Perceived stigma and its correlates among Asian patients with advanced cancer: A multi-country APPROACH study.

Autor: Teo I; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.; Programme for Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.; Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore., Bhaskar A; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore., Ozdemir S; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.; Programme for Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore., Malhotra C; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.; Programme for Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore., Hapuarachchi T; National Cancer Institute (Apeksha Hospital), Maharagama, Sri Lanka., Joad AK; Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India., Manalo MF; Supportive Oncology & Palliative Care, Augusto P. Sarmiento Cancer Institute, The Medical City, Philippines., Mariam L; Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh., Ning X; Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China., Palat G; Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India., Rahman R; Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh., Tuong PN; Oncology Center, Hue Central Hospital, Hue, Vietnam., Finkelstein EA; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.; Programme for Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Psycho-oncology [Psychooncology] 2022 Jun; Vol. 31 (6), pp. 938-949. Date of Electronic Publication: 2022 Jan 28.
DOI: 10.1002/pon.5882
Abstrakt: Objectives: Perceived cancer-related stigma can affect mental health and potentially treatment choices for patients with cancer. Nevertheless, perceived stigma is not very well understood in Asia. This study investigated across six developing Asian countries: (1) the prevalence of perceived stigma among advanced cancer patients, (2) its risk factors, and (3) its association with patient treatment preferences.
Methods: This cross-sectional study recruited patients receiving oncology care across major hospitals in Bangladesh, China, India, Philippines, Sri Lanka and Vietnam. Participants (N = 1358) were adults diagnosed with stage IV metastatic solid cancer who completed self-reported surveys. Multi-variable logistic regression and ordered logit models examined the associations with perceived stigma and variables of interest.
Results: Across the countries, 35%, 95% CI [32%, 38%] of patients reported experiencing at least one facet of cancer-related stigma often or always, while 60% [57%, 63%] reported it occurring occasionally. Top-endorsed facets of perceived stigma across the Asian countries suggest a distinct pattern. Having knowingly engaged in health-risk behaviours (OR = 2.03-2.24, 95% CI [1.14-1.19, 3.43-4.41]), unemployment (2.64 [1.67, 4.19]) and body image change (1.57 [1.00, 2.45]) were associated with higher odds of perceived stigma, while time mitigated perceived stigma (0.49-0.65 [0.30-0.45, 0.76-0.92]). Perceived stigma was associated with lower odds of preference for life-extending treatments, although the associations did not hold up in the adjusted model.
Conclusions: Perceived stigma is unique among Asian advanced cancer patients. Stigma is important to assess and address, taking into consideration the various sociodemographic, clinical and psychological factors of cancer patients.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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