TY - JOUR
T1 - A systematic review of the impact of stigma and nihilism on lung cancer outcomes
AU - Chambers, Suzanne K.
AU - Dunn, Jeffrey
AU - Occhipinti, Stefano
AU - Hughes, Suzanne
AU - Baade, Peter
AU - Sinclair, Sue
AU - Aitken, Joanne
AU - Youl, Pip
AU - O'Connell, Dianne L.
N1 - Funding Information:
The project was funded by Cancer Australia under the National Lung Cancer Program. We thank Dr Bronwyn Morris for her input to our quality assessment process. We also acknowledge and thank Profs Kwun Fong and David Ball; Ms Joyce Graham; and Assoc. Profs Shalini Vinod, Gail Garvey and Patricia Valery for their comments on the key clinical questions applied in this review.
PY - 2012/5/20
Y1 - 2012/5/20
N2 - 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 1st January 1999 and 31st 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.
AB - 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 1st January 1999 and 31st 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.
KW - Health-related stigma
KW - Lung neoplasms
KW - Systematic review
KW - Therapeutic nihilism
UR - http://www.scopus.com/inward/record.url?scp=84861125567&partnerID=8YFLogxK
U2 - 10.1186/1471-2407-12-184
DO - 10.1186/1471-2407-12-184
M3 - Journal article
C2 - 22607085
AN - SCOPUS:84861125567
SN - 1471-2407
VL - 12
JO - BMC Cancer
JF - BMC Cancer
M1 - 184
ER -