title: Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients.
abstract: OBJECTIVE
  This study aims to evaluate the impact of chemotherapy-induced alopecia (CIA) distress on body image, psychosocial well-being, and depression among breast cancer patients.
  
  
  METHODS
  A cross-sectional survey was conducted at the breast cancer advocacy events held at 16 hospitals in Korea. Alopecia distress was assessed using the 'Chemotherapy-Induced Alopecia Distress Scale', body image and psychosocial well-being were measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and breast specific module (BR23), and depression was measured using the Center for Epidemiological Studies Depression scale. Means of outcomes were compared between low and high CIA distress groups. Univariable and multivariable linear regression models were used to analyze the relationship between the CIA distress and body image, psychosocial well-being, and depression.
  
  
  RESULTS
  One hundred sixty-eight breast cancer patients participated in the study; the mean age was 48.4 (SD = 8.4) years, and 55.3% of the patients experienced higher distress from alopecia. In fully adjusted models, the high distress group was more likely to have a poorer body image than the low distress group (35.2 vs. 62.0; p < 0.001). Distressed patients were also more likely to report lower emotional (55.3 vs. 76.9; p < 0.001), role (58.6 vs. 72.0; p < 0.001), and social functioning (51.3 vs. 70.9; p < 0.001). The high distress group was also more likely to have depression compared with the low distress group (19.6 vs. 14.8; p < 0.001).
  
  
  CONCLUSIONS
  Chemotherapy-induced alopecia distress was negatively associated with body image, psychosocial well-being, and depression in women with breast cancer. It is necessary to develop specific interventions to minimize distress due to alopecia for women with breast cancer.
authors.affiliation: Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choi
authors.forename: Im-Ryung
authors.initials: IR
authors.lastname: Kim
authors.forename: Oliver
authors.initials: O
authors.lastname: Chang
authors.forename: Danbee
authors.initials: D
authors.lastname: Kang
authors.forename: Seok-Jin
authors.initials: SJ
authors.lastname: Nam
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.forename: Se Kyung
authors.initials: SK
authors.lastname: Lee
authors.forename: Young-Hyuck
authors.initials: YH
authors.lastname: Im
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Park
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yang
authors.forename: Juhee
authors.initials: J
authors.lastname: Cho
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000505:Alopecia / Q000139:chemically induced* / Q000523:psychology; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D056910:Republic of Korea; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: body image; cancer; chemotherapy-induced alopecia distress; depression; oncology; psychosocial well-being