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Auriol C, Raynal P, Cantisano N. Stigmatization of drinking patients with liver cancer: The role of socioeconomic status. Heliyon 2024; 10:e29105. [PMID: 38623242 PMCID: PMC11016613 DOI: 10.1016/j.heliyon.2024.e29105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Patients with liver cancer may face stigmatization due to cancer, alcohol consumption, or both. This study addresses gaps in the existing literature regarding stigmatization of alcohol-related liver cancer patients, particularly its connection with socioeconomic status (SES). The study explores whether the SES of a fictional character with alcohol addiction and liver cancer influences stigma levels reported by participants. Additionally, it investigates how participants' personal characteristics, such as alcohol consumption and healthcare professional status, impact stigmatization. This study aims to provide new insights regarding the role of stigmatization in liver cancer treatment and management, emphasizing in socioeconomic determinants. The method is based on three scenarios describing a woman character with alcohol abuse and liver cancer. The scenarios depicted a woman character with either low, medium or high SES. Each participant (N = 991) was randomly assigned to one of the three scenarios. After reading it, each participant answered questionnaires assessing negative attitudes towards the character. Four scales were used: "Negative attributions about people with health problems", "Causality of cancer", "Controllability of drinking" and "Reluctance to helping behavior". Data were analyzed using ANOVA and t-tests. The scenario describing a character with a low SES significantly received more "Negative attributions about people with health problems" than the character with medium or high SES. Participants having higher alcohol consumption themselves showed lower stigma scores for three out of four scales than participants with lower consumption. In addition, participants identified as health professionals had lower stigma scores regarding the scales "Negative attributions about people with health problems" and "Controllability of drinking", and higher scores for the subscale "Reluctance to helping behavior", compared with non-professionals. A character with low SES received more negative attributions than the one with higher SES. Participants' own alcohol consumption and professional status (being health professional or not), influenced their stigmatizing attitudes.
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Affiliation(s)
- Camille Auriol
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Patrick Raynal
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Nicole Cantisano
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
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Prabhu NS, Maiya GA, Bhat K V. Implementation of physical rehabilitation programs for children with cancer across low- and middle-income countries: A need of the hour perspective. Pediatr Blood Cancer 2024; 71:e30876. [PMID: 38243768 DOI: 10.1002/pbc.30876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Nivedita S Prabhu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Bhat K
- Division of Pediatric Hematology and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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AL Naabi M, Al Zaabi A. Quantitative Evaluation of Cancer Stigma among Non-Patient Population in Oman. Asian Pac J Cancer Prev 2024; 25:1223-1229. [PMID: 38679981 PMCID: PMC11162736 DOI: 10.31557/apjcp.2024.25.4.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/12/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Cancer is widely considered as one of the most stigmatized diseases globally, despite scientific advances in the medicine. While most existing literatures focuses on cancer stigma as perceived by patients, there has been limited research on stigma towards cancer among the non-cancer population. In 2014, Marlow et al developed and validated the "Cancer Stigma Scale" (CASS) specifically for the non-Cancer population. This study aims to quantitatively evaluate cancer stigma within the non-patient population in Oman. METHODS This is a cross-sectional study conducted in Oman. The Cancer Stigma Scale (CASS) has been used to evaluate the cancer-related stigma among the non-cancer patient population in Oman. RESULTS A total of 510 participants completed the survey of whom 57.6% were male. The personal responsibility section had the highest mean score, followed by the avoidance and financial discrimination. The lowest mean scores were observed in the danger and policy opposition sections. Female participants showed ore disagreement with cancer stigma statements compared to males. Participants who knew someone with cancer expressed more disagreement with stigma statements than those who did not know anyone with cancer. CONCLUSION This study provides a baseline measurement of cancer-related stigma among non-cancer patients in Oman, tilizing the CASS in a representative sample of the population. The results indicate generally low levels of stigma, though certain aspects are more pronounced, varying according to the participants' gender, age, and personal connections to someone with cancer.
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Affiliation(s)
| | - Adhari Al Zaabi
- Human and Clinical Anatomy, College of Medicine and Health Sciences, Muscat, Sultanate of Oman.
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Cenit-García J, Buendia-Gilabert C, Contreras-Molina C, Puente-Fernández D, Fernández-Castillo R, García-Caro MP. Development and Psychometric Validation of the Breast Cancer Stigma Assessment Scale for Women with Breast Cancer and Its Survivors. Healthcare (Basel) 2024; 12:420. [PMID: 38391796 PMCID: PMC10887980 DOI: 10.3390/healthcare12040420] [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: 11/29/2023] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The increase in breast cancer cases and breast cancer survival makes it advisable to quantify the impact of the health-related stigma of this disease. PURPOSE/OBJECTIVES To develop and validate a breast cancer stigma scale in Spanish. METHODS Women diagnosed with, or survivors of, breast cancer were included. The development of the Breast Cancer Stigma Assessment Scale (BCSAS) involved both a literature review and personal interviews. Content validity was assessed using a Delphi study and a pilot test; construct validity was evaluated using an exploratory factor analysis; and convergent validity was assessed using six scales. Cronbach's α internal consistency and test-retest reliability were used to determine the reliability of the scales. RESULTS 231 women responded to the 28-item scale. The BCSAS showed good reliability, with α = 0.897. Seven factors emerged: concealment (α = 0.765), disturbance (α = 0.772), internalized stigma (α = 0.750), aesthetics (α = 0.779), course (α = 0.599), danger (α = 0.502), and origin (α = 0.350). The test-retest reliability was 0.830 (p < 0.001). Significant correlation was observed with event centrality (r = 0.701), anxiety-depression (r = 0.668), shame (r = 0.645), guilt (r = 0.524), and quality of life (r = -0.545). CONCLUSIONS The BCSAS is a reliable and valid measure of stigma in women with breast cancer and its survivors. It could be useful for detecting stigma risk and establishing psychotherapeutic and care priorities.
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Affiliation(s)
- Judit Cenit-García
- Virgen de las Nieves University Hospital, 18014 Granada, Spain
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
| | | | | | - Daniel Puente-Fernández
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
| | - Rafael Fernández-Castillo
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
| | - María Paz García-Caro
- ibs.GRANADA-Biosanitary Research Institute, 18012 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18071 Granada, Spain
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Kang D, Park S, Kim HJ, Kim SW, Lee JE, Yu J, Lee SK, Kim JY, Nam SJ, Cho J, Park YH. Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study. Cancer Res Treat 2024; 56:125-133. [PMID: 37669709 PMCID: PMC10789941 DOI: 10.4143/crt.2023.673] [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: 05/20/2023] [Accepted: 09/03/2023] [Indexed: 09/07/2023] Open
Abstract
PURPOSE We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study. MATERIALS AND METHODS Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes. RESULTS The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis. CONCLUSION In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seri Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Hyo Jung Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
- Research Institution for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Auriol C, Cantisano N, Raynal P. Factors influencing the acceptability of alcohol drinking for a patient with colorectal cancer. PLoS One 2023; 18:e0296409. [PMID: 38153919 PMCID: PMC10754451 DOI: 10.1371/journal.pone.0296409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Colorectal cancer is the second deadliest cancer worldwide. One of the risk factors for the development of this type of cancer is alcohol consumption. Patients with colorectal cancer may be stigmatized regarding their cancer and regarding drinking behaviors they may exhibit. This study aimed to analyze community persons' and health professionals' acceptability judgments regarding alcohol drinkers having colorectal cancer. METHOD This study relies on an experimental method enabling the identification of variables involved in one's judgment, based on the exhaustive combination of factors yielding several scenarios rated by participants. Scenarios implemented factors possibly influencing participants' perception of a woman character having colorectal cancer. Factors included her drinking habits, post-diagnosis drinking behavior and type of diagnosis/prognosis. The participants were community persons (N' = 132) or health professionals (N" = 126). Data were analyzed using a within-subject factorial ANOVA. RESULTS In both samples, the "Post-diagnosis behavior" factor had large effect sizes, with drinking cessation being more acceptable than other drinking behaviors. Another factor, "Drinking habits", had significant influences on participants judgments, as higher drinking was considered less acceptable. A third factor, "Diagnosis" (polyps, early- or late-stage cancer), was taken into account by participants when it interacted with "Drinking habits" and "Post-diagnosis behavior". Indeed, participants considered most acceptable to continue drinking in the case of late-stage cancer, especially in the health professional sample where the acceptability of continuing drinking was almost doubled when the character had advanced- rather than early-cancer. CONCLUSION The lesser the drinking behavior, the better the acceptability. However, advanced cancer stage attenuated the poor acceptability of drinking in both samples, as participants' attitudes were more permissive when the patient had advanced cancer.
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Affiliation(s)
- Camille Auriol
- Centre d’Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, Toulouse, France
| | - Nicole Cantisano
- Centre d’Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, Toulouse, France
| | - Patrick Raynal
- Centre d’Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, Toulouse, France
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Xie XM, Gao J, Bai DX, Chen H, Li Y. Assessment tools for stigma in breast cancer patients based on COSMIN guidelines: a systematic review. Support Care Cancer 2023; 32:65. [PMID: 38150049 DOI: 10.1007/s00520-023-08276-3] [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: 06/05/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The objective of this study was to conduct a systematic review of the measurement properties and methodological quality of stigma assessment tools designed for breast cancer patients. The aim was to provide clinical medical staff with a foundation for selecting high-quality assessment tools. METHODS A comprehensive computer search was carried out across various databases, including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database(VIP), Embase, PubMed, Web of Science, The Cochrane Library, and Scopus, which were searched from the inception of the databases until March 20, 2023. Literature screening and data extraction were performed independently by two researchers, adhering to predefined inclusion and exclusion criteria. The assessment tools were evaluated using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic evaluation guidelines. RESULTS In the final analysis, a total of 9 assessment tools were included. However, none of these tools addressed measurement error, cross-cultural validity, criterion validity, and responsiveness. Following the COSMIN guidelines, BCSS and CSPDS were assigned to Class A recommendations, while the remaining tools received Class B recommendations. CONCLUSION The BCSS and CSPDS scales demonstrated comprehensive assessment in terms of their measurement characteristics, exhibiting good methodological quality, measurement attribute quality, and supporting evidence. Therefore, it is recommended to utilize these scales for evaluating breast cancer stigma. However, further validation is required for the remaining assessment tools.
