Pressures and stresses can distort views of the self and impose limits that make it impossible for people to feel self-esteem, or respect for themselves based on their lives (present, past, and future) and accomplishments. Self-esteem is synonymous with self-satisfaction, self-respect, and self-worth. A multiplicity of variables can affect how one perceives the self, including life events that threaten physical health. Low or decreased self-esteem is correlated with quality of life and long-term problems such as neuroses, depression, psychosomatic complaints, and anxiety.

A recent study analyzed the self-esteem effects on women undergoing chemotherapy and serves to provide interesting insight into their reactions. Researchers found that each and every patient differed where her self-esteem was concerned. While most patients were concerned with skin change, hair loss, loss of a body part, or other physical changes, other patients were primarily concerned with questions of mortality and missed opportunities for the future. Assuming that all patients have the same primary concerns about and reactions to cancer and its treatment leads to an incorrect analysis of the psychological reactions of patients. A wide variance in factors thought to influence self-esteem were reported by the women involved in the study, including physical, social, psychological, and/or spiritual factors.

Sometimes other issues are ignored or overlooked due to an emphasis on body image and physical changes. While physical transformations are important and often a source of self-esteem increase or decrease, other important issues should not be ignored or avoided. Data shows that other concerns may be equally important or of even greater concern. Feeling well, functioning adequately, having faith, experiencing hope, appreciating life, having effective coping skills, accepting the disease, achieving desired goals, and social characteristics such as feeling attractive, experiencing positive relationships, and being independent were reported as factors that affected self-esteem.

Taking the time to develop a meaningful relationship with the patient can assist patients to deal with self-esteem issues. Helping patients understand the decisions they face and the consequence of their actions can help with life changes, which generally impact self-esteem.

Other strategies for health care professionals include:

• Acknowledge potential differences in the factors that influence the patients' self-esteem.
• Develop the kind of relationship that enables patients to discuss their concerns.
• Provide the kind of support necessary for individuals to regain a solid appreciation of themselves.

Source: Brockopp, D.Y., and Carpenter, J.S. (1996). The place of self-esteem on the cancer experience. Cope(January/February), 34-3