Supportive Care in Cancer

, Volume 26, Issue 10, pp 3365–3377 | Cite as

A two-dimensional model of disrupted body integrity: initial evaluation in head and neck cancer

  • Kenneth Mah
  • Sophie Lebel
  • Jonathan Irish
  • Andrea Bezjak
  • Ada Y. M. Payne
  • Gerald M. Devins
Original Article



This cross-sectional study presents an initial psychometric evaluation of a two-dimensional (perceptual and evaluative) conceptualization and measure of disrupted body integrity (DBI)—illness-related disruption of the sense of the body as an integrated, smoothly functioning whole.


Male and female head and neck cancer (HNC) outpatients (N = 98) completed a questionnaire package prior to outpatient visits.

Main outcome measures

The Disrupted Body Integrity Scale (DBIS) was developed to measure the perceptual and evaluative facets of DBI. Self-report measures of disfigurement, stigma, depressive symptoms, and negative affect were also completed.


Almost all DBIS subscales demonstrated good internal consistency. Results largely supported the DBIS’s construct validity. The majority of subscales correlated within the predicted range of r’s = .40–.70. Almost all DBIS constructs were positively linked with either depressive symptoms or disfigurement. None correlated with positive affect, and only two subscales, abnormal sensations (perceptual) and physical vulnerability (evaluative), correlated with negative affect. DBIS constructs showed little relation with stigma, once disfigurement effects were controlled for.


Findings offer preliminary evidence for the DBIS and the relevance of DBI in HNC. Further evaluation of DBI in disease adaptation and the DBIS’s factor structure is warranted.


Head and neck cancer Body experience Embodiment Psychometric evaluation Adaptation 



We appreciate the efforts of our research assistants on this project: Michelle Majcen, Jackie Wan, Colleen Simpson, Vivian Tsung, and Ka Ming Fong. We extend our gratitude to the members of the UHN Quality of Life Manuscript-Review Seminar for their invaluable feedback and suggestions on earlier versions of this manuscript.

Funding information

This research was supported in part by the Canadian Institutes of Health Research through a Postdoctoral Fellowship to Sophie Lebel, a Senior Investigator Award to Gerald M. Devins, and a grant from the Psychosocial Oncology and Palliative Care Program (Princess Margaret Cancer Centre) to Sophie Lebel.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Supportive CarePrincess Margaret Cancer Centre (University Health Network)TorontoCanada
  2. 2.School of PsychologyUniversity of OttawaOttawaCanada
  3. 3.Department of Surgical OncologyPrincess Margaret Cancer Centre (University Health Network)TorontoCanada
  4. 4.Department of MedicineUniversity of TorontoTorontoCanada
  5. 5.Ontario Cancer InstituteTorontoCanada
  6. 6.Department of Radiation OncologyPrincess Margaret Cancer Centre (University Health Network)TorontoCanada
  7. 7.Cancer Care OntarioTorontoCanada
  8. 8.Department of PsychiatryUniversity of TorontoTorontoCanada

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