Comparison of Illness Behavior and Stigma Among Depressive and Non-Depressive Patients With Head and Neck Cancer

Yu Lee ； Wei-Ting Tseng ； Chi-Fa Hung ； Pao-Yen Lin ； Chih-Yen Chien ； Hui-Ching Chuang ； Fu-Min Fang ； Shau-Hsuan Li ； Tai-Lin Huang ； Mian-Yoon Chong ； Liang-Jen Wang

《International Journal of Head and Neck Science》 5卷2期 (2021/06) Pp. 76-85

https://doi.org/10.6696/IJHNS.202106_5(2).0005

摘要

Background: Cancer is a highly stigmatized illness that affects the patient's help-seeking intentions. Although depression is prevalent in head and neck (HNC) patients, very few studies have compared the illness behavior and stigma of depressives and non-depressives among HNC patients. Therefore, this study aimed to compare the illness behavior (patterns of distress, perceived cause, and help-seeking) and stigma among these two groups of HNC patients. Methods: This study used a cross-sectional design with consecutive sampling. Study subjects were recruited from the HNC outpatient clinic and inpatient ward in a medical center from March 2018 to February 2019. Patients with HNC were collected and assessed using the Mini International Neuropsychiatric Interview, Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Explanatory Model Interview Catalogue, and the Chinese version of the Shame and Stigma Scale. Results: In all, 159 subjects (mean age: 56.8 years, 95% males) successfully completed the study. Physical symptoms were the most troubling patterns of distress (62.3%). The most frequently perceived cause of HNC patients was physical cause (78.6%). The most effective help-seeking behavior was professionals (90.6%), followed by ＂not yet met＂ (8.8%). Depressed HNC patients experienced fatigue, physical pain, sleep disturbance, depressed mood, interpersonal problems, and feelings of shame more frequently than non-depressed HNC patients. Conclusions: The above results reveal that most of the HNC patients had somatic, rather than psychological concerns. Depressive HNC patients had more psychologization and stigma than non-depressive HNC patients. Early detection and management of depressed HNC patients' stigma and psychological problems are very crucial to improving their quality of life.

關鍵字

illness behavior ； stigma ； depression ； head and neck cancer