Psychological distress, body image, and nutritional status during hospitalization for gynecological cancer surgery: a prospective observational study

Background: Hospitalization for gynecological cancer surgery represents a critical window for assessing and addressing psychological and nutritional vulnerabilities. This prospective observational study investigated changes in emotional distress, anxiety, depression, body-image dissatisfaction, orthorexic tendencies, and nutritional status from admission to discharge, and explored associations between psychological and nutritional variables. Methods: A total of 220 women hospitalized for surgical treatment of gynecological cancer were enrolled, with 181 (82.3%) completing both baseline (T0) and discharge (T1) assessments. Psychological outcomes were evaluated using the Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Body-Image Scale (BIS), and Teruel Orthorexia Scale (TOS). Nutritional status was assessed through the Mini Nutritional Assessment (MNA). Changes between T0 and T1 were analyzed using paired t-tests. Pearson’s correlations examined associations between psychological and nutritional variables. A multivariable logistic regression identified predictors of clinically relevant distress (DT ≥ 4) at discharge. Results: Significant improvements were observed in anxiety (p < 0.001), depression (p < 0.001), emotional distress (p < 0.001), and orthorexic tendencies (p < 0.001) between admission and discharge. Conversely, body-image dissatisfaction increased significantly (p < 0.001). Nutritional risk remained high throughout hospitalization, with no statistically significant change (p = 0.221). Higher body-image dissatisfaction at admission predicted a greater likelihood of clinically relevant distress at discharge (p = 0.003). Conclusions: Hospitalization offers a pivotal opportunity to identify and address emotional and nutritional needs in women with gynecological cancers. Integrated, multidisciplinary supportive care models targeting both psychological and nutritional vulnerabilities are crucial to promote holistic recovery during and beyond the surgical course.