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马来西亚癌症患者的感知羞耻与污名以及心理困扰的其他社会心理预测因素

Perceived Shame and Stigma, and Other Psychosocial Predictors of Psychological Distress Among Cancer Patients in Malaysia.

作者信息

Eyu Hui Ting, Nik Jaafar Nik Ruzyanei, Leong Abdullah Mohammad Farris Iman, Salleh Salimi Hajar Mohd, Mohamad Yunus Mohd Razif, Ismail Fuad, Ab Muin Nur Fa'izah, Abdul Aziz Noor Syazwani

机构信息

Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Department of Psychiatry and Mental Health, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia.

出版信息

Psychooncology. 2024 Dec;33(12):e70020. doi: 10.1002/pon.70020.

Abstract

BACKGROUND

Patients' sociodemographic factors, clinical characteristics, distress factors, perceived shame and stigma may give rise to psychological distress in cancer patients that bring about further psychosocial impact.

AIMS

(1) to determine the degrees of shame and stigma towards cancer and psychological distress among cancer patients in Malaysia and (2) to examine the clinical and psychosocial predictors of psychological distress.

METHODS

This cross-sectional study recruited a total of 217 cancer patients. The participants were administered the sociodemographic and clinical characteristics questionnaires, the Malay version of the Shame and Stigma Scale (SSS-M) to assess for the degree of cancer shame and stigma, and the Malay version of the Distress Thermometer and Problem List to assess for presence of psychological distress and identify its sources.

RESULTS

There was a significant level of shame and stigma among cancer patients with the total mean SSS-M score of 12.08 (SD = 6.09). Anger (adjusted odds ratio [AOR] = 11.97, 95% confidence interval [CI] = 2.96-86.8, p = 0.001), loss of interest or enjoyment (AOR = 14.84, 95% CI = 2.93-75.20, p = 0.001), loneliness (AOR = 8.10, 95% CI = 1.13-58.02, p = 0.001), feeling of worthlessness or being a burden (AOR = 6.24, 95% CI = 1.32-29.59, p = 0.021), fear (AOR = 4.52, 95% CI = 1.79-11.43, p = 0.001), pain (AOR = 4.07, 95% CI = 1.53-10.82, p = 0.005), financial constraint (AOR = 2.95, 95% CI = 1.22-7.13, p = 0.016), and having regret (AOR = 1.89, 95% CI = 1.03-3.79, p = 0.039) increased the odds of developing psychological distress.

CONCLUSION

Treating clinicians should monitor for and provide psychosocial interventions for the biopsychosocial factors which may worsen psychological distress among cancer patients.

摘要

背景

患者的社会人口学因素、临床特征、困扰因素、感知到的羞耻感和污名化可能导致癌症患者出现心理困扰,进而带来进一步的心理社会影响。

目的

(1)确定马来西亚癌症患者对癌症的羞耻感和污名化程度以及心理困扰程度;(2)研究心理困扰的临床和心理社会预测因素。

方法

这项横断面研究共招募了217名癌症患者。参与者接受了社会人口学和临床特征问卷、马来语版的羞耻感和污名化量表(SSS-M)以评估癌症羞耻感和污名化程度,以及马来语版的苦恼温度计和问题清单以评估心理困扰的存在并确定其来源。

结果

癌症患者中存在显著程度的羞耻感和污名化,SSS-M总平均得分为12.08(标准差=6.09)。愤怒(调整后的优势比[AOR]=11.97,95%置信区间[CI]=2.96-86.8,p=0.001)、兴趣或乐趣丧失(AOR=14.84,95%CI=2.93-75.20,p=0.001)、孤独感(AOR=8.10,95%CI=1.13-58.02,p=0.001)、无用感或成为负担的感觉(AOR=6.24,95%CI=1.32-29.59,p=0.021)、恐惧(AOR=4.52,95%CI=1.79-11.43,p=0.001)、疼痛(AOR=4.07,95%CI=1.53-10.82,p=0.005)、经济困难(AOR=2.95,95%CI=1.22-7.13,p=0.016)和后悔(AOR=1.89,95%CI=1.03-3.79,p=0.039)会增加出现心理困扰的几率。

结论

治疗临床医生应监测并为可能加重癌症患者心理困扰的生物心理社会因素提供心理社会干预措施。

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