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Ricerche di Psicologia/Psychological Research Journal - Open Access

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Fattori legati all’immagine corporea delle donne dopo un intervento per tumore al seno: un modello triadico

DOI
https://doi.org/10.3280/rip2025oa20233
Inviata
22 maggio 2025
Pubblicato
06-08-2025

Abstract

La percezione dell’immagine corporea rappresenta un complesso processo intrapsichico e interpersonale, che coinvolge la percezione, la valutazione e la definizione del Sé, anche attraverso le esperienze emotive vissute nelle relazioni con gli altri. Nel contesto della malattia oncologica, quando l’organo colpito riveste un forte valore simbolico, associato culturalmente alla femminilità, alla bellezza e alla fertilità, le ripercussioni psicologiche possono avere un impatto significativo e duraturo sulla qualità di vita della donna. L’obiettivo del presente studio è l’individuazione di un modello che illustri quali variabili siano significativamente legate alla percezione dell’immagine corporea nell’immediato post-operatorio di donne italiane neo-operate di carcinoma mammario, ipotizzando l’esistenza di tre classi di fattori interagenti: (1) variabili socio-demografiche e mediche; (2) variabili intrapsichiche; e (3) variabili interpersonali-diadiche.

Il disegno di ricerca è osservazionale trasversale. Attraverso una strategia di campionamento di convenienza, sono state reclutate 162 donne italiane a seguito di un intervento chirurgico per rimozione di un tumore al seno. Le informazioni mediche delle pazienti sono state estratte dalla cartella clinica. Tramite un booklet di questionari sono state, invece, raccolte: (1) informazioni socio-demografiche: età e stato civile; (2) misure intrapsichiche: immagine corporea (Body Image Scale), tratti di personalità (Big Five Questionnaire Short Form), strategie di coping individuale (Mini-Mental Adjustment to Cancer e Perceived Ability to Cope with Trauma) e sintomatologia ansioso-depressiva (Hospital Anxiety and Depression Scale); e (3) misure interpersonali-diadiche: coping diadico (Dyadic Coping Questionnaire) e percezione di vicinanza del partner (Inclusion of the Other in the Self).

È stato condotto un modello di regressione lineare multipla. I risultati hanno messo in luce che l’operazione chirurgica (variabile medica), la disperazione (variabile intrapsichica) e il coping diadico negativo (variabile interpersonale-diadica) sono significativamente legati alla percezione dell’immagine corporea delle donne del campione considerato.

In accordo con quanto riportato nella letteratura scientifica, si evidenzia che la qualità dell’immagine corporea percepita dalle pazienti con pregresso carcinoma mammario scaturisce da un intreccio complesso di caratteristiche individuali distintive, dinamiche interpersonali e influenze contestuali strettamente interrelate.