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Affiliation(s)
- Xue-Mei Xie
- School of Nursing, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, Sichuan Province, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, Sichuan Province, China.
| | - Ding-Xi Bai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, Sichuan Province, China
| | - Huan Chen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, Sichuan Province, China
| | - Yue Li
- School of Nursing, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Chengdu, 611137, Sichuan Province, China
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Qin QY, Li SW, Li W, Li YR. The mediating role of cognitive emotion regulation in the relationship between self-concealment and quality of life among breast cancer chemotherapy patients. J Clin Psychol 2023; 79:2918-2931. [PMID: 37590235 DOI: 10.1002/jclp.23584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/29/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE This study aimed to explore whether self-concealment (SC) affects the quality of life (QOL), and whether cognitive emotion regulation (CER) mediates the relationship between SC and QOL among breast cancer chemotherapy patients. METHODS This cross-sectional study was conducted among 228 breast cancer chemotherapy patients from November 2021 to March 2022 in Anhui Province, China. Data were collected using the Self-Concealment Scale, Cognitive Emotion Regulation Questionnaire, and Short Form 36 Questionnaire. Descriptive statistics, independent-sample t test, one-way analysis of variance, and structural equation modeling were used to explore associations among SC, CER, and QOL. RESULTS QOL levels differed significantly by participant age, monthly per capita household income and home location. SC was negatively correlated with QOL. SSC was negatively correlated with adaptive-CER strategies and positively correlated with maladaptive-CER strategies. Adaptive-CER strategies were positively correlated with QOL. Maladaptive-CER strategies were negatively correlated with QOL. CER fully mediated the association between SC and QOL in breast cancer chemotherapy patients. CONCLUSION Nursing staff should help breast cancer chemotherapy patients reduce the use of maladaptive-CER strategies in the care of patients in the future. Helping patients reduce SC is more conductive to improving the QOL of breast cancer chemotherapy patients.
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Affiliation(s)
- Qiao-Yun Qin
- Department of Nursing, School of Anhui Medical University, Hefei, China
| | - Shu-Wen Li
- Department of Nursing, School of Anhui Medical University, Hefei, China
| | - Wen Li
- Department of Nursing, School of Anhui Medical University, Hefei, China
| | - Yan-Ran Li
- Department of Nursing, School of Anhui Medical University, Hefei, China
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Torres TK, Hamann HA, Shen M, Stone J. Empathic Communication and Implicit Bias in the Context of Cancer Among a Medical Student Sample. HEALTH COMMUNICATION 2023:1-12. [PMID: 37906434 PMCID: PMC11058116 DOI: 10.1080/10410236.2023.2272359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Oncology clinicians often miss opportunities to communicate empathy to patients. The current study examined the relationship between implicit bias (based on cancer type and ethnicity) and medical students' empathic communication in encounters with standardized patients who presented as Hispanic (lung or colorectal) individuals diagnosed with cancer. Participants (101 medical students) completed the Implicit Association Test (IAT) to measure implicit bias based on cancer type (lung v. colorectal) and ethnicity (Hispanic v. non-Hispanic White). Empathic opportunities and responses (assessed by the Empathic Communication Coding System; ECCS) were evaluated in a mock consultation (Objective Structured Clinical Examination; OSCE) focused on smoking cessation in the context of cancer. Among the 241 empathic opportunities identified across the 101 encounters (M = 2.4), 158 (65.6%) received high empathy responses from the medical students. High empathy responses were most frequently used during challenge (73.2%) and emotion (77.3%) opportunities compared to progress (45.9%) opportunities. Higher levels of implicit bias against Hispanics predicted lower odds of an empathic response from the medical student (OR = 3.24, p = .04, 95% CI = 0.09-0.95). Further work is needed to understand the relationship between implicit bias and empathic communication and inform the development of interventions.
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Affiliation(s)
- Tara K. Torres
- Department of Psychology, University of Arizona, Tucson, AZ
| | - Heidi A. Hamann
- Department of Psychology, University of Arizona, Tucson, AZ
- University of Arizona Cancer Center, Tucson, AZ
| | - Megan Shen
- Fred Hutchinson Cancer Research Institute, Seattle, WA
| | - Jeff Stone
- Department of Psychology, University of Arizona, Tucson, AZ
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Roicke A, Esser P, Hornemann B, Ernst J. [Pain-related stigma in patients with breast, colon, prostate or lung cancer : Results of a bicentric register-based cross-sectional study]. Schmerz 2023:10.1007/s00482-023-00752-3. [PMID: 37710022 DOI: 10.1007/s00482-023-00752-3] [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: 06/21/2022] [Revised: 04/22/2023] [Accepted: 06/20/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Studies on cancer patients show a moderately high relevance of perceived stigmatization. However, no studies have explored the perceived stigmatization in relation to cancer-associated pain. In this work, we analysed the relationship between pain and perceived stigmatization across a large sample of four major cancer entities. METHODS Quantitative data of 858 patients (45.6% women, mean age 60.7 years) with breast, bowel, lung and prostate cancer were evaluated in a register-based, bicentric study. Perceived stigmatization was measured using the social impact cale (SIS-D), including a total score and four subscales. Pain was assessed with the brief pain inventory (BPI). The data were analysed using correlation und multiple regression with various sociodemographic and medical predictors. RESULTS Of all 858 cancer patients, those with lung and breast cancer were characterized by the greatest pain. The intensity of the pain was a predictor of the perceived stigma in patients with breast and colorectal cancer. In addition, younger age was also a predictor for perceived stigmatization. A good quality of life resulted as a protective factor. The final models showed a high goodness of the fit (corr. R2 > 0.35), except for the lung cancer patients. CONCLUSIONS Our findings support the assumption that the experience of pain can have an impact on the perceived stigmatization of cancer patients. Depression might influence the perceived stigmatization. Therefore, this group of patients should receive special attention and psycho-oncological care in clinical practice. Further research on the course and mechanisms of action of pain-related perceived stigmatization is also required.
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Affiliation(s)
- A Roicke
- Abteilung Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR, Philipp-Rosenthal-Str. 55, Haus W, 04103, Leipzig, Deutschland.
| | - P Esser
- Abteilung Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR, Philipp-Rosenthal-Str. 55, Haus W, 04103, Leipzig, Deutschland
| | - B Hornemann
- Universitäts KrebsCentrum (UCC), Psychoonkologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| | - J Ernst
- Abteilung Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR, Philipp-Rosenthal-Str. 55, Haus W, 04103, Leipzig, Deutschland
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Chen Y, Chen Q, Cai C, Lin X, Yu W, Huang H, Xie W, Lin M, Chen W, Wu H, Su T, Wang L. Effect of OPRM1/COMT gene polymorphisms on sufentanil labor analgesia: a cohort study based on propensity score matching. Pharmacogenomics 2023; 24:675-684. [PMID: 37610885 DOI: 10.2217/pgs-2023-0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Background: This study investigated the use of COMT G1947A and OPRM1 A118G polymorphisms as predictive markers for sufentanil epidural analgesia. Methods: The visual analogue scale (VAS) score, and sufentanil consumption of 136 pairs of parturients using sufentanil with lidocaine and ropivacaine for epidural analgesia were used for analysis. Results: OPRM1 AG/GG had lower VAS score difference between fifth and 0 min (1.55 vs 1.87; p = 0.012) and higher consumption (19.65 μg vs 17.11 μg; p = 0.049) than AA carriers. COMT GA/AA had higher VAS score difference than GG carriers (1.86 vs 1.55; p = 0.021). Conclusion: Sufentanil may provide better epidural labor analgesia in OPRM1 AA and COMT GA/AA carriers compared with OPRM1 AG/GG and COMT GG carriers. Clinical Trial Registration: ChiCTR1900026897 (Chinese Clinical Trial Center Registry).
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Affiliation(s)
- Yao Chen
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Quanyao Chen
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Can Cai
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Xiuxian Lin
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Weiwei Yu
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Huiqiong Huang
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Wenmin Xie
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Min Lin
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Weida Chen
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
| | - Hui Wu
- School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, 361003, China
| | - Tingting Su
- Fujian Medical University, Fuzhou, Fujian, 350000, China
| | - Lingsong Wang
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361003, China
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Blake SN, Hugtenburg JG, van der Vlugt M, Dekker E, Fransen MP. Decision-making on colorectal cancer screening in Curaçao - interviews with the target population. BMC Public Health 2023; 23:1437. [PMID: 37501171 PMCID: PMC10373279 DOI: 10.1186/s12889-023-16335-x] [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: 02/03/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND During the first year of the population based colorectal cancer (CRC) screening program on Curaçao, about 20% of invitees participated. This study explored the target population's perceptions and awareness on CRC (screening), beliefs on the program provision, their preferences and information needs for informed decision-making. METHODS Semi-structured interviews with 23 individuals, who were not yet invited for CRC screening, were recorded, transcribed, coded and analyzed. RESULTS CRC (screening) was discussed in the context of personal health, where own responsibility and food were important. Cancer was perceived as an unpredictable disease that causes suffering and leads to death and was also associated with fear. Despite being aware of the program, most respondents were not familiar with the screening procedure. Provision of the screening program was regarded positively and as an opportunity to contribute to health improvement. This seemed related to the expressed trust in the Caribbean Prevention Center (program organizer). Respondents preferred to make independent decisions about CRC screening participation. A personal approach, visual aids and media were the preferred sources of information. CONCLUSION The results of our interviews suggest that it may be beneficial to provide information on CRC screening in Curaçao within the context of personal health. While including sensitivity to fears and respect for the autonomy of the target population. Finally, electronic media maybe useful in supporting informed decision-making.
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Affiliation(s)
- Shacara N Blake
- Caribbean Prevention Center (Fundashon Prevenshon), Willemstad, Curaçao.
- Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam, the Netherlands.
| | - Jacqueline G Hugtenburg
- Caribbean Prevention Center (Fundashon Prevenshon), Willemstad, Curaçao
- Faculty of Social and Behavioral Sciences, University of Curaçao, Willemstad, Curaçao
- Department of Clinical Pharmacology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Manon van der Vlugt
- Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam, the Netherlands
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism (AGEM), Amsterdam, the Netherlands
| | - Mirjam P Fransen
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- National Institute for Public Health and the Environment, Centre for Nutrition Prevention and Health Services, Bilthoven, the Netherlands
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13
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Pan S, Wang L, Zheng L, Luo J, Mao J, Qiao W, Zhu B, Wang W. Effects of stigma, anxiety and depression, and uncertainty in illness on quality of life in patients with prostate cancer: a cross-sectional analysis. BMC Psychol 2023; 11:129. [PMID: 37098648 PMCID: PMC10131473 DOI: 10.1186/s40359-023-01159-6] [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: 10/01/2022] [Accepted: 04/04/2023] [Indexed: 04/27/2023] Open
Abstract
PURPOSE Although much work has been carried out on stigma, anxiety and depression, and quality of life(QoL) in cancer patients, far less work has been done to examine their associations. This study explores the effects of stigma, anxiety and depression, and uncertainty in illness on QoL in prostate cancer patients. METHODS A cross-sectional study surveyed levels of stigma, anxiety and depression, QoL, and uncertainty in illness in 263 people diagnosed with prostate cancer from the First Affiliated Hospital, Zhejiang University School of Medicine. The main study variables were analyzed by structural equation modeling. RESULTS Anxiety and depression were significantly negatively related to QoL, with a standardized regression coefficient (β=-0.312, S.E. =0.478, p < 0.05), which means that participants reporting higher levels of anxiety reported decreased levels of QoL. Stigma was positively related to anxiety and depression (β = 0.135, S.E. =0.203, p < 0.001) and uncertainty in illness (β = 0.126, S.E. =2.194, p < 0.05). Stigma has direct effects on QoL (β=-0.209, S.E. =1.655, p < 0.001), but in the presence of a third variable (anxiety and depression overall), direct effects are reduced, as indirect effects emerge through the variable anxiety and depression overall, with an indirect effect size of - 0.054. CONCLUSIONS Stigma impacts mental health, such as anxiety and depression, uncertainty in illness, and QoL. Health care professionals may help patients alleviate feelings of anxiety, depression, and uncertainty in illness to improve QoL outcomes.
