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Tomaz Santos N, Ramos C, de Almeida MF, Leal I. Group Intervention Program to Facilitate Post-Traumatic Growth and Reduce Stigma in HIV. Healthcare (Basel) 2024; 12:900. [PMID: 38727457 PMCID: PMC11083302 DOI: 10.3390/healthcare12090900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main objective was to evaluate the effectiveness of an intervention in increasing PTG and decreasing stigma in HIV, as well as to explore relationships between the variables. Methods: Quasi-experimental design with a sample of 42 HIV-positive adults (M = 46.26, SD = 11.90). The experimental group (EG) was subjected to a 9-week group intervention. Instruments: CBI, PTGI-X, PSS-10, HIV stigma, emotional expression, HIV stress indicators, HIV literacy, and skills. Multiple linear regression analysis was performed to assess the relationship between the variables. Results: There was an increase in PTG and a significant decrease in stigma in all domains and subscales in the EG. Compared to the control group, stigma (t(42) = -3.040, p = 0.004) and negative self-image (W = -2.937, p = 0.003) were significant, showing the efficacy of the intervention. Discussion: The intervention demonstrated success in facilitating PTG, attesting that in order to increase PTG, personal strength, and spiritual change, it is necessary to reduce stigma and negative self-image. The research provides more information on group interventions for PTG in HIV, relationships between variables, and population-specific knowledge for professionals.
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Affiliation(s)
| | - Catarina Ramos
- CiiEM—Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Monte da Caparica, 2829-511 Almada, Portugal
| | | | - Isabel Leal
- WJCR—William James Center for Research, ISPA—University Institute, 1149-041 Lisbon, Portugal; (M.F.d.A.); (I.L.)
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Quality of life, anxiety, depression, and distress in patients with advanced and metastatic lung cancer. Palliat Support Care 2022:1-8. [PMID: 36210754 DOI: 10.1017/s147895152200116x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Lung cancer (LC) patients have shown a predisposition for developing emotional and physical symptoms, with detrimental effects on the quality of life (QoL). This study evaluates the bidirectional relationship between main psychological disorders and clinical/sociodemographic factors with the QoL. METHODS In this observational cross-sectional study, patients with a confirmed LC diagnosis from February 2015 to March 2018 were eligible for this study. Each participant completed screening instruments of anxiety, depression, distress, and QoL assessment. Other relevant clinical data were extracted from electronic health records. Then comparisons, correlations, and logistic regression analyses were performed. RESULTS Two hundred and four cases were eligible; of them, the median age was 61 (24-84) years, most had clinical stage IV (95%), and most were under first-line therapy (53%). Concerning psychological status, 46% had symptoms of emotional distress, 35% anxiety, and 31% depression. Patients with psychological disorders experienced a worse global QoL than those without psychological impairment (p < 0.001). Increased financial issues and physical symptoms, combined with lower functioning, were also significantly associated with anxiety, depression, and distress. In the multivariate analysis, female sex and emotional distress were positively associated with an increased risk of depression; likewise, female sex, low social functioning, insomnia, and emotional distress were associated with anxiety. CONCLUSIONS Emotional symptoms and QoL had a significant bidirectional effect on this study; this underscores the necessity to identify and treat anxiety, depression, and distress to improve psychological well-being and the QoL in LC patients.
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McDonnell KK, Webb LA, Adams SA, Felder TM, Davis RE. The association between lung cancer stigma and race: A descriptive correlational study. Health Expect 2022; 25:1539-1547. [PMID: 35415934 PMCID: PMC9327804 DOI: 10.1111/hex.13495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/23/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Stigma is a formidable burden for survivors of lung cancer that can reduce the quality of life (QOL), resulting in physical, social and psychological challenges. This study investigates associations between stigma and depression, QOL and demographic and health-related characteristics, including race. DESIGN An adapted conceptual model derived from the Cataldo Lung Cancer Stigma Scale guided this descriptive correlation study assessing stigma in African American and Caucasian survivors of lung cancer. Self-reported, written surveys measuring depression, QOL, lung cancer stigma and demographics were administered. Statistical analysis was conducted to assess associations between stigma and depression, stigma and QOL and stigma and race, while adjusting for demographic characteristics. RESULTS Participants (N = 56) included 30 Caucasian and 26 African American survivors of lung cancer recruited from a cancer registry of an American College of Surgeons-accredited programme, a survivors' support club and an ambulatory oncology practice in the southeastern United States. Statistical analysis yielded (1) a significant moderate positive association between depression and lung cancer stigma; (2) a significant moderate negative association between QOL and lung cancer stigma; and (3) significant relationships between race and lung cancer stigma, specifically higher degree of stigma among African Americans compared to Caucasians. CONCLUSION Stigma affects many aspects of survivors' lives. Healthcare professionals need to consider how health-related stigma may further complicate the physical burdens, psychological distresses and social challenges that accompany the disease, especially among African American survivors. Additional enquiry and interventions are needed to assist with mitigating the negative effects of stigma on survivors and their family members and friends. PATIENT OR PUBLIC CONTRIBUTION Fifty-six survivors of lung cancer participated in this descriptivecorrelation study. They completed written surveys measuring depression, QOL, and lung cancer stigma, plus an investigator-developed demographic information form.
