Life after cancer: How does public stigma increase psychological distress of childhood cancer survivors?

Psychosocial Follow‐Up in Survivorship as a Standard of Care in Pediatric Oncology

“…Cross‐sectional survey Nordic Society of Pediatric Hematology and Oncology registryn = 398 Nordic CCS (>1 year‐old at diagnosis, currently >13 years‐old) Current older age (>18 years) associated with higher fatigue compared to patients ages 13–18 years (14% vs. 6% with chronic fatigue, respectively, p < 0.05) Patients >18 years with chronic fatigue reported poorer physical health (p < 0.05) but better mental health (=0.001) than population controls moderate sample size, no controls data collection appropriate, reporting comprehensive, missing data described6xxJones, 2011, Adolescent cancer survivors: identity paradox and the need to belong QualitativeN = 12 adolescent cancer survivors between the age of 12 and 21 at time of interview, post‐treatment Adolescent cancer survivors experienced both risk and protective factors after cancer treatment. Adolescents struggled to form an identity that included both their cancer and their survivor experience Adolescents attempted to find a way to belong and receive social support that promoted their health. Participants reported finding meaning and positive benefits from facing their disease. Research question clearly stated; qualitative approach clearly justified; study context clearly described; method of data collection clearly described; analysis appropriate for research question6xKim, 2013 Psychological distress in AYA survivors of childhood cancer in Korea Cross‐sectional survey‐based studyN = 223 Korean childhood cancer survivors, between 15–39 years of age. 20% of participants were classified as psychologically distressed Significant levels of psychological distress were associated with age, economic status, and time since diagnosis.Moderate sample size, no comparison population, data collection appropriate, Appropriate analysis, reporting clearly described4xKim, 2014 Life after cancer Cross‐sectional survey‐based.Korean adolescent survivors of childhood cancer (n = 223, diagnosed prior to age 19 years, current age 15–29 years), recruited from websites and advocacy groups Childhood cancer survivors perceive public stigma Increased perceptions of stigma associated with increased patient‐reported shame and self‐blame, and decreased patient‐reported social support and disclosure of cancer‐history. Patient reported shame, self‐blame, and poor social support associated with psychological distress. Moderate sample size, no control sample, data collection and analyses appropriate, reporting clearly described.6xxKirchhoff, 2011, Physical, mental, and neurocognitive status and employmen...…”

Body image mediates the effect of cancer‐related stigmatization on depression: A new target for intervention

“…Therefore, one may turn to mediator models as a way of understanding whether and how the relationship between stigmatization and depression is exerted by a third variable . Previous mediator studies showed that the effect of stigmatization on distress was mediated through cancer disclosure, social support availability, and illness intrusiveness . In search for other mediators being relevant for cancer patients, the theory of Fife and Wright proposed that stigmatization adversely affects the self, including self‐esteem, mastery, and body image.…”

Investigation of Stigma Phenomenon in Cancer: A Grounded Theory Study

“…Perceived stigma may lead to psychological distress by increasing the feelings of shame and self-blaming, limiting the social support and non-disclosure of cancer experiences. Generally, these results showed the important role of cognitive and social factors which are associated with stigma phenomenon (24).…”

“…Results illustrated that patients were not willing to disclose their illness when social stigma exists (24). According to what was explained, non-disclosure as one of the coping mechanisms may reduce internalized stigma, while defending patients against social stigma.…”