Body Image, Embodiment and Chronic Illness Experience in the Ghanaian Context: A Social Psychological Study

Abstract

Individuals living with chronic illness experience changes to their body image and sense of embodiment. These changes significantly impact individuals' physical, psychological, and social well-being. Understanding these changes, particularly within the socio-cultural context of Ghana, is critical for developing effective care strategies. Despite growing interest in the interplay between chronic illness and body image, limited research has examined these issues, particularly in African contexts. This study applied a social psychological approach to explore the social representations of body image among individuals living with a range of chronic illnesses in Accra, how these representations intersect with their bodily experiences and how these representations and bodily experiences shape body image management and management of their conditions, care needs and experiences. A mixed-qualitative research design was employed, guided by Social Representation Theory (SRT). Data collection involved in-depth individual interviews, dyadic interviews, focus group discussions, and ethnographic observations. The data was gathered from 91 participants, comprising 31 individuals with chronic illnesses, 15 caregivers, 8 healthcare providers, 33 (self reported healthy) focus group participants, and 4 participants who were observed during ethnographic fieldwork. All participants were purposively selected from three communities in Accra, Ghana: Jamestown, Ussher Town, and Legon. Theory-driven thematic analysis was used to identify themes across individual, interpersonal, community, and structural levels. Findings revealed that chronic illness shaped largely negative post-diagnosis body image. This undermined participants’ sense of embodiment, leading to physical, emotional, and social challenges such as stigmatization, reduced self-esteem, and social withdrawal. Caregivers and healthcare providers also faced psychological distress due to the visible physical changes in care recipients and the caregiver burden. Management of body image concerns emerged as a critical aspect of chronic illness care. Participants emphasized the need for culturally sensitive healthcare approaches that integrate biomedical, cultural, and spiritual knowledge systems. Effective management also required addressing societal stigma and enhancing public awareness to reduce misconceptions and promote supportive environments. The study highlighted the importance of multi-level, culturally sensitive interventions in chronic care, which consider the interplay of personal, social, and structural influences. Future research should address socioeconomic diversity and adopt broader observational strategies to deepen understanding of these complex phenomena.