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Affiliation(s)
| | - Lisa A Webb
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Swann A Adams
- College of Nursing and Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Tisha M Felder
- College of Nursing, Cancer Prevention & Control Program and Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Rachel E Davis
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Lv XQ, Feng Y, Li JR, Zhang XQ, Xiang R, Hong JF. Validation of a Chinese version of the short-form Cataldo lung cancer stigma scale. Heart Lung 2021; 51:59-66. [PMID: 34731699 DOI: 10.1016/j.hrtlng.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/08/2021] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lung cancer stigma is a widespread psychosocial problem. We developed a short form of the Cataldo lung cancer stigma scale for Chinese people with lung cancer (CLCSS-C-SF) and compared its psychometric properties with those of the full and short versions. METHODS This was a secondary analysis using data from the full CLCSS-C, distress thermometer and perceived social support of Chinese people with lung cancer (N = 394). Exploratory and confirmatory factor analysis (CFA) were used to identify factor structure and assess construct validity. The internal consistency and concurrent and known-group validity were evaluated. RESULTS The 22-item CLCSS-C-SF comprised four factors. The convergent validity evaluated using average variance extracted and discriminant validity were acceptable. Cronbach's alphas, concurrent and known-group validity were satisfactory for three versions. Only the four-factor model proposed was validated by CFA. CONCLUSION The CLCSS-C-SF is reliable and valid and can be used in Chinese lung cancer populations.
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Affiliation(s)
- Xiao-Qing Lv
- School of Nursing, Anhui Medical University, Anhui, PR China.
| | - Yuan Feng
- School of Nursing, Anhui Medical University, Anhui, PR China.
| | - Jing-Ru Li
- School of Nursing, Anhui Medical University, Anhui, PR China.
| | - Xin-Qiong Zhang
- School of Nursing, Anhui Medical University, Anhui, PR China.
| | - Ru Xiang
- School of Nursing, Anhui Medical University, Anhui, PR China.
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, Anhui, PR China.
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5
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Rose S, Boyes A, Kelly B, Cox M, Palazzi K, Paul C. Lung cancer stigma is a predictor for psychological distress: A longitudinal study. Lung cancer stigma is a predictor for psychological distress. Psychooncology 2021; 30:1137-1144. [PMID: 33624377 DOI: 10.1002/pon.5665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To examine if baseline stigma predicts psychological distress at 3 and 6 months follow-up among patients newly diagnosed with lung cancer. METHODS This longitudinal study was nested within a larger randomised controlled trial. Eligible participants were recruited via respiratory and oncology out-patient clinics in Australia (n = 194). Consenting participants were asked to complete surveys at baseline, 3 and 6 months post-recruitment. Measures included lung cancer stigma (Cataldo Lung Cancer Stigma Scale) and psychological distress (General Health Questionnaire-12 [GHQ-12]). RESULTS One-hundred and ninety-four participants were included for analysis. Most were male (57.7%) with a mean age of 68 years (SD = 8.8). A significant relationship between baseline lung cancer stigma and psychological distress at 6 months was found, where a one unit increase in lung cancer stigma increases psychological distress by 0.044 when adjusting for age, gender, smoking status, baseline GHQ-12 scores and intervention allocation (as part of the larger trial; p = 0.001; β = 0.044, 95% CI = 0.010, 0.079). CONCLUSION Temporal links between lung cancer stigma and psychological distress was found at 6 months, suggesting stigma-related experiences may have a delayed impact. Development of routine lung cancer stigma assessments is recommended to identify those at risk of psychological distress.
