A systematic review of the impact of stigma and nihilism on lung cancer outcomes

BMC Cancer

Suzanne K Chambers²  Jeffrey Dunn²  Stefano Occhipinti³  Suzanne Hughes¹  Peter Baade²  Sue Sinclair⁵  Joanne Aitken²  Pip Youl²  Dianne L O’Connell⁴ 

[1] Cancer Council New South Wales, Sydney, Australia

[2] Cancer Council Queensland, Brisbane, Australia

[3] Griffith Health Institute, Griffith University, Brisbane, Australia

[4] Sydney Medical School – Public Health, University of Sydney, Sydney, Australia

[5] National Lung Cancer Program, Cancer Australia, Sydney, Australia

关键词: Therapeutic nihilism;    Health-related stigma;    Systematic review;    Lung neoplasms;   

Others  :  1080423
DOI  :  10.1186/1471-2407-12-184

 received in 2011-12-22, accepted in 2012-04-15,  发布年份 2012

【 摘 要 】

Background

This study systematically reviewed the evidence on the influence of stigma and nihilism on lung cancer patterns of care; patients’ psychosocial and quality of life (QOL) outcomes; and how this may link to public health programs.

Methods

Medline, EMBASE, ProQuest, CINAHL, PsycINFO databases were searched. Inclusion criteria were: included lung cancer patients and/or partners or caregivers and/or health professionals (either at least 80% of participants had lung cancer or were partners or caregivers of lung cancer patients, or there was a lung cancer specific sub-group focus or analysis), assessed stigma or nihilism with respect to lung cancer and published in English between 1^st January 1999 and 31^st January 2011. Trial quality and levels of evidence were assessed.

Results

Eighteen articles describing 15 studies met inclusion criteria. The seven qualitative studies were high quality with regard to data collection, analysis and reporting; however most lacked a clear theoretical framework; did not address interviewer bias; or provide a rationale for sample size. The eight quantitative studies were generally of low quality with highly selected samples, non-comparable groups and low participation rates and employed divergent theoretical and measurement approaches. Stigma about lung cancer was reported by patients and health professionals and was related to poorer QOL and higher psychological distress in patients. Clear empirical explorations of nihilism were not evident. There is qualitative evidence that from the patients’ perspectives public health programs contribute to stigma about lung cancer and this was supported by published commentary.

Conclusions

Health-related stigma presents as a part of the lung cancer experience however there are clear limitations in the research to date. Future longitudinal and multi-level research is needed and this should be more clearly linked to relevant theory.

【 授权许可】

   
2012 Chambers et al.; licensee BioMed Central Ltd; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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