1
|
Honda N, Shiroshita Y, Miyazaki A, Sobue I. Factors associated with cancer disclosure in adolescent and young adult cancer survivors: An integrative review from the social-ecological model perspective. Eur J Oncol Nurs 2024; 69:102542. [PMID: 38460390 DOI: 10.1016/j.ejon.2024.102542] [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: 05/26/2022] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Young cancer survivors ("young survivors") may need to disclose their cancer experiences to reintegrate into society. In such cases, the recognition of social support through the disclosure of cancer experiences may prevent potential social disadvantages. This review aimed to describe the motivations, strategies and outcomes, and benefits and disadvantages of disclosure in young survivors based on the social-ecological model (SEM) to identify the support survivors need when disclosing their cancer experiences. METHODS Using the integrated review methodology, we systematically searched six databases in English and Japanese as well as searched the reference lists of the selected studies. The themes identified via thematic analysis were categorized within the SEM levels. RESULTS This review analyzed 14 studies and identified four themes, including "Motivation for Cancer Disclosure," "Barriers to Cancer Disclosure," "Consequences of Cancer Disclosure: Benefits," and "Consequences of Cancer Disclosure: Disadvantages." Motivations for young survivors to disclose their cancer involved post-cancer differences, perceptions, relationships, and social context. In navigating barriers, including self-stigma, peer exclusion, and discrimination, they employed strategies such as reassurance and information limitation. Tailored disclosure strategies at each SEM level offered social and psychological benefits, however, disadvantages, including stress, vulnerability, employment issues, and limited insurance coverage, were experienced by young survivors due to cancer disclosure. CONCLUSIONS To optimize the benefits of cancer disclosure for young survivors, addressing psychological burdens, enhancing disclosure skills, offering familial psychological support, and fostering public awareness of cancer are essential.
Collapse
Affiliation(s)
- Naoko Honda
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Yui Shiroshita
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Asuka Miyazaki
- Department of Reproductive Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Ikuko Sobue
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Kurisu K, Harashima S, Fujimori M, Akechi T, Yoshiuchi K, Uchitomi Y. Regional disparities in suicide among patients with cancer: A nationwide population-based study in Japan. Cancer Med 2023; 12:20052-20058. [PMID: 37737044 PMCID: PMC10587921 DOI: 10.1002/cam4.6574] [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: 08/09/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND This study aimed to explore prefecture-level differences in suicide risk among patients with cancer in Japan. METHODS Data from the National Cancer Registry, which covers the entire Japanese population, were used. Patients diagnosed with cancer between 2016 and 2017 were included. The standardized mortality ratio (SMR) for suicide within 2 years after cancer diagnosis was quantified compared with the general population for each prefecture. Multivariate Poisson regression analysis was conducted to quantify the adjusted relative risk using Hokkaido as the reference. RESULTS The analysis included 2,133,502 patients. The SMRs were high among patients with cancer residing in certain prefectures, such as the Hokuriku region (the middle and western parts of Japan's main island). These areas also exhibited a significant relative risk in the Poisson regression model. CONCLUSION The results demonstrated that patients with cancer in certain prefectures in Japan have a high suicide risk.
