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Zhu J, Tan CX, Guo JY, Yang RH, Ye M. A qualitative study on experiences of stigma among postoperative oral cancer patients. Support Care Cancer 2024; 32:286. [PMID: 38613655 DOI: 10.1007/s00520-024-08491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
AIM This study aimed to explore the characteristics of stigma in postoperative oral cancer patients to provide a reference for the formulation of targeted intervention measures. METHODS A qualitative study was conducted on 25 postoperative oral cancer patients in a tertiary A hospital in Hunan, China, from March to July 2021. Semi-structured face-to-face interviews focused on experiences of stigma were performed. The interview data was analyzed using the NVivo V.12 software based on the reflexive intuitive thematic analysis method. The paper complies with the COREQ. RESULTS The stigma experience of postoperative oral cancer patients can be divided into 3 themes: (1) triggers (impaired appearance and oral function and psycho-social pressure); (2) forms (overall isolation, unpleasant feeling of inferiority, and unpleasant social discrimination); (3) coping strategies (positive psychological adjustment, seeking social support and coming out of the unpleasant shadows). CONCLUSION Postoperative oral cancer patients clearly articulated that stigma was present in their lives and they experienced multiple forms of stigma. Further work is needed to increase education and awareness about oral cancer to guide them to take positive coping and reduce stigma.
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Affiliation(s)
- Jie Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
| | - Chu-Xia Tan
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Jia-Yi Guo
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China
| | - Rong-Hong Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
- Intensive Care Unit of Stomatology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
- Xiangya Nursing School of Central South University, Changsha, 410013, Hunan, China.
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2
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Minchew LA. Self-Blame Attribution: Concept Analysis and Application to HPV-Related Cancers. J Christ Nurs 2024:00005217-990000000-00018. [PMID: 38319227 DOI: 10.1097/cnj.0000000000001167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
ABSTRACT The attribution of self-blame for a negative physical health outcome can lead to further deterioration of one's mental and spiritual state. Using Walker and Avant's eight-step model for concept analysis, self-blame attribution is explored following the diagnosis of a human papillomavirus-related cancer in women. Conceptual case examples provide application of the concept to patient situations. Spiritual assessment tools for nurses caring for those who evidence self-blame are provided.
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Affiliation(s)
- Leigh Anne Minchew
- Leigh Anne Minchew, PhD, DNP, RN, WHNP-BC, PMHNP-BC, a dual-certified women's health and psychiatric nurse practitioner, provides supportive care to patients with gynecologic cancers. Her practice is devoted to addressing women's psychological and spiritual health needs
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3
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Sarfraz M, Waqas H, Ahmed S, Rurush-Asencio R, Mushtaque I. Cancer-Related Stigmatization, Quality of Life, and Fear of Death Among Newly Diagnosed Cancer Patients. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221140650. [PMID: 36409065 DOI: 10.1177/00302228221140650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The purpose of the study is to investigate the gender differences among newly diagnosed cancer patients from the cultural perspective of Pakistan. The data comprised two equal groups: men (50%) and women (50%). Most participants were 31-45 years old, and the duration of the cancer diagnosis was less than 6 months (74.6%). The data was collected on the following scales: the discrimination and stigma scale, the internalized stigma scale, the WHO-quality of life scale, and the fear of death scale. Data was analyzed using SPSS v.25; descriptive statistics, an independent sample t-test, and simple linear regression were applied to the data. The results revealed that men and women are both experiencing cancer-related stigmatization in Pakistan. However, women face a higher level of stigmatization, lower quality of life, and higher fear of death than men. Furthermore, the regression analysis result confirms that the cancer-related stigma faced by the diagnosed patients decreases the patient's quality of life and induces the fear of death.
