Scott Nicola, Crane Melanie, Lafontaine Mayanne, Seale Holly, Currow David
1NSW Public Health Officer Training Program,NSW Ministry of Health,Sydney,Australia.
2School of Public Health,University of Sydney,NSW,Australia.
Prim Health Care Res Dev. 2015 Nov;16(6):618-22. doi: 10.1017/S1463423615000043. Epub 2015 Feb 9.
The prognosis for people with lung cancer may be worsened by delays in seeking medical help following the onset of symptoms. Previous research has highlighted that patients' experiences of stigma and blame may contribute to these delays. This short report focuses on stigma as a barrier to diagnosis of lung cancer, from patient and general practitioner (GP) perspectives. Semi-structured interviews were conducted with people diagnosed with lung cancer (n=20) and with GPs (n=10) in New South Wales, Australia. Participants' experiences of blame and stigma, GPs preconceptions of lung cancer risk and the impact of anti-smoking messaging were explored. Participants reported experiencing stigma owing to a diagnosis of lung cancer. For some, the anticipation of stigma resulted in delays in seeking diagnosis and hence treatment. The sense of blame associated with a lung cancer diagnosis was also reflected in GP interviews. Successful tobacco control activities have increased societal awareness of lung cancer as smoking related and potentially contributed to the participants' experiences of stigma. Removing blame associated with smoking is central to reducing delays in diagnosis of lung cancer.
肺癌患者在出现症状后寻求医疗帮助的延迟可能会使预后恶化。先前的研究强调，患者所经历的污名化和指责可能是导致这些延迟的原因。本简短报告从患者和全科医生的角度，聚焦污名化这一肺癌诊断的障碍。在澳大利亚新南威尔士州，对20名肺癌确诊患者和10名全科医生进行了半结构化访谈。探讨了参与者所经历的指责和污名化、全科医生对肺癌风险的先入之见以及反吸烟信息的影响。参与者报告称，因肺癌诊断而遭受污名化。对一些人来说，对污名化的预期导致了寻求诊断及治疗的延迟。全科医生的访谈中也反映出与肺癌诊断相关的指责感。成功的控烟活动提高了社会对与吸烟相关的肺癌的认识，并可能导致了参与者的污名化经历。消除与吸烟相关的指责对于减少肺癌诊断延迟至关重要。
