Feelings of guilt among cancer patients and the usage of complementary or alternative medicine - A cross-sectional survey.

Objectives: This study aimed to investigate the influence of feelings of guilt among cancer patients on their health behavior, with a specific focus on the use of complementary and alternative medicine (CAM).

Methods: A multicentric cross-sectional study was conducted, involving 162 oncological patients, assessing sociodemographic variables, feelings of guilt, patient activation, self-efficacy, and CAM usage. The Shame-Guilt-Scale was employed to measure guilt, with subscales including punitive guilt, self-criticism (actions), moral perfectionism, and empathy-reparation. To assess patient activation and self-efficacy, we used the German Version of the Patient Activation Measure 13 and the Short Scale for Measuring General Safe-efficacy Beliefs, respectively. To evaluate CAM-usage, we used a standardized instrument from the working group Prevention and Integrative Oncology of the German Cancer Society. Statistical analyses, including regression models, were employed to examine potential associations.

Results: Female gender was associated with more frequent CAM usage. Regarding holistic and mind-body-methods, younger patients more often used these methods. No significant association was found between feelings of guilt and CAM usage. Patients experienced guilt most strongly related to empathy and reparation for their own actions.

Significance of results: Our results do not support the hypothesis of a direct link between guilt and CAM usage. Guilt may be an important aspect in psychological support for cancer patients, yet, with respect to counselling on CAM, it does not play an important part to understand patients' motivations.