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Affiliation(s)
| | - Hamid Waqas
- School of Business and Management, Westminster International Universityin Tashkent, Uzbekistan
| | - Saba Ahmed
- Fatima Jinnah Women University, Rawalpindi, Pakistan
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4
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Puleo GE, Borger T, Bowling WR, Burris JL. The State of the Science on Cancer Diagnosis as a "Teachable Moment" for Smoking Cessation: A Scoping Review. Nicotine Tob Res 2021; 24:160-168. [PMID: 34212198 DOI: 10.1093/ntr/ntab139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/30/2021] [Indexed: 12/28/2022]
Abstract
Theoretically, cancer diagnosis has potential to spur health behavior changes in physical activity, diet, substance use, medication adherence and the like. The Teachable Moment heuristic is a parsimonious, transtheoretical framework for understanding the conditions under which behavior change might occur, with constructs that include affective, cognitive, and social factors. Application of the Teachable Moment to smoking cessation after cancer diagnosis might aid selection of predictors in observational studies and inform how to optimally design interventions to promote quit attempts and sustain abstinence, as many smoking cessation interventions for cancer survivors do not yield positive outcomes. This scoping review of 47 studies that span nearly 20 years of literature examines measurement of the Teachable Moment constructs and what empirical support they have in explaining cancer survivors' smoking behavior. From this review, it appears the construct of affective response is more widely explored than risk perceptions, social role, and self-concept. Strong, negative affective responses (e.g., anxiety, general distress) may be a powerful contributor to continued smoking after cancer diagnosis. Risk perceptions may also play a role in smoking behavior, such that never and former smokers espouse stronger perceptions of smoking-related risks than current smokers. Finally, due to a paucity of studies, the role of cancer survivors' self-concept (e.g., identity as a "cancer survivor") and changes in their social role (e.g., employee, athlete) are unclear contributors to their smoking behavior. In summary, the Teachable Moment holds promise in its application to smoking cessation after cancer diagnosis, though more direct research is needed.
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Affiliation(s)
| | - Tia Borger
- Department of Psychology, University of Kentucky
| | | | - Jessica L Burris
- Department of Psychology, University of Kentucky.,Markey Cancer Center, University of Kentucky
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Sun L, Liu X, Weng X, Deng H, Li Q, Liu J, Luan X. Narrative therapy to relieve stigma in oral cancer patients: A randomized controlled trial. Int J Nurs Pract 2021; 28:e12926. [PMID: 33817894 DOI: 10.1111/ijn.12926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to evaluate the efficacy of narrative therapy in relieving stigma in oral cancer patients who underwent major surgical treatment. BACKGROUND Health-related stigma compromises mental health and life quality in people with physical or mental abnormalities. Narrative therapy has been implemented to overcome stigma among populations in a diversity of disease states. However, the effectiveness of narrative therapy in relieving stigma among patients with oral cancer is not known. DESIGN This study was a randomized controlled trial, in which 100 oral cancer patients were selected and randomly assigned to the 'narrative therapy' group, who received narrative therapy treatment in addition to standard care, and the 'control' group, who was provided standard care only. METHODS This research combined measurement of several questionnaires to evaluate stigma. Analysis of variance and paired t tests were employed for data analysis. RESULTS Findings in this study demonstrated that narrative therapy treatment effectively relieved oral cancer patients' sense of shame, reducing overall stigma and significantly improving self-esteem and social relationships. CONCLUSIONS Narrative therapy was demonstrated to be a promising therapeutic intervention for stigma relief in oral cancer patients. SUMMARY STATEMENT What is already known about this topic? Stigma is common among oral cancer patients, especially those who undergo major surgical resection. Psychological intervention is highly recommended in addition to postsurgical care. Narrative therapy might help relieve stigma among oral cancer patients. What this paper adds? Conventional postsurgical care did not improve oral cancer patients' psychological situation. A 7-week intervention of narrative therapy treatment significantly reduced stigma and enhanced sense of self-worth and social support among oral cancer patients. The implications of this paper: Narrative therapy can be clinically accepted as a therapeutic approach to assist oral cancer patients with stigma after major surgery. Tailored approaches, including patient-customized methods, should be encouraged in conducting narrative therapy.
