Assessing the Relationship between Body Image and Quality of Life Among Rural and Urban Breast Cancer Survivors in China

Abstract Purpose This study aimed to examine the associations between multidimensional body image and quality of life (QoL) and test whether the associations between body image and QoL are moderated by rural-urban residence in Chinese breast cancer survivors. Methods A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (Body Image Self-Rating Questionnaire for Breast Cancer and SF-36) and questions assessing demographic and clinical covariates were administered. Results In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical and mental well-being. Better perception of body image-related social and behavior change domains was only significantly associated with better mental well-being. The association between body image and mental well-being was much stronger in urban subjects (b = -0.38, p < 0.001) than in rural subjects (b = -0.20, p < 0.001). Conclusions Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our findings indicate that incorporating interventions that address body image issues would be advantageous for survivorship care programs focused on enhancing QoL in breast cancer survivors. Considering the rural-urban differences supports strategic design of the care programs in rural and urban settings.