Collapse
Affiliation(s)
- Ken Kurisu
- Division of Survivorship ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Saki Harashima
- Division of Survivorship ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Maiko Fujimori
- Division of Survivorship ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University, Graduate School of Medical SciencesNagoyaJapan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yosuke Uchitomi
- Division of Survivorship ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer CenterTokyoJapan
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Soejima T, Tokita M, Kitao M. Impact of flexible work arrangements on job resignation after cancer diagnosis among Japanese young adult cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01421-1. [PMID: 37480472 DOI: 10.1007/s11764-023-01421-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/15/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Many workers had flexible work arrangements during the COVID-19 pandemic. This study aimed to identify the association between flextime and remote working and job resignation among Japanese young adult cancer survivors after diagnosis. METHODS This cross-sectional observational study was conducted using an online survey with 401 Japanese young adult cancer survivors diagnosed with adult-onset cancer and aged 20-39 years at the time of the survey in January 2022. A multivariable Cox regression analysis was performed to analyze the impact of flextime and remote working on job resignation. RESULTS In the sample, 264 participants (65.8%) were female, and 185 (46.1%) had been diagnosed with cancer between 1 and 5 years ago. After adjusting for potential confounders, the multivariable Cox regression analysis revealed that young adult cancer survivors using remote working only (HR 0.44, 95% CI 0.21-0.96, p = 0.04) and both flextime and remote working (HR 0.37, 95% CI 0.21-0.64, p < 0.01) experienced a lower risk of job resignation after cancer diagnosis compared to those who did not use flextime and remote working. CONCLUSIONS Young adult cancer survivors who used remote working only or remote working combined with flextime could reduce their risk of job resignation after a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS This study showed that having the option of remote working can be important for young adult cancer survivors' continuing employment. Furthermore, social welfare systems need to promote a workplace culture and climate that allows remote working.
Collapse
Affiliation(s)
- Takafumi Soejima
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-Ku, Kobe, Hyogo, 654-0142, Japan.
| | - Masahito Tokita
- Keio Research Institute at SFC, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan
| | - Mari Kitao
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-Ku, Kobe, Hyogo, 654-0142, Japan
| |
Collapse
|
6
|
Liu Q, Zhang L, Xiang X, Mao X, Lin Y, Li J, Cui W. The influence of social alienation on maintenance hemodialysis patients' coping styles: chain mediating effects of family resilience and caregiver burden. Front Psychiatry 2023; 14:1105334. [PMID: 37457762 PMCID: PMC10342202 DOI: 10.3389/fpsyt.2023.1105334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Research on the possible impact of social alienation, family resilience, and caregiver burden on the coping styles of Chinese patients on maintenance hemodialysis (MHD) is scarce. We explore the influence of social alienation, family resilience, and caregiver burden on the coping styles of MHD patients, both directly and indirectly. Methods We invited 173 MHD patients and their primary caregivers for a cross-sectional study; the study using convenience sampling method at the hemodialysis center of the First People's Hospital of Foshan. The Chinese version of the generalized social of alienation scale, the Chinese version of the simplified coping style questionnaire, and a sociodemographic questionnaire were completed by the MHD patients, while their primary caregivers had filled out the Chinese family resilience assessment scale, the Chinese version of the Zarit caregiver burden interview, and provided socio-demographic information. SPSS macro program PROCESS v3.3 Model 6 were used for analyses of chain-mediated effects. Results In the mediating effects model, the direct influence of social alienation upon coping styles was significant (95% CI -0.050, -0.014), and social alienation indirectly impacted coping style by family resilience in a significant way (95% CI -0.012, -0.001) or caregiver burden (95% CI -0.013, -0.001). In addition, social alienation significantly impacted coping style by both family resilience and caregiver burden (95% CI -0.008, -0.001). Conclusion Social alienation can exert both a direct and indirect influence on coping styles through the mediating factors of family resilience and caregiver burden. Clinicians can take interventions to strengthen family resilience and reduce caregiver burden, which may be useful in improving socially isolated behaviors and coping skills in MHD patients.
