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Perceived injustice and its impact on psychological distress in cancer patients and survivors

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Abstract

Purpose

Perceived injustice is a novel psychosocial construct that reflects negative cognitive appraisals of unfairness, externalized blame and the irreparability and severity of one’s loss. Previous research has highlighted the negative impact of perceived injustice on recovery and mental health outcomes, particularly in pain-related samples. This study aimed to (i) explore the role of perceived injustice on psychological outcomes in a general cancer population and (ii) describe demographic and psychosocial characteristics associated with perceptions of injustice.

Methods

The study employed a cross-sectional, observational design. Using a purposive convenience sampling technique, individuals that have or have had cancer completed an online survey assessing perceived injustice (IEQ), psychological distress (HADS), mental adjustment to cancer (Mini-MAC) and satisfaction with care (PSCC) (N = 121).

Results

Levels of perceived injustice were high with 43.2% of the sample scoring in the clinical range. Hierarchical regression analyses showed that perceived injustice contributed unique variance to the prediction of anxiety and depression. Low satisfaction with care, being under the age of 40 and not having children were identified as significant predictors of perceived injustice. Satisfaction with care did not significantly moderate the association between perceived injustice and mental health outcomes but directly impacted anxiety levels.

Conclusion

Cancer patients reporting high levels of perceived injustice are at greater risk of feeling psychologically distressed. Prevention and management of injustice perceptions may require interventions targeting specific negative attributions, as well as cancer care in general. Further implications for healthcare practice are discussed.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank all participants that took part in our study. All authors listed have contributed sufficiently to the work to qualify for authorship.

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Authors and Affiliations

  1. School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland

    Luisa Schmieder & Keith Gaynor

  2. Department of Psychology, St. Vincent’s University Hospital, Dublin, Ireland

    Julie Lynch & Paul D’Alton

Authors
  1. Luisa Schmieder
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  2. Keith Gaynor
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  3. Julie Lynch
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  4. Paul D’Alton
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Luisa Schmieder. The first draft of the manuscript was written by Luisa Schmieder, and all authors revised and contributed to subsequent versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Luisa Schmieder.

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Ethical approval

Ethical approval was obtained from the Taught Masters Research Ethics Committee of the University College Dublin (TMREC-PSY-2021–20). This research was conducted in accordance with the Helsinki declaration and the Psychological Society of Ireland Guidelines [36, 37].

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Schmieder, L., Gaynor, K., Lynch, J. et al. Perceived injustice and its impact on psychological distress in cancer patients and survivors. Support Care Cancer 31, 433 (2023). https://doi.org/10.1007/s00520-023-07833-0

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