Riferimenti bibliografici

  1. Acquati, C., & Saita, E. (2017). Affrontare insieme la malattia: Il coping diadico fra teoria e pratica. Roma: Carocci Editore.
  2. Aizpurua-Perez, I., & Perez-Tejada, J. (2020). Resilience in women with breast cancer: A systematic review. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 49, 101854. DOI: 10.1016/j.ejon.2020.101854.
  3. Antonovsky, A. (1966). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11(1), 11-18. DOI: 10.1093/heapro/11.1.11.
  4. Aron, A., Aron, E., & Smollan, D. (1992). Inclusion of the other in the Self-Scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology, 63(4), 596-612. DOI: 10.1037/0022-3514.63.4.596.
  5. Aydogan, D., Özgülük Üçok, S. B., & Randall, A. K. (2024). Being One and Staying Two as a Couple: Turkish Married Couples’ Sense of We-Ness, Psychological Distress, and Common Dyadic Coping. Journal of Couple & Relationship Therapy, 23(4), 282-304. DOI: 10.1080/15332691.2024.2406812.
  6. Bahrami, M., Mohamadirizi, M., Mohamadirizi, S., & Hosseini, S. A. (2017). Evaluation of body image in cancer patients and its association with clinical variables. Journal of education and health promotion, 6, 81. DOI: 10.4103/jehp.jehp_4_15.
  7. Bodenmann, G. (1997). Dyadic coping: A systemic-transactional view of stress and coping among couples: Theory and empirical findings. European Review of Applied Psychology / Revue Européenne de Psychologie Appliquée, 47(2), 137-141.
  8. Bodenmann, G. (2000). Stress und coping bei paaren [Stress and coping in cou-ples]. Göttingen, Germany: Hogrefe.
  9. Bodenmann, G. (2005). Dyadic coping and its significance for marital functioning. In T. Revenson, K. Kayser, & G. Bodenmann (Eds.), Couples coping with stress: Emerging perspectives on dyadic coping (pp. 33-50). Washington, DC: American Psychological Association.
  10. Bodenmann, G., Meuwly, N., Bradbury, T. N., Gmelch, S., & Ledermann, T. (2010). Stress, anger and verbal aggression in intimate relationships: moderating effects of individual and dyadic coping. Journal of Social and Personal Relationships, 27(3), 408-424. DOI: 10.1177/0265407510361616.
  11. Boing, L., Pereira, G. S., Araújo, C. D. C. R., Sperandio, F. F., Loch, M. D. S. G., Bergmann, A., Borgatto, A. F., & Guimarães, A. C. A. (2019). Factors associated with depression symptoms in women after breast cancer. Revista de saude publica, 53(30). DOI: 10.11606/S1518-8787.2019053000786.
  12. Bonanno, G. A., & Pat-Horenczyk, R. (2011). Coping flexibility and trauma: The Perceived Ability to Cope with Trauma (PACT) Scale. Psychological Trauma: Theory, Research and Policy, 3(2), 117-119. DOI: 10.1037/a0020921.
  13. Brunet, J., Price, J., & Harris, C. (2022). Body image in women diagnosed with breast cancer: A grounded theory study. Body image, 41, 417-431. DOI: 10.1016/j.bodyim.2022.04.012.
  14. Canguilhem, G. (2009). What is health? The ability to adapt. The Lancet, 373(9666), 371. DOI: 10.1016/S0140-6736(09)60456-6.
  15. Caprara, G. V, Barbanelli, C., Borgogni, L., & Perugini, M. (1993). The “Big Five Questionnaire”: A new questionnaire to assess the Five Factor Model. Journal of personality and Individual Differences, 15(3), 281-288. DOI: 10.1016/0191-8869(93)90218-R.
  16. Cash, T. F. (2012). Cognitive-behavioral perspectives on body image. In T. F. Cash (Ed.), Encyclopedia of body image and human appearance (pp. 334-342). Elsevier Academic Press.
  17. Cash, T. F., & Smolak, L. (Eds.) (2011). Body image: A handbook of science, practice, and prevention (2nd ed.). The Guilford Press.
  18. Cheli, S., Agostini, A., Herd-Smith, A., Calignani, L., Martella, F., & Fioretto, L. (2016). The Italian version of Body Image Scale reliability and sensitivity in a sample of breast cancer patients. Psicoterapia Cognitiva e Comportamentale, 22(1), 65-79. DOI: 10.1037/t56642-000.
  19. Chen, M., Gong, J., Cao, Q., Luo, X., Li, J., & Li, Q. (2021). A literature review of the relationship between dyadic coping and dyadic outcomes in cancer couples. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 54, 102035. DOI: 10.1016/j.ejon.2021.102035.
  20. Cho, Y. U., Lee, B. G., & Kim, S. H. (2020). Coping style at diagnosis and its association with subsequent health-related quality of life in women with breast cancer: A 3-year follow-up study. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 45, 101726. DOI: 10.1016/j.ejon.2020.101726.
