A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

doi:10.1007/s00520-021-06114-y

. 2021 Oct;29(10):5763-5776.

doi: 10.1007/s00520-021-06114-y. Epub 2021 Mar 18.

A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

Heleen C Melissant^{1

2

3}, Femke Jansen^{4

5

6}, Simone E J Eerenstein¹, Pim Cuijpers³, Birgit I Lissenberg-Witte⁷, Kerry A Sherman⁸, Ellen T M Laan⁹, C René Leemans¹, Irma M Verdonck-de Leeuw^{1

2

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
² Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
³ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁴ Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands. f.jansen1@amsterdamumc.nl.
⁵ Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. f.jansen1@amsterdamumc.nl.
⁶ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. f.jansen1@amsterdamumc.nl.
⁷ Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁸ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
⁹ Department of Sexology and Psychosomatic OBGYN, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.

PMID: 33738593
PMCID: PMC8410700
DOI: 10.1007/s00520-021-06114-y

A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

Heleen C Melissant et al. Support Care Cancer. 2021 Oct.

. 2021 Oct;29(10):5763-5776.

doi: 10.1007/s00520-021-06114-y. Epub 2021 Mar 18.

Authors

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
² Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
³ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁴ Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands. f.jansen1@amsterdamumc.nl.
⁵ Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. f.jansen1@amsterdamumc.nl.
⁶ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. f.jansen1@amsterdamumc.nl.
⁷ Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁸ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
⁹ Department of Sexology and Psychosomatic OBGYN, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.

PMID: 33738593
PMCID: PMC8410700
DOI: 10.1007/s00520-021-06114-y

Abstract

Purpose: The aim of this pretest-posttest study was to investigate the reach and effects of My Changed Body (MyCB), an expressive writing activity based on self-compassion, among head and neck cancer (HNC) survivors.

Methods: This pilot study had a pretest-posttest design. HNC survivors received an invitation to complete a baseline survey on body image-related distress. At the end of the survey, HNC survivors were asked if they were interested in the intervention study. This entailed the writing activity and a survey 1 week and 1 month post-intervention. The reach was calculated by dividing the number of participants in the intervention study, by the number of (1) eligible HNC survivors and (2) those who filled in the baseline survey. Linear mixed models were used to analyze the effect on body image-related distress. Logistic regression analysis was used to investigate factors associated with the reach and reduced body image-related distress. MyCB was evaluated using study-specific questions.

Results: The reach of MyCB was 15-33% (depending on reference group) and was associated with lower education level, more social eating problems, and fewer wound healing problems. Among the 87 participants, 9 (10%) showed a clinically relevant improvement in body image-related distress. No significant effect on body image-related distress was found. Self-compassion improved significantly during follow-up until 1 month post-intervention (p=0.003). Users rated satisfaction with MyCB as 7.2/10.

Conclusion: MyCB does not significantly improve body image-related distress, but is likely to increase self-compassion, which sustains for at least 1 month.

Keywords: Body image; Expressive writing; Head and neck cancer; Health-related quality of life; Self-compassion.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 2**
The course of body image-related distress of the total sample (n=87); participants with BIS score ≥8 (n=24) and participants with BIS score <8 (n=63)

See this image and copyright information in PMC

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References

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[1] Sherman KA, Przezdziecki A, Alcorso J, Kilby CJ, Elder E, Boyages J, Koelmeyer L, Mackie H. Reducing body image-related distress in women with breast cancer using a structured online writing exercise: results from the My Changed Body randomized controlled trial. J Clin Oncol. 2018;36(19):1930–1940. doi: 10.1200/jco.2017.76.3318. - DOI - PubMed

[2] Sherman KA, Przezdziecki A, Alcorso J, Kilby CJ, Elder E, Boyages J, Koelmeyer L, Mackie H. Reducing body image-related distress in women with breast cancer using a structured online writing exercise: results from the My Changed Body randomized controlled trial. J Clin Oncol. 2018;36(19):1930–1940. doi: 10.1200/jco.2017.76.3318. - DOI - PubMed

[3] Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ. Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients. Head Neck. 2000;22(2):132–141. doi: 10.1002/(SICI)1097-0347(200003)22:2<132::AID-HED4>3.0.CO;2-K. - DOI - PubMed

[4] Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ. Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients. Head Neck. 2000;22(2):132–141. doi: 10.1002/(SICI)1097-0347(200003)22:2<132::AID-HED4>3.0.CO;2-K. - DOI - PubMed

[5] Hung TM, Lin CR, Chi YC, Lin CY, Chen EY, Kang CJ, Huang SF, Juang YY, Huang CY, Chang JT. Body image in head and neck cancer patients treated with radiotherapy: the impact of surgical procedures. Health Qual Life Outcomes. 2017;15(1):165. doi: 10.1186/s12955-017-0740-7. - DOI - PMC - PubMed

[6] Hung TM, Lin CR, Chi YC, Lin CY, Chen EY, Kang CJ, Huang SF, Juang YY, Huang CY, Chang JT. Body image in head and neck cancer patients treated with radiotherapy: the impact of surgical procedures. Health Qual Life Outcomes. 2017;15(1):165. doi: 10.1186/s12955-017-0740-7. - DOI - PMC - PubMed

[7] Rhoten BA, Murphy B, Ridner SH. Body image in patients with head and neck cancer: a review of the literature. Oral Oncol. 2013;49(8):753–760. doi: 10.1016/j.oraloncology.2013.04.005. - DOI - PubMed

[8] Rhoten BA, Murphy B, Ridner SH. Body image in patients with head and neck cancer: a review of the literature. Oral Oncol. 2013;49(8):753–760. doi: 10.1016/j.oraloncology.2013.04.005. - DOI - PubMed

[9] Deng J, Murphy BA, Dietrich MS, Wells N, Wallston KA, Sinard RJ, Cmelak AJ, Gilbert J, Ridner SH. Impact of secondary lymphedema after head and neck cancer treatment on symptoms, functional status, and quality of life. Head Neck. 2013;35(7):1026–1035. doi: 10.1002/hed.23084. - DOI - PMC - PubMed

[10] Deng J, Murphy BA, Dietrich MS, Wells N, Wallston KA, Sinard RJ, Cmelak AJ, Gilbert J, Ridner SH. Impact of secondary lymphedema after head and neck cancer treatment on symptoms, functional status, and quality of life. Head Neck. 2013;35(7):1026–1035. doi: 10.1002/hed.23084. - DOI - PMC - PubMed

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A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

Affiliations

A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?

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