The indirect effect of body image on distress in women with breast cancer undergoing chemotherapy

BACKGROUND This study assessed the indirect effect of body image in the relationship between illness duration, optimism, coping strategies and psychological distress as well as the moderator role of being or not submitted to surgery and type of surgery, in women with breast cancer undergoing chemotherapy. PARTICIPANTS AND PROCEDURE This cross-sectional study included eighty-seven women with breast cancer undergoing chemotherapy, who answered instruments that assessed sociodemographic and clinical issues, optimism, coping, concerns with body image and psychological distress. Bayesian statistics were performed to test the indirect effect model that included also the moderator effects. RESULTS Lower optimism, lower use of humor, and higher denial and illness duration predicted lower body image and high er distress. Longer illness duration was associated with higher distress. Body image had an indirect effect in the relationship between optimism and distress; between denial coping and distress; between humor coping and distress and between illness duration and distress. Being submitted to surgery but not the type of surgery was a moderator in the indirect effect model. CONCLUSIONS Body image is critical to psychological distress. Future interventions for women with breast cancer should consider body image as a target, in order to promote adaptive coping strategies specially when women have had surgery.