Rebecca H Lehto

Rebecca H Lehto
Michigan State University | MSU · College of Nursing

PhD

About

121
Publications
43,506
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2,073
Citations
Introduction
Skills and Expertise
Additional affiliations
August 2009 - July 2015
Michigan State University
Position
  • Professor (Assistant)

Publications

Publications (121)
Article
Full-text available
Objective Family caregivers (FCGs) of cancer patients who are in hospice experience psychological challenges and poor quality of life (QOL) as a consequence of caregiving demands and anticipatory loss. Supportive interventions are needed. Exposure to nature offers a source of relaxation; however, FCGs are often homebound and have limited opportunit...
Article
Objectives Hospice family caregivers (CGs) may experience poor emotional health and diminished quality of life (QOL) secondary to stressors that accompany home-based end-of-life caregiving. Innovative flexible strategies are needed to support hospice CGs in their homes. Being outdoors in nature enhances well-being but is often not accessible to hom...
Article
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Introduction: Socio-psychological factors such as fear of recurrence and presence of social support may affect quality of life (QOL) of cancer patients. Identifying mediating factors that impact QOL are crucial for targeting vulnerability in patients undergoing cancer treatments. The study purpose was therefore to determine relationships between p...
Article
Introduction: Due to their remote location, rural-dwelling family caregivers (FCGs) experience geographic and psychosocial challenges when providing home-based palliative and end-of-life (PEOL) care for their care recipient. Limited research has evaluated the social and environmental factors that may compound FCG burden and contribute to adverse em...
Article
Purpose: To address cancer screening disparities and reduce cancer risk among sexual minority (SM) groups, this review identifies individual, interpersonal, and community/societal determinants of cancer screening (non)participation among differing SM identities. Methods: Seven scientific databases were searched. Inclusion criteria were as follows:...
Article
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Background: A cancer diagnosis can be psychologically challenging to individuals due to perceptions that the disease is potentially incurable truncating life expectancy. The purpose of the study was to examine the relationships among religious well-being, existential well-being, fear of progression and quality of life in Iranian patients with cance...
Article
Aim This review aimed to evaluate factors associated with anaesthesia‐related postoperative cognitive dysfunction (POCD) among adults younger than 65 years who underwent cardiothoracic surgeries. Study Design A systematic keyword search, following the scoping review framework, was performed in the PubMed and CINAHL databases. Original English‐lang...
Article
Friends and family members of patients with cancer are increasingly relied on to perform critical multifaceted roles in home-based care, such as appointment scheduling and transportation. The demands associated with this ongo.
Article
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Background: With advances in healthcare options for the medical management of breast cancer, treatment decision-making has become more complex. Objectives: Guided by self-efficacy theory, the study investigated the impact of a question prompt list (QPL) on decision-making outcomes among women with breast cancer in Iran who were post-surgery. Method...
Article
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Home-based informal caregivers (CGs), such as the family members and friends of cancer patients, often suffer averse emotional symptoms, such as anxiety and depression, due to the burden associated with providing care. The natural environment has been valued as a healing sanctuary for easing emotional pain, promoting calmness, relaxation, and resto...
Article
Background and Purpose: The reality of death is a source of concern for humans. Managing issues associated with preparation for the inevitability of death may contribute to onset of death depression for aging individuals. The study purpose was to clarify the death depression concept in older adults including relevant features, antecedents, and cons...
Article
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Aims: To identify and provide clarity on factors that influence coping and the type of coping strategies used by patients with heart failure (HF) to improve health-related quality of life (HRQoL). Methods and results: The Arksey and O'Malley template framed this scoping review guided by the stress and coping model. Five databases were explored:...
Article
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Purpose To conduct a secondary analysis focused on health-related quality of life (HRQOL) among caregivers engaged in a 12-week complementary therapy sequential multiple assignment randomized trial (SMART) of reflexology and/or meditative practices (MP), to manage cancer patients’ symptoms. Methods In this SMART, patient-caregiver dyads were initi...