  21. Cohen J. (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates Publishers.
  22. Conte, L., De Nunzio, G., Lupo, R., Mieli, M., Lezzi, A., Vitale, E., Carriero, M. C., Calabrò, A., Carvello, M., Rubbi, I., & Federico, M. (2023). Breast Cancer Prevention: The Key Role of Population Screening, Breast Self-Examination (BSE) and Technological Tools. Survey of Italian Women. Journal of cancer education: the official journal of the American Association for Cancer Education, 38(5), 1728-1742. DOI: 10.1007/s13187-023-02327-3.
  23. Costa, P. T., & McCrae, R. R. (1992). The Five-Factor Model of Personality and Its Relevance to Personality Disorders. Journal of Personality Disorders, 6(4), 343-359. DOI: 10.1521/pedi.1992.6.4.343.
  24. Costantini, M., Musso, M., Viterbori, P., Bonci, F., Del Mastro, L., Garrone, O., Ven-turini, M., & Morasso, G. (1999). Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Supportive care in cancer: official journal of the Multinational Associ-ation of Supportive Care in Cancer, 7(3), 121-127. DOI: 10.1007/s005200050241.
  25. Davis, C., Tami, P., Ramsay, D., Melanson, D., MacLean, L., Nersesian, S., et al. (2020). Body image in older breast cancer survivors: A Systematic review. Psychooncology, 29(5), 823-832. DOI: 10.1002/pon.5359.
  26. Donato, S., Iafrate, R., Barni, D., Bertoni, A., Bodenmann, G. & Gagliardi, S. (2009). Measuring dyadic coping: The factorial structure of Bodenmann’s “Dyadic coping questionnaire” in an Italian sample. Testing, Psychometrics, Methodology, in applied psychology, 16(1), 25-47. DOI: 10807/12851.
  27. Engel G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science (New York, N.Y.), 196(4286), 129-136. DOI: 10.1126/science.847460.
  28. Engel, G. L. (1980). The clinical application of the biopsychosocial model. The American Journal of Psychiatry, 137(5), 535-544. DOI: 10.1176/ajp.137.5.535.
  29. Esplen, M. J., Warner, E., Boquiren, V., Wong, J., & Toner, B. (2020). Restoring body image after cancer (ReBIC): A group therapy intervention. Psycho-Oncology, 29(4), 671-680. DOI: 10.1002/pon.5304.
  30. Fang, S. Y., Shu, B. C., & Chang, Y. J. (2013). The effect of breast reconstruction surgery on body image among women after mastectomy: a meta-analysis. Breast Cancer Research and Treatment, 137(1), 13-21. DOI: 10.1007/s10549-012-2349-1.
  31. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods, 39(2), 175-191. DOI: 10.3758/bf03193146.
  32. Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior research methods, 41(4), 1149-1160. DOI: 10.3758/BRM.41.4.1149.
  33. Grassi, L., Biondi, M., & Costantini, A. (2003). Manuale pratico di psico-oncologia. Roma: Il pensiero scientifico editore.
  34. Grassi, L., Buda, P., Cavana, L., Annunziata, A., Torta, R., & Varetto, A. (2005) Styles of coping with cancer: The Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) Scale. Psycho-Oncology, 14(2), 115-124. DOI: 10.1002/pon.826.
  35. Guan Ng, C., Mohamed, S., Kaur, K., Sulaiman, A. H., Zainal, N. Z., & Taib, N. A. (2017). Perceived distress and its association with depression and anxiety in breast cancer patients. PloS ONE, 12(3), e0172975.
  36. Gul, A., Ustundag, H., Andsoy, I. I., & Kalkanli, S. (2015). Anxiety and pain in surgically treated breast cancer patients. Asian pacific Journal of Cancer Prevention: APCJC, 16(10), 4261-4264. DOI: 10.7314/apjcp.2015.16.10.4261.
  37. Holland, J. C. (2018). Psycho-oncology: overview, obstacles and opportunities. Psycho-oncology, 27(5), 1364-1376. DOI: 10.1002/pon.4692.
  38. Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, A. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37(2), 189-197. DOI: 10.1016/S0959-8049(00)00353-1.
  39. Hopwood, P., & Hopwood, N. (2019). New challenges in psycho-oncology: An embodied approach to body image. Psycho-Oncology, 28(2), 211-218. DOI: 10.1002/pon.4936.
  40. Izydorczyk, B., Kwapniewska, A., Lizinczyk, S., & Sitnik-Warchulska, K. (2018). Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer. International journal of environ-mental research and public health, 15(6), 1181. DOI: 10.3390/ijerph15061181.
  41. Istituto Superiore di Sanità, ISS (2018). Guadagnare Salute. Accessibile da: https://www.epicentro.iss.it/guadagnare-salute/programma/corniceriferimento.