Collapse
Affiliation(s)
- Qiaoling Liu
- School of Nursing, College of Medicine, Shantou University, Shantou, China
| | - Li Zhang
- Department of Office, First People’s Hospital of Foshan, Foshan, China
| | - Xia Xiang
- Department of Nursing, First People’s Hospital of Foshan, Foshan, China
| | - Xiaoying Mao
- Department of Office, First People’s Hospital of Foshan, Foshan, China
| | - Ying Lin
- School of Nursing, College of Medicine, Shantou University, Shantou, China
| | - Jingfeng Li
- Hemodialysis Center, First People‘s Hospital of Foshan, Foshan, China
| | - Wen Cui
- College of Nursing, Zunyi Medical University, Zhuhai, China
| |
Collapse
|
7
|
Padmanabhan H, Mariapun S, Lee SY, Hassan NT, Lee DSC, Meiser B, Wong SW, Lee YQ, Yip CH, Teo SH, Thong MK, Taib NAM, Yoon SY. Impact of BRCA1/2 cascade testing on anxiety, depression, and cancer worry levels among unaffected relatives in a multiethnic Asian cohort. J Genet Couns 2023; 32:43-56. [PMID: 35913122 DOI: 10.1002/jgc4.1619] [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: 09/13/2021] [Revised: 06/10/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022]
Abstract
Cascade testing for families with BRCA pathogenic variants is important to identify relatives who are carriers. These relatives can benefit from appropriate risk management and preventative strategies arising from an inherited increased risk of breast, ovarian, prostate, melanoma, and pancreatic cancers. Cascade testing has the potential to enable cost-effective cancer control even in low- and middle-income settings, but few studies have hitherto evaluated the psychosocial impact of cascade testing in an Asian population, where the cultural and religious beliefs around inheritance and destiny have previously been shown to influence perception and attitudes toward screening. In this study, we evaluated the short- and long-term psychosocial impact of genetic testing among unaffected relatives of probands identified through the Malaysian Breast Cancer Genetics Study and the Malaysian Ovarian Cancer Study, using validated questionnaires (Hospital Anxiety and Depression Scale and Cancer Worry Scale) administered at baseline, and 1-month and 2-year post-disclosure of results. Of the 305 unaffected relatives from 98 independent families who were offered cascade testing, 256 (84%) completed predictive testing and family history of cancers was the only factor significantly associated with uptake of predictive testing. We found that the levels of anxiety, depression, and cancer worry among unaffected relatives decreased significantly after result disclosure and remained low 2-year post-result disclosure. Younger relatives and relatives of Malay descent had higher cancer worry at both baseline and after result disclosure compared to those of Chinese and Indian descent, whereas relatives of Indian descent and those with family history of cancers had higher anxiety and depression levels post-result disclosure. Taken together, the results from this Asian cohort highlight the differences in psychosocial needs in different communities and inform the development of culture-specific genetic counseling strategies.
Collapse
Affiliation(s)
| | | | | | | | | | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | | | | | | | | | - Meow-Keong Thong
- Department of Paediatrics, Genetic Medicine Unit, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Bu X, Li S, Cheng ASK, Ng PHF, Xu X, Xia Y, Liu X. Breast Cancer Stigma Scale: A Reliable and Valid Stigma Measure for Patients With Breast Cancer. Front Psychol 2022; 13:841280. [PMID: 35756211 PMCID: PMC9226439 DOI: 10.3389/fpsyg.2022.841280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/28/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose This study aims to develop and validate a stigma scale for Chinese patients with breast cancer. Methods Patients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale’s content validity was assessed by a Delphi study (n = 15) and feedback from patients with breast cancer (n = 10); exploratory factor analysis (n = 200) was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale (n = 50); internal consistency Cronbach’s α (n = 200), split-half reliability (n = 200), and test–retest reliability (N = 50) were used to identify the reliability of the scale. Results The final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale (ρ = 0.641, P < 0.001). Exploratory factor analysis (EFA) revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach’s α for the total scale was 0.86, and each subscale was 0.75–0.882. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.947 (P < 0.001), and split-half reliability with intra-class correlation coefficients of the total scale was 0.911 (P < 0.001). The content validity index (CVI) was 0.73–1.0. Conclusion The newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China.
