Psycho-oncology · 2026
Otolaryngologic Symptom Burden, Emotional Distress, and Stigma in Nasopharyngeal Carcinoma Survivors: A Prospective Cohort Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Shih Yi-Lun, Lin Chung-Ying, Chen Wei-Chih, Luo Sheng-Dean, Wang Yu-Ming, Li Shau-Hsuan, Hwang Chung-Feng, Hsieh Han-Chin, Wu Ching-Nung
Аннотация
OBJECTIVE: To examine whether otolaryngology-specific symptom burden is associated with perceived and self-stigma among nasopharyngeal carcinoma (NPC) survivors, and the mediating role of emotional well-being.
STUDY DESIGN: Prospective observational cohort with repeated assessments.
SETTING: Kaohsiung Chang Gung Memorial Hospital, Taiwan.
METHODS: From April 2021 to October 2024, 340 NPC survivors (560 assessments) completed stigma questionnaires (assessing perceived stigma [PS] and self-stigma [SS]) and condition-specific symptom instruments (SNOT-22, ETDQ-7, EAT-10). Gaussian kernel smoothing illustrated symptom trajectories over time. Linear mixed-effects models identified factors independently associated with stigma, while mediation analysis quantified indirect effects via the SNOT-22 emotional domain.
RESULTS: Participants had a median age of 53 years (IQR 44.0-61.5) and a median follow-up of 36 months (IQR 14.0-82.0). PS > 0 occurred in 8.0% of assessments, whereas high SS (> 2.5) was present in 9.5%. High-stigma groups exhibited significantly worse symptom trajectories. In adjusted models, only the SNOT-22 emotional domain was independently associated with PS (β = 0.036; 95% CI 0.004-0.068; p = 0.026) and SS (β = 0.075; 95% CI 0.053-0.097; p < 0.001), with large between-group effect sizes (d = 0.97 and 1.41, respectively). Mediation analyses indicated full mediation of most symptom-PS associations and partial mediation of symptom-SS associations by the emotional domain.
CONCLUSION: Emotional well-being may be an important correlate of both perceived and self-stigma in NPC survivorship. Whether addressing emotional well-being can reduce stigma warrants evaluation in future studies.
STUDY DESIGN: Prospective observational cohort with repeated assessments.
SETTING: Kaohsiung Chang Gung Memorial Hospital, Taiwan.
METHODS: From April 2021 to October 2024, 340 NPC survivors (560 assessments) completed stigma questionnaires (assessing perceived stigma [PS] and self-stigma [SS]) and condition-specific symptom instruments (SNOT-22, ETDQ-7, EAT-10). Gaussian kernel smoothing illustrated symptom trajectories over time. Linear mixed-effects models identified factors independently associated with stigma, while mediation analysis quantified indirect effects via the SNOT-22 emotional domain.
RESULTS: Participants had a median age of 53 years (IQR 44.0-61.5) and a median follow-up of 36 months (IQR 14.0-82.0). PS > 0 occurred in 8.0% of assessments, whereas high SS (> 2.5) was present in 9.5%. High-stigma groups exhibited significantly worse symptom trajectories. In adjusted models, only the SNOT-22 emotional domain was independently associated with PS (β = 0.036; 95% CI 0.004-0.068; p = 0.026) and SS (β = 0.075; 95% CI 0.053-0.097; p < 0.001), with large between-group effect sizes (d = 0.97 and 1.41, respectively). Mediation analyses indicated full mediation of most symptom-PS associations and partial mediation of symptom-SS associations by the emotional domain.
CONCLUSION: Emotional well-being may be an important correlate of both perceived and self-stigma in NPC survivorship. Whether addressing emotional well-being can reduce stigma warrants evaluation in future studies.