Introduction: Internalized lung cancer stigma (i.e., feelings of regret, shame, and self‐blame about one’s lung cancer) is related to poorer psychological outcomes. Less is known about how internalized stigma relates to physical and functional outcomes or how constrained disclosure (i.e., avoidance of or discomfort about disclosing one’s lung cancer status to others) relates to well‐being. Furthermore, no study has examined whether internalized stigma and constrained disclosure predict changes in well‐being for lung cancer patients. This longitudinal study characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional outcomes. Methods: Participants (N = 101, 52.4% male, 63.4% currently/formerly smoked) were lung cancer patients on active medical treatment who completed questionnaires on stigma and well‐being at study entry and at 6‐ and 12‐week follow‐up. Multivariable linear regressions characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional well‐being at study entry and across time. Results: Participants who currently or formerly smoked reported higher levels of internalized stigma (but not constrained disclosure), compared to never smokers (p < 0.001). Higher internalized stigma and constrained disclosure were uniquely associated with poorer emotional and physical/functional well‐being at study entry (all p < 0.05), beyond sociodemographic characteristics, time elapsed since diagnosis, and smoking status. Higher internalized stigma predicted significant declines in emotional well‐being across 6 and 12 weeks (all p < 0.01) and declines in physical/functional well‐being across 6 weeks (p < 0.05). Conclusions: Internalized lung cancer stigma and constrained disclosure relate to emotional and physical/functional maladjustment. Findings carry implications for provider‐ and patient‐focused interventions to reduce internalized stigma and promote well‐being.

中文翻译：

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对接受积极肿瘤治疗的肺癌患者 12 周内的内在耻辱、受限披露和生活质量进行纵向调查

简介：内化的肺癌耻辱感（即对肺癌的遗憾、羞耻和自责感）与较差的心理结果有关。人们对内在耻辱如何与身体和功能结果相关，或如何限制披露（即避免向他人披露自己的肺癌状况或感到不适）与幸福感的关系知之甚少。此外，还没有研究检验内在的耻辱和受限的披露是否可以预测肺癌患者的福祉变化。这项纵向研究描述了内在耻辱和限制性披露与情感和身体/功能结果之间的关系。方法：参与者（N = 101，52.4% 男性，63.4% 目前/曾经吸烟）是正在积极接受治疗的肺癌患者，他们在研究开始时以及 6 周和 12 周随访时完成了有关耻辱感和幸福感的问卷调查。多变量线性回归描述了内在耻辱和受限披露与研究开始时和整个时间段的情绪和身体/功能健康之间的关系。结果：与从不吸烟者相比，目前或曾经吸烟的参与者报告了更高水平的内在耻辱（但不限制披露）（p < 0.001）。除了社会人口学特征、诊断后经过的时间和吸烟状况之外，较高的内在耻辱感和有限的披露与研究开始时较差的情绪和身体/功能健康存在独特的相关性（所有p <0.05）。较高的内化耻辱预示着 6 周和 12 周内情绪健康状况显着下降（均 p < 0.01），并且 6 周内身体/功能健康状况显着下降（p < 0.05）。结论：内化的肺癌耻辱感和有限的披露与情绪和身体/功能失调有关。研究结果对以提供者和患者为中心的干预措施具有重要意义，以减少内在的耻辱并促进福祉。