Volume 22, Issue 5 (3-2023)
TB 2023, 22(5): 107-120 |
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Ethics code: ir.yazd.rec.1401.065
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mazloomi O, parsamehr M, zare-shahabadi A. Structural Equation Modeling of the Relationship between Social Stigma of Cancer and Mental Habitus of Cancer among Family Caregivers of Cancer Patients. TB 2023; 22 (5) :107-120
URL: http://tbj.ssu.ac.ir/article-1-3584-en.html
URL: http://tbj.ssu.ac.ir/article-1-3584-en.html
yazd University , parsamehr@yazd.ac.ir
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Structural Equation Modeling of the Relationship between Social Stigma of Cancer and Mental Habitus of Cancer among Family Caregivers of Cancer Patients
Omid Mazlumi(Ph.D.s)1 ,Mehraban Parsamehr(Ph.D.)2 , Akbar Zare-shahabadi(Ph.D.)3
1. Ph.D. Student of Sociology, Yazd University, Iran.
2.Corresponding author: Associate Professor of Sociology, Faculty of Social Sciences, Yazd University, Iran. Email:parsamehr@yazd.ac.ir, Tel: 09113115819
3. Associate Professor of Sociology, Faculty of Social Sciences, Yazd University, Iran.
Abstract
Introduction: In societies, incorrect beliefs about cancer cause stigma and weaken the health care and patients' treatment. The purpose of this studu is to investigate the impact of cancer habitus on cancer social stigma among family caregivers of cancer patients.
Methods: Survey method was usedand the statistical population included family caregivers of cancer patients in Tehran hospitals in 1401. Sample size included 384 people selected by convenience sampling method of multi-stage stratified type by referring to the hospitals under study. Data collection tool was the standard cancer stigma index questionnaire and the researcher-made cancer habitus questionnaire. Data were analyzed through correlation tests, mean difference, path analysis and structural equation modeling in SPSS and Amos.
Results: According to the results, there was a relationship between cancer stigma (with dimensions of others-avoidance, self-avoidance, and being released) and cancer habitus (with dimensions of enchantment and cure-avoidance); according to the path model, habitus explains 19/6% of the variation in stigma. Moreover, enchantment and cure-avoidance had the highest and lowest contribution to explaning stigma with an impact factor of 0/29 and 0/25. The results of structural equation model test also indicated appropriate fit of the presented conceptual model (GFI=0/973, RMSEA=0/067, CFI=0/958).
Conclusion: Caregivers of cancer patients, as the main supporters of the patient, are always influenced by incorrect cultural stereotypes of society. Identifying different dimensions of habitus (especially the aspect of enchanment), paying more attention to the aspect of being released of stigma, paying attention to the role of education and awareness in reducing false beliefs and more interaction with patients have a significant role in reducing the stigma of cancer and makes it easier for patients to bear the pain and suffering of cancer
Keywords: Cancer, Stigma, Habitus, Family Caregivers
References
1-Park YM, Kim HY, Kim JY, et al. Relationship between type D personality, symptoms, cancer stigma, and quality of life among patients with lung cancer. European Journal of Oncology Nursing 2022.
2-Larkin D, Birtle AJ, Bradley L, Dey P, Martin CR, Pilkington M & Romero-Rivas C. A systematic review of disease related stigmatization in patients living with prostate cancer 2022; Plos one, 17(2), e0261557.
3-IARC World Cancer Report (2020). Available from: https://www.iccp portal.org/system/files/resources/IARC%20World%20Cancer%20Report%202020.pdf
4-Amirkhah R, Naderi-meshkini H, Mirahmadi M, Allahyari & Sharifi H. Cancer Statistics in Iran: Towards Finding Priority for Prevention and Treatment. cancer press 2017; 3(2): 27-38. [in Persian].