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Affiliation(s)
- Shiho Rose
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Allison Boyes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Brian Kelly
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Centre for Brain and Mental Health Research, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Martine Cox
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kerrin Palazzi
- Clinical Research, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.,Hunter Cancer Research Alliance, University of Newcastle, Callaghan, New South Wales, Australia
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Abstract
In this study, the Turkish adaptation of the Korean Cancer Stigma Scale (CSS), which was developed by So, Chae, Kim, (2017), was studied for validity and reliability. Modeling of the methodological type of study sample in medicine. Of the cancer patients who came to oncology clinics and ambulatory chemotherapy units for treatment, 327 were included. Data were collected by using a personal information form and the CSS. The translation-retranslation method was used to test the Turkish validity and reliability of the original version of the CSS in English. Six sub-dimensions similar to the original CSS form were identified and factor loads were found between 0.197 and 0.903 as a result of exploratory factor analysis. However, item 6 (0.197) was removed from the scale as its factor load diverged from the recommended value. Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity tests were used to evaluate the adequacy and suitability of the sample of the research before performing the factor analysis. The KMO value was found to be 0.894, and this value showed that the scale was suitable for factor analysis. Likewise, Bartlett's sphericity test results (x2 = 4008.269, p = 0.000) show that the data are suitable for factor analysis. Many indices were used to examine the fit of the model belonging to CSS. Of these, x2/SD value was found to be 2.928, GFI 0.856, IFI 0.905, CFI 0.904, RMSEA 0.077 and SRMR 0.057, and it was decided that the scale was acceptable. The Cronbach alpha coefficient value measured for CSS is equal to 0.897. The Cronbach alpha coefficient for the CSS sub-dimension 'social isolation' is equal to 0.917, 'distancing or avoiding' 0.852, 'attribution' 0.898, 'guilt' 0.758, 'discrimination' 0.692 and 'lack of medical support' 0.664. Confirmatory factor analysis fit index values, normal and acceptable values were determined for CSS consisting of 23 items and 6 sub-dimensions.
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Affiliation(s)
- Birsen Paltun
- Department of Nursing, Institute of Health Sciences, Ordu University, Ordu, Turkey
| | - Nurgül Bölükbaş
- Department of Nursing, Faculty of Health Sciences, Ordu University, Ordu, Turkey
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Huang Z, Yu T, Wu S, Hu A. Correlates of stigma for patients with cancer: a systematic review and meta-analysis. Support Care Cancer 2020; 29:1195-1203. [PMID: 32951087 DOI: 10.1007/s00520-020-05780-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/11/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The systematic review and meta-analysis was performed to summarize the available evidence and identify the correlates of cancer stigma. METHODS PubMed, EMBASE, Web of Science, the Cochrane Library, and PsycINFO were electronically searched to identify eligible studies about correlates of stigma for patients with cancer. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies. A meta-analysis was performed using the statistical program R. RESULTS Thirty-one studies involving a total of 7114 patients were included in the systematic review and meta-analysis. The results of the meta-analysis showed that cancer stigma shared positive associations with male gender, symptoms, depression, anxiety, body image loss, self-blame, social constraint, intrusive thoughts, and ambivalence over emotional expression, and negative associations with income, NK cell subsets, QOL, self-esteem, self-efficacy, cancer screening attendance, doctor's empathy, and medical satisfaction. The results of the descriptive analysis indicated that cancer stigma was positively associated with self-perception of aging, anger, internal attributions, stressful life events, self-perceived burden, and sleep dysfunction, while negatively associated with patient-provider communication and sleep quality. CONCLUSION Healthcare staff should pay attention to the identified correlates of cancer stigma. The results of our research can inform the design of interventions to reduce stigma and to improve clinical outcomes in people with cancer.
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Affiliation(s)
- Zehao Huang
- Nursing Department, Lingnan Branch of the Third Affiliated Hospital of Sun Yat-sen University, No. 2693 Kaichuang Street, Huangpu District, Guangzhou, China
| | - Ting Yu
- Nursing Department, Lingnan Branch of the Third Affiliated Hospital of Sun Yat-sen University, No. 2693 Kaichuang Street, Huangpu District, Guangzhou, China
| | - Siyu Wu
- The Second Clinical Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ailing Hu
- Nursing Department, Lingnan Branch of the Third Affiliated Hospital of Sun Yat-sen University, No. 2693 Kaichuang Street, Huangpu District, Guangzhou, China.