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Affiliation(s)
- Shucheng Pan
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Zheng
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Luo
- Department of Urology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinjiao Mao
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenbo Qiao
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Binbin Zhu
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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14
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Latency of breast cancer stigma during survivorship and its influencing factors: A qualitative study. Front Oncol 2023; 13:1075298. [PMID: 36998442 PMCID: PMC10043425 DOI: 10.3389/fonc.2023.1075298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
IntroductionBreast cancer diagnosis and treatment have been shown in studies to have a negative impact on patients’ physical, psychological, and social well-being, as well as overall quality of life. Psychologically, it’s linked to sadness, anxiety, and demoralisation. Stigma contributes to the hidden burden of breast cancer as a chronic illness. Research on the elements that breast cancer survivors encounter as influences on stigma associated to the disease is lacking. Based on the lived experiences of breast cancer survivors, this study sought to investigate the factors that lead to the manifestations of both self- and public breast cancer stigma.MethodsIndividual semi-structured interviews with 24 patients diagnosed with breast cancer were performed, followed by five focus groups with 25 patients diagnosed with breast cancer. Interviews were verbatim transcribed and analysed using thematic framework analysis.ResultsTwo major themes have emerged from the data: a) Breast cancer stigma among breast cancer survivors, highlighting the various manifestations of stigma and the variables that influence them; including disease-related factors, patients’ views of cancer, public perceptions of breast cancer, family and interpersonal dynamics, and b) Stigma resilience and empowerment, emphasising the necessity of sociocultural transformation and coping strategies to preserve resilience.ConclusionsTo improve the well-being of breast cancer survivors, practitioners and health policymakers should be aware of the breast cancer stigma that underpins patients’ emotional and behavioural outlooks and its potential consequences on patients’ quality of life. They need to develop interventions to address the different stages of cancer stigma taking into consideration sociocultural influences, norms, and beliefs.
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15
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Sommers-Spijkerman M, Kavanaugh MS, Kruitwagen-Van Reenen E, Zwarts-Engelbert A, Visser-Meily JMA, Beelen A. Stigma experienced by ALS/PMA patients and their caregivers: a mixed-methods study. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:327-338. [PMID: 36593637 DOI: 10.1080/21678421.2022.2161911] [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: 01/04/2023]
Abstract
Objective: Previous work suggests that stigma negatively impacts quality of life in people living with amyotrophic lateral sclerosis (ALS) and progressive muscular atrophy (PMA). This study aimed to explore experiences of enacted stigma (experienced discrimination) and felt stigma (shame, fear of exclusion) among Dutch ALS/PMA patients and their caregivers. A secondary aim was to assess associated factors of enacted/felt stigma among patients. Methods: A two-phase mixed-methods study was conducted, comprising cross-sectional surveys among 193 ALS/PMA patients and 87 caregivers, and semi-structured interviews with 8 ALS/PMA patients and 11 family caregivers. Descriptive and multivariable regression analyses along with qualitative content analysis were used to analyze survey and interview data. Results: Survey findings indicate that patients and caregivers experience enacted and felt stigma. Interviews with both patients and caregivers revealed two manifestations of enacted stigma, including social exclusion (e.g. relationship distancing) and stigmatizing attitudes/behaviors displayed by others (e.g. staring), and three manifestations of felt stigma, including alienation (e.g. shame/embarrassment), perceived discrimination (e.g. feeling judged) and anticipated stigma (e.g. fear of exclusion). Patients and caregivers engaged in concealing and resisting responses to stigma. More bulbar symptoms, King's clinical stage, younger age and living without a partner were significantly associated with enacted/felt stigma among patients. Conclusions: Our findings reveal a range of perceptions and experiences underlying enacted/felt stigma among ALS/PMA patients and their caregivers that may serve as conversation topics in clinical practice. Future research may shed more light on the determinants as well as the consequences of stigmatizing experiences among patients and caregivers.
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Affiliation(s)
- Marion Sommers-Spijkerman
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands, and
| | - Melinda S Kavanaugh
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Esther Kruitwagen-Van Reenen
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands, and
| | - Aimée Zwarts-Engelbert
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands, and
| | - Anita Beelen
- Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands, and
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16
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Rai R, Malik M, Valiyaveettil D, Ahmed SF, Basalatullah M. Assessment of late treatment-related symptoms using patient-reported outcomes and various factors affecting return to work in survivors of breast cancer. Ecancermedicalscience 2023; 17:1533. [PMID: 37138959 PMCID: PMC10151075 DOI: 10.3332/ecancer.2023.1533] [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: 10/13/2022] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer is the most common cancer in women worldwide. Survival in these patients has increased because of early diagnosis and multimodality treatment methods. Return to premorbid functional status after treatment is essential for rehabilitation and good quality of life. Many patients suffer from late treatment-related symptoms which affect their return to premorbid status. Various health-related and work-related variables also affect the return to premorbid status. Materials and methods This is a cross-sectional study in which 98 patients with breast carcinoma who received curative treatment were included 6-12 months post-radiotherapy completion. Patients were interviewed to assess their type of work and hours of work prior to diagnosis and at the time of the study. The extent to which they are able to return to their pre-diagnosis level of work was noted and various factors that were hindering them were documented. Treatment-related symptoms were assessed using selected questions from NCI PRO-CTCAE (version 1.0) questionnaire. Results The median age of diagnosis of patients included in the study was 49-50 years. The most common symptoms experienced by patients were fatigue (55%), pain (34%) and oedema (27%). 57% of patients were employed before diagnosis, of which only 20% were able to return to their employment post-treatment. All patients were involved in household work prior to diagnosis and 93% were able to get back to their routine household work, with 20% of patients requiring frequent work breaks. About 40% of patients reported social stigma as a factor that hindered them from returning to work. Conclusion Most patients return to household work post-treatment. Fatigue, pain and social stigma were the most common barriers to return to employment. Patient-reported outcomes and functional assessments can enable better survivorship care.
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Affiliation(s)
- Rajeshwari Rai
- Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India
| | - Monica Malik
- Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India
| | | | - Syed Fayaz Ahmed
- Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India
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17
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Can Oncology Nursing Education Change the Attitude of Nursing Students toward Cancer (Cancer Stigma)? A Quasi-Experimental Study. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.958583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose: This study was conducted to assess the effect of the oncology nursing internship education on the attitudes of students (stigma) toward cancer patients. The study was conducted in a faculty of nursing in İzmir, Turkey.
Methods: The quasi-experimental pre-test post-test design was used in this study. The sample of the study was composed of totally 84 students, who attended the course of Oncology Nursing Internship (n:43) and the course of Gynaecology and Obstetrics Nursing Internship (n:41). The Student Information Form and Questionnaire for Measuring Attitudes Toward Cancer - Community Version were used as the data collection tool in the study. The students who were interns in oncology nursing received an education on oncology nursing including 280 hours of practice and 56 hours of theory and the other group had no education on the subject. In order to assess the efficiency of the education of oncology nursing internship on cancer attitude and to compare the groups, The Questionnaire for Measuring Attitudes Toward Cancer - Community Version was applied again to both groups at the end of the semester.
Results: As a result of this study, it was found that the course of oncology nursing internship increased the positive attitudes of the students toward cancer patients (t=5.591, p=0.000).
Conclusion: The education programs of oncology nursing should be integrated into the nursing curricula to provide that nursing students provide more effective care services for cancer patients and develop more positive attitudes.
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18
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Tang WZ, Yusuf A, Jia K, Iskandar YHP, Mangantig E, Mo XS, Wei TF, Cheng SL. Correlates of stigma for patients with breast cancer: a systematic review and meta-analysis. Support Care Cancer 2022; 31:55. [PMID: 36526859 DOI: 10.1007/s00520-022-07506-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study was conducted to examine the factors associated with stigma in breast cancer women. METHODS PubMed, Embase, the Cochrane Library, Web of Science, and two Chinese electronic databases were electronically searched to identify eligible studies that reported the correlates of stigma for patients with breast cancer from inception to July 2022. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. R4.1.1 software was used for statistical analysis. RESULTS Twenty articles including 4161 patients were included in the systematic review and meta-analysis. Results showed that breast cancer stigma was positively correlated with working status, type of surgery, resignation coping, depression, ambivalence over emotional expression, and delayed help-seeking behavior and negatively correlated with age, education, income, quality of life, social support, confrontation coping, psychological adaptation, self-efficacy, and self-esteem. Descriptive analysis showed that breast cancer stigma was positively correlated with intrusive thoughts, body image, anxiety, and self-perceived burden but negatively correlated with a sense of coherence, personal acceptance of the disease, sleep quality, cancer screening attendance and doctor's empathy. CONCLUSION Many demographic, disease-related, and psychosocial variables are related to breast cancer stigma. Our view can serve as a basis for health care professionals to develop health promotion and prevention strategies for patients with breast cancer.
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Affiliation(s)
- Wen-Zhen Tang
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azlina Yusuf
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
| | - Kui Jia
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.
| | | | - Ernest Mangantig
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Xin-Shao Mo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Tian-Fu Wei
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Shi-Li Cheng
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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19
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Block C, König HH, Hajek A. Oral health and quality of life: findings from the Survey of Health, Ageing and Retirement in Europe. BMC Oral Health 2022; 22:606. [PMID: 36517821 PMCID: PMC9753255 DOI: 10.1186/s12903-022-02599-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this study was to clarify the link between oral health and quality of life among older adults in Europe. METHODS Cross-sectional data from wave 5 (n = 59,048 observations) were used from the representative Survey of Health, Ageing and Retirement in Europe. Oral health was quantified by three questions: presence of all natural teeth (yes; no); among individuals with missing natural teeth, the number of missing teeth and the extent of replaced natural teeth were quantified. Quality of life was quantified using the widely used CASP-12. Multiple linear regressions were used to determine the association between oral health and quality of life, adjusting for various potential confounders. RESULTS Multiple linear regressions showed that higher quality of life was associated with (1) the presence of all natural teeth and among individuals with missing natural teeth, with (2) a lower number of missing natural teeth and (3) completely replaced natural teeth. Additionally, quality of life was positively associated with younger age, being female, being married or in a partnership, higher income, higher educational level, not currently smoking, a lower number of functional impairments, better self-rated health, a lower number of depressive symptoms and a lower number of chronic diseases. CONCLUSION Study findings showed an association between oral health and quality of life among older adults in Europe. Thus, the importance of good oral health for successful ageing was stressed. Future research is required to clarify the underlying mechanisms. Moreover, longitudinal studies are required to confirm our current findings.
