Efficacy of psychosocial and physical activity-based interventions to improve body image among women treated for breast cancer: A systematic review

Lewis-Smith, Helena; Diedrichs, Phillippa Claire; Rumsey, Nichola; Harcourt, Diana

Abstract

© 2018 John Wiley & Sons, Ltd. Objective: Body image concerns warrant attention among women who have undergone treatment for breast cancer, due to their significant consequences for psychological and physical health, and interpersonal relationships. This paper systematically reviews the effectiveness of interventions on body image outcomes among this group, in order to inform health care provision and strategic directions for research. Methods: Fourteen electronic databases were searched for articles published between 1992 and 2017 that evaluated interventions with women who had undergone treatment for breast cancer in controlled trials with at least one body image measure. Data were extracted and studies were assessed for their methodological quality using the Cochrane Collaboration tool for assessing risk of bias. Results: Twenty-one articles evaluating 26 interventions met inclusion criteria. Nine interventions significantly improved body image at either post-test or follow-up (ds=0.15-1.43), with none reporting sustained effects across all time points. Effective interventions comprised psychotherapy, psychoeducation, or physical activity, were delivered at different treatment stages and mostly adopted a multisession, face-to-face, group format. However, only 4 interventions were evaluated within methodologically rigorous studies and are therefore recommended for use by health professionals aiming to improve the body image of women at different stages of treatment for breast cancer. Conclusions: To advance the field, we recommend a less biomedical disease- and treatment-focused approach to interventions, and instead a more biopsychosocial theoretical approach targeting broader modifiable psychosocial influences upon body image. Replication and randomised controlled trials of greater rigour are also required to improve the methodological quality of studies.

• Journal Article Type: Review
• Acceptance Date: Aug 20, 2018
• Online Publication Date: Aug 30, 2018
• Publication Date: Dec 1, 2018
• Deposit Date: Sep 11, 2018
• Publicly Available Date: Aug 31, 2019
• Journal: Psycho-Oncology
• Print ISSN: 1057-9249
• Electronic ISSN: 1099-1611
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 12
• Pages: 2687-2699
• DOI: https://doi.org/10.1002/pon.4870
• Keywords: breast cancer, oncology, body image, intervention, systematic review
• Public URL: https://uwe-repository.worktribe.com/output/855319
• Publisher URL: https://doi.org/10.1002/pon.4870
• Additional Information: Additional Information : This is the peer reviewed version of the following article: [Lewis-Smith, H., Diedrichs, P., Nichola, R. and Diana, H. (2018) Efficacy of psychosocial and physical activity-based interventions to improve body image among women treated for breast cancer: A systematic review. Psycho-oncology. ISSN 1057-9249], which has been published in final form at https://doi.org/10.1002/pon.4870. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Sep 11, 2018