Stigma towards functional disability and anxiety among patients with cancer: The moderating role of physicians’ behaviors

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-01-06 DOI:10.1016/j.pec.2025.108643

Anat Katalan , Efrat Dagan , Anat Drach-Zahavy

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引用次数: 0

Abstract

Objective

To explore the moderating role of physicians' behaviors in medical encounters with cancer patients in the association between physicians’ public stigma towards functional disability and post-meeting patient anxiety.

Methods

A three time-point prospective nested study was conducted between November 2019 and July 2022 in two medical centres. Before the medical encounters, 32 physicians completed the Disability Attitudes in Health Care Scale, and 150 adult cancer patients completed the State-Trait Anxiety Inventory (STAI), pre and post medical encounters. During the medical encounters, structured ‘real-time’ observations of the physicians’ behaviors were recorded using the Four Habits Coding Scheme.

Results

The mixed linear analysis model revealed that the two-way interaction between stigma towards functional disability and physicians’ communication behaviors was significantly associated with post-meeting anxiety (b=.161, p < .05). When physicians’ behaviors were more negative, the association between physicians’ stigma and patients’ post-meeting anxiety was stronger. Additionally, pre-meeting anxiety was positively associated with post-meeting anxiety (b=.578, p < .01).

Conclusions

The findings highlight the positive effect of stigma and the importance of physicians' communication behaviors in alleviating patients’ anxiety associated stigma towards functional disability.

Practice implications

Healthcare training programs should address stigma and develop protocols encouraging healthcare professionals to request patients' to share their specific needs.

查看原文本刊更多论文

癌症患者对功能障碍的耻感与焦虑：医生行为的调节作用。

目的：探讨医生在会诊癌症患者时的行为在医生对功能障碍的公开污名与会诊后患者焦虑之间的调节作用。方法：2019年11月至2022年7月在两家医疗中心进行三时间点前瞻性巢式研究。在就诊前，32名医生完成了《医疗保健残疾态度量表》，150名成年癌症患者完成了“状态-特质焦虑量表”（STAI）。在就医过程中，对医生行为的结构化“实时”观察使用四种习惯编码方案进行记录。结果：混合线性分析模型显示，功能障碍耻感与医生沟通行为的双向交互作用与会后焦虑显著相关(b=。结论：研究结果强调了耻辱感的积极作用，以及医生沟通行为在缓解患者对功能障碍的耻辱感焦虑中的重要性。实践启示：医疗保健培训项目应解决耻辱感问题，并制定方案，鼓励医疗保健专业人员要求患者分享他们的具体需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.