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Affiliation(s)
- Celina Block
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - André Hajek
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
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20
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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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21
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The association between comorbidities and stigma among breast cancer survivors. Sci Rep 2022; 12:13682. [PMID: 35953505 PMCID: PMC9368698 DOI: 10.1038/s41598-022-15460-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/23/2022] [Indexed: 01/10/2023] Open
Abstract
This study aimed to explore the association between types and numbers of comorbidities and stigma among breast cancer survivors (BCSs). A cross-sectional study was conducted among 937 BCSs in Shanghai Cancer Rehabilitation Club. All participants were asked to fill in an online questionnaire including Stigma Scale for Chronic Illnesses 8-item version (SSCI-8) and questions on sociodemographic characteristics and health status. Multivariate linear regression was used to analyze the association between comorbidities and stigma, adjusting for confounding factors. Results showed that nearly 70% of the participants had one or more comorbidities. The participants with stroke, digestive diseases or musculoskeletal diseases had significantly higher stigma than those without the above comorbidities. In addition, stigma was higher among survivors in the group with a greater number of comorbidities. Thus, it is important to strengthen the management of stigma in BCSs, especially for those with comorbidities.
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22
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Patel MI, Agrawal M, Duron Y, O'Brien D, Koontz Z. Perspectives of Low-Income and Minority Populations With Lung Cancer: A Qualitative Evaluation of Unmet Needs. JCO Oncol Pract 2022; 18:e1374-e1383. [DOI: 10.1200/op.22.00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE: Lung cancer is the second most common cancer and the leading cause of cancer death in the United States. Persistent disparities remain in the incidence, mortality, and quality of lung cancer care received among minorities and populations with low income. This study aims to evaluate perspectives of low-income and minority patients with lung cancer on health system–level barriers and facilitators to high-quality lung cancer care delivery. METHODS: Informed by community-based participatory research, we conducted semistructured interviews with 48 patients with lung cancer in the San Francisco Peninsula and Central Coast regions of California. We recorded, transcribed, and analyzed interviews using thematic analysis. RESULTS: Participants described four major structural and process barriers in current lung cancer care: unmet psychosocial support needs, lack of understanding of precision medicine, undertreated symptoms, and financial concerns about cancer, which exacerbate concerns regarding families' well-being. Participants described that trusting relationship with their cancer care team members was a facilitator for high-quality care and suggested that proactive integration of proactive psychosocial and community-based peer support could overcome some of the identified barriers. CONCLUSION: This study identified modifiable health system lung cancer care delivery barriers that contribute to persistent disparities. Opportunities to improve care include integration of community-based peer support.
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Affiliation(s)
- Manali I. Patel
- Division of Oncology, Stanford University School of Medicine, Stanford, CA
- Medical Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Madhuri Agrawal
- Division of Oncology, Stanford University School of Medicine, Stanford, CA
- Palo Alto Veterans Research Institute, Palo Alto, CA
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23
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Knight JM, Taylor MR, Rentscher KE, Henley EC, Uttley HA, Nelson AM, Turcotte LM, McAndrew NS, Amonoo HL, Mohanraj L, Kelly DL, Costanzo ES. Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients. Front Immunol 2022; 13:877558. [PMID: 35865530 PMCID: PMC9295749 DOI: 10.3389/fimmu.2022.877558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/01/2022] [Indexed: 01/13/2023] Open
Abstract
A growing body of literature has emphasized the importance of biobehavioral processes - defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes - for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.
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Affiliation(s)
- Jennifer M. Knight
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States,Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, United States,*Correspondence: Jennifer M. Knight,
| | - Mallory R. Taylor
- Department of Pediatrics, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, WA, United States,Palliative Care and Resilience Program, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Kelly E. Rentscher
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Elisabeth C. Henley
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Hannah A. Uttley
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ashley M. Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
| | - Lucie M. Turcotte
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Natalie S. McAndrew
- College of Nursing, University of Wisconsin – Milwaukee, Milwaukee, WI, United States,Froedtert Hospital, Froedtert & The Medical College of Wisconsin, Milwaukee, WI, United States
| | - Hermioni L. Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Lathika Mohanraj
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, VA, United States
| | - Debra Lynch Kelly
- Department of Nursing, University of Florida, Gainesville, FL, United States,Cancer Population Science, University of Florida Health Cancer Center, University of Florida, Gainesville, FL, United States
| | - Erin S. Costanzo
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
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Zhang Z, Leong Bin Abdullah MFI, Shari NI, Lu P. Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: A randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life. PLoS One 2022; 17:e0267887. [PMID: 35536828 PMCID: PMC9089868 DOI: 10.1371/journal.pone.0267887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background and aim Head and neck cancer patients are vulnerable to various psychological complications due to the effects of both cancer itself and cancer treatment on patients’ appearance and physical well-being. Nevertheless, few data have been obtained on effective psychosocial interventions that could protect this group of cancer patients’ psychological well-being. Therefore, this three-armed, parallel-group, double-blind, randomized control trial (RCT) aims to evaluate and compare the effects of acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR) on positive psychology (such as posttraumatic growth [PTG], hope, and optimism), quality of life (QoL), and psychological complications (depression, anxiety, and experiential avoidance) among newly diagnosed head and neck cancer patients. Methods and analysis This RCT will target newly diagnosed head and neck cancer patients who have been treated only with surgery or who have not yet received any treatment. In total, 120 patients who meet all of the study’s inclusion criteria and none of its exclusion criteria will be randomly assigned into three groups—an ACT group, an MBSR group, and a treatment-as-usual control group—at a 1:1:1 allocation ratio. Participants in the two intervention groups (the ACT and MBSR groups) will undergo an eight-week group intervention program. During this program, each intervention will comprise eight modules based on ACT and MBSR, respectively. Outcome assessments will be performed across a three-point timeline, including before the intervention (t0), immediately after the psychosocial intervention at eight weeks (t1), and six months after the intervention (t2). The primary outcome that will be assessed during this RCT is PTG. Meanwhile, the secondary outcomes that will be evaluated in this study are such as QoL, hope, optimism, depression, anxiety, and experiential avoidance. Trial registration number NCT04800419 (ClinicalTrials.gov). Registered on March 16, 2021.
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Affiliation(s)
- Zheng Zhang
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
| | | | - Nurul Izzah Shari
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia
| | - Ping Lu
- Department of Oncology, 1 Affiliated Hospital, Xinxiang Medical University, Henan, People’s Republic of China
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Razavi M, Bergerot CD, Clark KL, Loscalzo M, Nuristani H, Obenchain R, Baik SH, Dale W. Association between requests for supportive care assistance and patients' characteristics, prior to treatment in a comprehensive cancer center. Psychooncology 2022; 31:1347-1353. [PMID: 35416373 PMCID: PMC9545017 DOI: 10.1002/pon.5938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022]
Abstract
Purpose Patients with cancer experience a wide array of distress symptoms (emotional, practical, physical, and functional), which often hinders their quality of life and survival. Unfortunately, only a small proportion of these patients request assistance for these problems. This study explored the relationship between requests for supportive care assistance and distress of patients newly diagnosed with cancer. Methods This study was conducted at city of hope, an NCI‐designated comprehensive cancer center, and included 2658 patients treated between 2009 and 2017. Patients were asked to complete a 30‐item biopsychosocial problem‐related distress survey via SupportScreen®, prior to any treatment. Correlations between requests for assistance and distress domains were evaluated. Primary types of requests were examined for all patients, and general linear modeling was used to determine the significant predictors of requests for assistance. p‐values <0.05 were considered significant. Results Strong correlations were observed between distress subscales and requests for assistance (r ranging from 0.67 to 0.69). The primary types of requests varied by domain: items such as feeling anxious or fearful, finances, and sleep ranked first within the emotional, practical, and physical‐functional domains respectively (∼20% requests for each item). Verbal assistance was generally preferred to the written form of assistance, with the exception of a few items, including finances. Overall, household income of <$100,000 and completing the survey in Spanish were significant predictors of requests for assistance. Regarding the practical and physical‐functional domains, having an advanced stage of disease was significantly related to an increase in demands for assistance. Being older was associated to a decrease in requests for assistance vis‐à‐vis both the emotional and physical functional subscales. Conclusion We demonstrated that distress levels were strongly correlated with requests for assistance. Patients' clinical and demographic characteristics such as age, household income, disease stage and survey language were associated with inquiries for psychosocial support, highlighting the importance of targeting interventions towards those most likely to need them, to better aim patients' needs. Therefore, tailoring supportive care assistance to patients' characteristics could help boost the frequency of requests, reduce distress burden, and improve health outcomes.
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Affiliation(s)
- Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Hussai Nuristani
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Richard Obenchain
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sharon H Baik
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA
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Zamanian H, Amini-Tehrani M, Jalali Z, Daryaafzoon M, Ramezani F, Malek N, Adabimohazab M, Hozouri R, Rafiei Taghanaky F. Stigma and Quality of Life in Women With Breast Cancer: Mediation and Moderation Model of Social Support, Sense of Coherence, and Coping Strategies. Front Psychol 2022; 13:657992. [PMID: 35237203 PMCID: PMC8882621 DOI: 10.3389/fpsyg.2022.657992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
Objectives The breast cancer stigma affects Health-related quality of life (HRQoL), while general resilience resources (GRRs), namely, sense of coherence (SOC), social support, and coping skills, are thought to alleviate this effect. The study aimed to explore the mediating/moderation role of GRRs in the relationship between stigma and HRQoL and its dimensions in Iranian patients with breast cancer. Methods In this cross-sectional study, Stigma Scale for Chronic Illness 8-item version (SSCI-8), SOC-13, Medical Outcome Survey- Social Support Scale (MOS-SSS), Brief COPE, and Functional Assessment of Cancer Therapy-Breast (FACT-B) were investigated in a convenience sample of Iranian women with confirmed non-metastatic breast cancer. Following the establishment of correlations using Pearson's correlation, single and parallel mediation analysis and moderation analysis were conducted to determine the extent to which each GRR might be impacted by stigma or decrease the adverse impact of stigma on HRQoL. Results An analysis of 221 women (response rate of 87.5%) with the mean age of 47.14 (9.13) showed that stigma was negatively correlated to all HRQoL's dimensions (r = -0.27∼0.51, p < 0.05), SOC (r = -0.26∼0.35, p < 0.01), social support (r = -0.23∼0.30, p < 0.01), and the bulk of coping skills. In the single mediation analysis, stigma affected all facets of SOC, all subscales of social support, and positive reframing, which partially reduced breast cancer HRQoL. Stigma affects general HRQoL through damaging meaningfulness, social support (except for tangible), and positive reframing. Meaningfulness was marked as the most impacted GRR in terms of all domains of HRQoL. In parallel mediation, reduced meaningfulness, total social support, and positive reframing were highlighted as the pathways of diminished breast cancer HRQoL. Moderation analysis indicated the higher levels of humor, behavioral disengagement, and use of instrumental support behaviors to be functional in protecting different dimensions of HRQoL, while the results were mixed for venting, especially in patients with mastectomy surgery. Conclusion While GRRs may be impacted by stigma, they exert a relatively small protective effect against the impact of stigma on HRQoL. This study provides some novel findings, but longitudinal studies are needed to further verify these before any causal conclusion or recommendations for health policy can be drawn.
