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Jang and Park: Subjective Health Status, Mental Health, and Cancer Stigma in Long-term Cancer Survivors after Gastric Surgery
Original Article

Asian Oncol Nurs 2018;18(2):86-93.

Published online: 5 June 2018

DOI: https://doi.org/10.5388/aon.2018.18.2.86

Subjective Health Status, Mental Health, and Cancer Stigma in Long-term Cancer Survivors after Gastric Surgery

Bo Yun Jang1, Jeong Yun Park2

1Department of Nursing, Asan Medical Center, Seoul, Korea

2Department of Clinical Nursing, University of Ulsan, Seoul, Korea

∗ This article is an addition based on the first author's master's thesis from University of Ulsan.

Address reprint requests to: Park, Jeong Yun Department of Clinical Nursing, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5333 Fax: +82-2-3010-5332 E-mail: pjyun@ulsan.ac.kr

Received 1 Jun 201820 Jun 2018       Accepted 25 Jun 2018

Copyright © 2018 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

The aim of this study was to explore the relationship among subjective health status, mental health, and cancer stigma of long-term cancer survivors after gastric surgery.

Methods

In this cross-sectional study, 135 cancer survivors visiting the family medicine clinic of a tertiary hospital were surveyed. Data were collected from March 1 to May 31, 2017. Using the questionnaire, subjective health status, mental health, and cancer stigma were measured and analyzed.

Results

The mean scores for subjective health status, stress, and cancer stigma were 80.16, 2.97 and 1.59 respectively. Anxiety and depression rates were 37.1% and 28.9% respectively. Cancer stigma was negatively correlated with subjective health status (r=-.18, p=.036) and positive association with anxiety (r=.23, p=.009), depression (r=.20, p=.023), and stress (r=.21, p=.017).

Conclusion

In this study, long-term cancer survivors’ subjective health status, mental health, and cancer stigma were low and these variables were significantly associated. In order to improve the quality of life of long-term gastric cancer survivors, it is necessary to actively evaluate anxiety, depression, stress, and cancer stigma. The appropriate psychosocial care interventions developed through repeated research of survivors of long-term cancer should be continued.

Keywords: Health status, Mental Health, Neoplasms, Stigma, Survivors

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Table 1.
General Characteristics of the Subjects (N =135)
Characteristic Categories n (%) or M ± SD
Gender Male 84 (62.2)
  Female 51 (37.8)
Age (year) ＜50 15 (11.1)
  50~59 42 (31.1)
  60~69 64 (47.4)
  ≥ 70 14 (10.4)
    59.9 ± 8.07
Marital status Married 118 (87.4)
  Unmarried† 17 (12.6)
Education ＜ High school 33 (24.4)
  ≥ High school 102 (75.6)
Current employment status Yes 114 (84.4)
  No 21 (15.6)
Current monthly family income (10,000 won) ＜150 30 (22.2)
  150~299 48 (35.6)
  ≥ 300 57 (42.2)
Cancer classification EGC 112 (83.0)
  AGC 22 (16.3)
  No record 1 (0.7)
Comorbidity Yes 93 (68.9)
  No 42 (31.1)
Time from diagnosis (year) 5~9 108 (80.0)
  10~14 20 (14.8)
  ≥ 15 7 (5.2)
    7.75 ± 3.37

EGC= early gastric cancer; AGC= advanced gastric cancer

† Divorced/wid-owed/separated.