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Affiliation(s)
- Liying Sun
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xueli Liu
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoling Weng
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Haiyan Deng
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Qian Li
- Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Jingpeng Liu
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiaorong Luan
- Department of Nursing, Qilu Hospital, Shandong University, Jinan, China
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6
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Eways KR, Bennett KK, Hamilton JL, Harry KM, Marszalek J, Marsh MJO, Wilson EJ. Development and Psychometric Properties of the Self-Blame Attributions for Cancer Scale. Oncol Nurs Forum 2020; 47:79-88. [PMID: 31845915 DOI: 10.1188/20.onf.79-88] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To adapt the Cardiac Self-Blame Attributions Scale into the Self-Blame Attributions for Cancer Scale (SBAC) for use in patients with cancer and analyze its psychometric properties. SAMPLE & SETTING 113 patients receiving radiation therapy at the University of Kansas Cancer Center. METHODS & VARIABLES The SBAC and other self-report measures were administered during outpatient oncology appointments for radiation therapy to establish the psychometric properties of the SBAC. RESULTS A two-factor structure represented behavioral and characterological self-blame attributions. Reliability estimates for each factor were excellent and evidence of convergent and discriminant validity was found, indicating support for the SBAC as a valid and reliable measure of self-blame attributions in patients with cancer. IMPLICATIONS FOR NURSING The SBAC may help healthcare providers, including nursing staff, to identify the self-blame patterns exhibited by patients with cancer. Future research can assess the reliability and validity of SBAC across stages of treatment and establish the predictive validity of the scale in individuals with cancer.
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7
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Nightingale CL, Steffen LE, Tooze JA, Petty W, Danhauer SC, Badr H, Weaver KE. Lung Cancer Patient and Caregiver Health Vulnerabilities and Interest in Health Promotion Interventions: An Exploratory Study. Glob Adv Health Med 2019; 8:2164956119865160. [PMID: 31360617 PMCID: PMC6637827 DOI: 10.1177/2164956119865160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/14/2019] [Accepted: 06/28/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Lung cancer patients and their caregivers are at risk for negative health behaviors and poor psychosocial functioning, but few interventions exist that target this population. To inform intervention development, we explored potential targets and interest and concordance in health promotion interventions among lung cancer patients and their caregivers. Methods Lung cancer patients (n = 18) with a smoking history and their caregivers (n = 15) participated in a cross-sectional, observational survey study (an average of 1 month postdiagnosis) to assess health behaviors, psychosocial functioning, and interest in health promotion interventions. Fisher’s exact and Wilcoxon rank-sum tests examined factors associated with intervention interest. McNemar’s test examined concordance in interest. Results Many caregivers (40%) reported providing care at least 4 days per week, and over half (53.3%) reported a smoking history. Patients reported high cancer self-blame (mean = 3.1, standard deviation = 0.9, range = 1–4). Patients (55.6%) and caregivers (60%) reported clinically significant depressive symptoms. There was high interest and concordance in interest in cancer education (patients, 77.8%; caregivers, 86.7%) and diet and exercise (patients, 66.7%; caregivers, 80%) interventions. Significantly more caregivers were interested in stress reduction (patients, 53.3%; caregivers, 73.3%; P = .05) and yoga (patients, 16.7%; caregivers, 50%; P = .03) than patients. Caregivers interested in stress reduction interventions had higher levels of distress than those not interested. Discussion Health promotion interventions are needed and of interest to lung cancer patients and caregivers. Shared interests in interventions suggest dyadic interventions may be appropriate, yet interventions should also address distinct patient and caregiver needs.