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Self-stigma predicts lower quality of life in Chinese American breast cancer survivors: exploring the mediating role of intrusive thoughts and posttraumatic growth. Qual Life Res 2019; 28:2753-2760. [DOI: 10.1007/s11136-019-02213-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2019] [Indexed: 12/20/2022]
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Hamann HA, Ver Hoeve ES, Carter-Harris L, Studts JL, Ostroff JS. Multilevel Opportunities to Address Lung Cancer Stigma across the Cancer Control Continuum. J Thorac Oncol 2018; 13:1062-1075. [PMID: 29800746 PMCID: PMC6417494 DOI: 10.1016/j.jtho.2018.05.014] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 12/13/2022]
Abstract
The public health imperative to reduce the burden of lung cancer has seen unprecedented progress in recent years. Fully realizing the advances in lung cancer treatment and control requires attention to potential barriers in their momentum and implementation. In this analysis, we present and evaluate the argument that stigma is a highly significant barrier to fulfilling the clinical promise of advanced care and reduced lung cancer burden. This evaluation of the stigma of lung cancer is based on a multilevel perspective that incorporates the individual, persons in the individual's immediate environment, the health care system, and the larger societal structure that shapes perceptions and decisions. We also consider current interventions and interventional needs within and across aspects of the lung cancer continuum, including prevention, screening, diagnosis, treatment, and survivorship. Current evidence suggests that stigma detrimentally affects psychosocial, communication, and behavioral outcomes over the entire lung cancer control continuum and across multiple levels. Interventional efforts to alleviate stigma in the context of lung cancer show promise, yet more work is needed to evaluate their impact. Understanding and addressing the multilevel role of stigma is a crucial area for future study to realize the full benefits offered by lung cancer prevention, control, and treatment. Coordinated, interdisciplinary, and well-conceptualized efforts have the potential to reduce the barrier of stigma in the context of lung cancer and facilitate demonstrable improvements in clinical care and quality of life.
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Affiliation(s)
- Heidi A. Hamann
- University of Arizona, Departments of Psychology and Family and Community Medicine, 1503 E University Blvd., Tucson, AZ, USA, ,
| | - Elizabeth S. Ver Hoeve
- University of Arizona, Departments of Psychology and Family and Community Medicine, 1503 E University Blvd., Tucson, AZ, USA, ,
| | - Lisa Carter-Harris
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN, USA,
| | - Jamie L. Studts
- University of Kentucky College of Medicine, Department of Behavioral Science, Lexington, KY, USA,
| | - Jamie S. Ostroff
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA,
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Rose S, Paul C, Boyes A, Kelly B, Roach D. Stigma-related experiences in non-communicable respiratory diseases: A systematic review. Chron Respir Dis 2017; 14:199-216. [PMID: 28111991 PMCID: PMC5720230 DOI: 10.1177/1479972316680847] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The stigma of non-communicable respiratory diseases (NCRDs), whether perceived or otherwise, can be an important element of a patient’s experience of his/her illness and a contributing factor to poor psychosocial, treatment and clinical outcomes. This systematic review examines the evidence regarding the associations between stigma-related experiences and patient outcomes, comparing findings across a range of common NCRDs. Electronic databases and manual searches were conducted to identify original quantitative research published to December 2015. Articles focussing on adult patient samples diagnosed with asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, lung cancer or mesothelioma, and included a measurement of stigma-related experience (i.e. perceived stigma, shame, blame or guilt), were eligible for inclusion. Included articles were described for study characteristics, outcome scores, correlates between stigma-related experiences and patient outcomes and methodological rigor. Twenty-five articles were eligible for this review, with most (n = 20) related to lung cancer. No articles for cystic fibrosis were identified. Twenty unique scales were used, with low to moderate stigma-related experiences reported overall. The stigma-related experiences significantly correlated with all six patient-related domains explored (psychosocial, quality of life, behavioral, physical, treatment and work), which were investigated more widely in COPD and lung cancer samples. No studies adequately met all criteria for methodological rigor. The inter-connectedness of stigma-related experiences to other aspects of patient experiences highlight that an integrated approach is needed to address this important issue. Future studies should adopt more rigorous methodology, including streamlining measures, to provide robust evidence.
