Consumer experiences of shame in clinical encounters for breast cancer treatment. "Who do you think you are- Angelina Jolie?"

Patient's sexual dignity discomfort in healthcare setting: A concept development

Background: Body touch and close physical proximity are inevitable in some healthcare procedures and can evoke feelings of shame, humiliation, and anger in patients. Given the increasing recognition of human dignity, exploring the occurrence of these negative emotional experiences and identifying mechanisms for their prevention are crucial.Aim: To develop and define the concept of "patient's sexual dignity discomfort." Design: A hybrid model of concept development was utilized.Methods: In the theoretical phase, a scoping review was conducted to establish a working definition of patient's sexual dignity discomfort. This definition was refined and validated using qualitative data collected during the fieldwork phase. In the analytical phase, a final conceptual model of patient's sexual dignity discomfort was proposed by integrating findings from both the theoretical and fieldwork phases.Ethical considerations: All participants completed an informed consent process, and interviews were conducted via Zoom or phone by a certified psychiatric nurse to ensure confidentiality, anonymity, and comfort.Results: Four themes describing attributes of patient's sexual dignity discomfort were explored: experiencing shame and embarrassment, vulnerability-induced loss of control, dehumanization and objectification, and uncertain sexual autonomy. Patient's sexual dignity discomfort occurs when patients perceive care procedures as sexually inappropriate or as involving unnecessary sexual activity, particularly when healthcare providers display unprofessional attitudes or when patients lack consent or are not mentally prepared for the procedure because of insufficient information. This discomfort leads patients to refuse or avoid healthcare treatments and prioritize finding better healthcare services over their health. It can also prompt providers to avoid patients, resulting in a compromised quality of care and poor health outcomes.Conclusions: Patient's sexual dignity discomfort poses a significant threat to the quality of patient care and preservation of dignity. Nurses can trigger this intentionally or unintentionally, highlighting the need for comprehensive education and training to prevent it.

A Critical Discourse Analysis of the Language of Stigmatization of Breast Cancer Patients in Nigeria

Breast cancer is a significant health concern globally, including in Nigeria, where its incidence is rising. An essential component of breast cancer care is the psychosocial wellbeing of patients, which is often shaped by the language used in healthcare and society. While some research has explored stigmatization of breast cancer patients, no study has focused on language as a tool for this stigmatization in Nigeria. This study examines how language perpetuates the stigmatization of breast cancer patients and explores ways to use language to improve their lives and health. Using Norman Fairclough's model of critical discourse analysis and a descriptive design, data was collected through interviews with 50 respondents at the University College Hospital in Ibadan, Nigeria. The study's discourse analysis revealed that stigmatization is perpetuated through language, including negative stereotypes, body shaming, spiritual interpretations, and derogatory terms. These discourses reflect broader social and cultural factors such as norms, beliefs, and power dynamics that reinforce stigmatization. The research highlights the effects of stigmatizing language, including denial, loss of femininity, shame, and fear of a new identity. The findings call for policies and interventions to reduce stigma, improve patient experiences, and raise public awareness of breast cancer.

Shame, health literacy and consent

This paper is particularly concerned with shame, sometimes considered the 'master emotion', and its possible role in affecting the consent process, specifically where that shame relates to the issue of diminished health literacy. We suggest that the absence of exploration of affective issues in general during the consent process is problematic, as emotions commonly impact upon our decision-making process. Experiencing shame in the healthcare environment can have a significant influence on choices related to health and healthcare, and may lead to discussions of possibilities and alternatives being closed off. In the case of impaired health literacy we suggest that it obstructs the narrowing of the epistemic gap between clinician and patient normally achieved through communication and information provision. Health literacy shame prevents acknowledgement of this barrier. The consequence is that it may render consent less effective than it otherwise might have been in protecting the person's autonomy. We propose that the absence of consideration of health literacy shame during the consent process diminishes the possibility of the patient exerting full control over their choices, and thus bodily integrity.

Personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer

BACKGROUND

Psychological factors are a risk factor for the incidence of breast cancer and have a significant impact on patient prognosis.

OBJECTIVE

The present study aims to investigate the effects of personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer.

METHODS

A total of 200 patients with breast cancer were randomly divided into two groups: an experimental group (n= 100) and control group (n= 100). Both groups received routine nursing care. The experimental group received personalised graded psychological intervention care, and the control group received routine nursing measures. After 2 months of standard treatment, the patients' quality of life and negative emotions were evaluated using the self-rating depression scale (SDS), self-rating anxiety scale (SAS), social support rating scale (SSRS) and quality of life measurement scale (FACT-B) scoring criteria.

RESULTS

There were no significant differences in the general data between the two groups (p> 0.05). Furthermore, there were no significant differences in the SDS, SAS, SSRS and FACT-B scores between the two groups before personalised graded psychological intervention (p> 0.05). After the intervention, the experimental group exhibited an improved nursing effect compared with the control group. The SDS and SAS scores were lower in the experimental group than in the control group (p< 0.05); after the intervention, the SDS and SAS scores were significantly lower in the experimental group than in the control group (p< 0.05). The SSRS and FACT-B scores were higher in the experimental group than in the control group (p< 0.05), and the experimental group's post-intervention SSRS and FACT-B scores were significantly higher than before the intervention (p< 0.05).

CONCLUSIONS

The use of personalised graded psychological intervention for the nursing of patients with breast cancer in clinical practice can significantly reduce patients' negative emotions as well as improve positive emotions and quality of life; thus, this method can be popularised in the nursing process.