  42. Jabłoński, M. J., Mirucka, B., Streb, J., Słowik, A. J., & Jach, R. (2019). Exploring the relationship between the body self and the sense of coherence in women after surgical treatment for breast cancer. Psycho-Oncology, 28(1), 54-60. DOI: 10.1002/pon.4909.
  43. Karimi, M., & Brazier, J. (2016). Health, health-related quality of life, and quality of life: what is the difference?. Pharmaco Economics, 34(7), 645-659. DOI: 10.1007/s40273-016-0389-9.
  44. Kling, J., Wängqvisit, M., & Frisén, A. (2018). “This body is me”: Discovering the ways in which the body is salient in people’s identities. Body Image, 24, 102-110. DOI: 10.1016/j.bodyim.2017.12.009.
  45. Kołodziejczyk, A., & Pawłowski, T. (2019). Negative body image in breast cancer patients. Advances in Clinical Experimental Medicine, 28(8), 1137-1142. DOI: 10.17219/acem/103626.
  46. Kvillemo, P., & Bränström, R. (2014). Coping with breast cancer: a meta-analysis. PloS one, 9(11), e112733. DOI: 10.1371/journal.pone.0112733.
  47. Langellier, K. M., & Sullivan, C. F. (1998). Breast talk in breast cancer narratives. Qualitative Health Research, 8(1), 76-94. DOI: 10.1177/104973239800800106.
  48. Larsen L. (2022). “I think it is a powerful campaign and does a great job of raising awareness in young women”: Findings from Breast Cancer Awareness campaigns targeting young women in Canada. Canadian oncology nursing journal: Revue canadienne de nursing oncologique, 32(1), 61-67. DOI: 10.5737/236880763216167.
  49. Lelorain, S., Bonnaud-Antignac, A., & Florin, A. (2010). Long term post-traumatic growth after breast cancer: prevalence, predictors and relationships with psychological health. Journal of clinical psychology in medical settings, 17(1), 14-22. DOI: 10.1007/s10880-009-9183-6.
  50. Moss, T., Chirico, A., Mallia, L., Lucidi, F., Fucito, A., D’Aiuto, M., & Giordano, A. (2016). Psychosocial Outcomes of Quadrantectomy Versus Mastectomy in a Southern Italian Sample: Development and Needs of the Italian Derriford Ap-pearance Scale 24. Anticancer research, 36(4), 1519-1526.
  51. National Cancer Institute, NCI (2020). Types of cancer treatment. Accessibile da: https://www.cancer.gov/about-cancer/treatment.
  52. Pat-Horenczyk, R., Perry, S., Hamama-Raz, Y., Ziv, Y., Schramm-Yavin, S., & Stemmer, S. M. (2015). Posttraumatic Growth in Breast Cancer Survivors: Constructive and Illusory Aspects. Journal of traumatic stress, 28(3), 214-222. DOI: 10.1002/jts.22014.
  53. Phoosuwan, N., & Lundberg, P. C. (2022). Psychological distress and health-related quality of life among women with breast cancer: a descriptive cross-sectional study. Supportive care in cancer: official journal of the Multinational Associ-ation of Supportive Care in Cancer, 30(4), 3177-3186. DOI: 10.1007/s00520-021-06763-z.
  54. Phoosuwan, N., & Lundberg, P. C. (2023). Life satisfaction, body image and associated factors among women with breast cancer after mastectomy. Psycho-oncology, 32(4), 610-618. DOI: 10.1002/pon.6106.
  55. Przezdziecki, A., Alcorso, J., & Sherman, K. A. (2016). My Changed Body: Background, development and acceptability of a self-compassion based writing activity for female survivors of breast cancer. Patient education and counseling, 99(5), 870-874. DOI: 10.1016/j.pec.2015.12.011.
  56. Rossi, G., & Bramanti, D. (2015). La famiglia come intreccio di relazioni: La prospettiva sociologica. Milano: Vita e Pensiero.
  57. Rottmann, N., Hansen, D. G., Larsen, P. V., Nicolaisen, A., Flyger, H., Johansen, C., & Hagedoorn, M. (2015). Dyadic coping within couples dealing with breast cancer: A longitudinal, population-based study. Health psychology: official journal of the Division of Health Psychology, 34(5), 486-495. DOI: 10.1037/hea0000218.
  58. Shi, G., Shi, T., Liu, Y., & Cai, Y. (2021). Relationships between dyadic coping, intimate relationship and post-traumatic growth in patients with breast cancer: A cross-sectional study. Journal of advanced nursing, 77(12), 4733-4742. DOI: 10.1111/jan.14946.
  59. Saita, E., Acquati, C., Fenaroli, V., Zuliani, C., & Bonanno, G. A. (2017). A confirmatory factor analysis of the perceived ability to cope with trauma (PACT) scale. Testing, Psychometrics, Methodology in Applied Psychology, 24(2), 255-258. DOI: 10.4473/tpm24.2.5.
  60. Saita, E., Acquati, C., Molgora, S., Vagnini, D., Piccolo, E. M., Valenti, F., Stratta, G., & Grassi, M. M. (2023). Locally advanced breast cancer (LABC) and delayed care: a qualitative analysis of psychosocial factors. Psychology, Health & Medicine, 28(2), 408-418. DOI: 10.1080/13548506.2022.2073379.