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Affiliation(s)
- Chandylen L Nightingale
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Laurie E Steffen
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - William Petty
- Section on Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Suzanne C Danhauer
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn E Weaver
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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8
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Yeung NCY, Lu Q, Mak WWS. Self-perceived burden mediates the relationship between self-stigma and quality of life among Chinese American breast cancer survivors. Support Care Cancer 2019; 27:3337-3345. [PMID: 30617433 DOI: 10.1007/s00520-018-4630-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/27/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Cancer-related self-stigma (the internalized sense of shame about having cancer) has been found to associate with poorer quality of life (QoL) among cancer survivors. However, culturally salient illness beliefs (e.g., cancer is contagious; cancer is a result of karma; and cancer brings shame to the family) may make Chinese cancer survivors vulnerable to self-stigmatization. This study examined the association between self-stigma and QoL among Chinese American breast cancer survivors (BCS). To understand the potential mechanism, the mediating role of self-perceived burden to caregivers between self-stigma and QoL was also examined. METHODS Chinese American BCS (n = 136) were recruited through community-based cancer associations. Participants' self-stigma, self-perceived burden, and QoL were measured in a questionnaire package. RESULTS Structural equation modeling results supported the proposed mediation model in predicting physical QoL (χ2(100) = 123.041, CFI = 0.982, TLI = 0.975, RMSEA = 0.041) and emotional QoL (χ2(84) = 137.277, CFI = 0.958, TLI = 0.940, RMSEA = 0.069), with satisfactory model fit indices. Both the indirect effects from self-stigma to QoL via self-perceived burden (physical: β = - 0.13; 95% CI = - 0.22, - 0.07 and emotional: β = - 0.11; 95% CI = - 0.22, - 0.04) and the direct effects from self-stigma to poorer QoL were significant (physical: β = - 0.22; 95% CI = -0.34, -0.10 and emotional: β = - 0.39; 95% CI = - 0.54, - 0.23), suggesting a partial mediation effect of self-perceived burden between self-stigma and QoL. CONCLUSIONS Self-stigma could reduce physical and emotional QoL through increasing self-perceived burden. Interventions aiming to reduce Chinese American BCS' self-stigma and perceptions of burdensomeness may facilitate improvement in QoL, which in turn promotes better cancer survivorship.
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Affiliation(s)
- Nelson C Y Yeung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Room 508, Postgraduate Education Centre, Prince of Wales Hospital, School of Medicine, Shatin, Hong Kong.
| | - Qian Lu
- Health Disparities Research Department - UNIT 1440, UT MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230-1402, USA.
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Rm 354, Sino Building, Shatin, Hong Kong
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Harry KM, Bennett KK, Marszalek JM, Eways KR, Clark JM, Smith AJ, Waters M, Bergland D, Umhoefer A, Wilson EJ. Scale development and psychometric properties of the Cardiac Self-Blame Attributions scale in patients with cardiovascular disease. Health Psychol Open 2018; 5:2055102918786865. [PMID: 30083370 PMCID: PMC6069032 DOI: 10.1177/2055102918786865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with cardiovascular disease may attribute their cardiovascular disease
to their behaviors (behavioral self-blame) or to their dispositions
(characterological self-blame). However, findings are mixed on the effects of
behavioral self-blame and characterological self-blame on health outcomes,
possibly because there are no validated, multiple-item measures. This study
developed and tested an 11-item Cardiac Self-Blame Attributions scale via
questionnaire data from 121 patients with cardiovascular disease. Results
yielded a two-factor structure that explained 65 percent of the variance, with
good reliability and discriminant validity. Findings suggest that the scale is
reliable and valid and can be used to understand the cardiac attributions
patients create.
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Affiliation(s)
| | | | | | | | | | - Andrew J Smith
- University of Missouri-Kansas City, USA.,Truman Medical Centers, USA
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10
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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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11
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Callebaut L, Molyneux P, Alexander T. The Relationship Between Self-Blame for the Onset of a Chronic Physical Health Condition and Emotional Distress: A Systematic Literature Review. Clin Psychol Psychother 2016; 24:965-986. [PMID: 27925335 DOI: 10.1002/cpp.2061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Past literature presents contrasting perspectives regarding the potential influence of self-blame on adjustment to illness. This systematic literature review aimed to summarize findings from all investigations to date that have explored the relationship between self-blame for the onset of a chronic physical health condition and emotional distress. METHOD Between November 2014 and February 2015, electronic databases were searched for relevant literature. Only those studies which assessed self-blame directly and related specifically to illness onset were included within the review. The methodological and reporting quality of all eligible articles was assessed, and themes within the findings were discussed using a narrative synthesis approach. RESULTS The majority of studies found self-blame to be associated with increased distress. However, several concerns with the quality of the reviewed articles may undermine the validity of their conclusions. CONCLUSIONS It is important for professionals supporting people with chronic physical health conditions to have an understanding of how of self-critical causal attributions might relate to emotional distress. Further research is required to understand the concept of self-blame, the factors that may encourage this belief and to develop reliable and valid measures of this experience. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE What does this study add? The review presents an exploration of the role of self-blame in emotional adjustment following the diagnosis of a chronic physical health condition. This is the first review to synthesize findings from studies measuring self-blame beliefs directly and specifically for illness onset and their relationship to indicators of distress and wellbeing. Findings suggest that self-blame for illness onset is often associated with emotional distress for people with cancer, HIV/AIDS and cardiovascular disease. This has implications for how healthcare professionals respond to self-blaming beliefs in the context of illness. Research quality concerns are identified for many of the reviewed studies, highlighting a need for further research on this topic.