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Affiliation(s)
- Hadi Zamanian
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.,Health Psychology and Behavior Medicine Research Group, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadali Amini-Tehrani
- Health Psychology and Behavior Medicine Research Group, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Zahra Jalali
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mona Daryaafzoon
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Fatemeh Ramezani
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Negin Malek
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Maede Adabimohazab
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Roghayeh Hozouri
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Fereshteh Rafiei Taghanaky
- Health Psychology and Behavior Medicine Research Group, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Larkin D, Birtle AJ, Bradley L, Dey P, Martin CR, Pilkington M, Romero-Rivas C. A systematic review of disease related stigmatization in patients living with prostate cancer. PLoS One 2022; 17:e0261557. [PMID: 35148315 PMCID: PMC8836305 DOI: 10.1371/journal.pone.0261557] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background Prostate cancer has been shown to be susceptible to significant stigmatisation, because to a large extent it is concealable, it has potentially embarrassing sexual symptoms and has significant impact on the psychosocial functioning. Methods This review included studies that focused on qualitative and/or quantitative data, where the study outcome was prostate cancer and included a measure of stigmatization. Electronic databases (CINAHL, Medline, PubMed, PsycInfo, Cochrane Library, PROSPERO, and the Joanna Briggs Institute) and one database for grey literature Opengrey.eu, were screened. We used thematic analysis, with narrative synthesis to analyse these data. We assessed risk of bias in the included studies using the RoBANS. Results In total, 18 studies met review inclusion criteria, incorporating a total of 2295 participants. All studies recruited participants with prostate cancer, however four studies recruited participants with other cancers such as breast cancer and lung cancer. Of the 18 studies, 11 studies evaluated perceived or felt stigma; four studies evaluated internalised or self-stigma; three studies evaluated more than one stigma domain. Discussion We found that patients living with prostate cancer encounter stigmatisation that relate to perception, internalisation, and discrimination experiences. We also identified several significant gaps related to the understanding of prostate cancer stigmatization, which provides an opportunity for future research to address these important public health issues. Registration This systematic review protocol is registered with PROSPERO, the international prospective register of systematic reviews in health and social care. Registration number: CRD42020177312.
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Affiliation(s)
- Derek Larkin
- Department of Psychology, Edge Hill University, Lancashire, United Kingdom
- * E-mail:
| | - Alison J. Birtle
- Department of Oncology, Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, United Kingdom
| | - Laura Bradley
- Department of Psychology, Edge Hill University, Lancashire, United Kingdom
| | - Paola Dey
- Faculty of Health, Social Care and Medicine, Edge Hill University, Lancashire, United Kingdom
| | - Colin R. Martin
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, United Kingdom
| | - Melissa Pilkington
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
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Grusdat NP, Stäuber A, Tolkmitt M, Schnabel J, Schubotz B, Wright PR, Heydenreich M, Zermann DH, Schulz H. Cancer treatment regimens and their impact on the patient-reported outcome measures health-related quality of life and perceived cognitive function. J Patient Rep Outcomes 2022; 6:16. [PMID: 35190938 PMCID: PMC8861246 DOI: 10.1186/s41687-022-00422-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background and purpose Breast cancer can be a significant challenge for those affected. Knowledge of physical function, social-emotional challenges, and perceived cognitive function based on the cancer treatment regimens may help to inform adequate support. Methods For this prospective observational pilot study, we collected data of seventy-nine women (mean age 54.6 ± 9.5 years) before (T0) and after (T1) initial breast cancer treatment. Functional Assessment of Cancer Therapy-Breast (FACT-B) and Functional Assessment of Cancer Therapy–Cognitive-Function (FACT-Cog) were used to collect data of four treatment subgroups: SCR = Surgery + Chemotherapy + Radiation Therapy; SC = Surgery + Chemotherapy; SR = Surgery + Radiation Therapy; S = Surgery. A mixed ANOVA and posthoc analysis (Tukey, Games-Howell) were used to detect interactions (group by time) and the main effect. A repeated-measures ANOVA displayed individual group differences (time). Results Significant interaction showed more deterioration was experienced with SC and SCR than SR and S for FACT-B (p < 0.01) and FACT-Cog (p < 0.001). The longitudinal comparison between T0 and T1 indicated a significant group main effect on all subscales (p < 0.001) except for Emotional Well-Being. Significant reductions (p < 0.05) in FACT-B, (− 19%); FACT-Cog, (− 21%) with most pronounced effect in Physical Well-Being (− 30%), Functional Well-Being (− 20%), Breast Cancer Subscale (− 20%), Perceived Cognitive Impairments (− 18%) and Impact of Cognitive Impairments on Quality of Life (− 39%) were detected for SCR. Conclusion Our study showed that the extent of change in health-related quality of life (HRQoL) and perceived cognitive function (PCF) depends on the treatment regimen. Multidisciplinary support initiated early in breast cancer therapy is needed, especially for women undergoing combined cancer treatment. Routine assessment of patient-reported outcomes (PROs) in oncology practice may increase the transparency of patients’ perceived circumstances, leading to personalized and optimized acute and survivorship care.
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Peng T, Hamann HA, David EA. Stigma May Exacerbate Disproportionately Low Guideline-Concordant Treatment Rates for Patients with Advanced Stage Lung Cancer in the United States. JTO Clin Res Rep 2022; 3:100302. [PMID: 35400082 PMCID: PMC8983342 DOI: 10.1016/j.jtocrr.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Terrance Peng
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Heidi A. Hamann
- Department of Psychology, University of Arizona, Tucson, Arizona
- Department of Family & Community Medicine, University of Arizona, Tucson, Arizona
| | - Elizabeth A. David
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California
- Corresponding author. Address for correspondence: Elizabeth A. David, MD, MAS, Division of Thoracic Surgery, Department of Surgery, University of Southern California, 1510 San Pablo Street, HCC1 Suite 514, Los Angeles, CA 90033-4612.
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Akin-Odanye EO, Husman AJ. Impact of stigma and stigma-focused interventions on screening and treatment outcomes in cancer patients. Ecancermedicalscience 2021; 15:1308. [PMID: 34824631 PMCID: PMC8580722 DOI: 10.3332/ecancer.2021.1308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Indexed: 12/11/2022] Open
Abstract
Background Stigma is known to negatively influence cancer patients’ psychosocial behaviour and treatment outcomes. The aim of this study was to systematically review the current data on cancer-related stigma across different populations and identify effective interventions used to address it. Methodology The protocol, search, appraisal, synthesis, analysis and reporting framework was used for conducting this systematic literature review. CINAHL, PubMed, PsycINFO and Google Scholar databases were searched using the different combination of keywords that include ‘cancer stigma’. Articles publication period was set for 2010–2020. A total of 54 articles (31 quantitative, 19 qualitative, 2 mixed methods and 2 scoping reviews) that met inclusion criteria were reviewed out of the 958 articles initially identified. Quality assessment of included studies revealed the studies had varying levels of methodological quality. Extracted data were organised and narratively analysed. Results Cancer stigma was expressed across different segments of the society including amongst the elites and healthcare providers. Developing countries had higher rates of stigma reported and experience of stigma varied by cancer type. Cancer was consistently associated with imminent death in all studies reviewed. Cancer patients experiencing stigma were more inclined to conceal their diagnosis and to seek medical help later. Whilst cancer stigma majorly resulted in negative psychosocial outcomes in patients, there were also instances of posttraumatic growth emanating from the stigma experienced. Literature on cancer-related stigma interventions was scant. Conclusion Cancer related stigma remains high in both clinical settings and amongst the general public. There is need for more interventions to combat cancer stigma and its effect in both patient and non-patient population. Anti-cancer public enlightenment campaigns should be sensitively designed to not further fuel stigma against patients with certain types of cancers.
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Affiliation(s)
- Elizabeth O Akin-Odanye
- Department of Clinical Psychology, University College Hospital, Queen Elizabeth Road, Oritamefa, Ibadan, Oyo State, 200212, Nigeria
| | - Anisah J Husman
- College of Health Professions and Sciences, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816, USA
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Teo I, Ozdemir S, Malhotra C, Yang GM, Ocampo RR, Bhatnagar S, Hapuarachchi T, Joad AK, Mariam L, Palat G, Rahman R, Finkelstein EA. High anxiety and depression scores and mental health service use among South Asian advanced cancer patients: A multi-country study. J Pain Symptom Manage 2021; 62:997-1007. [PMID: 33872721 DOI: 10.1016/j.jpainsymman.2021.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of anxiety and depression and mental health service use among advanced cancer patients in South Asia. OBJECTIVES To examine among South Asian advanced cancer patients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use. METHODS This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer and aware they had cancer. Participants' high anxiety and depression scores (using clinically-relevant Hospital Anxiety and Depression Scale threshold of >10), sociodemographic characteristics, patient-perceived cancer stigma and mental health service use were assessed. RESULTS In the overall sample (N = 1140), 54% met threshold for high anxiety and/or depression scores: 32% reported high anxiety scores and 47% reported high depression scores. Symptom burden (OR's [95% CI's] = 1.09-1.13 [1.05-1.09, 1.12-1.17]) and perceived stigma (1.11-1.16 [1.06-1.11, 1.16-1.22]) were statistically significantly associated with high anxiety and depression scores. Of the patients with high anxiety and/or depression scores (n = 617), 97% had not received mental health services, and 38% of them indicated they were open to a referral. CONCLUSION High, clinically-relevant anxiety and depression scores are common among South Asian advanced cancer patients. Efforts should be made to alleviate psychological morbidity, including providing greater access to supportive/palliative medicine teams or mental health services.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore.
