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肺癌患者的心理困扰与生活质量:健康相关耻辱感、疾病认知及社会限制的作用

Psychological distress and quality of life in lung cancer: the role of health-related stigma, illness appraisals and social constraints.

作者信息

Chambers Suzanne K, Baade Peter, Youl Philippa, Aitken Joanne, Occhipinti Stefano, Vinod Shalini, Valery Patricia C, Garvey Gail, Fong Kwun M, Ball David, Zorbas Helen, Dunn Jeff, O'Connell Dianne L

机构信息

Menzies Health Institute of Queensland, Griffith University, Brisbane, Australia.

Cancer Council Queensland, Brisbane, Australia.

出版信息

Psychooncology. 2015 Nov;24(11):1569-77. doi: 10.1002/pon.3829. Epub 2015 Apr 29.

Abstract

OBJECTIVE

Health-related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect.

METHODS

A self-administered cross-sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health-related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes.

RESULTS

Forty-nine percent of patients reported elevated anxiety; 41% were depressed; and 51% had high global distress. Health-related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints.

CONCLUSIONS

Health-related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health-related stigma among lung cancer patients.

摘要

目的

与健康相关的污名与肺癌患者的负面心理和生活质量结果相关。本研究描述了污名对肺癌患者心理困扰和生活质量的影响,并探讨社会限制和疾病评估作为影响中介的作用。

方法

一项自填式横断面调查研究了来自昆士兰和新南威尔士州的151名被诊断为肺癌的患者(回复率59%)的心理困扰和生活质量。评估了与健康相关的污名、社会限制和疾病评估作为调整结果的预测因素。

结果

49%的患者报告焦虑情绪升高;41%的患者有抑郁情绪;51%的患者有高度的总体困扰。与健康相关的污名与总体心理困扰和生活质量显著相关,污名和羞耻感越强,结果越差。这些影响通过疾病评估和社会限制起中介作用。

结论

与健康相关的污名似乎通过限制关于癌症的人际讨论和加剧威胁感而导致更差的调整。需要开发和评估干预措施,以减轻肺癌患者中与健康相关污名的负面影响。

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