Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.
Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.
Psychooncology. 2021 Aug;30(8):1347-1355. doi: 10.1002/pon.5690. Epub 2021 Apr 15.
Previous qualitative studies found cancer stigma was associated with work discrimination and job loss among cancer patients. This study aims to quantify the association between cancer stigma and job loss among cancer survivors.
For this study, we used the data from a face-to-face cross sectional survey conducted at two cancer hospitals in Seoul and Hwasun in South Korea from October 2017 to March 2018. Cancer stigma was assessed using a validated questionnaire which consists of 12 items in three domains: (a) impossibility of recovery; (b) stereotypes; and (c) discrimination. Multivariable logistic regression was performed to evaluate the association between cancer stigma and job loss adjusting age, sex, marital status, education, job type, residence area, cancer site, stage, comorbidity, time since diagnosis, and self-efficacy.
Among 433 cancer survivors, 24.0% lost their jobs after cancer, and 20.7% experienced discrimination at work. Of total, 21.7% of the survivors agreed that it was difficult to treat cancer regardless of highly developed medical science. Survivors with stigma on impossibility of recovery and stereotypes were 3.10 (95% confidence interval [CI]: [1.76, 5.44]) and 2.10 (95% CI: [1.20, 3.67]) times more likely to lose a job than survivors without cancer stigma. Survivors with discrimination experience at work had 1.98 (95% CI: [1.05, 3.74]) times higher risk of losing a job than survivors without it.
Survivors with cancer stigma were more likely to lose their jobs than survivors without cancer stigma. Considering its social and economic impact on job loss, comprehensive interventions for working cancer survivors as well as public campaigns against cancer stigma would be necessary.
先前的定性研究发现,癌症污名与癌症患者的工作歧视和失业有关。本研究旨在定量评估癌症幸存者的癌症污名与失业之间的关系。
本研究使用了 2017 年 10 月至 2018 年 3 月在韩国首尔和华信的两家癌症医院进行的面对面横断面调查的数据。使用经过验证的问卷评估癌症污名,该问卷由三个领域的 12 个项目组成:(a)无法康复;(b)刻板印象;和(c)歧视。使用多变量逻辑回归来评估癌症污名与工作损失之间的关系,调整年龄、性别、婚姻状况、教育程度、工作类型、居住地区、癌症部位、分期、合并症、诊断后时间和自我效能感。
在 433 名癌症幸存者中,24.0%的人在癌症后失业,20.7%的人在工作中受到歧视。总的来说,21.7%的幸存者认为,无论医学科学如何发达,癌症都难以治愈。有无法康复和刻板印象污名的幸存者失去工作的可能性分别是没有癌症污名的幸存者的 3.10 倍(95%置信区间[CI]:[1.76, 5.44])和 2.10 倍(95%CI:[1.20, 3.67])。有工作歧视经历的幸存者失去工作的风险比没有这种经历的幸存者高 1.98 倍(95%CI:[1.05, 3.74])。
有癌症污名的幸存者比没有癌症污名的幸存者更有可能失去工作。考虑到失业对社会和经济的影响,有必要为癌症幸存者提供全面的工作干预措施,并开展反对癌症污名的公众宣传活动。