5-Globocan. international agency research on cancer 2020. Available from: https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf
6-LeSeure P, Chongkham‑ang S. The experience of caregivers living with cancer patients: A systematic review and meta‑synthesis. J Pers Med 2015; 19(2): 406‑39.
7-Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol 2004; 2:145‑55.
8-Nyblade L, Stockton MA, Giger K, Bond V, Ekstrand ML, Lean RM, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Med 2019; 17:1-15.
9-Harding R, Nair S, Ekstrand M. Multilevel model of stigma and barriers to cancer palliative care in India: A qualitative study. BMJ Open 2019;9(3):e024248.
10-Best AL, Shukla R, Adamu AM, Martinez Tyson D, Stein KD & Alcaraz KI. Impact of caregivers’ negative response to cancer on long‑term survivors’ quality of life. Support Care Cancer 2021; 29:679‑86.
11-Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, New Jersey, Prentice-Hall Inc 1963.
12-Dovidio JF, Major BA, Crocker J. Stigma: introduction and overview. In The Social Psychology of Stigma. Edited by Heatherton TF, Kleck RE, Hebl MR, Hull JG. New York: Guilford Press. 2000; 1–28.
13-Scambler G. Health-related stigma. Sociol Health Illn 2009; 31:441–455.
14-Weiss MG, Ramakrishna J, Somma D. Health-related stigma: rethinking concepts and interventions. Psychol Health Med. 2006; 11:277–287.
15-Nyblade L, Stockton M, Nyato D, Wamoyi J. Perceived, anticipated and experienced stigma: exploring manifestations and implications for young people’s sexual and reproductive health and access to care in North- Western Tanzania. National Library of Medicine. 2017; 19(10): 1–16.
16-Bourdieu P. The Logic of Practice. Stanford CA, Stanford University Press; 1990.
17-Wagstaff A. Stigma: breaking the vicious circle; patient voice, Cancer World. 2013; 24-29.
18-Maria O E, Anita Ch, Brian S, Rebekkah S, Claire N & Ruth R. Developing a Global Cancer Stigma Index. SAGE JOURNALS. 2014;4(3):2158244014547875.
19-Broom A, Doron A. The rise of cancer in urban India: cultural understandings, structural inequalities and the emergence of the clinic. Health. 2012; 16(3):250–66.
20-Webb LA, McDonnell KK, Adams SA, et al. Exploring stigma among lung cancer survivors: A scoping literature review. Oncol Nurs Forum. 2019; 46:402-418.
21-Hasan Shiri F, Mohtashami J, Nasiri M, Manoochehri H, & Rohani C. Stigma and Related Factors in Iranian People with Cancer. Asian Pacific journal of cancer prevention: APJCP. 2018; 19(8):2285-2290.
22-Oystacher T, Blasco D, He E, Huang D, Schear R, McGoldrick D, et al. Understanding stigma as a barrier to accessing cancer treatment in South Africa: Implications for public health campaigns. Pan Afr Med J. 2018; 29:73.
23-Elangovan V, Rajaraman S, Basumalik B & Pandian D. Awareness and perception about cancer among the public in Chennai, India. J Glob Oncol. 2016; 3:469‑79.
24-Mosadeghrad AM. Factors influencing healthcare service quality. Int J Health Policy Manag. 2014; 3:77‑89.
25-Tripathi L, Datta SS, Agrawal SK, Chatterjee S & Ahmed R. Stigma perceived by women following surgery for breast cancer. Indian J Med Paediatr Oncol. 2017; 38(2):146–52.
26-Abd-Razak SF, Abdul-Manaf NB & Nawang DB. An Analysis of Cancer Awareness and Stigma Among Malaysia's Non-Patient Population 2023.
27-Yusof, MM & Wan-Ishak, WZ. Cancer in My Community: Addressing Increasing Cancer Cases in Malaysia. 2022.
