88.5% (n.92 of n.104) of the eligible patients completed the psychological evaluations, while n.12 refused the participation (they didn’t sign the informed consent). The reasons given for not participating included lack of time. Participants were distributed into two groups by gender: Female Group (n.55) and Male Group (n.37); then we divided the sample by median age (43 years old): Young Group (n.46; range age 22-42) and Adult Group (n.46; range age 43-50). Table 2 shows the means value and standard deviations of the raw scores performed to the psychological testing battery.
First, MANOVA statistical analysis (4x2x2) was conducted to compare the variables of the 4 emotional traits (PDI, DASS-21, MCQ-10 and BSP-q), gender (2: F, M) and age group (2: young, adult). Statistical analysis evidenced a significant effect for gender variable; no significant effect among aging and neither no significant interaction between age and group variables. Between effect test indicated significant differences in distress (PDI) (F(1,88) = 10,3; η2 = 0,8; p = 0.002), body image perception (BSP-q) (F(1,88) = 6,4; η2 = 0,7; p = 0.01), anxiety severity degree (DASS-21) (F(1,88) = 4,4; η2 = 0,5; p = 0.03) (see Figure 1). Females appeared psychologically more vulnerable than males; another interesting point was no aging depending. Female emotional pattern showed higher anxiety, and psychological distress associated to lower positive self-perception of body image.
Then, we analyzed the indexes of each psychological test. ANOVA analysis (5x2) comparing 5 MCQ-10 indexes (POS, NEG, CC, NC, CSC) and 2 gender groups (F, M) highlighted the significant difference in NEG index: female group showed higher negative believes concerning the consequences of not controlling thoughts (F(90,1) = 5,7; η2 = 0,6; p = 0.01).
ANOVA (3X2) comparing 3 domains of PDI emotional traits (3: depression, anxiety, stress) and gender (3: F, M) showed significant effect on anxiety (F(90,1) = 4,0; η2 = 0,5; p = 0.04) and stress (F(90,1) = 4,0; η2 = 0,5; p = 0.04), but no significant difference in depression variable. Female group appeared suffering higher degree of anxiety and even resulted more stressed.
Finally, ANOVA (3x2) conducted comparing BSP-q indexes (3: TCBI, SW, PF) of and gender groups (2: F., M) showed a significant difference in TCBI (consequences of clinical treatment on body image) (F(90,1) = 6.3,0; η2 = 0,7; p = 0.01), and well-being with own body index (PF, physical feeling) (F(90,1) = 4.1,0; η2 = 0,6; p = 0.04), whereas no significant differences were in well-being in social interaction index (SW).
We performed a linear regression to explain the relation between emotional traits and TCBI and then PF indexes. The TCBI resulted to be impacted by psychological distress (F(1,90) = 8,0; R2 = 0,14; t = -3,95; p = 0.01) by anxiety level (F(1,90) = 16,5; R2 = 0,15; t = -4,07; p = 0.01) depression (F(1,90) = 11,0; R2 = 0,109;t = -3,32; p = 0,001), stress (F(1,90) = 6,60; R2 = 0,06; t = -2,57; p = 0.01). The PF index resulted influenced by psychological distress (F(1,90) = 9,77; R2 = 0,09; t = -3,13; p = 0.002).
Afterward, we wanted to analyze the performance of patients by cancer stage and gender variables. Participants were divided into 3 groups by (AJCC) Cancer staging: Group T0 composed of n. 24 patients ; Group T1a composed of n. 51 patients, and then Group T1b within n. 17 patients. In Table 3 are reported psychological performance of groups.
A MANCOVA analysis (3x3x2) on BSP indexes (3: TBCI, SW, PF), Cancer Stage (3: T0, T1a, T1b) and Gender (2) groups covariated by age was conducted; BSP indexes resulted significant different are: TCBI (F(85,1) = 4,7; η2 = 0,5; p = 0.02) and PF (F(85,1) = 4,1; η2 = 0,5; p = 0.04) by gender comparison showing female group with higher fragility dealing with the consequences of clinical treatment on body image (TCBI index) and physical feelings; no significant difference among cancer staging, as well as no interaction effect and neither significant covariance.
Finally, MANCOVA analysis (5x3x2) comparing MCQ-10 indexes (5: POS, NEG, CC, NC, CSC), Cancer Stage (3: T0, T1a, T1b) and Gender (2: F, M) groups covariated by age was conducted. NEG index resulted significant (F(85,1) = 6,9; η2 = 0,7; p = 0.01) showing Female group more affected by negative thoughts; no significant difference among cancer staging, as well as no interaction effect and neither significant covariance.