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  O25 - Stigma and Nihilism (ID 139)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Nurses
  • Presentations: 1
  • Moderators:J.K. Cataldo, S. Sinclair
  • Coordinates: 10/29/2013, 16:15 - 17:45, Bayside Gallery B, Level 1

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    O25.05 - Stigma and nihilism in lung cancer: the perspective of Australian health professionals and consumers (ID 2653)

    16:55 - 17:05  |  Author(s): D. O'Connell
    • Abstract
    • Presentation
    • Slides

    Background
    It has been proposed that stigma and nihilism surrounding lung cancer may influence lung cancer outcomes. A clear understanding of the impact of lung cancer related stigma and nihilism from the perspectives of health professionals and consumers will assist in informing best practice lung cancer care and health promotion messages in Australia. As part of a national lung cancer program, Cancer Australia commissioned Cancer Council Queensland, in partnership with Griffith University, to undertake a three-phase research project on stigma and nihilism about lung cancer in the Australian context.

    Methods
    Phase 1: A systematic literature review examined 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. Phase 2: The perspectives of health professionals on the impact of stigma and nihilism on diagnosis and disease management were investigated. Semi-structured interviews and a Delphi process with 31 key informants developed a consensus view, which was then tested with 323 health professionals in a national online survey. Phase 3: The perspectives of lung cancer patients and carers on the effects of stigma and nihilism on their cancer experience were investigated. Qualitative interviews were undertaken with 17 patients and 11 carers followed by a cross-sectional survey with 147 lung cancer patients in QLD and NSW.

    Results
    Systematic review: Stigma relating to lung cancer was reported by both patients and health professionals and was related to poorer QOL and higher psychological distress in patients. Empirical explorations of nihilism were not evident. Qualitative evidence from patients’ perspectives suggested that public health programs contribute to stigma about lung cancer. Health professionals’ perspectives: Health-related stigma and the need for positive messaging about lung cancer and smoking cessation were priorities. Geographical barriers to access and a lack of rural/regional services were described. Barriers for Aboriginal and Torres Strait Islander people included fear of dying away from community and poor cancer knowledge. Patient and carer perspectives: Qualitative data were consistently indicative of stigma amongst patients due to perceived personal responsibility in the smoking-lung cancer relationship and perceived links between lung cancer and negative outcomes. Quantitative data revealed high levels of psychological distress but low help seeking; health-related stigma was significantly related to poorer psychological and QOL outcomes.

    Conclusion
    Health-related stigma has negative impacts on people affected by lung cancer in Australia and may contribute to poorer psychological health and QOL outcomes. The research helps to build the evidence about factors influencing lung outcomes in Australia. It provides an important foundation for further research and the development of strategies to ameliorate the effects of stigma on patients and carers.

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