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Grace Meijuan Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore
| | - Remee R Ocampo
- Department of Psychology, Singapore Management University, Singapore
| | - Sushma Bhatnagar
- Department of Oncology-Anaesthesiology and Palliative Medicine, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anjum Khan Joad
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Gayatri Palat
- Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India
| | - Rubayat Rahman
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
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Göral Türkcü S, Uludağ E, Serçekuş P, Özkan S, Yaren A. Experiences and coping strategies of women receiving treatment for breast and gynecological cancers during the COVID-19 pandemic: A qualitative study. Eur J Oncol Nurs 2021; 54:102045. [PMID: 34619418 PMCID: PMC8489965 DOI: 10.1016/j.ejon.2021.102045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023]
Abstract
Purpose The aim of this study was to examine experiences and coping strategies of women receiving treatment for breast and gynecological cancers during the COVID-19 pandemic. Methods A descriptive, phenomenological approach was adopted. The study included 15 women receiving treatment for breast and gynecological cancers in the chemotherapy center of a university hospital. Data was collected with a descriptive characteristic form and semi-structured in-depth interviews. Results Data analysis revealed three main themes: Problems, protection and coping. The main theme of 'problems' was grouped into four categories: living with anxiety and fear, social isolation, physical difficulties, and financial difficulties. 'Protection' was grouped into four categories: decreased stigmatization, increased preventive measures, increased communication between family members, and keeping distance. Coping was grouped into four categories: religious practices, social support, positive thinking, and hobbies. Conclusions The participants were found to experience psychosocial, financial and physical difficulties. However, they also mentioned positive aspects of the pandemic: elimination of stigmatization due to the obligation for everyone to wear a mask, lack of visits due to the lockdown and enhanced communication with family members due to increased time spent at home. Religious practices, social support, positive thinking and spending time on hobbies were helpful to cope with the problems experienced during the pandemic. The results of this study can guide nurses in offering high-quality nursing care and counseling to women treated for breast and gynecological cancers during the pandemic.
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Affiliation(s)
- Sinem Göral Türkcü
- Department of Obstetrics and Gynecology Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Turkey
| | - Elif Uludağ
- Department of Obstetrics and Gynecology Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Turkey.
| | - Pınar Serçekuş
- Department of Obstetrics and Gynecology Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Turkey
| | - Sevgi Özkan
- Department of Obstetrics and Gynecology Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Turkey
| | - Arzu Yaren
- Department of Internal Medicine, Division of Medical Oncology, University of Pamukkale, Denizli, Turkey
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Yıldız K, Koç Z. Stigmatization, discrimination and illness perception among oncology patients: A cross-sectional and correlational study. Eur J Oncol Nurs 2021; 54:102000. [PMID: 34492525 DOI: 10.1016/j.ejon.2021.102000] [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: 01/06/2021] [Revised: 06/07/2021] [Accepted: 07/07/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Many individuals who get cancer may be exposed to stigmatization from their close relatives and their entourage. This cross-sectional and correlational study was conducted in order to determine stigmatization, discrimination and perception of illness among oncology patients in Northern Turkey. METHOD The sample of the study consisted of 367 inpatients who were hospitalized in the oncology and hematology clinics of a University Hospital in northern Turkey between 31.01.2019 and 30.07.2019. Data were collected using the demographics form, Cataldo Lung Cancer Stigma Scale and Illness Perception Questionnaire. RESULTS The mean total score of the patients according to Cataldo Lung Cancer Stigma Scale is 30.4 ± 8.8. In this study, no statistically significant relationship was determined between Cataldo Lung Cancer Stigma Scale total score and Illness Perception Questionnaire sub-dimension scores (p > .05). It can be said that the oncology patients were exposed to stigmatization and discrimination, and that certain socio demographic and clinical characteristics such as sex, marital status, education level, employment status, diagnosis, and the clinical phase of the disease are significant predictors of Cataldo Lung Cancer Stigma Scale scores. CONCLUSIONS In order to help them express their feelings in oncology patients, reduce their anxiety, increase their adaptation to their illness and treatment, help them cope with the multi-faceted crisis caused by the disease and improve their quality of life, cancer stigmatization should be evaluated objectively.
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Affiliation(s)
- Kübra Yıldız
- Ondokuz Mayıs University Health Application and Research Hospital, Turkey.
| | - Zeliha Koç
- Ondokuz Mayıs University, Health Science Faculty, Turkey.
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Syed Alwi SM, Narayanan V, Mohd Taib NA, Che Din N. Chemotherapy-related cognitive impairment (CRCI) among early-stage breast cancer survivors in Malaysia. J Clin Exp Neuropsychol 2021; 43:534-545. [PMID: 34369307 DOI: 10.1080/13803395.2021.1945539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Breast cancer survivors frequently develop cognitive impairment following chemotherapy which can significantly hamper their well-being, ability to function independently, and overall quality of life. Evidence of cognitive functioning in breast cancer survivors from lower and middle-income countries remains scarce. We examined the prevalence of cognitive impairment among Malaysian multiethnic early-stage breast cancer survivors one to three years post-chemotherapy.Methods: This cross-sectional study included 160 breast cancer survivors from the University Malaya Medical Center (UMMC). The cognitive assessments used included the Montreal Cognitive Assessment (MoCA-BM), the Rey Auditory and Verbal Learning Test (RAVLT-BM), and the digit span and arithmetic of the Working Memory Index (WMI) of Wechsler Adult Intelligence Scale-IV (WAIS-IV). Data were analyzed using independent sample t-tests and Pearson's correlation.Results: Our breast cancer survivors demonstrated poor performances in MoCA-BM (31.9%) RAVLT-BM, recall (53.8%), and WMI of WAIS-IV (51.3%) with 30.6% of them performed poorly in all three cognitive tests administered. There were no significant mean group differences in cognitive performances between <24 months after chemotherapy and ≥24 months after chemotherapy.Conclusions: A high proportion of breast cancer survivors exhibited poor performances in the cognitive assessments. Cognitive rehabilitation programmes tailored to the needs of these survivors should be incorporated into cancer care management.
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Affiliation(s)
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Normah Che Din
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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The prevalence of perceived stigma and self-blame and their associations with depression, emotional well-being and social well-being among advanced cancer patients: evidence from the APPROACH cross-sectional study in Vietnam. BMC Palliat Care 2021; 20:104. [PMID: 34233662 PMCID: PMC8265020 DOI: 10.1186/s12904-021-00803-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background There is very limited evidence on the existence of cancer-related perceived stigma and self-blame among patients with advanced cancer in Asia, and how they are associated with psychosocial outcomes. This study aimed to address the gap in the current literature by (1) assessing perceived stigma, behavioural self-blame and characterological self-blame among Vietnamese patients with advanced cancer, and (2) investigating the associations of perceived stigma and self-blame (behavioural and characterological) with depression, emotional well-being and social well-being. Methods This cross-sectional study involved 200 Vietnamese patients with stage IV solid cancer. Depression was measured using the Center for Epidemiologic Studies Depression (CES-D) Scale. Emotional well-being and social well-being were measured with the relevant domains of the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Perceived stigma was assessed using the sense of stigma subscale of Kissane’s Shame and Stigma Scale. Behavioural self-blame and characterological self-blame were measured by the patients’ answers to the questions on whether their cancer was due to patient’s behaviour or character. Multivariable linear regressions were used to investigate the associations while controlling for patient characteristics. Results Approximately three-fourths (79.0%, n = 158) of the participants reported perceived stigma with an average score of 20.5 ± 18.0 (out of 100). More than half of the participants reported behavioural self-blame (56.3%, n = 112) or characterological self-blame (62.3%, n = 124). Higher perceived stigma was associated with lower emotional well-being (ß = -0.0; p = 0.024). Behavioural self-blame was not significantly associated with depressive symptoms, emotional well-being or social well-being. Patients who reported characterological self-blame reported greater depressive symptoms (ß = 3.0; p = 0.020) and lower emotional well-being (ß = -1.6; p = 0.038). Conclusion Perceived stigma and self-blame were common amongst Vietnamese advanced cancer patients. Perceived stigma was associated with lower emotional well-being while characterological self-blame were associated with greater depressive symptoms and lower emotional well-being. Interventions should address perceived stigma and self-blame among this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00803-5.
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İnkaya B, Karadağ E. Turkish validity and reliability study of type 2 diabetes stigma assessment scale. Turk J Med Sci 2021; 51:1302-1306. [PMID: 33486913 PMCID: PMC8283479 DOI: 10.3906/sag-2006-255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 01/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background/aim Stigma has a high incidence and adversely affects people with diabetes. In this context, patients face difficulties such as fear of losing their jobs, travel restrictions, isolation from social life, problems related to mental health, and feeling of wellness. The aim of this study was to investigate the validity and reliability of the stigma assessment scale in individuals with type 2 diabetes. Materials and methods The study sample consisted of 153 diabetic individuals. The validity of language, content, and construct were examined to evaluate the validity of the type 2 diabetes stigma assessment scale. Cronbach’s alpha was used to assess internal consistency reliability. Results The content validity index of 19 items which were detected as significant was found to be 0.86. The Cronbach’s alpha coefficient of the scale is 0.92. The results of the item analysis show that all factor loads are significant (t-value > ±1.96). The coefficient of correlation between type 2 diabetes stigma assessment scale and test–retest technique was 0.82. Conclusion It was concluded that the stigma assessment scale is a valid and reliable measurement tool in individuals with type 2 diabetes mellitus. Nurses may use this tool to better understand and help relieve the prevalence and severity stigma of individuals with type 2 diabetes in Turkey.
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Affiliation(s)
- Bahar İnkaya
- Department of Nursing, Faculty of Health Science, Ankara Yıldırım Beyazıt University, Turkey, Ankara
| | - Ezgi Karadağ
- Department of Oncology Nursing, Faculty of Nursing, Dokuz Eylül University, Turkey, İzmir
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Jin R, Xie T, Zhang L, Gong N, Zhang J. Stigma and its influencing factors among breast cancer survivors in China: A cross-sectional study. Eur J Oncol Nurs 2021; 52:101972. [PMID: 33991869 DOI: 10.1016/j.ejon.2021.101972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Although stigma has attracted considerable scholarly attention, few studies have focused on its influencing factors among discharged breast cancer survivors, especially in a Chinese cultural context. The present study therefore explores stigma and its influencing factors among breast cancer survivors in China. METHOD Between December 2017 and May 2018, 103 breast cancer survivors at the outpatient clinic of a tertiary cancer center in southern China were enrolled in a cross-sectional study. The research instruments comprised the Social Impact Scale (SIS), the General Self-Efficacy Scale (GSES), the Medical Coping Modes Questionnaire (MCMQ), and sociodemographic and disease-related questionnaires. Descriptive statistics, univariate analysis, and multivariable linear regression were used to explore the current status of stigma and to identify influencing factors. RESULTS Of the respondents, 76.7% and 8.7%, respectively, reported moderate and high levels of stigma. The mean SIS score was 55.20 ± 12.15 (moderate), and the SIS subscale with the highest average score was financial insecurity. The results of a multivariable linear regression showed that body image (β = 0.32, P<0.001), spousal support (β = -0.47, P < 0.001), personal acceptance of the disease (β = -0.22, P<0.001), coping modes (resignation) (β = 0.14, P < 0.001), support from medical staff (β = -0.23, P < 0.001) and self-efficacy (β = -0.10, P = 0.037) were the main factors influencing stigma among breast cancer survivors (R2 = 0.83). CONCLUSIONS Stigma, among breast cancer survivors, which is influenced by various sociocultural factors, is a neglected issue requiring attention. Healthcare professionals should therefore formulate effective measures for alleviating stigma in this group by improving their self-efficacy and acceptance of the disease, reducing their poor body image and negative coping mode, and eliciting more support from their spouses and medical staff.