Article
Hospice professionals face practice challenges that place them at increased risk for burnout. Limited research has reported on organizational efforts to address burnout and reduce work-related stressors with participatory involvement from employee stakeholders. In a large state-wide hospice organization, focus groups were initially conducted by ext...
Article
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Cancers are globally prevalent often life-threatening diseases that carry an immense psychological burden such as death anxiety. Thus, identifying protective psychological factors affecting death anxiety in individuals with cancer is of strong relevance. This study investigated the potential mediating role of hope in the relationship between religi...
Article
Background: Studies evaluating the use of meditative practices for supporting symptom management among patients undergoing cancer treatment have increased substantially in recent years. Although meditative practices as adjuncts to promoting health have become mainstream, concerns that such strategies conflict with traditional religious tenets have...
Article
Full-text available
Home-based informal caregiving by friends and family members of patients with cancer is becoming increasingly common globally with rates continuing to rise. Such caregiving is often emotionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural e...
Article
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PurposeMaintenance of quality of life (QOL) is vital for adaptation to life-threatening and chronic illnesses such as cancer. Therefore, the evaluation and strengthening of personal psychological resources that support QOL for patients with cancer is paramount. This study investigated the potential mediating role of hope in the relationship between...
Article
Treatments for addressing psychiatric mental health issues in vulnerable patients with cancer are established. Yet, many patients persist with unrelenting psychological difficulties despite intervention. There is growing interest in the role of psilocybin-assisted psychotherapy for managing treatment-resistant mental health challenges in patients w...
Article
Optimal sequencing of complementary therapies can help improve symptom management through nonpharmacological approaches. A 12‐week sequential multiple assignment randomized trial comparing home‐based reflexology and meditative practices on severity of fatigue and other symptoms was conducted among patients with cancer and their informal caregivers....
Article
(188/250 words) Purpose To evaluate factors associated with burden reported by caregivers of people undergoing treatment for solid tumor cancers. Methods A secondary analysis of baseline data collected in a cancer symptom management trial was conducted guided by the Organizing Framework for Caregiver Interventions. A total of 349 caregivers compl...
Article
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The purpose of the present study was to examine the relationship among spiritual intelligence, spiritual well-being and death anxiety among Iranian veterans. In this predictive correlational study, 211 veterans completed King and DeCicco’s Spiritual Intelligence Scale, Paloutzian and Ellison’s Spiritual Well-being Scale and Templer’s Death Anxiety...
Article
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(1) Background. This research examined the feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hospice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. This article was written for dif...
Article
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Background: Women with advanced breast cancer often experience significant pain. Previous studies indicate that spirituality may serve as a resource to alter pain perceptions; yet, the role of spirituality in pain management has not been examined as a lived experience among this population. Objective: This study qualitatively explored how women...
Article
Objectives: To examine pain and spirituality, demographic and clinical factors associated with pain and spirituality, the contribution of spirituality to experiences of pain over time, and how pain and spirituality relate to engagement with a caregiver-delivered intervention. Sample & setting: Women with advanced breast cancer (N = 256) enrolled...
Article
Objective Recent shifts in healthcare delivery and treatment for solid tumour cancer patients have modified the responsibilities of informal caregivers. The objective of this study was to: review informal caregiver burden factors and determine areas where future research is needed. Methods The Arksey and O’Malley’s framework and a modified Preferr...
Article
A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (β = 0.6, p = 0.016), unskil...
Preprint
Full-text available
1) Background. This research examined feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hos-pice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. The manuscript was written for diffe...
Article
Background Prescribing oral oncolytic agents (OAs) for advanced cancers is increasing. Aims To explore changes in medication beliefs and the effects of symptom severity, cognitive effectiveness and depressive symptoms on medication beliefs over 12 weeks. Methods Secondary analysis of a randomized controlled trial, testing an intervention to promo...
Article
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This review study fills an important gap by aiming to determine the age changes in attempted and completed suicide in Iran during the past decade. A systematic review of related articles in international and Iranian databases from January 2008 to January 2020 was first conducted and relevant studies were extracted based on established criteria. Res...
Article
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Background: When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death....
Article
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Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. T...
