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Stigma and related influencing factors in postoperative oral cancer patients in China: a cross-sectional study

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A Correction to this article was published on 19 April 2022

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Abstract

Purpose

To examine the level of stigma and identify its influencing factors among postoperative oral cancer patients in China.

Methods

In total, 274 postoperative oral cancer patients were recruited from a Grade A Tertiary Hospital in China using convenience sampling methods. Patients completed the Social Impact Scale (SIS), Medical Coping Mode Questionnaire (MCMQ), Social Support Rating Scale (SSRS), and General Self-efficacy Scale (GSE).

Results

Stigma reported by postoperative oral cancer patients was moderate (50.17 ± 21.24). Stepped multiple linear regression showed that the related factors influencing their feelings of stigma were educational level (β =  − 0.110, P = 0.001), smoking (β =  − 0.152, P < 0.001), betel quid (β =  − 0.120, P = 0.001), tumor location (β =  − 0.390, P < 0.001), tumor stage (β = 0.219, P < 0.001), self-efficacy (β =  − 0.253, P < 0.001), and confrontation (β =  − 0.117, P = 0.001) and avoidance (β = 0.123, P < 0.001), which explained 74.2% of the total variation in stigma (F = 99.378, P < 0.001).

Conclusions

Stigma was positively predicted by tumor stage and avoidance but negatively predicted by education level, smoking, betel quid, tumor location, confrontation, and self-efficacy. Further work should focus on developing interventions to reduce stigma by improving protective factors and decreasing risk factors.

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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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References

  1. Warnakulasuriya S (2009) Causes of oral cancer – an appraisal of controversies. Br Dent J 207(10):471–475. https://doi.org/10.1038/sj.bdj.2009.1009

    Article  CAS  PubMed  Google Scholar 

  2. Rao S, Mejia G, Ro Be Rts-Thomson K et al (2013) Epidemiology of Oral Cancer in Asia in the Past Decade- An Update (2000–2012). Asian Pac J Cancer Prev 14(10):5567–5577. https://doi.org/10.7314/apjcp.2013.14.10.5567

    Article  Google Scholar 

  3. Sung H, Ferlay J, Siegel RL et al (2020) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660

    Article  Google Scholar 

  4. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics. Ca-Cancer J Clin 68(1):7–30. https://doi.org/10.3322/caac.21442

    Article  PubMed  Google Scholar 

  5. Day TA, Davis BK, Gillespie MB et al (2003) Oral cancer treatment. Curr Treat Options Oncol 4(1):27–41. https://doi.org/10.1007/s11864-003-0029-4

    Article  PubMed  Google Scholar 

  6. Van D (2012) Are we able to reduce the mortality and morbidity of oral cancer: some considerations. Med Oral Patol Oral Cir Bucal 18(1):33–37. https://doi.org/10.4317/medoral.18486

    Article  Google Scholar 

  7. Wang TF, Li YJ, Chen LC et al (2020) Correlation Between Postoperative Health-Related Quality of Life and Care Needs of Oral Cancer Patients. Cancer Nurs 43(1):12–21. https://doi.org/10.1097/NCC.0000000000000677

    Article  CAS  PubMed  Google Scholar 

  8. Fingeret MC, Vidrine DJ, Reece GP et al (2009) A multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer. Head Neck 32(3):301–309. https://doi.org/10.1002/hed.21181

    Article  Google Scholar 

  9. Goffman E (1963) Stigma: notes on the management of spoiled identity. Prentice Hall, Englewood Cliffs

    Google Scholar 

  10. Carter-Harris L, Hermann CP, Schreiber J et al (2014) Lung cancer stigma predicts timing of medical help-seeking behavior. Oncol Nurs Forum 41(3):203–210. https://doi.org/10.1188/14.ONF.E203-E210

    Article  Google Scholar 

  11. Meacham E, Orem J, Nakigudde G et al (2016) Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda. Psychooncology 25(10):1206–1211. https://doi.org/10.1002/pon.4215

    Article  PubMed  Google Scholar 

  12. Hatzenbuehler ML, Phelan JC, Link BG (2013) Stigma as a fundamental cause of population health inequalities. Am J Public Health 103(5):813–821. https://doi.org/10.2105/Ajph.2012.301069