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Affiliation(s)
- Shiho Rose
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Allison Boyes
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Della Roach
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
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So HS, Chae MJ, Kim HY. Reliability and Validity of the Korean Version of the Cancer Stigma Scale. J Korean Acad Nurs 2017; 47:121-132. [DOI: 10.4040/jkan.2017.47.1.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/26/2016] [Accepted: 11/01/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Hyang Sook So
- College of Nursing, Chonnam Research Institute of Nursing Science, Chonnam National University, Gwangju, Korea
| | | | - Hye Young Kim
- College of Nursing · Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea
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Resilience moderates the association between stigma and psychological distress among family caregivers of patients with schizophrenia. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.062] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rojewski AM, Baldassarri S, Cooperman NA, Gritz ER, Leone FT, Piper ME, Toll BA, Warren GW. Exploring Issues of Comorbid Conditions in People Who Smoke. Nicotine Tob Res 2016; 18:1684-96. [PMID: 26783291 DOI: 10.1093/ntr/ntw016] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/06/2016] [Indexed: 01/21/2023]
Abstract
UNLABELLED Smoking affects comorbid disease outcomes, and patients with comorbid conditions may have unique characteristics that are important to consider when treating tobacco use. However, addressing tobacco in patients being treated for comorbid conditions is not a consistent practice. Recognizing the need for a "call-to-action" to address tobacco use in people with comorbid conditions, the Tobacco Treatment Network within the Society for Research on Nicotine and Tobacco (SRNT) convened a Comorbidities Workgroup to explore the relationship between smoking and comorbid disease to identify common themes including: the harms associated with continued tobacco use, the frequency of comorbid disease and tobacco use, the potential effect of comorbid disease on the ability to quit tobacco use, the association between tobacco use and suboptimal disease-specific treatment response, and evidence regarding potential approaches to improve addressing tobacco use in patients with comorbid disease. Five candidate conditions (psychiatric, cancer, cardiovascular, pulmonary, and human immunodeficiency virus infected patients) were explored. Across comorbid conditions, smoking adversely affects treatment efficacy and promotes other adverse health conditions. People with comorbid conditions who smoke are motivated to quit and respond to evidence-based smoking cessation treatments. However, tobacco cessation is not regularly incorporated into the clinical care of many individuals with comorbidities. Optimal strategies for addressing tobacco use within each comorbid disease are also not well defined. Further work is needed to disseminate evidence-based care into clinical practice for smokers with comorbid disease and addiction research should consider comorbid conditions as an important construct to explore. IMPLICATIONS This article explores how physical and psychiatric conditions may interact in the treatment of tobacco dependence, and discusses the need for smoking cessation as a critical component of comorbid condition management. Five common comorbid domains-psychiatric, cancer, pulmonary, cardiovascular, and human immunodeficiency virus (HIV)-are highlighted to illustrate how these different conditions might interact with smoking with respect to prevalence and harm, motivation to quit, and cessation treatment utilization and success.
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Affiliation(s)
- Alana M Rojewski
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Stephen Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT
| | - Nina A Cooperman
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Ellen R Gritz
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Frank T Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Presbyterian Medical Center, Philadelphia, PA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Benjamin A Toll
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC; Department of Cancer Prevention and Control, Yale Cancer Center, New Haven, CT; Tobacco Treatment Service, Smilow Cancer Hospital at Yale-New Haven, New Haven, CT; Tobacco Treatment and Lung Cancer Screening Programs, Hollings Cancer Center, Charleston, SC
| | - Graham W Warren
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC; Department of Cell and Molecular Pharmacology, Medical University of South Carolina, Charleston, SC
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Kaptein AA, Kobayashi K, Matsuda A, Kubota K, Nagai S, Momiyama M, Sugisaki M, Bos BC, Warning TD, Dik H, Klink RV, Inoue K, Ramai R, Taube C, Kroep JR, Fischer MJ. We’re in this together: Patients’, caregivers’ and health care providers’ illness perceptions about non-small-cell lung cancer (NSCLC). Lung Cancer 2015; 90:575-81. [DOI: 10.1016/j.lungcan.2015.10.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/08/2015] [Accepted: 10/12/2015] [Indexed: 12/17/2022]
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