Stigma and mental health in patients with a cancer diagnosis
Abstract
Objective: To determine the relationship between stigma and mental health in patients diagnosed with cancer.
Material and Methods: Correlational study with a non-probabilistic sample of 250 patients diagnosed with cancer, between 26 and 72 years of age (85.2% women and 14.8% men). Data collection was carried out in a private health center using the Perceived, Experienced and Internalized Stigma Questionnaire, the Patient Health Questionnaire-4 (PHQ-4), and a sociodemographic characteristics form. Data analysis was performed using Pearson's correlation coefficient, and the magnitude of the effects was analyzed using the Gignac and Szodorai criteria.
Results: Large effect inverse associations were identified between mental health and perceived stigma (r = -0.362), experienced stigma (r = -0.413) and internalized stigma (r = -0.479).
Conclusions: The results support that the higher the perceived, experienced, and internalized stigma, the lower the mental health scores of patients with a cancer diagnosis.
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References
The Global Cancer Observatory. Estimated number of new cases in 2020, worldwide, both sexes, all ages [Internet]. 2022 [citado 02 Feb 2023]. Disponible en: https://gco.iarc.fr/today/online-analysis-pie?v=2020&mode=cancer&mode_population=continents&population=900&populations=900&key=total&sex=0&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=7&group_cancer=1&include_nmsc=1&include_nmsc_other=1&half_pie=0&donut=0
Park G, Kim J. Depressive symptoms among cancer patients: Variation by gender, cancer type, and social engagement. Res. Nurs. Health. 2021; 44(5): 811-21. Doi: 10.1002/nur.22168
Williamson T, Ostroff J, Haque N, Martin C, Hamann H, Banerjee S, Shen M. Dispositional shame and guilt as predictors of depressive symptoms and anxiety among adults with lung cancer: The mediational role of internalized stigma. Stigma health. 2020; 5(4): 425–33. Doi: 10.1037/sah0000214
Teo I, Ozdemir S, Malhotra C, Meijuan G, Ocampo R, Bhatnagar S, et al. High anxiety and depression scores and mental health service use among South Asian advanced cancer patients: A multi-country study. J. Pain Symptom Manag. 2021; 62(5), 997-1007. Doi: 10.1016/j.jpainsymman.2021.04.005
Yilmaz M, Dissiz G, Usluoglu A, Iriz S, Demir F, Alacacioglu A. Cancer-Related Stigma and Depression in Cancer Patients in A Middle-Income Country. Asia Pac. J. Clin. Oncol. 2020; 7(1): 95-102. Doi: 10.4103/apjon.apjon_45_19
Fujisawa D, Umezawa S, Fujimori M, Miyashita M. Prevalence and associated factors of perceived cancer-related stigma in Japanese cancer survivors. Jpn. J. Clin. Oncol. 2020; 50(11): 1325-29. Doi: 10.1093/jjco/hyaa135
Squiers L, Siddiqui M, Kataria I, Dhillon P, Aggarwal A, Bann C, et al. Perceived, Experienced, and Internalized Cancer Stigma: Perspectives of Cancer Patients and Caregivers in India. RTI Press. 2021. Doi: 10.3768/rtipress.2021.rr.0044.2104
Borges G. Current status of violence, suicide, alcohol use, and stigma in Mexico. Salud mental. 2021; 44(2): 41-2. Doi: 10.17711/sm.0185-3325.2021.007
Vrinten C, Gallagher A, Waller J, Marlow L. Cancer stigma and cancer screening attendance: a population based survey in England. BMC Cancer. 2019; 19(566). Doi: 10.1186/s12885-019-5787-x
López C, López A, Arbesú ME. Evolución del estigma hacia salud mental en especialistas sanitarios en formación en Asturias. Enfermería Global. 2023; 22(1): 105-33. Doi: 10.6018/eglobal.525701
Fujisawa D, Hagiwara N. Cancer Stigma and its Health Consequences. Curr. Breast Cancer Rep. 2015; 7(3): 143–50. Doi: 10.1007/s12609-015-0185-0
Zhang Y, Cui C, Wang Y, Wang L. Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a cross-sectional study. Health Qual. Life Outcomes. 2020; 18(112). Doi: 10.1186/s12955-020-01353-9
