Date of Award


Degree Name

Doctor of Nursing Science

Dissertation Committee

Mary P. Quayhagen, DNSc, RN, FAAN, Chairperson; Kathleen Heinrich, PhD, RN; Judith Chodil, PhD, RN


body image appraisal, Brain tumors, nursing, self-image, Stress-Coping-Adaptation framework


Within a stress-coping-adaptation framework, a path analytic model was hypothesized to explain the interrelationships among the variables of gender, age, duration of illness, steroid dosage, social support, perceived health status limitations, and coping skills, and their subsequent effect on body image appraisal in the population of subjects undergoing treatment for a malignant brain tumor. The many potential changes in physical appearance and functional abilities, including the loss of hair, the onset of Cushing's syndrome and varied physical disabilities, may cause devastating alterations in body image, requiring tremendous coping skills for adaptation in these individuals. One hundred and ten subjects were assisted, during home or clinic visits, to complete a demographic questionnaire, the Sickness Impact Profile Scale (SIPS) to assess perceived health status limitations, the PRQ-85 social support instrument, the Revised Jalowiec Coping Scale, the Body Cathexis/Self-Cathexis Scale to measure body attitude, and the Modified Topographic Device to measure body perception. The data were analyzed using descriptive statistics along with bivariate and multiple regression techniques to explain the greatest amount of variance in the causal model. The simplified model contained 12 significant direct effects and two significant indirect effects for predicting the dependent variables. In the post hoc analysis, differences were found between the low grade tumor group and the high grade tumor group in terms of their impact on causal relationships within the model. The variables with the strongest ability to predict body image appraisal in the high grade tumor group included steroid dosage and physical health status limitations. Conversely, the variables able to explain the greatest amount of variance in body image appraisal for the low grade tumor group included confrontive coping, duration of illness, and social support through confrontive coping. Among both groups, male gender and age negatively influenced body attitude, while male gender was predictive of a positive body perception. Knowledge about the concept/construct of body image has implications for the practice, research and theoretical realms of nursing. Spanning the scope of all nursing settings and populations, and applicable within nursing conceptual frameworks, body image should impact the arenas of the clinical practitioners, researchers and educators within our profession.

Document Type

Dissertation: Open Access



Included in

Nursing Commons