Article
Introduction While spirituality and quality of life (QOL) are essential components of end-of-life (EOL) care, limited studies have examined these constructs for indigenous peoples. Therefore, the purpose of this article was to examine the state of the science regarding spirituality and QOL at EOL for indigenous people, particularly Native Americans...
Article
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Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice ca...
Article
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Background: There is increasing awareness that patients with cancer desire information as well as strategies to support their capacity to actively participate in informed decision-making. This study will evaluate outcomes of using a question prompt list (QPL) on shared decision making (SDM), decision-making self-efficacy, and preferences for partic...
Article
Objective This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia. Method A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well a...
Article
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Background Patients with advanced cancer often experience adverse events related to oral antineoplastic agents (OAAs) and permanent OAA medication stoppages, yet it is unknown how these factors impact medication beliefs. Such beliefs about OAA therapy may lend insight into decisions about continued cancer treatment near the end of life.PurposeTo ex...
Article
Families with children who have developmental disabilities and complex communication needs (CCNs) face challenging demands affecting family adaptation. Many children with CCNs use augmentative and alternative communication (AAC) devices to support communication, yet little is known about family adaptation to such technology. To fill this gap, an in...
Article
Purpose: Heart failure (HF) is associated with poor health-related quality of life (HRQoL) secondary to decrements in functional status. Patients’ adoption of coping strategies may affect their HRQoL. The review purpose was to characterize what is known about factors that impact selection of coping strategies that contribute to HRQoL among HF patie...
Article
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Background/Objective: Clinical nurse educators globally have recognized the prominent necessity of evaluating for death anxiety in students, and adopting curriculum that provides education about death and dying. Reliable assessment tools are needed to evaluate death anxiety in the student population. The study evaluates the hierarchical factor stru...
Article
Problem statement: To describe research mentorship strategies needed to strengthen oncology nursing science and ensure that a cadre of nurse scientists are available to carry out the research mission of the Oncology Nursing Society (ONS). Design: Multimethod consensus-building approach by content experts of the ONS Research Mentorship Task Force...
Article
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Objective: The purpose of this study was to explore perceptions about barriers to decision-making in Iranian patients with cancer about their care. Methods: Utilizing a qualitative approach, semi-structured interviews were conducted with 15 cancer patients. Results: Data analysis revealed four central categories reflecting patient perceptions...
Article
Background: Treatment decision making largely depends on patients' own preferences. However, the availability of different treatment approaches often results in decisional conflict, discomfort, doubtfulness, and uncertainty about the best option. Objectives: This study evaluated decision-making participation regarding surgery among women with ea...
Article
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Ensuring use of valid and reliable scales for evaluating death anxiety that are relevant to the cultural context where they are applied is essential. The purpose of the study was to conduct a systematic review of the psychometric properties of Templer’s Death Anxiety Scale (DAS) across cultures. PubMed, Scopus, Web of Knowledge, SID, and Magiran da...
Article
Objective: To assess rationale for usage and types of complementary and integrative health therapies used as self-care by unpaid cancer caregivers. Data sources: CINAHL, PubMed, PsycINFO, Embase, and Alt HealthWatch. Conclusion: Six articles provide updated information on caregiver preferences and desires relative to use of complementary and i...
Conference Paper
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Introduction and Aim: This study investigated relationships among spirituality, hope and overall quality
Conference Paper
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Background and Objective: The study evaluates the hierarchical factor structure of the Persian version of TDAS) in a sample of Iranian nursing students. Materials and Methods: A repeated measures standard psychometric analysis was conducted. 400 nursing students from a major university campus in Sari, Iran completed the Persian version of the 15-it...
Article
Objectives: The aim of the present review was to characterize how pain and spirituality have been conceptualized, assessed, and addressed and how these concepts may be related among women with advanced breast cancer. Design: A scoping review was conducted including publications of various methodologies. Data sources: Searches were conducted in...
Article
Objective This paper describes a derived model that provides a conceptual framework for understanding medication beliefs among patients with advanced cancer receiving oral oncolytic agents. Methods Theory derivation was used to (a) examine the phenomenon of medication beliefs in cross‐disciplinary research; (b) select a parent theory for derivatio...