Table 2.
Subjects’ Subjective Health Status and Mental Health (N =135)
Characteristics Categories n (%) M ± SD
Subjective health status (0~100)     80.16 ± 17.50
Mental health      
 Anxiety (0~21) Normal (0~7) 85 (63.0) 6.29 ± 4.95
  Borderline abnormal (8~10) 26 (19.3)  
  Abnormal (11~21) 24 (17.8)  
 Depression (0~21) Normal (0~7) 96 (71.1) 5.81 ± 4.57
  Borderline abnormal (8~10) 17 (12.6)  
  Abnormal (11~21) 22 (16.3)  
Stress (0~10)     2.97 ± 2.70
Table 3.
Subjects’ Cancer Stigma (N =135)
Items M ± SD Disagree Agree
n (%) n (%)
Cancer is difficult to treat in spite of highly advanced modern medicine 1.08 ± 0.27 124 (91.9) 11 (8.1)
I would not be as socially active as I used to be 1.06 ± 0.24 124 (94.1) 8 (5.9)
My job performance at work might decline even after successful cancer treatment 1.19 ± 0.39 110 (81.5) 25 (18.5)
It is hard for a cancer patient get back to a healthy state with any treatment 1.17 ± 0.38 112 (83.0) 23 (17.0)
Cancer patients can be easily identified by their appearance 1.09 ± 0.29 123 (91.1) 12 (8.9)
Cancer patients have difficulty leading a normal sex life 1.07 ± 0.26 125 (92.6) 10 (7.4)
Cancer patients are the socially weak 1.08 ± 0.28 124 (91.9) 11 (8.1)
Cancer patients cannot make a big contribution to society 1.04 ± 0.21 129 (95.6) 6 (4.4)
My friends tend to stay away from me because I'm a cancer patient 1.03 ± 0.17 131 (97.0) 4 (3.0)
Some Neighbors seem to avoid interacting with me because I am a cancer patient 1.01 ± 0.12 133 (98.5) 2 (1.5)
Cancer causes problems with my family and marriage life 1.01 ± 0.09 134 (99.3) 1 (0.7)
I have been treated unfairly by my colleague or boss because I am a cancer patient 1.04 ± 0.04 123 (95.6) 5 (3.7)
Total 1.59 ± 0.52 92.3 7.7
Table 4.
Subjective Health Status, Mental Health and Cancer Stigma according to General Characteristics (N=135)
Variables Categories Subjective health status
 Anxiety
 Depression
 Stress
 Cancer stigma
M ± SD M ± SD M ± SD M ± SD M ± SD
Gender Male
Female
t (p)		 79.56 ± 17.56
81.16 ± 17.47
0.001 (0.61)		 1.44 ± 0.70
1.73 ± 0.87
10.13 (0.05)		 1.42 ± 0.71
1.53 ± 0.83
3.87 (0.36)		 2.80 ± 2.41
3.25 ± 3.10
4.23 (0.37)		 19.73 ± 6.70
17.78 ± 5.44
1.84 (0.07)
Age (year) <50
50~60
60~70
>70
F (p)		 77.00 ± 15.33
77.62 ± 17.95
81.52 ± 18.17
85.00 ± 17.47
0.95 (0.42)		 1.87 ± 0.99
1.52 ± 0.74
1.55 ± 0.80
1.29 ± 0.47
1.39 (0.25)		 1.80 ± 0.94
1.33 ± 0.69
1.52 ± 0.78
1.14 ± 0.36
2.38 (0.07)		 3.60 ± 2.72
3.30 ± 2.80
2.75 ± 2.63
2.36 ± 2.65
0.85 (0.47)		 19.27 ± 8.32
19.45 ± 5.75
18.09 ± 6.06
21.43 ± 6.48
1.22 (0.31)
Marital status Married
Unmarried
t (p)		 79.64 ± 18.09
83.82 ± 12.19
2.24 (0.36)		 1.53 ± 0.77
1.65 ± 0.86
0.66 (0.71)		 1.40 ± 0.73
1.82 ± 0.88
2.73 (0.03)		 2.91 ± 2.71
3.41 ± 2.60
0.01 (0.47)		 19.13 ± 6.32
18.06 ± 6.26
0.65 (0.52)
Education <High school
≥High school
t (p)		 79.52 ± 17.71
80.37 ± 17.48
0.30 (0.81)		 1.67 ± 0.85
1.51 ± 0.75
2.28 (0.32)		 1.42 ± 0.79
1.46 ± 0.75
0.00 (0.81)		 2.79 ± 2.78
3.03 ± 2.68
0.29 (0.66)		 19.03 ± 6.20
19.00 ± 6.36
0.04 (0.97)
Current employment status Yes
No
t (p)		 80.50 ± 16.98
78.33 ± 20.33
2.50 (0.60)		 1.49 ± 076
1.86 ± 0.85
0.80 (0.48)		 1.46 ± 0.77
1.43 ± 0.75
0.14 (0.88)		 2.75 ± 2.59
4.14 ± 2.99
0.77 (0.29)		 18.75 ± 6.23
20.33 ± 6.66
-1.06 (0.29)
Current monthly family income (10,000 won) <150
150~299
≥300
F (p)		 78.76 ± 18.73
81.93 ± 17.25
78.60 ± 15.65
0.57 (0.57)		 1.57 ± 0.82
1.57 ± 0.76
1.44 ± 0.77
0.29 (0.75)		 1.45 ± 0.77
1.43 ± 0.76
1.52 ± 0.77
0.13 (0.88)		 3.04 ± 3.03
3.08 ± 2.23
2.56 ± 2.42
0.37 (0.70)		 19.02 ± 6.15
19.05 ± 5.97
18.80 ± 7.59
0.01 (0.99)
Cancer classification EGC
AGC
t (p)		 79.48 ± 18.20
82.73 ± 13.07
2.39 (0.43)		 1.52 ± 0.76
1.73 ± 0.88
2.35 (0.25)		 1.44 ± 0.76
1.55 ± 0.80
0.42 (0.55)		 2.91 ± 2.68
3.36 ± 2.80
0.07 (0.47)		 18.82 ± 6.44
20.05 ± 5.70
-0.83 (0.41)
Comorbidity Yes
No
t (p)		 79.81 ± 18.09
80.95 ± 16.20
0.13 (0.73)		 1.56 ± 0.79
1.52 ± 0.77
0.13 (0.81)		 1.42 ± 0.73
1.52 ± 0.83
2.58 (0.46)		 3.06 ± 2.70
2.76 ± 2.72
0.07 (0.55)		 18.80 ± 6.13
19.43 ± 6.74
-0.54 (0.60)
Time from diagnosis (year) 5~9
10~14
≥15
F (p)		 78.92 ± 17.83
82.50 ± 16.42
92.71 ± 8.06
2.30 (0.10)		 1.64 ± 0.81
1.25 ± 0.55
1.00 ± 0.00
4.10 (0.01)		 1.46 ± 0.80
1.40 ± 0.60
1.43 ± 0.79
0.06 (0.94)		 3.20 ± 2.76
2.50 ± 2.26
0.71 ± 1.50
3.27 (0.04)		 18.44 ± 6.01
21.80 ± 7.64
19.43 ± 5.03
2.46 (0.09)

EGC= Early gastric cancer; AGC= Advanced gastric cancer

Table 5.
Relationship of Subjective Health Status, Mental Health and Cancer Stigma (N =135)
Variables Subjective health status
 Anxiety
 Mental Health Depression
 Stress
 Cancer stigma
r (p) r (p) r (p) r (p) r (p)
Subjective health status 1        
Anxiety −.41 (＜.001) 1      
Depression −.31 (＜.001) .37 (＜.001) 1    
Stress −.37 (＜.001) .77 (＜.001) .19 (.032) 1  
Cancer stigma −.18 (.036) .23 (.009) .20 (.023) .21 (.017) 1
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