28-Bakhshalizadeh F, shahidi SH, Hazini A. Attitude towards death and life meaning in dying cancer patients: a phenomenological study. Quarterly Journal of Health Psychology. 2021;10(37):65-82
29-Ohlsson-Nevo E, Ahlgren J & Karlsson J. Impact of health-related stigma on psychosocial functioning in cancer patients: Construct validity of the stigma-related social problems scale. European Journal of Cancer Care (Engl) 2020; 29(6), e13312.
30-Sabgul AA, Qattan AMN, Hashmi R, et al. Husbands’ knowledge of breast cancer and their wives’ attitudes and practices related to breast cancer screening in Saudi Arabia: Crosssectional Online Survey. Journal of Medical Internet Research 2021; 23(2): e25404.
31-Squiers L, Siddiqui M, Kataria I, Dhillon PK, Aggarwal A, Bann C, et al. Perceived, Experienced, and Internalized Cancer Stigma: Perspectives of Cancer Patients and Caregivers in India. Research Triangle Park (NC): RTI Press. 2021.
32-Gershfeld-Litvin a, halabi s & bellizzi k. Stigma related to breast cancer among women and men: The case of the Druze minority in Israel. J Health Psychol 2023; 28(2):189-199.
33-Bedi M, Devins GM. Cultural considerations for south Asian women with breast cancer. Journal of Cancer Survivorshi. 2016; 10:31–50.
34-Pak LM, Purad CC, Nadipally S, Rao MP, Mukherjee S, Hegde SKB, et al. Cancer awareness and stigma in Rural Assam India: Baseline survey of the detect early and save her/him (DESH) program. Ann Surg Oncol. 2021; 28:7006‑13.
35-Yılmaz M, Dissiz G, Usluoğlu AK, Iriz S, Demir F, Alacacioglu A. Cancer-Related Stigma and Depression in Cancer Patients in A Middle-Income Country. Asia Pac J Oncol Nurs. 2019 Oct 23;7(1):95-102. doi: 10.4103/apjon.apjon_45_19. PMID: 31879690; PMCID: PMC6927157.
36-Mohabbat-bahar S, Bigdeli I, Mashhadi A,and Moradi-Joo M; Investigation of Stigma Phenomenon in Cancer: A Grounded Theory Study. International Journal of Cancer Management. 2017; 10(2): 1-7. [Persian]
Omid Mazlumi(Ph.D.s)1 ,Mehraban Parsamehr(Ph.D.)2 , Akbar Zare-shahabadi(Ph.D.)3
1. Ph.D. Student of Sociology, Yazd University, Iran.
2.Corresponding author: Associate Professor of Sociology, Faculty of Social Sciences, Yazd University, Iran. Email:parsamehr@yazd.ac.ir, Tel: 09113115819
3. Associate Professor of Sociology, Faculty of Social Sciences, Yazd University, Iran.
Abstract
Introduction: In societies, incorrect beliefs about cancer cause stigma and weaken the health care and patients' treatment. The purpose of this studu is to investigate the impact of cancer habitus on cancer social stigma among family caregivers of cancer patients.
Methods: Survey method was usedand the statistical population included family caregivers of cancer patients in Tehran hospitals in 1401. Sample size included 384 people selected by convenience sampling method of multi-stage stratified type by referring to the hospitals under study. Data collection tool was the standard cancer stigma index questionnaire and the researcher-made cancer habitus questionnaire. Data were analyzed through correlation tests, mean difference, path analysis and structural equation modeling in SPSS and Amos.
Results: According to the results, there was a relationship between cancer stigma (with dimensions of others-avoidance, self-avoidance, and being released) and cancer habitus (with dimensions of enchantment and cure-avoidance); according to the path model, habitus explains 19/6% of the variation in stigma. Moreover, enchantment and cure-avoidance had the highest and lowest contribution to explaning stigma with an impact factor of 0/29 and 0/25. The results of structural equation model test also indicated appropriate fit of the presented conceptual model (GFI=0/973, RMSEA=0/067, CFI=0/958).
