1
|
Feliciano J, Chang A, Venkatraman D, Brooks S, Zagaja C, Ettinger D, Hann C, Naidoo J, Voong R, Hales R, Turner M, Peterson V, Bodurtha J. Lung cancer and family-centered concerns. Support Care Cancer 2019; 28:497-505. [PMID: 31065838 DOI: 10.1007/s00520-019-04839-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 04/24/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Genetic and environmental interactions predispose certain groups to lung cancer, including families. Families or caregiving units experience the disease interdependently. We have previously evaluated the concerns and preferences of patients in addressing the lung cancer experience and cancer risks in their families. This qualitative study evaluates the concerns and preferences of family members and caregivers of patients with lung cancer in the lung cancer experience and familial cancer risks. METHODS We held focus groups to discuss the format and timing of addressing these preferences and concerns. Qualitative data generated was analyzed using a grounded theory approach. RESULTS Five focus groups totaling 19 participants were conducted. Seven themes were identified: (1) journey to lung cancer diagnosis has core dimensions for patient and family, (2) importance of communication between patients, families, and providers, (3) challenges for caregivers and family, (4) mixed perceptions of lung cancer causation among relatives, (5) discussion of cancer risk with relatives has complex dynamics, (6) impact of diagnosis on family health behaviors and screening, (7) role of genetic counseling. CONCLUSIONS Family members of patients with lung cancer are interested in discussing risk factors, prevention, and diagnoses and also would like access to other supportive services do learn about and cope with some of the stresses and barriers they experience in the family lung cancer journey. The diagnosis represents a potential teachable moment with the opportunity to reduce the risk of LC development or improve early detection in LC patient's family members.
Collapse
Affiliation(s)
- Josephine Feliciano
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA.
| | - Alexander Chang
- Johns Hopkins University, 3400 North Charles Street, Baltimore, 21218, USA
| | - Deepti Venkatraman
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Samara Brooks
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Ciara Zagaja
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - David Ettinger
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA
| | - Christine Hann
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA
| | - Jarushka Naidoo
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA
| | - Ranh Voong
- Johns Hopkins Department of Radiation Oncology, 401 North Broadway, Baltimore, MD, 21287, USA
| | - Russell Hales
- Johns Hopkins McKusick-Nathans Institute of Genetic Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Michelle Turner
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA
| | - Valerie Peterson
- Johns Hopkins Sidney Kimmel Cancer Center at Bayview, 301 Mason Lord Drive, Suite 4500, Baltimore, MD, 21224, USA
| | - Joann Bodurtha
- Johns Hopkins McKusick-Nathans Institute of Genetic Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| |
Collapse
|
2
|
Hamann HA, Ostroff JS, Marks EG, Gerber DE, Schiller JH, Lee SJC. Stigma among patients with lung cancer: a patient-reported measurement model. Psychooncology 2013; 23:81-92. [PMID: 24123664 DOI: 10.1002/pon.3371] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/08/2013] [Accepted: 07/12/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although stigma may have negative psychosocial and behavioral outcomes for patients with lung cancer, its measurement has been limited. A conceptual model of lung cancer stigma and a patient-reported outcome measure are needed to mitigate these sequelae. This study identified key stigma-related themes to provide a blueprint for item development through a thematic analysis of semi-structured interviews and focus groups with lung cancer patients. METHODS Participants were recruited from two outpatient oncology clinics and included (i) 42 lung cancer patients who participated in individual interviews and (ii) 5 focus groups (inclusive of 23 new lung cancer patients). Never smokers, long-term quitters, recent quitters, and current smokers participated. Individual interviews facilitated theme development and a conceptual model of lung cancer stigma, whereas subsequent focus groups provided feedback on the conceptual model. Qualitative data analyses included iterative coding and validation with existing theory. RESULTS Two main thematic elements emerged from interviews with lung cancer patients: perceived (felt) stigma and internalized (self) stigma. Discussions of perceived stigma were pervasive, whereas those of internalized stigma were more commonly endorsed among current and recently quit smokers. Participants also discussed maladaptive (e.g., decreased disclosure) and adaptive (e.g., increased advocacy) stigma-related consequences. CONCLUSIONS Results indicate widespread acknowledgment of perceived stigma among lung cancer patients but varying degrees of internalized stigma and associated consequences. Next steps for patient-reported outcome measure development are item consolidation, item development, expert input, and cognitive interviews before field testing and psychometric analysis. Future work should address stigma-related consequences and interventions for reducing lung cancer stigma.
Collapse
Affiliation(s)
- Heidi A Hamann
- Harold C. Simmons Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | | | | |
Collapse
|