Lay beliefs, knowledge, and attitudes towards cancer: a pilot study in Japan

Impact of Hospital Closure on Patients with Communicable and Non-Communicable Diseases During the COVID-19 Pandemic in Uganda: A Cross-Sectional and Mixed-Methods Study

Background

The COVID-19 pandemic and its measures have had a profound impact on universal access to health services. We investigated the impact of the closure of the Entebbe Regional Referral Hospital (ERRH) for two years on the accessibility to necessary healthcare among non-COVID-19 patients.

Methods

This mixed-methods study focused on ERRH patients with tuberculosis (TB), human immunodeficiency virus (HIV), diabetes/hypertension, and mental illness. A quantitative study used a structured-questionnaire with a primary outcome measure to assess the discontinuation of healthcare accessibility. A qualitative study with a focus group discussion (FGD) was conducted on eight patients.

Results

Of the 202 quantitative survey participants, 17.8% discontinued necessary healthcare due to the ERRH closure, and the discontinuation rates differed by disease: 48.1% of TB patients, 16.0% of HIV patients, 7.8% of diabetes/hypertension patients, and 4.0% of mental health patients (P < 0.001). Almost 90% of the patients reported a worsened health condition, regardless of the disease. Multivariable logistic regression analysis showed that patients with diabetes/hypertension (adjusted odds ratio [AOR], 12.69; 95% confidence interval [CI], 2.57-62.52) and HIV (AOR, 7.52; 95% CI, 1.37-41.27) were more likely to discontinue healthcare than those with mental illness. The factors associated with discontinued healthcare included age ≥50 years vs ≤30 years (AOR, 4.88; 95% CI, 1.07-22.34), and high transportation cost vs low cost (AOR, 3.15; 95% CI, 1.13-8.75). The FGD also identified difficulties in obtaining medication, especially for TB, even though ERRH provided the outreach services.

Conclusion

Our study revealed that the ERRH closure and lockdowns had an overall profound negative impact on access to healthcare and health conditions. Younger patients and those with TB were the most affected patients. This study provides practical suggestions from the field for policy makers to strengthen universal health access during health crises in Uganda and other sub-Saharan countries.

A Pilot Study for the Development and Evaluation of an Educational Program to Reduce Stigma Toward Cancer and Cancer Survivors: Focusing on Dating and Marriage After Cancer Diagnosis

The marriage rate of cancer survivors is lower than that of the general population and their siblings. This appears to be attributable to negative images and stigma in society regarding cancer and cancer survivors. In order to improve images and decrease stigma regarding cancer and cancer survivors, this study aimed to develop an educational program that primarily focuses on dating and marriage after cancer diagnosis. The education program was conducted for university students, and among 67 participants who attended the education program, 61 participants completed a self-report questionnaire both before and after the program. The questionnaire included measures to assess reluctance to date or marry a cancer survivor, attitudes toward marriage and having children, and level of empathy. Scores on most items assessing reluctance decreased after the program; however, only three items showed a significant decrease: reluctance to date a cancer survivor if cancer recurred or metastasized, and reluctance if one's family objects to dating a cancer survivor. Both before and after the program, disease severity was the main cause for reluctance to date. In addition, empathetic concern was associated with reduced reluctance to date or marry a cancer survivor, while conservative attitudes toward marriage were associated with greater reluctance which was a result of familial concerns regarding such relationships. Some of the reluctance could be attributable to sociocultural values in Asia, where the choice of romantic partner is likely to be subject to familial influence.

Development and validation of the Cancer Knowledge Scale for the general population: An item response theory approach

OBJECTIVE

To develop and validate a new measure of cancer knowledge for members of the general population who have never been diagnosed with cancer.

METHODS

Initially, 20 items were generated to measure cancer knowledge. After expert refinement and cognitive interviews, 11 items remained and were completed by 1,076 adults with no history of cancer. Responses were assessed using an item response theory (IRT) approach and differential item functioning.

RESULTS

Items were analyzed using a two-parameter logistic IRT model. Two items with tetrachoric correlation coefficients>0.8 and one item with a discrimination parameter>2.0 were excluded. The final eight items demonstrated a good range of discrimination (1.13 to 1.86) and difficulty (-1.11 to 0.85). No meaningful differential item functioning by participant attributes was detected for these eight items.

CONCLUSION

The Cancer Knowledge Scale appears to be a reliable and valid measure for the general population.

PRACTICE IMPLICATIONS

The eight-item scale could be used to assess the effects of psychoeducational programs, including those on cancer knowledge, for members of the general population with no cancer history.

Lay people's psychological reactions and helping intention after friends' cancer disclosure: An exploratory analysis using vignettes

OBJECTIVES

Stigma, anticipated responses from others, and their relationships may affect patients' decision-making of cancer disclosure. However, little research has explored responses to cancer disclosure and the outcome from receivers' perspectives who had stereotypic views of cancer. This vignette study aimed to explore how lay people with negative attitude to cancer would react to the friend's cancer disclosure.

METHODS

A cross-sectional survey study was conducted in community organisations. Of 161 recruited, 91 participants returned their questionnaires (56.5% of response rate). A total of 88 responses to open-ended questions were qualitatively analysed.

RESULTS

Thematic analysis extracted four themes: 'Initial emotional reactions and the acceptance of the friend's cancer diagnosis'; 'Empathy, trust and helping intention'; 'Sharing informational and emotional support provision'; and 'Offering help, but waiting and seeing the friend's request.' As a result of comparison to these themes by the participants' familiarity of cancer patients in their real life, it was found that participants, who had not known any cancer patients, did not report the acceptance of the friends' cancer diagnosis and informational support provision to share.

CONCLUSION

Intervention for lay people who felt difficulty with accepting friends' cancer diagnosis may be helpful to reduce the impact of friends' cancer diagnosis.

Controversial Messages on Cancer

A direct connection between certain lifestyle factors and an increased risk of cancer has already been established. Despite well-documented associations, controversial messages on causes of cancer often appear without taking into consideration their impact on the general population. While mainstream coverage of cancer research is clearly welcome, consideration must be given to the risk of transmitting provocative messages with serious negative consequences for cancer research and public health. We must avoid becoming a breeding ground for the misinterpretation of scientific information. Polemical results can stimulate scientific research and progress, but controversial messages encourage confusion and impotence in an increasingly disoriented population. The correct communication of health messages is at least as important as research on risk factors.