Reflective accounts

Altered body image

A CPD article improved Rose Gallacher’s knowledge of how to manage patients with altered body image.
Body image

A CPD article improved Rose Gallachers knowledge of how to manage patients with altered body image.

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed psychological support for patients with altered body image resulting from illness, injury or disability. These changes may affect appearance or function of the patients body.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article described body image as comprising of three concepts body reality, body ideal and body presentation. It emphasised that body changes that affect one of these areas are likely to affect the others, and can lead to lower self-esteem.

Patients with altered body image may need to progress through the different stages of grief and/or loss, including shock and

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A CPD article improved Rose Gallacher’s knowledge of how to manage patients with altered body image.


Picture: Alamy

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed psychological support for patients with altered body image resulting from illness, injury or disability. These changes may affect appearance or function of the patient’s body.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article described body image as comprising of three concepts – body reality, body ideal and body presentation. It emphasised that body changes that affect one of these areas are likely to affect the others, and can lead to lower self-esteem.

Patients with altered body image may need to progress through the different stages of grief and/or loss, including shock and anger, before adapting to body change. However, the length of time patients require for this varies because individuals respond differently to body image changes. This depends on factors such as the site and extent of the injury and other people’s reactions.

I learned that the acronym BATHE can be used to explore the patient’s psychological state. This consists of five aspects of questioning on the patient’s background, affect, trouble, handling and empathy. Asking these questions may enable patients to recollect the experience and attitudes that have resulted from sudden body image changes and can indicate which stage of grief and/or loss they have reached.

I understand there are many ways nurses can support patients with altered body image, such as assessing the patient’s body image care needs, offering advice, and involving friends, family and charities in their care. Patients may also require reassurance that any frustration, anger, fear or disempowerment they are feeling are commonly experienced by other patients in similar situations.

How did you change or improve your practice?

In my practice, I will consider using various ways to improve patients’ body image care, including fitness training, media literacy work, enhancing their self-esteem through cognitive behavioural therapy or counselling, and providing psychological education.

The article discussed the need for some patients to establish a revised identity following an illness or injury. This may involve the use of cosmetic camouflage, clothing, communication aids or prosthetics, as well as rehearsing their psychological responses to any future changes that may occur.

I will consider encouraging patients to write letters about the changes they have experienced, which can enable patients to adjust to their revised identity.

To support patients to adapt to any body image changes, I will recommend they record any emotions, doubts or challenges they experience in a diary. This would include documenting any coping strategies they developed, which could assist other patients to improve their perceptions of changes in their body image.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

The article provided information about the psychological needs that patients with altered body image may have, and outlined strategies for addressing these needs. This is relevant to the
theme of prioritising people, which states that nurses must assess and respond to people’s physical, social and psychological needs.

Rose Gallacher is a staff nurse at Queen Elizabeth University Hospital, Glasgow


This reflective account is based on NS874 Price B (2016) Enabling patients to manage altered body image. Nursing Standard. 31, 16-18, 60-70

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