Impact of Disgust on Intentions to Undergo Colorectal Surgery

Development and psychometric evaluation of the colostomy disgust scale in patients with colostomy

OBJECTIVE

To establish and validate the Colostomy Disgust Scale (CDS) for assessing disgust in colostomy patients.

DESIGN

Triphasic, cross-sectional psychometric study.

SETTING

A total of 423 patients with colostomy (222 first samples and 201 s samples) were recruited from a tertiary hospital between January 2015 and April 2016.

METHODS

Three phases were undertaken: (a) item generation, (b) item selection and (c) evaluation and validation. The evaluation and validation of the CDS were performed through feasibility and initial item analysis, exploratory factor analysis, confirmatory factor analysis and internal consistency.

RESULTS

Following item generation and item selection, a 22-item CDS was generated. Principal axis factoring indicated a two-factor solution for the proposed CDS model, which was also verified by confirmatory factor analysis. Moreover, the proposed CDS had a high internal consistency.

CONCLUSION

The CDS is a self-report instrument with initial evidence for its validity and reliability. It is a promising tool to identify the triggers of disgust in colostomy contexts, which can be of great importance for promoting the mental health of colostomy patients.

The “Ick” Factor: An Unrecognized Affective Predictor of Physical Symptoms During Chemotherapy

Background

Patients undergoing chemotherapy experience a range of aversive symptoms. These symptoms vary across individuals and at least some of this variation can be predicted by psychological factors, such as distress. However, while psychological distress predicts some of the symptoms, it is limited in important ways.

Purpose

To (a) assess the viability of disgust—a discrete emotion that specifically evolved for health-related reasons—as a predictor of chemotherapy-related symptoms (particularly, taste- and smell-related changes) and (b) compare the predictive utility of disgust sensitivity and propensity against the most commonly used affective predictor, that is, psychological distress.

Methods

Patients with cancer (N = 63) about to initiate chemotherapy were recruited in a prospective observational study. Psychosocial predictor variables were assessed at baseline, and outcomes (i.e., physical symptoms, body mass index [BMI], and food-based sensory-processing changes) were assessed at both baseline and 6 week follow-up.

Results

Psychological distress did not predict any of the outcomes. Both disgust sensitivity (β = .53, p = .003) and propensity (β = −.56, p = .002) predicted greater food-based sensory-processing changes, while disgust sensitivity marginally predicted greater chemotherapy-related physical symptoms (β = .34, p = .060); neither of these two forms of disgust predicted BMI.

Conclusions

The study provides first evidence showing (a) associations between trait disgust and food sensory-processing changes that arise during chemotherapy and (b) disgust as being a more useful predictor of food- and digestion-related symptoms than psychological distress. In doing so, it opens new doors for better care to be provided to patients undergoing chemotherapy.

Is it disgusting or am I just easily disgusted? The relation between situational disgust, dispositional disgust, and colonoscopy intentions

OBJECTIVE

While early detection is an effective way to reduce mortality from colorectal cancer, screening rates are low. An underlying factor in screening completion failure may be experiences of disgust when learning about screening and/or dispositional disgust.

METHOD

Participants recruited via Amazon MTurk (N = 296) read information about colonoscopy and completed an online survey assessing both dispositional forms of disgust (i.e. trait disgust and disgust sensitivity) and situational forms, including state disgust and disgust associated with colonoscopy. Participants reported intentions to discuss colonoscopy with a provider and to prepare for and complete screening.

RESULTS

Greater state disgust and the degree to which one associated disgust with colonoscopy predicted lower screening, preparation and provider discussion intentions. By contrast, neither trait disgust nor disgust sensitivity was associated with intentions. Both disgust sensitivity and trait disgust moderated the state disgust to intentions relation.

CONCLUSIONS

This is one of few investigations of disgust examining the relation between specific types and colonoscopy intentions. Screening uptake may be improved by identifying specific components of disgust that have an effect on colonoscopy intentions. Future work focusing on the interplay between different disgust mechanisms as they relate to colonoscopy behaviour is important for intervention development.