Stigma and Its Influencing Factors in Patients with Head and Neck Cancer

Abstract

Aims: Head and neck cancer (HNC) patients often suffer from stigma after treatment. The purpose of this study was to assess perceived body image, depression, physical function, psychosocial function, and stigma, as well as to identify factors associated with stigma in patients with HNC. Methods: This cross-sectional study recruited 156 HNC patients from the outpatient radiation department of a medical center in Northern Taiwan. Patients were assessed for patient reported outcomes using the Body Image Scale (BIS), the Hospital Anxiety and Depression Scale–Depression Subscale (HADS–Depression Subscale), the University of Washington Quality of Life Scale (UW-QOL) version 4.0, and the Shame and Stigma Scale (SSS). Data were analyzed by descriptive analysis, Pearson’s product-moment correlation, and multiple regression. Results: The two top ranked subscales of stigma were: “speech and social concerns” and “regret”. Stigma was positively correlated with younger age, longer time since the completion of treatment, being employed, body image dissatisfaction, depression, less physical function, and less psychosocial function. Multiple regression analysis showed that higher levels of body image concern, greater depression, a longer time since completing treatment, younger age, and less physical function were associated with greater stigma. These factors explained 69.2% of the variance in stigma. Conclusion: Patients’ body image concerns strongly influence overall stigma as well as each subscale of stigma. Oncology nurses should assess and record psychological status, provide available resources, and refer appropriate HNC patients to counselling.