Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

Abstract

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n = 107) or head and neck cancers (n = 99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs.

Methods: Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses.

Results: More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption.

Conclusions: Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.

Keywords:

• cancer
• health behaviour
• positive health changes
• self-blame
• stigma

Acknowledgements

This research was supported in part by the Canadian Institutes of Health Research through a Postdoctoral Fellowship to Sophie Lebel, a Senior Investigator Award to Gerald M. Devins, and a grant from the Psychosocial Oncology and Palliative Care Program (Princess Margaret Hospital) to Sophie Lebel. It was supported, in part, by Princess Margaret Hospital and by the Ontario Ministry of Health. We appreciate the efforts of our research assistants on this project: Michelle Majcen, Jackie Wan, Colleen Simpson, Vivian Tsung, and Ka Ming Fong.

Notes

1. We also examined cancer diagnosis as a qualifying variable – that is, examine diagnosis as a factor that might interact with stigma and/or self-blame in relation to PHCs and the specific PHC of smoking reduction or cessation. None of these interactions were statistically significant suggesting that the roles played by stigma and self-blame in relation to PHCs are not affected by cancer diagnosis in the present sample.