    Article  PubMed  PubMed Central  Google Scholar 

  13. Phelan MS, Griffin MJ, Jackson LG et al (2013) Stigma, perceived blame, self-blame, and depressive symptoms in men with colorectal cancer. Psychooncology 22(1):65–73. https://doi.org/10.1002/pon.2048

    Article  PubMed  Google Scholar 

  14. Quinn DM, Chaudoir SR (2009) Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. J Abnorm Soc Psychol 97(4):634–651. https://doi.org/10.1037/a0015815

    Article  Google Scholar 

  15. Johnson LA, Schreier AM, Swanson M et al (2019) Stigma and quality of life in patients with advanced lung cancer. Oncol Nurs Forum 46(3):318–328. https://doi.org/10.1188/19.ONF.318-328

    Article  PubMed  Google Scholar 

  16. Chu Q, Wong CCY, Chen L et al (2021) Self-stigma and quality of life among Chinese American breast cancer survivors: a serial multiple mediation model. Psychooncology 30(3):392–399. https://doi.org/10.1002/pon.5590

    Article  PubMed  Google Scholar 

  17. Sun L, Liu X, Weng X et al (2021) Narrative therapy to relieve stigma in oral cancer patients: a randomized controlled trial. Int J Nurs Pract 12926. https://doi.org/10.1111/ijn.12926

  18. Zhang Y, Cui C, Wang Y et al (2020) Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a cross-sectional study. Health Qual Life Outcomes 18(1):112. https://doi.org/10.1186/s12955-020-01353-9

    Article  PubMed  PubMed Central  Google Scholar 

  19. Deng C, Qi LB, Ly B et al (2019) Factors associated with stigma in community-dwelling stroke survivors in China: a cross-sectional study. J Neurol Sci 407:116459. https://doi.org/10.1016/j.jns.2019.116459

    Article  PubMed  Google Scholar 

  20. Liu XH, Zhong JD, Zhang JE et al (2020) Stigma and its correlates in people living with lung cancer: a cross-sectional study from China. Psychooncology 29(2):287–293. https://doi.org/10.1002/pon.5245

    Article  PubMed  Google Scholar 

  21. Rose S, Kelly B, Boyes A et al (2018) Impact of perceived stigma in people newly diagnosed with lung cancer: a cross-sectional analysis. Oncol Nurs Forum 45(6):737–747. https://doi.org/10.1188/18.ONF.737-747

    Article  PubMed  Google Scholar 

  22. Yuan JM, Zhang JE, Zheng MC et al (2018) Stigma and its influencing factors among Chinese patients with stoma. Psychooncology 27(6):1565–1571. https://doi.org/10.1002/pon.4695

    Article  PubMed  Google Scholar 

  23. Bulkley J, McMullen CK, Hornbrook MC et al (2013) Spiritual well-being in long-term colorectal cancer survivors with ostomies. Psychooncology 22(11):2513–2521. https://doi.org/10.1002/pon.3318

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lim JW, Shon EJ, Paek M et al (2014) The dyadic effects of coping and resilience on psychological distress for cancer survivor couples. Support Care Cancer 22(12):3209–3217. https://doi.org/10.1007/s00520-014-2334-9

    Article  PubMed  PubMed Central  Google Scholar 

  25. Dahlem NW, Zimet GD, Walker RR (1991) The multidimensional scale of perceived social support: a confirmation study. J Clin Psychol 47(6):756–761

    Article  CAS  Google Scholar 

  26. Wang D, Jia Y, Gao W et al (2019) Relationships between stigma, social support, and distress in caregivers of Chinese children with imperforate anus: a multicenter cross-sectional study. J Pediatr Nurs 49:15–20. https://doi.org/10.1016/j.pedn.2019.07.008

    Article  Google Scholar 

  27. Salles A (2017) Self-efficacy as a measure of confidence. JAMA Surg 152(5):506–507. https://doi.org/10.1001/jamasurg.2017.0035

    Article  PubMed  Google Scholar 

  28. Zhou G, Li X, Qiao S et al (2020) HIV symptom management self-efficacy mediates the relationship of internalized stigma and quality of life among people living with HIV in China. J Health Psychol 25(3):311–321. https://doi.org/10.1177/1359105317715077