Amini-Tehrani M, Zamanian H, Daryaafzoon M, Andikolaei S, Mohebbi M, Imani A, et al. Body image, internalized stigma and enacted stigma predict psychological distress in women with breast cancer: A serial mediation model. J. Adv. Nurs. 2021; 77(8): 3412-23. Doi: 10.1111/jan.14881
Sing S, Syurina E, Peters R, Ika A, Zweekhorst M. Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review. Int. J. Environ. Res. Public Health. 2020; 17(18): 6657. Doi: 10.3390/ijerph17186657
Huang Z, Yu T, Wu S, Hu A. Correlates of stigma for patients with cancer: a systematic review and meta-analysis. Support. Cancer. Ther. 2020; 29: 1195-1203. Doi: 10.1007/s00520-020-05780-8
Tseng W, Lee Y, Hung C, Lin P, Chien C, Chuang H, et al. Stigma, depression, and anxiety among patients with head and neck cancer. Support. Care Cancer. 2022; 30: 1529-37. Doi: 10.1007/s00520-021-06550-w
Daryaafzoon M, Amini-Tehrani M, Zohrevandi Z, Hamzehlouiyan M, Ghotbi A, Zarrabi-Ajami S, Zamanian H. Translation and Factor Analysis of the Stigma Scale for Chronic Illnesses 8-Item Version among Iranian Women with Breast Cancer. Asian Pac. J. Cancer Prev. 2020; 21(2): 449-55. Doi: 10.31557%2FAPJCP.2020.21.2.449
Pang N, Lee J, Pham N, Phan T, Tran K, Dang H, et al. The prevalence of perceived stigma and self-blame and their associations with depression, emotional well-being and social well-being among advanced cancer patients: evidence from the APPROACH cross-sectional study in Vietnam. BMC Palliat. Care. 2021; 20(104). Doi: 10.1186/s12904-021-00803-5
Kroenke K, Spitzer R, Williams J, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009; 50(6): 613-21. Doi: 10.1176/appi.psy.50.6.613
Gignac G, Szodorai E. Effect size guidelines for individual differences researchers. Pers, Individ. Differ. 2016; 102: 74-8. Doi: 10.1016/j.paid.2016.06.069
Miric M, Álvaro J, González R, Rosas A. Microsociología del estigma: aportes de Erving Goffman a la conceptualización psicosociológica del estigma social. Psicologia e Saber Social. 2017; 6(2): 172-85. Doi: 10.12957/psi.saber.soc.2017.33552
Hernández M, Cruzado A, Prado C, Rodríguez E, Hernández C, González M, Martín J. Salud mental y malestar emocional en pacientes oncológicos. Psicooncología. 2012; 9(2-3): 233-57. Doi: 10.5209/rev_PSIC.2013.v9.n2-3.40895
Suarez V, López O. La dimensión emocional en torno al cáncer. Estrategias de análisis desde la antropología de la salud. Revista de Ciencias Antropológicas. 2019; 26(76): 31-60. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-84882019000300031
Penagos J, Pintado S. Evaluación del estigma hacia pacientes con cáncer: una aproximación psicométrica. Psicología y Salud. 2020; 30(2): 153-60. Doi: 10.25009/pys.v30i2.2650
Ramos-Lira L. ¿Por qué hablar de género y salud mental? Salud Ment. 2014; 37(4):275-81. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252014000400001&lng=es
Mejía C, Rodríguez-Alarcón J, Garay-Rios L, Enriquez-Anco M, Moreno A, Haytán-Rojas K, et al. Percepción de miedo o exageración que transmiten los medios de comunicación en la población peruana durante la pandemia de la COVID–19. Rev. Cubana Inv. Beiméd. 2020; 39(2): e698. Disponible en: https://revibiomedica.sld.cu/index.php/ibi/article/view/698
Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown J. Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking. Am. J. Mens. Health. 2019; 13(3). Doi: 10.1177%2F1557988319857009
Diz R, Garza A, Olivas E, Montes J, Fernández G. Cáncer y depresión. Una revisión. Psicología y Salud. 2019; 29(1): 115-24. Doi: 10.25009/pys.v29i1.2573
Secinti E, Tometich D, Johns S, Mosher C. The relationship between acceptance of cancer and distress: A meta-analytic review. Clin. Psychol. Rev. 2019; 71: 27-38. Doi: 10.1016/j.cpr.2019.05.001
Páramo-Rodríguez L, Cavero-Carbonell C, Guardiola-Vilarroig S, López-Maside A, González-Sanjuán E, Zurriaga O. Demora diagnóstica en enfermedades raras: entre el miedo y la resiliencia. Gac. Sanit. 2023; 37: 102272. Doi: 10.1016/j.gaceta.2022.102272
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