Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China
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Abstract
Background: Breast cancer survivors experience altered body image and quality of life (QoL) due to the disease and its treatment. The multidimensional nature of body image and QoL makes their relationships complex. This study aimed to examine the associations between the two concepts in Chinese breast cancer survivors and test whether these associations are moderated by rural–urban residence. Methods: A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (the Body Image Self-Rating Questionnaire for Breast Cancer and 36-item Short-Form Health Survey) and questions assessing demographic and clinical covariates were administered. Multiple linear regressions were used to assess the relationship between body image and QoL domains and to examine the moderating effect of rural–urban residence. Results: In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical (β ranged from − 0.15 to − 0.11, p < 0.05) and mental (β ranged from − 0.46 to − 0.34, p < 0.001) well-being. Better perception of body image-related social and behavior change was significantly associated only with better mental well-being (β ranged from − 0.40 to − 0.33, p < 0.001). The association between body image and mental well-being was much stronger in urban subjects (b = − 0.38, p < 0.001) than in rural subjects (b = − 0.20, p < 0.001). Conclusions: Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our results indicate that incorporating interventions that address body image issues would be advantageous for survivorship care to enhance QoL in breast cancer survivors. Furthermore, rural–urban differences should be considered in the strategic design of survivorship care programs in rural and urban settings.
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Studies in different countries have shown similar observation of loss of self-esteem and negative perception of body image post-surgery.
“Such studies which have been done in different countries have shown a similar observation of loss of self-esteem and negative perception of body image post-surgery.39,40”
From Coping in Post-Mastectomy Breast Cancer Survivors and Need for Intervention: Systematic Review. (2023) · cites this paper as [40]
The Background (page unavailable) says breast cancer surgery can change physical appearance and affect survivors’ body image; the Discussion (page unavailable) also reports poorer body image after mastectomy than after lumpectomy. Our copy does not report a post-surgery loss of self-esteem or establish that studies in different countries found that same combination of outcomes. (LLM, conf=0.84)
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- Authors
- An, J., Zhou, K., Li, M., & Li, X.
- Affiliations
- Xi'an Jiaotong University (CN)
- Chinese University of Hong Kong (HK)
- Corresponding author
- Li, Xiaomei
- Venue
- BMC Women's Health
- Published
- 2022-03-04
- Volume
- 22
- Issue
- 1
- Pages
- 61-61
- ISSN
- 1472-6874 (ISSN-L)
- PMC
- PMC8896367
- OpenAlex
- W4221062647
- Cited by
- 29
- References
- 42
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 12 · 2022: 1
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Women s Health (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Natural Science Foundation of China (NO. 81502700)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- breast cancer survivors, body image, quality of life, urban-rural differences, psychological well-being, physical well-being, survivorship care, sexual function after cancer treatment, role transition, Chinese women
- MeSH terms
- Cancer Survivors, Body Image, Breast Neoplasms, China, Cross-Sectional Studies, Female, Humans, Quality of Life, Surveys and Questionnaires
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