  61. Saita, E., Ferraris, G., Acquati, C., Molgora, S., Sorge, A., Valenti, F., Grassi, M. M., & Vagnini, D. (2022). Dyadic Profiles of Couples Coping with Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Frontiers in Psychology, 13, 869905. DOI: 10.3389/fpsyg.2022.869905.
  62. Scabini, E. & Iafrate, R. (2003). Psicologia dei legami familiari. Bologna: il Mulino.
  63. Schilder, P. (1950). The image and the appearance of the human body. New York: International Universities Press.
  64. Siegel, D. J. (1999). La mente relazionale. Neurobiologia dell’esperienza interpersonale. Milano: Raffaello Cortina Editore.
  65. Tedeschi, R. G., & Calhoun, L. G. (2004). A Clinical Approach to Posttraumatic Growth. In P. A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 405-419). John Wiley & Sons, Inc. DOI: 10.1002/9780470939338.ch25.
  66. TenHouten, W. D. (2016). The emotions of powerlessness. Journal of Political Power, 9(1), 83-121. DOI: 10.1080/2158379X.2016.1149308.
  67. Vagnini, D., Grassi, M. M., & Saita, E. (2023). Evaluating Somatic Experiencing® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors. International Journal of Environmental Research and Public Health, 20(14), 6412. DOI: 10.3390/ijerph20146412.
  68. Vagnini, D., Grassi, M. M., Valenti, F., Bombardieri, E., Saita, E. (2024a). Beauty Therapy to Support Psychosocial Recovery from Oncological Care: A Qualitative Research on the Lived Experience of Women with Breast Cancer Treated with Chemotherapy. Current Oncology, 31(5), 2527-2541. DOI: 10.3390/curroncol31050189.
  69. Vagnini, D., Natalucci, V., Moi, S., Vallorani, L., Pietrelli, A., Panico R. A., Ferri Marini, C., Lucertini, F., Annibalini, G., Sisti, D., Rocchi, M. B. L., Catalano, V., Saita, E., Emili, R., & Barbieri, E. (2024b). Home-based lifestyle intervention for breast cancer survivors: a surprising improvement in the quality of life during the first year of COVID-19 pandemic. PloS One, 19(1), e0296163. DOI: 10.1371/journal.pone.0296163.
  70. Vagnini, D., Sorge, A., Acquati, C., Colafemmina, F. A., & Saita, E. (2024c). Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy. Journal of Cancer Survivorship: Research and Practice, 18(6), 1998-2007. DOI: 10.1007/s11764-023-01438-6.
  71. Vanstone, R., & Fergus, K. D. (2020). Online couple interventions in cancer. Current Opinion in Supportive and Palliative Care, 14(1), 67-73. DOI: 10.1097/SPC.0000000000000476.
  72. Vartanian, L. R. (2012). Self-discrepancy theory and body image. Encyclopedia of Body Image and Human Appearance, 2, 711-717.
  73. Watson, M., Greer, S., Young, J., Inayat, Q., Burgess, C., & Robertson, B. (1988). Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychological Medicine, 18(1), 203-209. DOI: 10.1017/S0033291700002026.
  74. Watson, M., Law, M., dos Santos, M., Greer, S., Baruch, J., & Bliss, J. (1994) The Mini-MAC: Further development of the Mental Adjustment to Cancer Scale. Journal of Psychosocial Oncology, 12(3), 33-46. DOI: 10.1300/J077V12N03_03.
  75. World Health Organization, WHO (1986). The 1st International Conference on Health Promotion, Ottawa, 1986. Accessibile da: https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference.
  76. Zehra, S., Doyle, F., Barry, M., Walsh, S., & Kell, M. R. (2020). Health-related qual-ity of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis. Breast Cancer, 27(4), 534-566. DOI: 10.1007/s12282-020-01076-1.
  77. Zhang, C., Hu, G., Biskup, E., Qiu, X., Zhang, H., & Zhang, H. (2018). Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and Meta-analysis. World journal of surgery, 42(7), 2076-2085. DOI: 10.1007/s00268-018-4477-1.
  78. Zhu, F., Liu, C., Zhang, W., Qiang, W., Yin, X., & Lu, Q. (2023). The mediating ef-fect of coping styles between self-compassion and body image disturbance in young breast cancer survivors: a cross-sectional study. BMC nursing, 22(1), 178. DOI: 10.1186/s12912-023-01342-5.
  79. Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. DOI: 10.1111/j.1600-0447.1983.tb09716.x.
  80. Zimmermann, T., Scott, J. L., & Heinrichs, N. (2010). Individual and dyadic predictors of body image in women with breast cancer. Psycho-oncology, 19(10), 1061-1068. DOI: 10.1002/pon.1660.

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