Conclusion: Caregivers of cancer patients, as the main supporters of the patient, are always influenced by incorrect cultural stereotypes of society. Identifying different dimensions of habitus (especially the aspect of enchanment), paying more attention to the aspect of being released of stigma, paying attention to the role of education and awareness in reducing false beliefs and more interaction with patients have a significant role in reducing the stigma of cancer and makes it easier for patients to bear the pain and suffering of cancer
Keywords: Cancer, Stigma, Habitus, Family Caregivers
References
1-Park YM, Kim HY, Kim JY, et al. Relationship between type D personality, symptoms, cancer stigma, and quality of life among patients with lung cancer. European Journal of Oncology Nursing 2022.
2-Larkin D, Birtle AJ, Bradley L, Dey P, Martin CR, Pilkington M & Romero-Rivas C. A systematic review of disease related stigmatization in patients living with prostate cancer 2022; Plos one, 17(2), e0261557.
3-IARC World Cancer Report (2020). Available from: https://www.iccp portal.org/system/files/resources/IARC%20World%20Cancer%20Report%202020.pdf
4-Amirkhah R, Naderi-meshkini H, Mirahmadi M, Allahyari & Sharifi H. Cancer Statistics in Iran: Towards Finding Priority for Prevention and Treatment. cancer press 2017; 3(2): 27-38. [in Persian].
5-Globocan. international agency research on cancer 2020. Available from: https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf
6-LeSeure P, Chongkham‑ang S. The experience of caregivers living with cancer patients: A systematic review and meta‑synthesis. J Pers Med 2015; 19(2): 406‑39.
7-Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol 2004; 2:145‑55.
8-Nyblade L, Stockton MA, Giger K, Bond V, Ekstrand ML, Lean RM, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Med 2019; 17:1-15.
9-Harding R, Nair S, Ekstrand M. Multilevel model of stigma and barriers to cancer palliative care in India: A qualitative study. BMJ Open 2019;9(3):e024248.
10-Best AL, Shukla R, Adamu AM, Martinez Tyson D, Stein KD & Alcaraz KI. Impact of caregivers’ negative response to cancer on long‑term survivors’ quality of life. Support Care Cancer 2021; 29:679‑86.
11-Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, New Jersey, Prentice-Hall Inc 1963.
12-Dovidio JF, Major BA, Crocker J. Stigma: introduction and overview. In The Social Psychology of Stigma. Edited by Heatherton TF, Kleck RE, Hebl MR, Hull JG. New York: Guilford Press. 2000; 1–28.
13-Scambler G. Health-related stigma. Sociol Health Illn 2009; 31:441–455.
14-Weiss MG, Ramakrishna J, Somma D. Health-related stigma: rethinking concepts and interventions. Psychol Health Med. 2006; 11:277–287.
15-Nyblade L, Stockton M, Nyato D, Wamoyi J. Perceived, anticipated and experienced stigma: exploring manifestations and implications for young people’s sexual and reproductive health and access to care in North- Western Tanzania. National Library of Medicine. 2017; 19(10): 1–16.
16-Bourdieu P. The Logic of Practice. Stanford CA, Stanford University Press; 1990.
17-Wagstaff A. Stigma: breaking the vicious circle; patient voice, Cancer World. 2013; 24-29.
18-Maria O E, Anita Ch, Brian S, Rebekkah S, Claire N & Ruth R. Developing a Global Cancer Stigma Index. SAGE JOURNALS. 2014;4(3):2158244014547875.
19-Broom A, Doron A. The rise of cancer in urban India: cultural understandings, structural inequalities and the emergence of the clinic. Health. 2012; 16(3):250–66.
20-Webb LA, McDonnell KK, Adams SA, et al. Exploring stigma among lung cancer survivors: A scoping literature review. Oncol Nurs Forum. 2019; 46:402-418.
