Lung Cancer Stigma, Anxiety, Depression and Symptom Severity

Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, Calif., USA.
Oncology (Impact Factor: 2.42). 06/2013; 85(1):33-40. DOI: 10.1159/000350834
Source: PubMed


Compared to other cancers, lung cancer patients report the highest levels of psychological distress and stigma. Few studies have examined the relationship between lung cancer stigma (LCS) and symptom burden. This study was designed to investigate the relationship between LCS, anxiety, depression and physical symptom severity.

This study employed a cross-sectional, correlational design to recruit patients online from lung cancer websites. LCS, anxiety, depression and physical symptoms were measured by patient self-report using validated scales via the Internet. Hierarchical multiple regression was performed to investigate the individual contributions of LCS, anxiety and depression to symptom severity.

Patients had a mean age of 57 years; 93% were Caucasian, 79% were current or former smokers, and 74% were female. There were strong positive relationships between LCS and anxiety (r = 0.413, p < 0.001), depression (r = 0.559, p < 0.001) and total lung cancer symptom severity (r = 0.483, p < 0.001). Although its contribution was small, LCS provided a unique and significant explanation of the variance in symptom severity beyond that of age, anxiety and depression, by 1.3% (p < 0.05).

Because LCS is associated with psychosocial and physical health outcomes, research is needed to develop interventions to assist patients to manage LCS and to enhance their ability to communicate effectively with clinicians.

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Available from: Janine K Cataldo, Dec 26, 2014
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    • "Σε σχετική έρευνα με σταθμισμένες κλίμακες μέσω διαδικτύου βρέθηκαν ισχυρές θετικές συσχετίσεις ανάμεσα στο στίγμα και το άγχος (r = 0.413, p<0.001), την κατάθλιψη (r = 0,559, p<0,001) και τη βαρύτητα των συμπτωμάτων (r = 0.483, p<0,001). Το στίγμα παρείχε μια σημαντική εξήγηση της διακύμανσης στη σοβαρότητα των συμπτωμάτων πέρα από εκείνη της ηλικίας, του άγχους και της κατάθλιψης κατά 1,3% (p<0,05) (Cataldo &Brodsky,2013). Παρόμοια, στη μελέτη των Gonzalez &Jacobsen (2012) σε 95 ασθενείς που λάμβαναν χημειοθεραπεία για μη-μικροκυτταρικό καρκίνο του πνεύμονα σταδίου II-IV βρέθηκε μια θετική συσχέτιση ανάμεσα στο αντιλαμβανόμενο στίγμα και την καταθλιπτική συμπτωματολογία (r= 0,46, p <0,001)(Gonzalez &Jacobsen, 2012). Προκύπτει λοιπόν ότι οι ασθενείς με καρκίνο πνεύμονα αισθάνονται σε σημαντικό βαθμό στιγματισμένοι. "
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    DESCRIPTION: Ανασκόπηση της βιβλιογραφίας σχετικά με την ψυχική υγεία ασθενών με καρκίνο πνεύμονα.
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    • "Lung cancer patients feel stigmatized reporting the highest levels of stigma and related psychological distress compared to all other cancers (Cataldo & Brodsky, 2013). In the United States, there will be an estimated 221,200 new cases and 158,040 lung cancer related deaths in 2015 (ACS, 2015). "
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    ABSTRACT: The purpose of this study was to examine the relationship of perceived lung cancer stigma and timing of medical help-seeking behavior in symptomatic individuals. A convenience sample was recruited from an academic thoracic oncology clinic and community hospital-based outpatient radiation center in a large city in the southeastern United States. This descriptive, cross-sectional study used survey methodology and semistructured interviews to examine the relationship of perceived lung cancer stigma and delayed medical help seeking finding a statistically significant positive correlation. Additional examination revealed positive correlations between the stigma and shame, social isolation, and smoking-related stigma subscales and delay. The discrimination-related subscale was not associated with delay. In addition, smoking status was not related to perceived lung cancer stigma. Findings support an association between lung cancer stigma and delayed medical help-seeking behavior. Therefore, lung cancer stigma is a potential barrier to timely medical help-seeking behavior in lung cancer symptoms, which can have important patient outcome implications. As primary care nurse practitioners, awareness that lung cancer stigma exists for patients is essential regardless of smoking status and efforts to decrease this barrier to timely health care are important. ©2015 American Association of Nurse Practitioners.
    Journal of the American Academy of Nurse Practitioners 03/2015; 27(5). DOI:10.1002/2327-6924.12227 · 1.02 Impact Factor
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    • "Patients with lung cancer (LC) are known to suffer from a number of severe physical, psychosocial and psychological problems compared to other groups of cancer patients (Barbera et al., 2010; Carlson et al., 2004; Cataldo and Brodsky, 2013). LC is the leading cause of cancer-associated mortality worldwide among both men and women (Jemal et al., 2010) and is associated with advanced cancer at the time of diagnosis, preventing the possibility of curative treatment for most patients. "
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    ABSTRACT: Purpose To explore the influence of symptom clusters and the most distressing concerns on global rating of quality of life (QoL) among patients with inoperable lung cancer (LC) over a three-month period following diagnosis. Methods Data were derived from a longitudinal study dealing with the symptom experiences of 400 patients with LC at three time points: close to diagnosis and one and three months later. The symptom clusters were derived from a QoL questionnaire using factor analysis, which resulted in three clusters: the Respiratory cluster, the Pain cluster and the Mood cluster. The most distressing concerns were derived from responses to a free listing question (‘What is most distressing at present’) and were categorised under three dimensions: Bodily distress, Life situation with LC and Iatrogenic distress. Cross-sectional, multivariate regression analyses with QoL as a dependent variable were used to determine predictors (symptom clusters and most distressing concerns) at the three time points. Results All three symptom clusters predicted QoL at each time point. Close to diagnosis, none of the dimensions of most distressing concerns predicted QoL, while the dimension Bodily distress was a significant predictor of QoL after one month. The Life situation with LC dimension was a significant predictor of QoL three months after diagnosis. Conclusions Symptom clusters are important to LC patients' QoL and need to be acknowledged by healthcare professionals. The present study shows the importance of patients' descriptions of key concerns, which vary from diagnosis onwards, and urges healthcare professionals to be vigilant to such changes.
    European journal of oncology nursing: the official journal of European Oncology Nursing Society 06/2014; 18(3). DOI:10.1016/j.ejon.2013.12.001 · 1.43 Impact Factor
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