Assessing Body Image and Quality
of Life in Medical Settings
THOMAS F. CASH
Many variables influence patients' evaluations of their health-related quality of life (HRQOL). Surprisingly, body image assessment has not been well integrated into the HRQOL literature, despite consistent observations that changes in physical appearance, function, and body integrity are central to the experience of illness and medical treatment (see Part VI of this volume).
In this brief chapter it is impossible to address fully the medical contexts and range of issues relevant to HRQOL and body image assessment. However, we can articulate the benefits of improving body image evaluation in HRQOL assessment and provide a general structure for planning body image assessment in the context of HRQOL issues.
To provide the most effective and efficient clinical services that maximize patients' HRQOL, we must readily distinguish between patients who do, and do not, have body image concerns. Currently, we have limited data regarding the epidemiology of body image concerns in specific medical populations. However, it appears safe to conclude that of all individuals experiencing any particular medical problem, only a minority report body image concerns. These findings are consistent with Fisher's observations in his 1986 comprehensive review, Development and Structure of the Body Image.