21-Hasan Shiri F, Mohtashami J, Nasiri M, Manoochehri H, & Rohani C. Stigma and Related Factors in Iranian People with Cancer. Asian Pacific journal of cancer prevention: APJCP. 2018; 19(8):2285-2290.
22-Oystacher T, Blasco D, He E, Huang D, Schear R, McGoldrick D, et al. Understanding stigma as a barrier to accessing cancer treatment in South Africa: Implications for public health campaigns. Pan Afr Med J. 2018; 29:73.
23-Elangovan V, Rajaraman S, Basumalik B & Pandian D. Awareness and perception about cancer among the public in Chennai, India. J Glob Oncol. 2016; 3:469‑79.
24-Mosadeghrad AM. Factors influencing healthcare service quality. Int J Health Policy Manag. 2014; 3:77‑89.
25-Tripathi L, Datta SS, Agrawal SK, Chatterjee S & Ahmed R. Stigma perceived by women following surgery for breast cancer. Indian J Med Paediatr Oncol. 2017; 38(2):146–52.
26-Abd-Razak SF, Abdul-Manaf NB & Nawang DB. An Analysis of Cancer Awareness and Stigma Among Malaysia's Non-Patient Population 2023.
27-Yusof, MM & Wan-Ishak, WZ. Cancer in My Community: Addressing Increasing Cancer Cases in Malaysia. 2022.
28-Bakhshalizadeh F, shahidi SH, Hazini A. Attitude towards death and life meaning in dying cancer patients: a phenomenological study. Quarterly Journal of Health Psychology. 2021;10(37):65-82
29-Ohlsson-Nevo E, Ahlgren J & Karlsson J. Impact of health-related stigma on psychosocial functioning in cancer patients: Construct validity of the stigma-related social problems scale. European Journal of Cancer Care (Engl) 2020; 29(6), e13312.
30-Sabgul AA, Qattan AMN, Hashmi R, et al. Husbands’ knowledge of breast cancer and their wives’ attitudes and practices related to breast cancer screening in Saudi Arabia: Crosssectional Online Survey. Journal of Medical Internet Research 2021; 23(2): e25404.
31-Squiers L, Siddiqui M, Kataria I, Dhillon PK, Aggarwal A, Bann C, et al. Perceived, Experienced, and Internalized Cancer Stigma: Perspectives of Cancer Patients and Caregivers in India. Research Triangle Park (NC): RTI Press. 2021.
32-Gershfeld-Litvin a, halabi s & bellizzi k. Stigma related to breast cancer among women and men: The case of the Druze minority in Israel. J Health Psychol 2023; 28(2):189-199.
33-Bedi M, Devins GM. Cultural considerations for south Asian women with breast cancer. Journal of Cancer Survivorshi. 2016; 10:31–50.
34-Pak LM, Purad CC, Nadipally S, Rao MP, Mukherjee S, Hegde SKB, et al. Cancer awareness and stigma in Rural Assam India: Baseline survey of the detect early and save her/him (DESH) program. Ann Surg Oncol. 2021; 28:7006‑13.
35-Yılmaz M, Dissiz G, Usluoğlu AK, Iriz S, Demir F, Alacacioglu A. Cancer-Related Stigma and Depression in Cancer Patients in A Middle-Income Country. Asia Pac J Oncol Nurs. 2019 Oct 23;7(1):95-102. doi: 10.4103/apjon.apjon_45_19. PMID: 31879690; PMCID: PMC6927157.
36-Mohabbat-bahar S, Bigdeli I, Mashhadi A,and Moradi-Joo M; Investigation of Stigma Phenomenon in Cancer: A Grounded Theory Study. International Journal of Cancer Management. 2017; 10(2): 1-7. [Persian]
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Received: 2023/09/3 | Accepted: 2023/12/3 | Published: 2024/03/16
Received: 2023/09/3 | Accepted: 2023/12/3 | Published: 2024/03/16
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