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感知污名化及其对生活质量的影响 - 基于大型登记研究的结果,包括乳腺癌、结肠癌、前列腺癌和肺癌患者。

Perceived stigmatization and its impact on quality of life - results from a large register-based study including breast, colon, prostate and lung cancer patients.

机构信息

Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, D - 04103, Leipzig, Germany.

Clinic of Otolaryngology, Head and Neck Surgery, University Medical Center Leipzig, Leipzig, Germany.

出版信息

BMC Cancer. 2017 Nov 9;17(1):741. doi: 10.1186/s12885-017-3742-2.

Abstract

BACKGROUND

To date, research on stigmatization among cancer patients and related psychosocial consequences has been scarce and mostly based on small and highly selected samples. We investigated stigmatization and its impact on quality of life among a large sample including four major tumor entities.

METHODS

We assessed 858 patients with breast, colon, lung or prostate cancer from two cancer registries. Stigmatization and quality of life (QoL) was assessed with the Social Impact Scale (SIS-D) and the EORTC Quality of Life Questionnaire (European Organization for Research and Treatment of Cancer), respectively. Group effects were analyzed via analyses of variance, relationships were investigated via Pearson's r and stepwise regression analyses.

RESULTS

The mean age was 60.7 years, 54% were male. Across cancer sites, the dimensions of stigmatization (isolation, social rejection, financial insecurity and internalized shame) were in the lower and middle range, with the highest values found for isolation. Stigmatization was lowest among prostate cancer patients. Stigmatization predicted all five areas of QoL among breast cancer patients (p < .05), but only affected emotional functioning (p < .01) among lung cancer patients.

CONCLUSIONS

We found an inverse relationship between perceived cancer-related stigmatization and various dimensions of QoL, with variation between cancer sites. Breast cancer patients should be focused in individual therapies regarding the negative consequences accompanied by perceived stigmatization.

摘要

背景

迄今为止,针对癌症患者的污名化及其相关心理社会后果的研究仍然很少,而且大多基于小样本和高度选择性的样本。我们调查了在包括四大肿瘤实体在内的大样本中,污名化及其对生活质量的影响。

方法

我们评估了来自两个癌症登记处的 858 名乳腺癌、结肠癌、肺癌或前列腺癌患者。污名化和生活质量(QoL)分别采用社会影响量表(SIS-D)和欧洲癌症研究与治疗组织生活质量问卷(EORTC)进行评估。通过方差分析分析组间效应,通过 Pearson r 检验和逐步回归分析调查关系。

结果

平均年龄为 60.7 岁,54%为男性。在所有癌症部位,污名化的维度(隔离、社会排斥、经济不安全和内化羞耻感)处于较低和中等水平,隔离的分值最高。前列腺癌患者的污名化程度最低。污名化预测了乳腺癌患者的所有五个 QoL 领域(p<0.05),但仅影响肺癌患者的情绪功能(p<0.01)。

结论

我们发现感知到的与癌症相关的污名化与 QoL 的各个维度呈负相关,并且在癌症部位之间存在差异。乳腺癌患者应该在个体治疗中关注伴随感知污名化的负面后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0be/5680772/72a8d4e26fe8/12885_2017_3742_Fig1_HTML.jpg

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