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Affiliation(s)
- Ruiqi Jin
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Tingting Xie
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Lijuan Zhang
- Department of Breast Surgery, Sun Yat-sen University Cancer Center, Dongfeng 1 Rd 651#, Guangzhou, Guangdong, PR China
| | - Ni Gong
- School of Nursing, Jinan University, Huangpudadaoxi Rd 601#, Guangzhou, Guangdong, PR China
| | - June Zhang
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China.
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Scharnetzki L, Schiller JH. Lung Cancer: Why the Stigma? And What Can Be Done? Chest 2021; 159:1721-1722. [PMID: 33965131 DOI: 10.1016/j.chest.2020.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 10/21/2022] Open
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Xun H, Lee E, Yesantharao P, El Eter L, Kraezlin F, Persing S, Sacks J. Reconstructive and restorative cues improve public perception on the value of plastic and reconstructive surgeries. J Plast Reconstr Aesthet Surg 2021; 74:2947-2956. [PMID: 33992560 DOI: 10.1016/j.bjps.2021.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/22/2020] [Accepted: 02/26/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Persistent public misconceptions of plastic and reconstructive surgery (PRS), ambiguity between cosmetic versus reconstructive surgical procedures, and subjective interpretation of aesthetics can result in undervaluing of the field. Our study analyzes how patient context (cosmetic or reconstructive/restorative cues) affect public perception of outcomes and value of surgery. METHODS We distributed Qualtrics™ surveys to laypersons via Amazon Mechanical Turk. Demographics were self-reported. The survey presented a series of pre- and post-operative photographs of PRS surgeries alongside either a cosmetic or reconstructive/restorative cue, followed by questions on values of procedure. Survey responses were analyzed using two-tailed Student's t tests and chi square analyses, univariate and multivariate analysis, and linear regression. RESULTS Of the 459 respondents, the mean age was 38.5 ± 12.1 years, and was 50.5% (232) male. The majority of respondents classified breast reconstruction as a cosmetic surgery (243, 66.8%), and was rated more attractive (p < 0.0005), higher impact on self-esteem (p < 0.001), and to be covered by health insurance (p < 0.0001) compared to breast augmentation. Reconstructive cued breast and facial procedures were viewed more favorably; the exception was gynecomastia reduction. Reconstructive classification had significant positive correlation with support for insurance coverage (R2 = 0.8268) and willingness to pursue (R2 = 0.5328). CONCLUSIONS This study revealed more public support for reconstructive/restorative cued PRS cases over cosmetic cued PRS cases, and persistent misconceptions of breast reconstruction as a cosmetic procedure. Reconstructive or restorative cues can be used to educate the public and address skewed perceptions on the roles and value of PRS.
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Affiliation(s)
- Helen Xun
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States.
| | - Erica Lee
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States
| | - Pooja Yesantharao
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States
| | - Leen El Eter
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States
| | - Franca Kraezlin
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States
| | - Sarah Persing
- Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, United States
| | - Justin Sacks
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, School of Medicine, St. Louis, MO, United States.
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Shim S, Kang D, Bae KR, Lee WY, Nam SJ, Sohn TS, Jeong BC, Sinn DH, Kweon SS, Shim YM, Cho J. Association between cancer stigma and job loss among cancer survivors. Psychooncology 2021; 30:1347-1355. [PMID: 33817907 DOI: 10.1002/pon.5690] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Previous qualitative studies found cancer stigma was associated with work discrimination and job loss among cancer patients. This study aims to quantify the association between cancer stigma and job loss among cancer survivors. METHODS For this study, we used the data from a face-to-face cross sectional survey conducted at two cancer hospitals in Seoul and Hwasun in South Korea from October 2017 to March 2018. Cancer stigma was assessed using a validated questionnaire which consists of 12 items in three domains: (a) impossibility of recovery; (b) stereotypes; and (c) discrimination. Multivariable logistic regression was performed to evaluate the association between cancer stigma and job loss adjusting age, sex, marital status, education, job type, residence area, cancer site, stage, comorbidity, time since diagnosis, and self-efficacy. RESULTS Among 433 cancer survivors, 24.0% lost their jobs after cancer, and 20.7% experienced discrimination at work. Of total, 21.7% of the survivors agreed that it was difficult to treat cancer regardless of highly developed medical science. Survivors with stigma on impossibility of recovery and stereotypes were 3.10 (95% confidence interval [CI]: [1.76, 5.44]) and 2.10 (95% CI: [1.20, 3.67]) times more likely to lose a job than survivors without cancer stigma. Survivors with discrimination experience at work had 1.98 (95% CI: [1.05, 3.74]) times higher risk of losing a job than survivors without it. CONCLUSIONS Survivors with cancer stigma were more likely to lose their jobs than survivors without cancer stigma. Considering its social and economic impact on job loss, comprehensive interventions for working cancer survivors as well as public campaigns against cancer stigma would be necessary.
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Affiliation(s)
- Sungkeun Shim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea
| | - Danbee Kang
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Ka Ryeong Bae
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byong Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
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Feng LS, Dong ZJ, Yan RY, Tu CL, Zhang LY, Shen JY, Zhang SY. Development and validation of the cancer symptoms discrimination scale: a cross-sectional survey of students in Yunnan, China. BMC Palliat Care 2020; 19:156. [PMID: 33046031 PMCID: PMC7552442 DOI: 10.1186/s12904-020-00662-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023] Open
Abstract
Background This study aimed to devise a Cancer symptoms Discrimination Scale (CSDS) suitable for China based on a cross-sectional survey. Methods The CSDS was developed using the classical measurement theory. A total of 3610 students from Yunnan province, China, participated in the cross-sectional survey. The test version of the scale was modified by the item analysis method, and after the official version of CSDS was developed, its reliability and validity were verified. A univariate analysis of variance and a multiple linear regression model were used to analyze the influencing factors of cancer symptoms discrimination among the university/college students. Results There were 21 items in total for the CSDS, including 3 subscales --- common clinical manifestations (11 items), physical appearance defects (6 items), and drainage tube(s) wearing (4 items). This CSDS had good validity (GFI = 0.930, AGFI = 0.905, RMR = 0.013, I-CVIs> 0.80, and the Pearson correlation coefficient was satisfactory.) and reliability (Cronbach’s alpha = 0.862, spearman-brown coefficient = 0.875). The multiple linear regression showed that certain factors may affect the students’ discrimination level against cancer symptoms (P < 0.05), including gender, major, current education degree, guardian’s highest record of formal schooling, self-rated health status, history of care for cancer patients, family relationship, ways of cancer knowledge acquisition, good/poor understanding of cancer-related information, degree of cancer fear, and their perception of cancer infectiousness. Conclusion This CSDS, with good reliability and validity, can be used for the evaluation of the discrimination risk and levels against cancer symptoms among healthy students.
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Affiliation(s)
- Lin-Sen Feng
- The Sixth Affiliated Hospital of Kunming Medical University (The People's Hospital of Yuxi City), Yuxi, Yunnan, China.
| | - Zheng-Jiao Dong
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Ruo-Yu Yan
- The Sixth Affiliated Hospital of Kunming Medical University (The People's Hospital of Yuxi City), Yuxi, Yunnan, China
| | - Chang-Ling Tu
- The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, Yunnan, China
| | - Lan-Yu Zhang
- No.1 School of Clinical Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Jiang-Yun Shen
- No.1 School of Clinical Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Shi-Yu Zhang
- The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, Yunnan, China
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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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Younger E, Smrke A, Lidington E, Farag S, Ingley K, Chopra N, Maleddu A, Augustin Y, Merry E, Wilson R, Benson C, Miah A, Zaidi S, McTiernan A, Strauss SJ, Dileo P, Gennatas S, Husson O, Jones RL. Health-Related Quality of Life and Experiences of Sarcoma Patients during the COVID-19 Pandemic. Cancers (Basel) 2020; 12:cancers12082288. [PMID: 32823999 PMCID: PMC7547383 DOI: 10.3390/cancers12082288] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023] Open
Abstract
Sarcomas are rare cancers with a spectrum of clinical needs and outcomes. We investigated care experiences and health-related quality of life (HRQoL) in sarcoma patients during the COVID-19 pandemic. Patients with appointments during the first two months of the UK lockdown were invited to complete a survey. Questions included views on care modifications, COVID-19 worry and psychosocial impact, and EORTC-QLQ-C30 items. 350 patients completed the survey; median age 58 (16–92) years. Care modifications included telemedicine (74%) and postponement of appointments (34%), scans (34%) or treatment (10%). Most felt the quality of care was not affected (72%), however, social life (87%) and emotional wellbeing (41%) were affected. Worry about COVID-19 infection was moderately high (mean 5.8/10) and significantly related to higher cancer-related worry; associated with lower emotional functioning irrespective of treatment intent. Curative patients (44%) with low resilient coping scores had significantly higher COVID-19 worry. Patients who did not know their treatment intent (22%) had significantly higher COVID-19 worry and insomnia. In summary, care experiences were generally positive; however, cancer-related worry, low resilient coping and uncertainty about treatment intent were associated with COVID-19 worry. These patients may benefit from additional psychological support during the pandemic and beyond.
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Affiliation(s)
- Eugenie Younger
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Alannah Smrke
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Emma Lidington
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Sheima Farag
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Katrina Ingley
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Neha Chopra
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Alessandra Maleddu
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Yolanda Augustin
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Eve Merry
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Roger Wilson
- Sarcoma Patients EuroNet e.V./Association, D-61200 Wolfersheim, Germany;
| | - Charlotte Benson
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Aisha Miah
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
- Institute of Cancer Research, London SM2 5NG, UK;
| | - Shane Zaidi
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Anne McTiernan
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Sandra J. Strauss
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Palma Dileo
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Spyridon Gennatas
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Olga Husson
- Institute of Cancer Research, London SM2 5NG, UK;
| | - Robin L. Jones
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
- Institute of Cancer Research, London SM2 5NG, UK;
- Correspondence: ; Tel.: +44-207-352-8171
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Fujisawa D, Umezawa S, Fujimori M, Miyashita M. Prevalence and associated factors of perceived cancer-related stigma in Japanese cancer survivors. Jpn J Clin Oncol 2020; 50:1325-1329. [DOI: 10.1093/jjco/hyaa135] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/22/2020] [Indexed: 01/26/2023] Open
Abstract
Abstract
This study aimed to examine the prevalence and associated factors of perceived cancer-related stigma among Japanese cancer survivors. In this web-based survey involving 628 Japanese cancer survivors, perceived cancer-related stigma, quality of life (Quality of Life-Cancer Survivors Instrument), psychological distress (K6) and perceived social support (multidimensional scale of perceived social support) were evaluated. Perceived cancer-related stigma was endorsed by 61.2% of the participants. Perceived cancer-related stigma was significantly associated with quality of life (R = 0.35–0.37), psychological distress (R = 0.35) and perceived social support (R = 0.10). Logistic regression analysis demonstrated that cancer survivors at younger ages (odds ratio = 0.96), with low income (odds ratio = 2.49), with poorer performance status (odds ratio = 2.33), and with breast, urinary or gynecological cancers (odds ratio = 4.27, 4.01, 4.01, respectively) were at higher risk for perceived cancer-related stigma.