Collapse
Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Shuangshuang Li
- Department of Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Xianghua Xu
- Department of Health Service Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yimin Xia
- Department of Health Service Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| |
Collapse
|
10
|
Lima TR, Lima MSFDS, Carvalho ESDS, Paranhos RFB, Araújo IFM, Souza ARD. CUIDADOS DE FAMILIARES ÀS PESSOAS COM FERIDAS NEOPLÁSICAS MALIGNAS EM DOMICÍLIO. ESTIMA 2022. [DOI: 10.30886/estima.v20.1222_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivos:Conhecer como os cuidadores de pessoas com feridas neoplásicas malignas realizam o cuidado em domicílio. Método: Estudo qualitativo que envolveu sete familiares de pessoas com feridas malignas em tratamento em uma unidade de alta complexidade em oncologia. Os dados foram produzidos por meio de entrevista semiestruturada e submetidos à análise de conteúdo temático, proposto por Bardin. Resultados: Entrevistadas sete familiares-cuidadoras, todas do sexo feminino, jovens que abandonaram o trabalho para se dedicarem à pessoa enferma. Emergiram três categorias após análise do conteúdo: familiares buscam orientações para cuidar do paciente com feridas neoplásicas malignas em domicílio; adotam estratégias no cuidado das feridas; e referem necessidade de apoio dos profissionais e instituições de saúde, porque enfrentam dificuldades no atendimento, principalmente nas unidades de atenção primária. Conclusão: Os familiares de pessoas com feridas neoplásicas malignas enfrentam dificuldades, principalmente pela escassez de conhecimento técnico e por falta de apoio das instituições e dos profissionais de saúde.
Collapse
|
11
|
Lima TR, Lima MSFDS, Carvalho ESDS, Paranhos RFB, Araújo IFM, Souza ARD. CARE OF FAMILY MEMBERS OF PEOPLE WITH MALIGNANT NEOPLASTIC WOUNDS AT HOME. ESTIMA 2022. [DOI: 10.30886/estima.v20.1222_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: To understand how caregivers of people with malignant neoplastic wounds perform care at home. Method: A qualitative study that involved seven relatives of people with malignant wounds undergoing treatment in a high complexity oncology unit. The data were produced through semistructured interviews and submitted to thematic content analysis, proposed by Bardin. Results: Seven family-caregivers, all female, young people who left work to dedicate themselves to the sick person were interviewed. Three categories emerged after content analysis: family members seek guidance to care for patients with malignant neoplastic wounds at home; they adopt strategies in wound care; and report the need for support from health professionals and institutions, because they face difficulties in care, especially in primary care units. Conclusion: Family members of people with malignant neoplastic wounds face difficulties, mainly due to the scarcity of technical knowledge and lack of support from health institutions and from professionals.
Collapse
|
12
|
Priority Analysis of Educational Needs of Forest Healing Instructors Related to Programs for Cancer Survivors: Using Borich Needs Assessment and the Locus for Focus Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095376. [PMID: 35564777 PMCID: PMC9103931 DOI: 10.3390/ijerph19095376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/07/2022]
Abstract
This study aimed to identify the priority of educational needs to strengthen the competency of forest healing instructors who operate forest healing programs for cancer survivors. A survey was conducted with 91 forest healing instructors using a questionnaire. The average perceived importance of the forest healing program for cancer survivors of forest healing instructors was higher compared to the average knowledge of the forest healing instructors. The Borich needs assessment model showed the highest educational need in the domains of “Cancer survivors’ overview” and “Health status screening method”. In addition, deriving the priority of educational needs using the Borich needs assessment model and the focus trajectory model revealed that the highest priority was for “Health status screening method” and “Effective communication with cancer survivors”. These results can be used as basic data for developing a forest healing instructors training program for cancer survivors that reflects the instructors’ needs and the characteristics of cancer survivors.
