A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer
- 96 Downloads
This cross-sectional study presents an initial psychometric evaluation of a two-dimensional (perceptual and evaluative) conceptualization and measure of disrupted body integrity (DBI)—illness-related disruption of the sense of the body as an integrated, smoothly functioning whole.
Male and female head and neck cancer (HNC) outpatients (N = 98) completed a questionnaire package prior to outpatient visits.
Main outcome measures
The Disrupted Body Integrity Scale (DBIS) was developed to measure the perceptual and evaluative facets of DBI. Self-report measures of disfigurement, stigma, depressive symptoms, and negative affect were also completed.
Almost all DBIS subscales demonstrated good internal consistency. Results largely supported the DBIS’s construct validity. The majority of subscales correlated within the predicted range of r’s = .40–.70. Almost all DBIS constructs were positively linked with either depressive symptoms or disfigurement. None correlated with positive affect, and only two subscales, abnormal sensations (perceptual) and physical vulnerability (evaluative), correlated with negative affect. DBIS constructs showed little relation with stigma, once disfigurement effects were controlled for.
Findings offer preliminary evidence for the DBIS and the relevance of DBI in HNC. Further evaluation of DBI in disease adaptation and the DBIS’s factor structure is warranted.
KeywordsHead and neck cancer Body experience Embodiment Psychometric evaluation Adaptation
We appreciate the efforts of our research assistants on this project: Michelle Majcen, Jackie Wan, Colleen Simpson, Vivian Tsung, and Ka Ming Fong. We extend our gratitude to the members of the UHN Quality of Life Manuscript-Review Seminar for their invaluable feedback and suggestions on earlier versions of this manuscript.
This research was supported in part by the Canadian Institutes of Health Research through a Postdoctoral Fellowship to Sophie Lebel, a Senior Investigator Award to Gerald M. Devins, and a grant from the Psychosocial Oncology and Palliative Care Program (Princess Margaret Cancer Centre) to Sophie Lebel.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 5.Bradburn NM (1969) The structure of psychological well-being. Aldine, ChicagoGoogle Scholar
- 8.Cash TF (2000) The multidimensional body-self relations questionnaire users’ manual. Old Dominion University, NorfolkGoogle Scholar
- 9.Charmaz K (2002) The self as habit: the reconstruction of self in chronic illness. OTJR 22:31S–41SGoogle Scholar
- 19.Gardner RM (2012) Perceptual measures of body image for adolescents and adults. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 146–153Google Scholar
- 33.McDowell I, Newell C (1996) Measuring health: a guide to rating scales and questionnaires. Oxford University, New YorkGoogle Scholar
- 35.Merleau-Ponty M (1978) Phenomenology of perception. Routledge & Kegan Paul, LondonGoogle Scholar
- 37.Nunnally JC (1978) Psychometric theory. McGraw-Hill, New YorkGoogle Scholar
- 43.Rabinor JR, Bilich M (2012) Experiential approaches to body image change. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 424–433Google Scholar
- 51.Smolak L, Cash TF (2012) Future challenges for body image science, practice, and prevention. In: Cash TF, Smolak L (eds) Body image: a handbook of science, practice, and prevention. Guilford, New York, pp 471–478Google Scholar
- 55.Weiss MG, Doongaji DR, Siddhartha S, Wypij D, Pathare S, Bhatawdekar M, Bhave A, Sheth A, Fernandes R (1992) The explanatory model interview catalogue (EMIC): Contribution to cross-cultural research methods from a study of leprosy and mental health. Br J Psychiatry 160:819–830CrossRefPubMedGoogle Scholar