Journal of Nursing & Patient CareISSN: 2573-4571

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Body image and self-image assessed by self-figure drawings in women diagnosed with breast cancer underwent different breast surgery

Ziva Ariela Barel-Shoshani and Shulamith Kreitler

School of Health and Welfare Sciences, Haifa University
School of Psychological Sciences, Tel-Aviv University

: J Nurs Patient Care


Background and Objective: Breast cancer is the most common cancer in women in Western society. Advances in medicine and technology have led to a significant reduction in the mortality rate. In many cases women with breast cancer are compelled to undergo surgery, which causes distortion or even complete removal of the breast. Hence, it is important to address the psychological consequences, especially focused on the body image, of the disease and surgery in breast cancer survivors. Materials and Methods: The participants were 80 breast cancer survivors. The Machover Draw-A-Person (DAP) test was administered twice: first they were asked to draw themselves today, then they were asked to draw themselves as they had seen themselves pre-illness. The features in the self figure drawings of the participants who underwent different kinds of surgery were compared. The features in self figure "today" were compared to those in the pre-illness figure for each subject. Results: Three indicators in the drawings distinguished significantly between the drawings of participants who underwent different kinds of surgery: figure height, mouth, and breast signs. Four drawing indices (body outline, eyes, hands, hair) indicated differences in self-perception pre-post cancer in the group who underwent lumpectomy, and two drawing indices (breast, hair) in the group who underwent mastectomy. The findings in the conservation surgery group indicate anxiety, connection to self, and need for social communication. In contrast, in the mastectomy group there were more indications of interest in appearance and difficulty in speaking about their cancer. Conclusions: It is suggested that the Machover Draw-A-Person test is a projective tool that could be used as an aid for planning supportive care for alleviating the distress of breast cancer survivors as part of a rehabilitation program. Note. Some of the findings will be reported in the PhD thesis of the first author, conducted under the supervision of the second author; some have already been published and others are in the process of being prepared for publication.


Ziva Ariela Barel-Shoshani has five academic degrees. She has graduated B.Sc. in Mechanical engineering and M.Sc. on Agricultural engineering at the Technion -Israel Institute of Technology, B.A in Psychology and MBA in the Open University of Israel, and M.A. in Art Therapy from Haifa University. Now she is in the final stages of her PhD studies of the School of Health and Welfare Sciences at Haifa University. The theme of her doctoral dissertation is the emotional implications in body image drawings of survivors of brest cancer. She is working as an Art therapist. And teaches physics, gifted high school students.


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