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Affiliation(s)
- Leah Callebaut
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
| | - Philip Molyneux
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
| | - Tim Alexander
- Department of Psychological Health and Wellbeing, The University of Hull, Hull, United Kingdom
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12
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Granger CL, Connolly B, Denehy L, Hart N, Antippa P, Lin KY, Parry SM. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer 2016; 25:983-999. [PMID: 27900549 DOI: 10.1007/s00520-016-3484-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/01/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Despite evidence and clinical practice guidelines supporting physical activity (PA) for people with lung cancer, this evidence has not translated into clinical practice. This review aims to identify, evaluate and synthesise studies examining the barriers and enablers for patients with lung cancer to participate in PA from the perspective of patients, carers and health care providers (HCPs). METHODS Systematic review of articles using electronic databases: MEDLINE (1950-2016), CINAHL (1982-2016), EMBASE (1980-2016), Scopus (2004-2016) and Cochrane (2016). Quantitative and qualitative studies, published in English in a peer-reviewed journal, which assessed the barriers or enablers to PA for patients with lung cancer were included. Registered-PROSPERO (CRD4201603341). RESULTS Twenty-six studies (n = 9 cross-sectional, n = 4 case series, n = 11 qualitative) including 1074 patients, 23 carers and 169 HCPs were included. Barriers and enablers to PA were identified (6 major themes, 18 sub-themes): Barriers included patient-level factors (physical capability, symptoms, comorbidities, previous sedentary lifestyle, psychological influences, perceived relevance), HCP factors (time/knowledge to deliver information) and environmental factors (access to services, resources, timing relative to treatment). Enablers included anticipated benefits, opportunity for behaviour change and influences from HCPs and carers. CONCLUSION This systematic review has identified the volume of literature demonstrating that barriers and enablers to PA in lung cancer are multidimensional and span diverse factors. These include patient-level factors, such as symptoms, comorbidities, sedentary lifestyle, mood and fear, and environmental factors. These factors should be considered to identify and develop suitable interventions and clinical services in attempt to increase PA in patients with lung cancer.
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Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia. .,Department of Physiotherapy, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia. .,Institute for Breathing and Sleep, Bowen Centre, 145 Studley Road, Hiedelberg, VIC, 3084, Australia.