Article
Purpose: To describe how family caregivers of patients receiving oral anticancer medication (OAM) may affect family caregivers' lives and determine what support caregivers need to manage OAM in the home successfully. Participants & setting: Family caregivers of individuals with cancer prescribed OAM recruited from oncology clinics in the Midwest...
Article
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Unavoidable emotional workplace stressors may threaten personal health and occupational wellbeing of clinicians who care for patients with cancer.1­4 Although advances in diagnostic technology and expanding treatment options have improved survival rates for individuals with many cancers, patients and their families are exposed to continued sufferin...
Article
Introduction: The mental health of patients with advanced cancer at the end of life is a strong contributor to suffering on the part of both the patient and family. A closer look is needed to address the complexity of psychological adaptation to provide a comfortable transition between life and death. Areas covered: This review describes patient re...
Article
Purpose: Healthcare providers who are involved in the care of patients at the end of life are at risk of developing compassion fatigue, a condition characterized by emotional exhaustion and reduced professional engagement. Research has shown that development of a meditation practice can modify stress perceptions and promote quality of life. This s...
Article
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Abstract Purpose The study investigated relationships among the extent of disease, religious coping, and death depression in Iranian patients with cancer. Method A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious c...
Article
Background: While much research and practice resources have addressed smoking cessation among cancer patients, less emphasis has been placed on personal psychological and environment factors associated with smoking at the time of diagnosis. Objective: The aim of this study was to examine differences in psychological distress, optimism, and perce...
Article
In this in-progress sequential multiple assignment randomized trial (SMART), dyads of solid tumor cancer patients and their caregivers are initially randomized to 4 weeks of reflexology or meditative (mindfulness) practices provided by/with their caregiver in the patient's home or to a control group. After 4 weeks, intervention group dyads in which...
Article
Purpose/Objectives: To determine the effects of delivering a reflexology intervention on health outcomes of informal caregivers, and to explore whether intervention effects are moderated by caregiver characteristics. Design: Two-group, randomized clinical trial. Setting: Eight oncology clinics in urban and rural regions of Michigan and Illinois. Sa...
Article
Research suggests that meditation can relieve stress, cultivate self-regulation skills, improve ability to focus, and modify risk for compassion fatigue (CF) and burnout in healthcare providers. However, studied interventions are time-consuming and combining disparate approaches, resulting in unclear mechanisms of effect. This pilot study examined...
Article
Background and purpose: Emotion regulation, the experiencing, processing, and modulating of emotional response, is necessary to manage the emotional stressors common in patients with chronic illness. Overwhelming emotional demands deplete the resources needed for everyday self-care management of chronic disease, contributing to poor health outcome...
Article
Full-text available
Rebecca H Lehto Michigan State University College of Nursing, Michigan State University, East Lansing, MI, USA Abstract: As compared to other cancers, lung malignancies are associated with high symptom burden, poorer prognosis, and stigmatization. Such factors increase psychological distress and negatively impact quality of life. Research has docum...
Article
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Objective: The surfacing of thoughts and depressive affect associated with the prospect of death are prevalent among patients with advanced cancer. Because death cognitions and associated negative affect occur along an adaptive-less adaptive continuum, it is essential that valid and reliable instruments are available to measure death depression. T...
Article
Full-text available
Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of the Persia...
Article
Family and friends are important resources for patients during cancer treatment and warrant an expanded review of not only what they contribute to patient care but also the support they need and the personal consequences of caregiving. A review of 14 randomized controlled trials published between 2009 and 2016 was completed utilizing the Preferred...
Article
Aim: To evaluate and quantify intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for breast cancer patients. Background: Studies on caregiver-delivered symptom management interventions seldom include adequate information on protocol fidelity, co...
Poster
The Feasibility of Heart Rate Variability to Test Dose Effectiveness of Home-based Meditative Practices in Lung Cancer Patients
Poster
Full-text available
Background/Purpose: Meditation can relieve stress, cultivate healthcare professionals (HCP)’ self‐regulation skills, and modify risk for and relieve symptoms of compassion fatigue and burnout. However, approaches such as mindfulness‐based stress reduction require attending 2‐hour weekly sessions over 4–8 weeks. We developed a minimally invasive 6‐w...