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Affiliation(s)
- Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shino Umezawa
- Department of Nursing, Toho University Omori Medical Center, Tokyo, Japan
| | - Maiko Fujimori
- Behavioral Research Section, Behavioral Science Division, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Park R, Shaw JW, Korn A, McAuliffe J. The value of immunotherapy for survivors of stage IV non-small cell lung cancer: patient perspectives on quality of life. J Cancer Surviv 2020; 14:363-376. [PMID: 31950409 PMCID: PMC7256093 DOI: 10.1007/s11764-020-00853-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/03/2020] [Indexed: 12/26/2022]
Abstract
Purpose The aim of this study was to examine what personally mattered to 24 patients who received immuno-oncology (IO) therapy for stage IV non-small cell lung cancer (NSCLC), as well as their families and friends, to understand how they evaluated their cancer treatments and the determinants of the quality of life (QoL) of long-term survivors. Methods Ethnographic research was conducted with 24 patients who had responded to IO (pembrolizumab, nivolumab, atezolizumab, or durvalumab) for stage IV NSCLC, and their families and friends, evenly split among field sites in Denmark, the USA, and the UK. Data were collected using in-depth qualitative interviews, written exercises, and participant observation. Data analysis methods included interpretative phenomenological analysis, coding, and the development of grounded theory. Researchers spent 2 days with participants in their homes and accompanied them on health-related outings. Results Our findings reveal that long-term survivors on IO experienced their journey in two phases: one in which their cancer had taken over their lives mentally, physically, and spiritually, and another in which their cancer consumed only a part of their everyday lives. Patients who survived longer than their initial prognosis existed in a limbo state in which they were able to achieve some semblance of normalcy in spite of being identified as having a terminal condition. This limbo state impacted their life priorities, decision-making, experience of patient support, and health information-seeking behaviors, all of which shaped their definitions and experience of QoL. Conclusions The results of this study, which identify the specific challenges of living in limbo, where patients are able to reclaim a portion of their pre-cancer lives while continuing to wrestle with a terminal prognosis, may inform how cancer research can more effectively define and measure the QoL impacts of IO treatments. Also, they may identify approaches that the cancer community can use to support the needs of patients living in a limbo state. These experiences may not be adequately understood by the cancer community or captured by existing QoL measures, which were designed prior to the emergence of IO and without sufficient incorporation of contextual, patient-driven experience. Implications for Cancer Survivors Increased awareness of the specific experiences that come with long-term survival on IO may direct how resources should be spent for cancer support for patients and their families. Expanding how QoL is evaluated based on patients’ lived experiences of IO can reflect a more accurate depiction of the treatment’s benefits and harms.
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Affiliation(s)
- Rebekah Park
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA.
| | - James W Shaw
- Worldwide Health Economics and Outcomes Research, Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ, USA
| | - Alix Korn
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA
| | - Jacob McAuliffe
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA
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Ge XJ, Jiang JY, Wang M, Li MY, Zheng LM, Feng ZX, Liu L. Cetuximab enhances the efficiency of irinotecan through simultaneously inhibiting the MAPK signaling and ABCG2 in colorectal cancer cells. Pathol Res Pract 2019; 216:152798. [PMID: 31889589 DOI: 10.1016/j.prp.2019.152798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The present study sought to investigate the combined effects of cetuximab and irinotecan on colorectal cancer cells as well as the mechanisms underlying their anti-cancer effects. MATERIAL AND METHODS High performance liquid chromatography, Hoechst staining assay, and western blotting analysis were used to detect intracellular drug concentrations, cell apoptosis, and protein expression in the presence of cetuximab, irinotecan, and the combination of both. RESULTS Cetuximab was found to increase intracellular concentrations of irinotecan as well as cytotoxicity by inhibiting the epidermal growth factor receptor and, by extension, the downstream RAS-RAF-MEK-ERK signaling pathway. Cetuximab therefore induced apoptosis and improved the effect of irinotecan in colorectal cancer cells. It was also shown that cetuximab inhibited the drug efflux activity of ABCG2. In combination with irinotecan, cetuximab can both significantly induce cell apoptosis by inhibiting the RAS-RAF-MEK-ERK signaling pathway and improve the effects of irinotecan by decreasing drug efflux through the inhibition of ABCG2. CONCLUSION These features contribute to its anti-cancer potential.
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Affiliation(s)
- Xiao-Jun Ge
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zun Yi, Guizhou, 563003, China.
| | - Jun-Yao Jiang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zun Yi, Guizhou, 563003, China
| | - Mei Wang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zun Yi, Guizhou, 563003, China
| | - Mei-Yong Li
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zun Yi, Guizhou, 563003, China
| | - Li-Mei Zheng
- Department of Dermatology, Affiliated Hospital of Zun Yi Medical University, Zun Yi, Guizhou, 563003, China
| | - Zhong-Xin Feng
- Department of Hematology, Affiliated Hospital of Zun Yi Medical University, Zun Yi, Guizhou, 563003, China
| | - Lan Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zun Yi, Guizhou, 563003, China
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Yılmaz M, Dissiz G, Usluoğlu AK, Iriz S, Demir F, Alacacioglu A. Cancer-Related Stigma and Depression in Cancer Patients in A Middle-Income Country. Asia Pac J Oncol Nurs 2019; 7:95-102. [PMID: 31879690 PMCID: PMC6927157 DOI: 10.4103/apjon.apjon_45_19] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/28/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: The aim of the current study are to determine the depression levels of adult oncology patients in the cancer treatment phase and identify both cancer-related stigma and the factors affecting their depression levels. Methods: In this correlational study, 303 adult patients who had been treated at a medical outpatient clinic were surveyed using the convenience sampling method. The “questionnaire for measuring attitudes toward cancer – patient version,” a sociodemographic characteristics questionnaire, and the beck depression inventory were used. A multivariable linear regression model was used for the analysis. Results: The questionnaire and its subscale scores indicated a positive relationship between depression and attitudes toward cancer. The predictive variables for depression were “being younger than 40-year-old” and “feelings of social exclusion,” which accounted for 4% of the total variance. Four factors indicating negative attitudes toward cancer were “being more than 60-year-old,” “higher education,” “low income,” and “feelings of social exclusion,” which accounted for 11% of the total variance. Conclusions: Cancer-related stigma, which underlies patients' emotional and behavioral outlooks, should be reduced in cancer patients. Members of health teams should be sensitive to cancer-related stigma.
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Affiliation(s)
- Medine Yılmaz
- Department of Nursing, Faculty of Health Sciences, University of Izmir Katip Celebi, Izmir, Turkey
| | - Gulcin Dissiz
- Medical Oncology Unit, Atatürk Training and Research Hospital, University of Izmir Kâtip Celebi, Izmir, Turkey
| | - Ayse Kurtulusoglu Usluoğlu
- Medical Oncology Unit, Atatürk Training and Research Hospital, University of Izmir Kâtip Celebi, Izmir, Turkey
| | - Sibel Iriz
- Medical Oncology Unit, Atatürk Training and Research Hospital, University of Izmir Kâtip Celebi, Izmir, Turkey
| | - Filiz Demir
- Department İzmir Public Association, University of Izmir Kâtip Celebi, Cigli, Izmir, Turkey
| | - Ahmet Alacacioglu
- Medical Oncology Unit, Atatürk Training and Research Hospital, University of Izmir Kâtip Celebi, Izmir, Turkey
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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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Toubat O, Farias AJ, Atay SM, McFadden PM, Kim AW, David EA. Disparities in the surgical management of early stage non-small cell lung cancer: how far have we come? J Thorac Dis 2019; 11:S596-S611. [PMID: 31032078 DOI: 10.21037/jtd.2019.01.63] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
It is currently estimated that nearly one-third of patients with newly diagnosed non-small cell lung cancer (NSCLC) have stage I-II disease on clinical evaluation. Curative-intent surgical resection has been a cornerstone of the therapeutic management of such patients, offering the best clinical and oncologic outcomes in the long-term. In 1999, Peter Bach and colleagues brought attention to racial disparities in the receipt of curative-intent surgery in the NSCLC population. In the time since this seminal study, there is accumulating evidence to suggest that disparities in the receipt of definitive surgery continue to persist for patients with early stage NSCLC. In this review, we sought to provide an up-to-date assessment of 20 years of surgical disparities literature in the NSCLC population. We summarized common and unrecognized disparities in the receipt of surgical resection for early stage NSCLC and demonstrated that demographic and socioeconomic factors such as race/ethnicity, special patient groups, income and insurance continue to impact the receipt of definitive resection. Additionally, we found that discrepancies in patient and provider perceptions of and attitudes toward surgery, access to invasive staging, distance to treatment centers and negative stigmas about lung cancer that patients experience may act to perpetuate disparities in surgical treatment of early stage lung cancer.
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Affiliation(s)
- Omar Toubat
- Keck School of Medicine of USC, Los Angeles, CA, USA.,Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Albert J Farias
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Scott M Atay
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - P Michael McFadden
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Anthony W Kim
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth A David
- Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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Midding E, Halbach SM, Kowalski C, Weber R, Würstlein R, Ernstmann N. Men With a "Woman's Disease": Stigmatization of Male Breast Cancer Patients-A Mixed Methods Analysis. Am J Mens Health 2018; 12:2194-2207. [PMID: 30222029 PMCID: PMC6199445 DOI: 10.1177/1557988318799025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Male breast cancer (MBC) is rare and known as a typical woman’s disease. This study is part of the N-MALE project (Male breast cancer: patient’s needs in prevention, diagnosis, treatment, rehabilitation and follow-up-care) and aims to investigate how MBC patients (MBCP) feel about suffering from a “woman’s disease,” what character the stigmatization has, and how it can be prospectively reduced. Therefore, a mixed methods design is applied including data of N = 27 qualitative interviews with MBCP and quantitative data of N = 100 MBCP. Findings identify a diverse picture, as stigmatization varies between contexts and patients: Most stigmatization concentrates on sexual stigmatization and ignorance of MBC and mostly occurs in cancer care systems and work-related contexts. The level of stigmatization varies with age and amount of treatment methods received, as reported within the created typology of different MBCP stigma types. To prospectively reduce stigmatization in MBCP, more publicity of MBC is needed, as well as gender-neutral communication and information material.
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Affiliation(s)
- Evamarie Midding
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
| | - Sarah Maria Halbach
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
| | | | - Rainer Weber
- 4 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Rachel Würstlein
- 5 Breast Center, Department of Gynecology and Obstetrics and CCCLMU, University of Munich (LMU), Munich, Germany
| | - Nicole Ernstmann
- 1 Center for Health Communication and Health Services Research (CHSR). Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,2 Center for Integrated Oncology Cologne Bonn, Germany
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