Quantitative And Qualitative Study On Stigma Status And Influencing Factors Among Postoperative Oral Cancer Patients

Objective1.To understand the current situation and related influencing factors of stigma among postoperative oral cancer patients,and to analyze the correlation between stigma and psychological resilience,social support,coping style,self-efficacy,anxiety and depression.2.To explore the experience,sources and coping strategies of long-term survivor of postoperative oral cancer patients’ stigma.Methods1.Cluster sampling was used to select 274 patients with oral cancer after surgery in the department of Stomatology of a Grade A hospital in Changsha,Hunan Province from September 2020 to June 2021 as the research object.General data questionnaire,Chinese version of social Impact Scale(SIS),Resilience Scale(CD-RISC),Social Support Rating Scale(SSRS),Medical Coping Style Questionnaire(MCMQ),General Self-efficacy Scale(GSES),generalized Anxiety Self-Rating Scale(GD-7)were used.Data were entered by two persons,and SPSS 20.0 was used for statistical analysis.2.Objective sampling was used to select 18 long-term survivors of postoperative oral cancer patients from March 2021 to October 2021 in the department of Stomatology of a Grade A hospital in Changsha,Hunan Province.Data were collected by semi-structured in-depth interview method and coded by Nvivo11.0 software.Colaizzi seven-step analysis method was used to analyze and integrate the data and refine the theme.Results1.The score of stigma in postoperative oral cancer patients was at a medium level,with a score of(50.17 ± 21.24),with social exclusion being(19.56 ± 8.48),intrinsic shame(8.42 ± 3.61)and social isolation(22.19 ± 9.42).The results of univariate analysis showed that there were statistically significant differences in stigma scores among postoperative oral cancer patients with different gender,education level,income,religious belief,smoking,drinking,betel nut chewing,cancer site,pathological type and clinical stage(P<0.05).Correlation analysis showed that the stigma score of postoperative oral cancer patients was significantly negatively correlated with psychological resilience,objective support,coping and self-efficacy(P<0.01),and significantly positively correlated with avoidance coping,submission coping,anxiety and depression(P<0.01).Multiple regression analysis showed that education level,smoking history,cancer site,clinical stage,resilience,coping,coping avoidance,self-efficacy and anxiety were the important influencing factors of stigma,which could explain 77.6% of the total variation.2.There were 3 themes and 15 sub-themes of stigma in postoperative oral cancer patients that were extracted in the qualitative study:(1)Sources of stigma: internal factors(self-image change,impaired physical function)and external factors(excessive attention,pressure to seek medical treatment,aggravated economic pressure,social stereotype);(2)Stigma experience: isolation and exclusion,anxiety and worry,self-blame and regret,shame and inferiority,doubt and powerlessness;(3)Coping strategies for stigma: self-psychological adjustment,seeking social support,and improving physical quality.ConclusionPostoperative oral cancer patients have a certain degree of stigma.The influencing factors of stigma in postoperative oral cancer patients included education level,smoking history,cancer site,clinical stage,coping with face,coping with avoidance,self-efficacy and anxiety.The stigma of long-term survivors after oral cancer surgery was caused by internal and external factors,which leaded to negative psychological experience of isolation,exclusion,self-blame and so on.Patients adopted strategies of self-psychological adjustment,seeking social support and improving physical quality to cope with stigma.Figure 3,Table 12,Reference 134.