Conference Paper
Full-text available
Objective: Meditation can relieve stress, cultivate self-regulation and attention-regulation skills, improve ability to focus, and modify risk for compassion fatigue and burnout in healthcare professionals (HCPs). To achieve these benefits, HCPs need to be introduced to meditation and motivated to practice. This pilot study examined engagement with...
Article
Full-text available
Abstract Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of t...
Article
Patients with terminal illness in their final stages of life may contemplate their options for death and dying. There has been growing public interest and media attention regarding patient decision making and autonomy at the end of life. The article provides updated legal and ethical discussion about issues and trends associated with the assisted d...
Article
Lung cancer is recognized to carry a high symptom burden with associated lowered quality of life as compared with other cancers. Research has shown that symptom severity can be a prognostic indicator of poorer clinical outcomes and survival post treatment. The purpose of this paper is to review current literature relative to symptom burden associat...
Article
Full-text available
Objective The purpose of the study was to examine relationships between death anxiety and quality of life (QOL) parameters of patients with cancer in the Iranian sociocultural context. Methods A descriptive, correlational methodology was used. The sample included 330 patients. Demographics, health information, religious behaviors, death anxiety, a...
Article
Nurse-researchers studying interventions for patients at the end-of-life may become close with participants due to the nature of interactions within the research protocol. In such studies, participants may request further interactions that would constitute clinical care beyond the scope of the protocol. Nurse-researchers may feel a conflict of valu...
Article
Context: Persons with Chronic Obstructive Pulmonary Disease (COPD) exhibit high levels of comorbid anxiety that severely worsens their sensation of dyspnea and is associated with high levels of avoidance of essential activities resulting in an increase morbidity and mortality. Increasing meditation and mind/body practices have been shown to decrea...
Article
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Background: Concerns about death may alienate and negatively impact communication among family members of patients with life-threatening illness. Little is known about the relationship of death anxiety to quality of life in cancer family caregivers. Objective: The aim of this study was to examine relationships between sociodemographic and patien...
Article
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Death anxiety, a negative affective state that is incited by mortality salience, may be experienced by nurses and other health care workers who are exposed to sickness, trauma, and violence. This paper examines death anxiety and management strategies among health providers in different health settings across cultures. A literature review of the res...
Article
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Objectives: The promotion of evidence-based practice (EBP) to ensure that the best scientific evidence, clinician expertise, and patient advocacy are used in health care delivery is an important leadership role of advanced practice nurses. While there has been much progress in advancing EBP, there are many hospital systems in the United States and...
Poster
Poster presentation at the 40th Annual ONS Congress, Orlando, FLA. [Abstract]. Oncology Nursing Forum, 42 (2), E213.
Article
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Recognition of death anxiety experienced by patients who have survived violence and threats to life during war is of strong importance in delivery of best care for veterans experiencing health stressors. The aim of the study was to explore the death anxiety experience of veterans from the Iran–Iraq war. Using a phenomenological approach, 11 war vet...
Article
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The purpose of this study was to determine the validity and reliability of the Persian version of Templer Death Anxiety Scale-Extended (DAS-E) in veterans of Iran-Iraq Warfare. In this cross-sectional study, 211 male veterans of Iran-Iraq Warfare completed the 51 item DAS-E. Principal components analysis with varimax rotation was used to assess dom...
Article
Full-text available
The four arm study investigates how use of a preoperative forced-air warming blanket and adjustment of ambient surgical room temperature may contribute to prevention of perioperative hypothermia. Active warming interventions may prevent the drop in core temperature that occur as a result of surgical anesthesia. Core body temperatures from a conveni...
Article
Purpose Patients with lung cancer, the leading cause of cancer death, are shown to have high levels of psychological distress and poorer quality of life as compared to patients with other cancer types. The purpose of this paper is to describe patient focus group discussions about the lung cancer experience in relation to perceived stigmatization, s...