sydney Medical SchoolUniversity of SydneySydneyAustralia
  5. 5.Quality of Life Office, School of Psychology, Faculty of ScienceUniversity of SydneySydneyAustralia
  6. 6.Sydney Nursing School, Cancer Nursing Research Unit (CNRU)University of SydneySydneyAustralia

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