Collapse
|
13
|
Factors affecting the quality of life of gastric cancer survivors. Support Care Cancer 2022; 30:3215-3224. [PMID: 34973098 PMCID: PMC8857153 DOI: 10.1007/s00520-021-06683-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
Background The number of gastric cancer survivors has been increasing, and such survivors experience various changes in their lives post-recovery. Adapting to these changes requires appropriate interventions that can improve their quality of life (QoL). This study was conducted to investigate the factors affecting the QoL of gastric cancer survivors and provide basic data for effective intervention. Methods Data were collected between September 8 and September 29, 2017, from the Gastric Cancer Center at a tertiary hospital. Questionnaire surveys were conducted using the EORTC QLQ-C30/STO22, Self-Efficacy-Scale, Multidimensional Scale of Perceived Social Support, and Quality of Life-Cancer Survivors Questionnaire on gastric cancer survivors who were followed up for 3 years after gastrectomy. Data were analyzed using descriptive statistics, t test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis. Results A total of 136 gastric cancer survivors completed the questionnaire survey. There were significant positive correlations of QoL with self-efficacy, functional status, and social support (r = .35, p < .001; r = .53, p < .001; r = .26, p < .001, respectively). There were significant negative correlations of QoL with general symptoms (r = − .39, p < .001) and gastric cancer-specific symptoms (r = − .51, p < .001). The regression model explained 48.3% of the QoL, and the affecting factors were gastric cancer-specific symptoms (β = − .397, p < .001), religious belief (β = .299, p < .001), functional status (β = .251, p = .003), and self-efficacy (β = .191, p = .004). Conclusion This study confirmed that gastric cancer-specific symptoms, spiritual well-being, self-efficacy, and functional status affect the QoL of gastric cancer survivors. Hence, these factors should be considered in the interventions to improve the QoL of gastric cancer survivors.
Collapse
|
14
|
Teo I, Bhaskar A, Ozdemir S, Malhotra C, Hapuarachchi T, Joad AK, Manalo MF, Mariam L, Hong NX, Palat G, Rahman R, Tuong PN, Finkelstein EA. Perceived Stigma and Its Correlates Among Asian Patients with Advanced Cancer: A Multi-Country APPROACH Study. Psychooncology 2022; 31:938-949. [PMID: 35048471 DOI: 10.1002/pon.5882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/29/2021] [Accepted: 12/30/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Perceived cancer-related stigma can affect mental health and potentially treatment choices for patients with cancer. Nevertheless, perceived stigma is not very well understood in Asia. This study investigated across six developing Asian countries: 1) the prevalence of perceived stigma among advanced cancer patients, 2) its risk factors, and 3) its association with patient treatment preferences. METHODS This cross-sectional study recruited patients receiving oncology care across major hospitals in Bangladesh, China, India, Philippines, Sri Lanka and Vietnam. Participants (N = 1358) were adults diagnosed with stage IV metastatic solid cancer who completed self-reported surveys. Multi-variable logistic regression and ordered logit models examined the associations with perceived stigma and variables of interest. RESULTS Across the countries, 35%, 95% CI [32%, 38%] of patients reported experiencing at least one facet of cancer-related stigma often or always, while 60% [57%, 63%] reported it occurring occasionally. Top-endorsed facets of perceived stigma across the Asian countries suggest a distinct pattern. Having knowingly engaged in health-risk behaviours (OR = 2.03-2.24, 95% CI [1.14-1.19, 3.43-4.41]), unemployment (2.64 [1.67, 4.19]) and body image change (1.57 [1.00, 2.45]) were associated with higher odds of perceived stigma, while time mitigated perceived stigma (0.49-0.65 [0.30-0.45, 0.76-0.92]). Perceived stigma was associated with lower odds of preference for life-extending treatments, although the associations did not hold up in the adjusted model. CONCLUSIONS Perceived stigma is unique among Asian advanced cancer patients. Stigma is important to assess and address, taking into consideration the various sociodemographic, clinical and psychological factors of cancer patients. This article is protected by copyright. All rights reserved.
Collapse
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.,Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - Adithya Bhaskar
- Lien Centre for Palliative Care, Duke-NUS Medical School, 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
| | | | - Anjum Khan Joad
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
| | - Maria Fidelis Manalo
- Supportive Oncology & Palliative Care, Augusto P. Sarmiento Cancer Institute, The Medical City, Philippines
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Ning Xiao Hong
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - 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
| | | |
Collapse
|
15
|
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.
Collapse
|
16
|
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.
Collapse
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.
| |
Collapse
|