الفهرس 
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Abstract
Body image is not only influenced by life events such as having breast cancer, but also by culture, socio-economic status, and personality. The personality traits extraversion (the disposition towards cheerfulness, sociability, and high activity) and neuroticism (the tendency to experience distressing emotions, such as fear, guilt, and frustration) may have an effect on QOL.
AIM OF STUDY
This study was aimed to assess the body image and self-esteem among women post mastectomy surgery.
RESEARCH QUESTION:
• What is the effect of mastectomy surgery on body image and self-esteem among women?
The subject and methods of the current study will be discussed under the following four (4) designs:
I. Research Design
II. Operational Design
III. Administrative Design
IV. Statistical Design
I. RESEARCH DESIGN
A descriptive exploratory design was used to conduct this study.
B. STUDY SETTING
This study was conducted at oncology center of Ain shams University.
C. SUBJECTS
The study sample is a purposive sample according to sample size equation 200 women with mastectomy out from 420 was participated in the study.
Inclusion criteria
• Women with breast cancer underwent mastectomy with or without chemotherapy after 2 month to 3 years from surgery
• Age from 30 to 60 years old
II. TECHNICAL DESIGN
Tools of data collection
Data were collected through use of the following tools:
1-InterviewQuestionaire: An Arabic questionnaire was developed by the researcher it includes two parts;
Part 1 Socio-demographic sheet: This sheet was designed by the researcher for collecting personal and socio-demographic characteristics of women (age, sex, marital status, education level, job, living place, number of family member, income)
Part 2 Medical history sheets: This sheet was including history of allergy, medications, surgery, chronic diseases and family history of cancer.
2-Body image questionnaire: It was developed by Koleck, M., 2012 and adopted well and translated to measurer body image in women with breast cancer (Koleck andBruchon-Schweitzer.2012)
3-Self-esteem Scale: It was developed by. (Hatcher,et al,2009) and adopted well and translated to measure Self-esteem Scale in women with breast cancer, this scale consists of 10 items, five in positive form and five in negative form.
III. OPERATION DESIGN
The operational design for this study consisted of three phases, namely preparatory phase, pilot study, and fieldwork.
PREPARATORY PHASE
This phase included reviewing of literature related to body image and self-esteem among women post mastectomy surgery using books, articles, journals, and internet. This served to develop the study tools for data collection. During this phase, the researcher also visited the selected places to get acquainted with the personnel and the study settings. Development of the tools was done under the supervisors’ guidance and experts’ opinions were considered.
Content and Face Validity and Reliability:
It was ascertained by 3 experts in psychiatric nursing specialty .Their opinions elicited regarding the format, layout, consistency, accuracy and relevancy of the tools. Reliability was don tested statistically (0.84).
1II. ADMINISTRATIVE DESIGN
An official permission to conduct the study obtained from the medical and nursing director of oncology center of Ain shams University. The researcher then met the hospital director and explained the purpose and the methods of the data collection.
ETHICAL CONSIDERATION:
Verbal approval was obtained from the women before inclusion in the study; a clear and simple explanation was given according to their level of understanding, physical and mental readiness. They secured that all the gathered data was confidential and used for research purpose only.
PILOT STUDY
Pilot study was carried out on 10% (20 women) of women at oncology center of Ain shams University to test the applicability of the constructed tools and the clarity of the questions related to body image and self-esteem among women post mastectomy surgery. The pilot has also served to estimate the time needed for each subject to fill in the questions. According to the results of the pilot, some corrections such as rephrasing and added questions were performed as needed. The pilot participants were not included in the main study sample.
FIELDWORK
To carry out the study, an approval was obtained from the medical and nursing director of oncology center of Ain shams University. A letter was issued to them from the Faculty of Nursing, Ain-Shams University, explaining the aim of the study in order to obtain their permission and cooperation. Six months periods / the researcher will be available period of 6 months, three days per week by rotation in the previous mentioned settings, during the morning shift. The questions sheet was filled by the women.
RESULTS:-
Finding of the current study can be summarized as the following:
• 57.5% of them were in age group ranged between 50-60 years with mean age 41.69±6.66
• 21.0 % of them were read and write.
• 39% of the studied women are working.
• 49.5% of the studied women were lived in rural areas.
• 22.5%of the studied women suffered from medical diseases such as diabetes mellitus, hypertension, cardiac diseases, liver diseases and other gynecological cancers e. g cervix cancer, ovarian cancer, uterine cancer and endometrial cancer.
• 32.5% of the studied women complained from psychological distress such as depression, anhedonia, hopelessness and anxiety.
• 41.5% of the studied women had other operations as mastectomy, ovarioectomy and lumpectomy.
• 60% of the studied women receive chemotherapy.
• 60% of the studied women received radiotherapy.
• 3.5% of the studied women have high concerns of their body image, more than one quarter (28%) have low concerns of their body image, while nearly three quarters (71.5%)of the studied women have moderate concerns of their body image.
• 24% of the studied women have low self-esteem, while about three quarters (72.0%) of them have moderate self-esteem and only (4%) have high self-esteem.
• There was highly statistically significant differences between age of the studied women and their body image (P<0.01).
• There was statistically significant differences between level of education of the studied women and their body image (P<0.05).
• There was highly statistically significant differences between occupation of the studied women and their body image (P<0.01).
• There was statistically insignificant differences between residence of the studied women and their body image (P>0.05).
• There was highly statistically significant differences between clinical data of the studied women and their body image (P<0.01).
• There was statistically insignificant differences between age of the studied women and their self-esteem (P>0.05).
• There was highly statistically significant differences between level of education of the studied women and their self-esteem (P<0.01).
• There are insignificant differences between occupation of the studied women and their self-esteem (P>0.05).
• There was statistically insignificant differences between residence of the studied women and their self-esteem (P>0.05).
• There was highly statistically significant differences between clinical data of the studied women and their self-esteem (P<0.01).
• There was positive correlation between body image of the studied women and their self-esteem with highly statistically significant differences at p < 0. 05.