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      Reconstruyendo un cuerpo: implicaciones psicosociales en la corporalidad femenina del cáncer de mamas

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          Abstract

          En Puerto Rico son escasos los programas disponibles para trabajar con las emociones de pacientes de cáncer de mamas; particularmente, si se toma en consideración que el cáncer de mama es la primera causa de muerte por cáncer en la mujer puertorriqueña. El rol social asignado a la mujer en nuestra sociedad plantea unas consideraciones que pudieran complicar el afrontamiento a esta enfermedad. Estas mujeres frecuentemente han internalizado los estándares de belleza femenina que enfatiza la sociedad. El propósito de este trabajo es realizar una mirada a la imagen corpórea de tres puertorriqueñas sobrevivientes de cáncer de mamas. Se discutirá la imagen corporal que estas mujeres tienen de sí mismas y su relación con los estándares de belleza femenina idealizados por la cultura puertorriqueña. Los resultados revelan que estas mujeres indican insatisfacción con respecto a su imagen corporal, miedo al rechazo y al abandono, necesidad de aprobación social, baja autoestima y dificultades sexuales que se relacionan a la manera en que perciben su cuerpo.

          Translated abstract

          There are very few programs available in Puerto Rico that deal with the emotions of breast cancer patients, particularíy taking into consideration that breast cancer is the leading cause of death by cancer in Puerto Rican women. The social role assigned to women in our society presents several considerations that have to be taken into account that could complícate the way women deal with this disease. These women frequently have internalized the standards of feminine beauty that are emphasized by society. The purpose of this article is to provide a view at the body image of three Puerto Rican breast cancer survivors. The body image that these women have of themselves and their relationship with the standards of feminine beauty idealized by Puerto Rican culture will be discussed. The results reveal that these women show dissatisfaction with regards to their body image, fear of rejection and abandonment, a need for social approval, low self-esteem, and sexual difficulties that relate to the way that they perceive their body.

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          Most cited references66

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          Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction.

          The aim of this study was to assess and compare the psychological outcome and satisfaction of patients whom underwent wide local excision, mastectomy alone and mastectomy with breast reconstruction. A total of 577 patients had different types of operations for primary breast cancer (254 (44%) had wide local excision, 202 (35%) had simple mastectomy and 121 (21%) had breast reconstruction). Psychosocial morbidity and satisfaction were studied retrospectively using self-evaluation questionnaires. The three different surgical groups were cross-matched into four different age group. Significant statistical differences existed between the three procedures regarding satisfaction and psychosocial morbidity (anxiety, depression, body image, sexuality and self-esteem) in favour of wide local excision followed by breast reconstruction. Greatest morbidity was seen in the mastectomy group. Patient satisfaction of cosmetic outcome and psychosocial aspects was greater with wide local excision than with breast reconstruction or mastectomy. However, since wide local excision is indicated in only a group of patients, breast reconstruction should be an option available to patients requiring mastectomy.
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            Life after breast cancer: understanding women's health-related quality of life and sexual functioning.

            To describe the health-related quality of life (HRQL), partner relationships, sexual functioning, and body image concerns of breast cancer survivors (BCS) in relation to age, menopausal status, and type of cancer treatment. A cross-sectional sample of BCS in two large metropolitan areas was invited to participate in a survey study that included the following standardized measures: the RAND 36-Item Health Survey; the Centers for Epidemiologic Studies-Depression Scale (CES-D); the Dyadic Adjustment Scale (DAS); the Breast Cancer Prevention Trial (BCPT) Symptom Checklist; the Watts Sexual Functioning Questionnaire (WSFQ); and subscales from the Cancer Rehabilitation Evaluation System (CARES). Eight hundred sixty-four BCS completed the survey. RAND Health Survey scores were as good or better than those of healthy, age-matched women, and the frequency of depression was similar to general population samples. Marital/partner adjustment was similar to normal healthy samples, and sexual functioning mirrored that of healthy, age-matched postmenopausal women. However, these BCS reported higher rates of physical symptoms (eg, joint pains, headaches, and hot flashes) than healthy women. Sexual dysfunction occurred more frequently in women who had received chemotherapy (all ages), and in younger women who were no longer menstruating. In women > or = 50 years, tamoxifen therapy was unrelated to sexual functioning. BCS report more frequent physical and menopausal symptoms than healthy women, yet report HRQL and sexual functioning comparable to that of healthy, age-matched women. Nevertheless, some survivors still experience poorer functioning, and clinicians should inquire about common symptoms to provide symptomatic management or counseling for these women.
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              Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors.

              Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds. We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship. Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al., 1996; Ries et al., 2000; Shinagawa, 2000). In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000). Copyright 2003 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                reps
                Revista Puertorriqueña de Psicología
                Rev. Puertorriq. Psicol.
                Asociación de Psicología de Puerto Rico (San Juan, , Puerto Rico )
                1946-2026
                2007
                : 18
                : 118-145
                Affiliations
                [01] orgnameUniversidad de Puerto Rico orgdiv1Recinto de Río Piedras orgdiv2Departamento de Psicología
                Article
                S1946-20262007000100008 S1946-2026(07)01800008
                a32baf92-624c-4e86-8392-2ba644783cc3

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 28
                Product

                SciELO Periódicos Eletrônicos em Psicologia

                Categories
                Sección Especial - El cuerpo en evidencia: Reflexiones sobre aspectos sociales y clínicos de la corporalidad

                Emociones,Femininity,Body image,Breast cancer,Emotions,Imagen corporal,Feminidad,Cáncer de mama

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