Stigma, shame, and blame experienced by patients with lung cancer: qualitative study
Stigma, shame, and blame experienced by patients with lung cancer: qualitative study
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DOI：
10.1136/bmj.38111.639734.7c
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发表时间：
2004-06-19
影响因子：
105.7
通讯作者：
McPherson, A
中科院分区：
文献类型：
--
作者：
Chapple, A;Ziebland, S;McPherson, A
目的 利用对肺癌患者的叙述性访谈，探讨他们对耻辱感的看法和经历。设计定性研究。背景为英国。参与者通过多种来源招募了 45 名肺癌患者。结果参与者经历了其他类型癌症患者常见的耻辱感，但是，无论他们是否吸烟，他们都感到特别耻辱，因为这种疾病与吸烟密切相关。因此，与家人、朋友和医生的互动常常受到影响，许多患者，特别是那些几年前戒烟或从未吸烟的患者，感到自己的疾病受到了不公正的指责。那些拒绝指责受害者的人坚称，真正的罪魁祸首是政策不择手段的烟草公司。一些患者隐瞒了自己的病情，这有时会带来不利的经济后果或使他们难以获得其他人的支持。一些人表示，报纸和电视报道可能加剧了这种耻辱：电视广告旨在让年轻人远离烟草，但它们通常描绘可怕的死亡，这可能会加剧恐惧和焦虑。一些患者担心肺癌的诊断、获得护理和研究可能会受到疾病耻辱感和吸烟者的不利影响。 结论 肺癌患者报告耻辱感具有深远的影响。帮助人们戒烟的努力很重要，但临床和教育干预措施应谨慎进行，以免增加肺癌和其他吸烟相关疾病患者的耻辱感。
Objectives To draw on narrative interviews with patients with lung cancer and to explore their perceptions and experience of stigma.Design Qualitative study.Setting United Kingdom.Participants 45 patients with lung cancer recruited through several sources.Results Participants experienced stigma commonly felt by patients with other types of cancer, but, whether they smoked or not, they felt particularly stigmatised because the disease is so strongly associated with smoking. Interaction with family, friends, and doctors was often affected as a result, and many patients, particularly those who had stopped smoking years ago or who had never smoked, felt unjustly blamed for their illness. Those who resisted victim blaming maintained that the real culprits were tobacco companies with unscrupulous policies. Some patients concealed their illness, which sometimes had adverse financial consequences or made it hard for them to gain support from other people. Some indicated that newspaper and television reports may have added to the stigma: television advertisements aim to put young people off tobacco, but they usually portray a dreadful death, which may exacerbate fear and anxiety. A few patients were worried that diagnosis, access to care, and research into lung cancer might be adversely affected by the stigma attached to the disease and those who smoke.Conclusions Patients with lung cancer report stigmatisation with far reaching consequences. Efforts to help people quit smoking are important, but clinical and educational interventions should be presented with care so as not to add to the stigma experienced by patients with lung cancer and other smoking related diseases.