    Article  PubMed  Google Scholar 

  29. Fife BL, Wright ER (2000) The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav 41(1):50–67. https://doi.org/10.2307/2676360

    Article  CAS  PubMed  Google Scholar 

  30. Pan AW, Chung L, Fife BL et al (2007) Evaluation of the psychometrics of the Social Impact Scale: a measure of stigmatization. Int J Rehabil Res 30(3):235–238. https://doi.org/10.1097/mrr.0b013e32829fb3db

    Article  PubMed  Google Scholar 

  31. Guan X, Sun T, Yang H, Liu J et al (2011) Reliability and validity of Chinese version Social Impact Scale applied in study of stigma in urinary incontinent women (in Chinese). Journal of nursing 26(7):63–65. https://doi.org/10.3870/hlxzz.2011.07.063

    Article  Google Scholar 

  32. Feifel H, Strack S, Nagy VT (1987) Coping strategies and associated features of medically ill patients. Psychosom 49(6):616–625. https://doi.org/10.1097/00006842-198711000-00007

    Article  CAS  Google Scholar 

  33. Shen X (2000) Report on application of Chinese version of MCMQ in 701 patients (in Chinese). Chin J Behav Med Sci. https://doi.org/10.3760/cma.j.issn.1674-6554.2000.01.008

    Article  Google Scholar 

  34. Xiao S Y (1994) Theoretical basis and application in research of Social Support Rating ScaleCNKI:SUN:LCJS.0.1994-02-019

  35. Schwarzer R, Jerusalem M (1995) Measures in Health Psychology: a user’s portfolio. Causal Control Beliefs 1:35–37

    Google Scholar 

  36. Zhang JX, Schwarzer R (1995) Measuring optimistic self-beliefs: a Chinese adaptation of the general self-efficacy scale. Psychologia 38(3):174–181. https://doi.org/10.1080/09515089508573160

    Article  Google Scholar 

  37. Yuan L, Pan B, Wang W et al (2020) Prevalence and predictors of anxiety and depressive symptoms among patients diagnosed with oral cancer in China: a cross-sectional study. BMC Psychiatry 20(1):394. https://doi.org/10.1186/s12888-020-02796-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Chen SC, Huang BS, Hung T et al (2018) Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs 36:89–94. https://doi.org/10.1016/j.ejon.2018.07.002

    Article  PubMed  Google Scholar 

  39. Moser RP, Arndt J, Han PK et al (2014) Perceptions of cancer as a death sentence: prevalence and consequences. J Health Psychol 19(12):1518–1524. https://doi.org/10.1177/1359105313494924

    Article  PubMed  Google Scholar 

  40. Perrott SB, Murray AH, Lowe J et al (2000) The psychosocial impact of psoriasis: physical severity, quality of life, and stigmatization. Physiol Behav 70(5):567–571. https://doi.org/10.1016/s0031-9384(00)00290-0

    Article  CAS  PubMed  Google Scholar 

  41. Cook TM, Wang J (2010) Descriptive epidemiology of stigma against depression in a general population sample in Alberta. BMC Psychiatry 10:29. https://doi.org/10.1186/1471-244X-10-29

    Article  PubMed  PubMed Central  Google Scholar 

  42. Nikus Fido N, Aman M, Brihnu Z (2016) HIV stigma and associated factors among antiretroviral treatment clients in Jimma town. Southwest Ethiopia HIV AIDS (Auckl) 23(8):183–193. https://doi.org/10.2147/HIV.S114177

    Article  Google Scholar 

  43. Liu H, Yang Q, Narsavage GL et al (2016) Coping with stigma: the experiences of Chinese patients living with lung cancer. Springerplus 5(1):1790–1798. https://doi.org/10.1186/s40064-016-3486-5

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kumar M, Nanavati R, Modi TG, Dobariya C (2016) Oral cancer: Etiology and risk factors: a review. J Cancer Res Ther 12(2):458–463. https://doi.org/10.4103/0973-1482.186696

    Article  CAS  PubMed  Google Scholar 

  45. Thuné-Boyle IC, Stygall J, Keshtgar MR et al (2013) Religious/spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psychooncology 22(3):646–658. https://doi.org/10.1002/pon.3048