| | - Bronwen Connolly
- Guy's and St. Thomas' NHS Foundation Trust and King's College London National Institute of Health Research Biomedical Research Centre, Strand, London, WC2R 2LS, UK.,Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,Centre of Human and Aerospace Physiological Sciences, King's College London, Strand, London, WC2R 2LS, UK
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia.,Institute for Breathing and Sleep, Bowen Centre, 145 Studley Road, Hiedelberg, VIC, 3084, Australia
| | - Nicholas Hart
- Guy's and St. Thomas' NHS Foundation Trust and King's College London National Institute of Health Research Biomedical Research Centre, Strand, London, WC2R 2LS, UK.,Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,Division of Asthma, Allergy and Lung Biology, King's College London, Strand, London, WC2R 2LS, UK
| | - Phillip Antippa
- Department of Thoracic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia
| | - Kuan-Yin Lin
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia
| | - Selina M Parry
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia
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13
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Weiss J, Yang H, Weiss S, Rigney M, Copeland A, King JC, Deal AM. Stigma, self-blame, and satisfaction with care among patients with lung cancer. J Psychosoc Oncol 2016; 35:166-179. [PMID: 27607144 DOI: 10.1080/07347332.2016.1228095] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We sought to understand the experiences of patients with lung cancer and to see if attitudes varied by demographic factors. METHODS We administered a 63-question survey by phone or online among 174 patients with lung cancer. Factor analysis was used to identify two groups of questions with a conceptual relationship and high Cronbach's alphas, stigma and satisfaction with care. We used a multivariable analysis to identify predictors of self-blame and the factors of stigma and satisfaction with care. RESULTS Patients were satisfied with the quality of their care and treatment choices but did not feel that there is enough public support for or research in lung cancer. Predictors of lower satisfaction with care were never being a smoker, lack of college education, not living in a rural location, refusing to report income, and not knowing/not being sure of stage. Self-blame was modest; in multivariable analysis, predictors of self-blame were believing that smoking was a cause of their lung cancer, younger age, male sex, living in a suburban location, and not knowing/not being sure of the stage of the cancer. Reported stigma was low and the only predictor for stigma was being married. Despite low scores on their personal experience of stigma, patients reported a high degree of stigmatization of lung cancer in general. Smoking was a significant predictor of personal stigma. CONCLUSION Despite satisfaction with their treatment and care, lung cancer patients feel that society stigmatizes them as a general population. Patients who smoke are more likely to report that they have personally experienced stigma.
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Affiliation(s)
- Jared Weiss
- a Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill , NC , USA
| | - Hojin Yang
- b Lineberger Comprehensive Cancer Center Biostatistics Core Facility, University of North Carolina , Chapel Hill , NC , USA
| | - Sara Weiss
- c Friday Institute for Educational Innovation, North Carolina State University , Raleigh , NC , USA
| | | | | | | | - Allison M Deal
- b Lineberger Comprehensive Cancer Center Biostatistics Core Facility, University of North Carolina , Chapel Hill , NC , USA
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Burris JL, Studts JL, DeRosa AP, Ostroff JS. Systematic Review of Tobacco Use after Lung or Head/Neck Cancer Diagnosis: Results and Recommendations for Future Research. Cancer Epidemiol Biomarkers Prev 2015; 24:1450-61. [PMID: 26282629 PMCID: PMC4592460 DOI: 10.1158/1055-9965.epi-15-0257] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 07/29/2015] [Indexed: 11/16/2022] Open
Abstract
Tobacco use after cancer diagnosis is associated with adverse cancer outcomes, yet reliable prevalence estimates for this behavior are lacking. We conducted a systematic literature review of the prevalence of current tobacco use among individuals with a history of lung or head/neck cancer (CRD #42012002625). An extensive search of electronic databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and Web of Science) identified 7,777 potentially relevant articles published between 1980 and 2014 and 131 of these yielded pertinent information. Aggregating results across heterogeneous study designs and diverse patient samples, the overall mean prevalence rate of current tobacco use (mostly cigarette smoking) was 33.0% (median, 31.0%). Among current tobacco users at cancer diagnosis, the mean prevalence rate of current tobacco use (mostly cigarette smoking) was 53.8% (median, 50.3%). In many cases, an operational definition of "current" tobacco use was absent, and biochemical verification of self-reported smoking status was infrequent. These and other observed methodologic limitations in the assessment and reporting of cancer patients' tobacco use underscore the necessity of uniform tobacco use assessment in future clinical research and cancer care.
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Affiliation(s)
- Jessica L Burris
- Lucille P. Markey Cancer Center, Cancer Prevention and Control Program, Lexington, Kentucky. University of Kentucky, Department of Psychology, Lexington, Kentucky.
| | - Jamie L Studts
- Lucille P. Markey Cancer Center, Cancer Prevention and Control Program, Lexington, Kentucky. University of Kentucky, Department of Behavioral Science, Lexington, Kentucky
| | - Antonio P DeRosa
- Memorial Sloan Kettering Cancer Center, Medical Library, New York, New York
| | - Jamie S Ostroff
- Memorial Sloan Kettering Cancer Center, Psychiatry and Behavioral Sciences Service, New York, New York
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