School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China.
Department of Breast Surgery, Sun Yat-sen University Cancer Center, Dongfeng 1 Rd 651#, Guangzhou, Guangdong, PR China.
Eur J Oncol Nurs. 2021 Jun;52:101972. doi: 10.1016/j.ejon.2021.101972. Epub 2021 May 4.
Although stigma has attracted considerable scholarly attention, few studies have focused on its influencing factors among discharged breast cancer survivors, especially in a Chinese cultural context. The present study therefore explores stigma and its influencing factors among breast cancer survivors in China.
Between December 2017 and May 2018, 103 breast cancer survivors at the outpatient clinic of a tertiary cancer center in southern China were enrolled in a cross-sectional study. The research instruments comprised the Social Impact Scale (SIS), the General Self-Efficacy Scale (GSES), the Medical Coping Modes Questionnaire (MCMQ), and sociodemographic and disease-related questionnaires. Descriptive statistics, univariate analysis, and multivariable linear regression were used to explore the current status of stigma and to identify influencing factors.
Of the respondents, 76.7% and 8.7%, respectively, reported moderate and high levels of stigma. The mean SIS score was 55.20 ± 12.15 (moderate), and the SIS subscale with the highest average score was financial insecurity. The results of a multivariable linear regression showed that body image (β = 0.32, P＜0.001), spousal support (β = -0.47, P < 0.001), personal acceptance of the disease (β = -0.22, P＜0.001), coping modes (resignation) (β = 0.14, P < 0.001), support from medical staff (β = -0.23, P < 0.001) and self-efficacy (β = -0.10, P = 0.037) were the main factors influencing stigma among breast cancer survivors (R = 0.83).
Stigma, among breast cancer survivors, which is influenced by various sociocultural factors, is a neglected issue requiring attention. Healthcare professionals should therefore formulate effective measures for alleviating stigma in this group by improving their self-efficacy and acceptance of the disease, reducing their poor body image and negative coping mode, and eliciting more support from their spouses and medical staff.
尽管耻辱感引起了相当多的学者关注，但很少有研究关注其在中国文化背景下对已出院乳腺癌患者的影响因素。因此，本研究旨在探讨中国乳腺癌患者的耻辱感及其影响因素。
2017 年 12 月至 2018 年 5 月，在我国南方一家癌症中心的门诊，对 103 名乳腺癌幸存者进行了横断面研究。研究工具包括社会影响量表（SIS）、一般自我效能感量表（GSES）、医学应对方式问卷（MCMQ）以及社会人口学和疾病相关问卷。采用描述性统计、单因素分析和多元线性回归分析来探讨耻辱感的现状，并确定影响因素。
受访者中，分别有 76.7%和 8.7%报告了中度和高度耻辱感。SIS 平均得分为 55.20±12.15（中度），平均得分最高的 SIS 亚量表是经济不安全。多元线性回归的结果显示，身体形象（β=0.32，P＜0.001）、配偶支持（β=-0.47，P＜0.001）、个人对疾病的接受程度（β=-0.22，P＜0.001）、应对方式（顺从）（β=0.14，P＜0.001）、医护人员支持（β=-0.23，P＜0.001）和自我效能（β=-0.10，P=0.037）是影响乳腺癌患者耻辱感的主要因素（R=0.83）。
在各种社会文化因素的影响下，乳腺癌患者存在耻辱感，这是一个被忽视的问题，需要引起重视。因此，医护人员应通过提高自我效能和对疾病的接受程度，减少患者不良的身体形象和消极的应对方式，以及获得更多配偶和医护人员的支持，为这一群体制定减轻耻辱感的有效措施。