    Article  PubMed  Google Scholar 

  46. Kao YC, Lien YJ, Chang HA et al (2017) Stigma resistance in stable schizophrenia: the relative contributions of stereotype endorsement, self-reflection, self-esteem, and coping styles. Can J Psychiatry 62(10):735–744. https://doi.org/10.1177/0706743717730827

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kissane DW, Patel SG, Baser RE et al (2013) Preliminary evaluation of the reliability and validity of the shame and stigma scale in head and neck cancer. Head Neck 35(2):172–183. https://doi.org/10.1002/hed.22943

    Article  PubMed  Google Scholar 

  48. Sasahira T, Kirita T (2018) Hallmarks of Cancer-Related Newly Prognostic Factors of Oral Squamous Cell Carcinoma. Int J Mol Sci 19(8):2413. https://doi.org/10.3390/ijms19082413

    Article  CAS  PubMed Central  Google Scholar 

  49. Lyimo RA, Stutterheim SE, Hospers HJ et al (2014) Stigma, disclosure, coping, and medication adherence among people living with HIV/AIDS in Northern Tanzania. Aids Patient Care Stds 28(2):98–105. https://doi.org/10.1089/apc.2013.0306

    Article  PubMed  Google Scholar 

  50. Earnshaw VA, Lang SM, Lippitt M et al (2015) hiv stigma and physical health symptoms: do social support, adaptive coping, and/or identity centrality act as resilience resources? AIDS Behav 19(1):41–49. https://doi.org/10.1007/s10461-014-0758-3

    Article  PubMed  PubMed Central  Google Scholar 

  51. Cantwell J, Muldoon O, Gallagher S (2015) The influence of self-esteem and social support on the relationship between stigma and depressive symptomology in parents caring for children with intellectual disabilities. J Intell Disabil Res 59(10):948–957. https://doi.org/10.1111/jir.12205

    Article  CAS  Google Scholar 

  52. Liu N, Liu S, Yu N et al (2018) Correlations among psychological resilience, self-efficacy, and negative emotion in acute myocardial infarction patients after percutaneous coronary intervention. Front Psychiatry 9:1. https://doi.org/10.3389/fpsyt.2018.00001

    Article  PubMed  PubMed Central  Google Scholar 

  53. Salcido RS (2018) Self-efficacy and patient-reported pain. Adv Skin Wound Care 31(3):101. https://doi.org/10.1097/01.ASW.0000530572.54497.56

    Article  PubMed  Google Scholar 

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Funding

This work was supported by Scientific Research Project of Hunan Provincial Health Commission (Grant numbers:202214 023438).

Author information

Authors and Affiliations

  1. Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, China

    Chuxia Tan, Chenxi Zhong, Ranran Mei, Xianjiao Deng, Shihao Chen & Man Ye

  2. Xiangya Nursing School of Central South University, Changsha, Hunan, 410013, China

    Chuxia Tan, Chenxi Zhong, Ranran Mei, Xianjiao Deng & Man Ye

  3. Department of Kidney Transplantation, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China

    Chenxi Zhong

  4. Intensive Care Unit of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China

    Ronghong Yang & Dangdang Wang

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  1. Chuxia Tan
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  2. Chenxi Zhong
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  3. Ranran Mei
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  8. Man Ye
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Contributions

Concept and design: Ye Man, Tan Chuxia. Acquisition, analysis, or interpretation of data: Zhong Chenxi, Mei Ranran, Yang Ronghong, Wang Dangdang. Drafting of the manuscript: Ye Man, Tan Chuxia. Critical revision of the manuscript for important intellectual content: Deng Xianjiao, Chen Shihao. Statistical analysis: Tan Chuxia. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Man Ye.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Review Committee of the School of Nursing, Central South University (No. E202060).

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

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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The original version of this article was revised. Should read ‘The version of the SIS used in the present study was revised by Guan et al. [31] in 2012’.

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Tan, C., Zhong, C., Mei, R. et al. Stigma and related influencing factors in postoperative oral cancer patients in China: a cross-sectional study. Support Care Cancer 30, 5449–5458 (2022). https://doi.org/10.1007/s00520-022-06962-2

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