Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

The mediating role of psychological help-seeking stigma on depression, anxiety, and stress in people with cancer from culturally and linguistically diverse communities (#499)

Sidney Davies 1 , Carlene Wilson 1 2 3 , Victoria White 4 , Trish Livingston 5 6 , Eva Yuen 6 7
  1. School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
  2. Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
  3. Psycho-Oncology Research Unit, ONJ Centre, Austin Health, Heidelberg, VIC, Australia
  4. School of Psychology, Deakin University, Burwood, VIC, Australia
  5. Faculty of Health, Deakin University, Burwood, VIC, 3125
  6. School of Nursing and Midwifery, Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
  7. Monash Health, Clayton, VIC

Aims: People with cancer from culturally and linguistically diverse (CALD) communities experience greater psychological morbidity than their native-born counterparts(1), however, understanding specific factors that influence psychological outcomes is limited. People from CALD communities have reported greater stigma relating to psychological help-seeking compared to non-CALD populations(2), which may hinder their interest in seeking psychological support. We investigated whether people with cancer from CALD communities have poor psychological outcomes compared to their English-speaking counterparts, and whether psychological help-seeking stigma mediates this relationship.

Methods: People diagnosed with cancer in the preceding five years (Arabic [n=42], Chinese [n=48], Greek [n=29], English-speaking [n=50]) completed the Depression, Anxiety, and Stress Scale–21(3), and Stigma Scale for Receiving Psychological Help(4). The influence of CALD status on depression, anxiety and stress was examined using ANOVA. Mediation models (n=3) were conducted with CALD-status as the independent variable, psychological help-seeking stigma as the mediator variable, and depression, anxiety, and stress, as the outcome variables, controlling for demographic characteristics.

Results: Participants were diagnosed with hematological (20.1%), lung (19.5%), breast (16%), prostate (13.6%), colorectal (8.9%), melanoma (7.1%), or other (14.8%) cancer, with a mean age of 51.80 (13.3) years. CALD participants had significantly higher depression (Arabic: M=10.19[SD=3.39]; Chinese:11.83[4.5];Greek: 11.14[3.65]), anxiety (Arabic:10.83[3.81]; Chinese:12.54[12.87]; Greek:11.31[3.66]), stress (Arabic:11.12[3.42]; Chinese:13.46[3.27]; Greek:11.31[3.16]) and psychological help-seeking stigma (Arabic:8.1[2.85]; Chinese:8.08[3.42]; Greek:9.17[2.70]) scores than English-speaking participants (Depression:5.6[4.84], Anxiety:4.02[4.00], Stress:6.4[4.42]; Stigma:5.02[3.17]). Psychological help-seeking stigma partially mediated the association between CALD-status and depression, anxiety, and stress.  

Conclusions: People with cancer from CALD communities experience higher levels of psychological morbidity compared to their English-speaking counterparts. Among CALD groups, stigma related to psychological help-seeking partly explained their psychological morbidity. Strategies to reduce help-seeking stigma have the potential to foster increased psychological service use and to reduce psychological sequelae in people with cancer from CALD communities.