Journal of Psychosomatic Research

Associations between physical activity, body esteem, and self-esteem among women with breast and gynecological cancer

Gynecological and breast cancers are among the most prevalent malignancies in women. While survival has improved due to advances in treatment, many survivors experience challenges such as body image disturbances and reduced self-esteem. Physical activity has been identified as a potential protective factor, but evidence specific to this population remains limited. The aim of this study was to evaluate the differences in body image and self-esteem among physically active and inactive women with a history of gynecological and breast cancer, as compared to active and inactive healthy controls. A cross-sectional online survey was conducted in Poland. Participants were allocated to four groups according to cancer status and physical activity: inactive controls (CON-PI), active controls (CON-PA), inactive cancer survivors (CAN-PI), and active cancer survivors (CAN-PA). Physical activity was defined based on World Health Organization recommendations. Body image and self-esteem were assessed using the Body-Esteem Scale for Adolescents and Adults (BESAA) and the Rosenberg Self-Esteem Scale (RSES). Physically active women reported significantly higher BESAA and RSES scores compared to inactive women. The CAN-PI group consistently showed the lowest scores across all domains, while the CON-PA group reported the highest. Differences were particularly marked in appearance, attribution, and global self-esteem. Meeting WHO-recommended physical activity levels was associated with more positive body image and higher self-esteem in women after gynecological and breast cancer treatment. The findings highlight the potential role of physical activity in psychosocial well-being and support its inclusion in survivorship care.

Personality traits as predictors of self-care agency in women with gynecological cancers: Cross-sectional study

Gynecological cancers present a dual burden of physiological and psychosocial distress. Self-care agency defined as an individual's capacity to initiate and maintain health-related behaviors is critical for optimizing well-being in cancer patients. While psychological factors, particularly personality traits, are known to influence self-care in chronic illnesses, their role in gynecological oncology remains underexplored. This study aimed to determine whether personality traits predict self-care agency among women with gynecological cancers. A descriptive, cross-sectional design was employed with 200 women recruited via convenience sampling. Data were collected using a demographic form, the Cervantes Personality Scale, and the Exercise of Self-Care Agency Scale. Simple linear regression analyses examined the predictive value of personality subscales on self-care agency. Personality traits were found to be significant predictors of self-care agency. Extroversion, emotional stability, and consistency explained 37.5 %, 20.1 %, and 30.4 % of the variance in self-care agency, respectively (p < 0.05). Women with higher levels of these traits demonstrated greater self-care capacity, while introversion, neuroticism, and inconsistency were linked to reduced self-care agency. This study highlights the significant role of personality traits in influencing self-care agency in this population. Tailoring supportive care to address individual personality characteristics may improve self-management and overall treatment outcomes. Incorporating psychosocial assessments into routine care and developing targeted interventions could enhance quality of life. Future research should focus on intervention studies to validate these approaches and optimize personalized care strategies in gynecological oncology.

Preoperative sleep quality and anxiety as predictors of postoperative pain and recovery in Gynecologic oncology surgery: A prospective observational study

This study evaluated associations between preoperative sleep quality, anxiety, and short-term postoperative outcomes in patients undergoing gynecologic oncology surgery. This prospective observational study included 72 women undergoing open gynecologic cancer surgery. Preoperative sleep quality and anxiety were assessed 24-48 h before surgery using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Anxiety Inventory (BAI). Postoperative pain was measured using the Numerical Rating Scale (NRS) at 0, 4, 8, 12, and 24 h. Complications, rescue analgesia use, and length of stay were recorded. Poor sleep quality (%31.9) and clinically significant anxiety (%19.4) were both associated with higher mean postoperative pain scores (PSQI ≥5: 6.3 ± 1.2 vs 5.1 ± 1.3, p = 0.002; BAI ≥16: 6.5 ± 1.1 vs 5.2 ± 1.4, p = 0.001). In adjusted analyses, higher PSQI (β = 0.112, 95 % CI 0.039-0.185, p = 0.003) and higher BAI scores (β = 0.044, 95 % CI 0.023-0.065, p < 0.001) remained significantly associated with increased mean pain. Poor sleep quality was also linked to longer hospitalization (4 vs 3 days, p < 0.001) and higher complication rates (%52.2 vs %12.2, p < 0.001). Elevated anxiety was similarly associated with higher complication rates (%57.1 vs %17.2, p = 0.004) and more frequent rescue analgesia use (%64.3 vs %29.3, p = 0.014). Preoperative sleep disturbances and anxiety are significantly associated with worse postoperative pain, higher complication rates, and prolonged recovery; routine screening and targeted interventions may therefore improve surgical outcomes. The study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07036549) on June 24, 2025.

Association of cancer and schizophrenia, major depression and bipolar disorder: A Mendelian randomization study