Nurses’ blame attributions towards different types of cancer: A cross-sectional study

doi:10.1016/j.ijnurstu.2015.06.005

International Journal of Nursing Studies

Volume 52, Issue 10, October 2015, Pages 1600-1606

https://doi.org/10.1016/j.ijnurstu.2015.06.005 Get rights and content

Abstract

Background

Public health education increasingly emphasizes the link of personal lifestyle with cancer risk, which may result in unintended negative social effects such as triggering stigma and/or blame towards cancer patients when their illness is perceived to be caused by personal behaviours or disapproved lifestyles.

Objectives

To explore nurses’ blame attributions towards patients with different types of cancer and to identify associated factors.

Design

Cross-sectional survey.

Setting

A tertiary cancer-specialized hospital in Beijing.

Participants

317 Chinese oncology nurses working in the cancer hospital.

Methods

Participant nurses completed a self-administrated anonymous questionnaire and rated how much they would blame someone with a diagnosis of breast cancer, cervical cancer, colon cancer, liver cancer, lung cancer, as well as leukaemia and obesity.

Results

More than half of the oncology nurses (57.1%) attributed at least some blame to patients with leukaemia, following with breast cancer (67.5%), cervical cancer (79.2%), liver cancer (79.2%), and colon cancer (78.5%). Lung cancer patients attracted at least some blame by 82.0% of participating nurses. Attributions of blame for patients with lung, cervical, colon and liver cancer were most common among nurses with shorter working experience.

Conclusions

This study demonstrated that a high proportion of Chinese nurses attributed at least some blame to patients with different cancers despite being working in a cancer-specialized hospital. Future education and support for nurses are essential to avoid negative attitudes and blame attributions to cancer patients in order to enhance the quality of care.

Section snippets

Background

It is estimated that 65% of all cancers are attributable to modifiable lifestyle factors (American Cancer Society, 2013). Recent decades, public health education increasingly emphasizes the link of personal lifestyle factors with cancer risk, which may result in unintended negative social effects such as triggering stigma and/or blame towards cancer patients when their illness is perceived to be caused by personal behaviours or (particularly disapproved) lifestyles (Chapple et al., 2004, Lebel

Study setting and sample

This study was performed in a territory cancer hospital located in Beijing, which is a renowned cancer centre in China devoted exclusively to cancer care, cancer education, cancer research, and cancer prevention. Total 320 nurses from different departments of the cancer hospital voluntarily completed a structured self-administered questionnaire in September 2014. Three respondents who completed only half of the questionnaire were excluded from the analysis. The effective response rate was 99.1%

Participants characteristics

Table 1 presents the characteristics of participants. The vast majority of participants were females (99.1%) and had associate degree or higher educational attainment (97.5%). More than half of all participants were married (51.3%) and aged less than 30 years (56.9%). Moreover, 23.3% of the participants had family history of cancer. Five (1.6%) participants reported that they have ever been diagnosed with tumour including breast fibroma (1), thyroid tumour (3), and trichoblastoma (1). The

Discussion

To the best of our knowledge, the present study is the first study exploring blame attributions across different cancer types in Chinese population with data collected from a sample of clinical nurses working in a territory cancer hospital. Compared to Marlow et al.’s findings (Marlow et al., 2010), the general pattern of blame attribution variation among selected cancers is similar in that lung cancer patients attracted the highest blame (support our Hypothesis 1) and leukaemia patients was

Acknowledgements

We would like to thank the staffs of the cancer hospital for their participation in this study.
Conflict of interest: The authors declare that there are no conflicts of interest.
Funding: This study did not receive grant support.
Ethical approval: Ethical approval was obtained from the hospital where data collected.

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¹: These authors contribute equally to this study.

View full text

Nurses’ blame attributions towards different types of cancer: A cross-sectional study

Abstract

Background

Objectives

Design

Setting

Participants

Methods

Results

Conclusions

Section snippets

Background

Study setting and sample

Participants characteristics

Discussion

Acknowledgements

Ann. Oncol.

Eur. J. Oncol. Nurs.

Facts and Figures 2013

Stigma, shame, and blame experienced by patients with lung cancer: qualitative study

BMJ

Cancer attributions, distress, and health practices among gynecologic cancer survivors

Psychosom. Med.

Illness beliefs about cancer among healthy adults who have and have not lived with cancer patients

Int. J. Behav. Med.

Perceived stigma, self-blame, and adjustment among lung, breast and prostate cancer patients

Psychol. Health

The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer

J. Health Soc. Behav.

The 10 most common cancers in national cancer registration areas

Public awareness of risk factors for cancer among the Japanese general population: a population-based survey

BMC Public Health

Attribution theory and research

Annu. Rev. Psychol.

Age-specific correlates of quality of life in Chinese women with cervical cancer

Support. Care Cancer