TY - JOUR
T1 - Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer
AU - LoConte, Noelle K.
AU - Else-Quest, Nicole M.
AU - Eickhoff, Jens
AU - Hyde, Janet
AU - Schiller, Joan H.
N1 - Funding Information:
Based on these data, we suggest that health care providers who care for patients with lung cancer seek out opportuni- ties to discuss underlying feelings of guilt or shame about a patient’s diagnosis, and to address underlying feelings of depression and anxiety. Acknowledgement This study was funded by the American Medical Association Seed Grant (recipient Noelle K. LoConte, MD), University of Wisconsin Department of Psychology and Women’s Studies Program. References
PY - 2008/5
Y1 - 2008/5
N2 - PURPOSE: Patients with lung cancer might feel more guilt and shame resulting from previous smoking. This study was designed to determine the levels of guilt and shame among patients with non-small-cell lung cancer (NSCLC) compared with breast and prostate cancer. PATIENTS AND METHODS: Surveys were sent to participants 3 times (at enrollment, 2 months, and 6 months). Patients were eligible if they had stage IV NSCLC, breast cancer, or prostate cancer. The survey included tests of generalized guilt, shame, depression, and anxiety as well as guilt, shame, and embarrassment related to one's cancer. RESULTS: One hundred seventy-two participants completed ≥ 1 questionnaire: 96 patients with NSCLC, 30 patients with breast cancer, and 46 patients with prostate cancer. Of the patients with NSCLC, 91.7% were current or former smokers versus 67.1% of the comparison patients. A composite score of embarrassment related to one's cancer (perceived cancer-related stigma; PCRS) was higher in patients with NSCLC (P < .01). Mean baseline generalized guilt and shame scores were not different among groups and did not change over time. A history of smoking correlated with increased levels of guilt and shame, regardless of tumor type. A personal identification of past behaviors as contributing to cancer correlated with higher levels of guilt, shame, anxiety, and depression. Of the patients with NSCLC, 29.5% felt that their behaviors contributed to their cancer compared with 10.5% of the comparison patients. CONCLUSION: Patients with NSCLC had higher levels of PCRS than patients with prostate cancer or breast cancer but not higher baseline levels of shame and guilt. Smoking is correlated with higher levels of guilt and shame. A belief that one caused one's own cancer is correlated with higher levels of guilt, shame, anxiety, and depression. These findings could be translated into an increased need for open communication among patients and their providers surrounding issues of cancer causation, guilt, shame, depression, and anxiety.
AB - PURPOSE: Patients with lung cancer might feel more guilt and shame resulting from previous smoking. This study was designed to determine the levels of guilt and shame among patients with non-small-cell lung cancer (NSCLC) compared with breast and prostate cancer. PATIENTS AND METHODS: Surveys were sent to participants 3 times (at enrollment, 2 months, and 6 months). Patients were eligible if they had stage IV NSCLC, breast cancer, or prostate cancer. The survey included tests of generalized guilt, shame, depression, and anxiety as well as guilt, shame, and embarrassment related to one's cancer. RESULTS: One hundred seventy-two participants completed ≥ 1 questionnaire: 96 patients with NSCLC, 30 patients with breast cancer, and 46 patients with prostate cancer. Of the patients with NSCLC, 91.7% were current or former smokers versus 67.1% of the comparison patients. A composite score of embarrassment related to one's cancer (perceived cancer-related stigma; PCRS) was higher in patients with NSCLC (P < .01). Mean baseline generalized guilt and shame scores were not different among groups and did not change over time. A history of smoking correlated with increased levels of guilt and shame, regardless of tumor type. A personal identification of past behaviors as contributing to cancer correlated with higher levels of guilt, shame, anxiety, and depression. Of the patients with NSCLC, 29.5% felt that their behaviors contributed to their cancer compared with 10.5% of the comparison patients. CONCLUSION: Patients with NSCLC had higher levels of PCRS than patients with prostate cancer or breast cancer but not higher baseline levels of shame and guilt. Smoking is correlated with higher levels of guilt and shame. A belief that one caused one's own cancer is correlated with higher levels of guilt, shame, anxiety, and depression. These findings could be translated into an increased need for open communication among patients and their providers surrounding issues of cancer causation, guilt, shame, depression, and anxiety.
KW - Depression
KW - Self-blame
KW - Smoker status
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U2 - 10.3816/CLC.2008.n.026
DO - 10.3816/CLC.2008.n.026
M3 - Article
C2 - 18621628
AN - SCOPUS:45849142970
SN - 1525-7304
VL - 9
SP - 171
EP - 178
JO - Clinical lung cancer
JF - Clinical lung cancer
IS - 3
ER -