INTRODUCTION OF THE STUDY

Cancer is perhaps the most widely discussed disease on television and newspapers. People participate in support walks, and give donations to the best of their abilities. It has touched the life of virtually everyone, whether directly or through a loved one, colleague or a friend. So, it is surprising to find that in the infosaturated society, there are still many myths and misconceptions that abound in cancer. The society has its own stigma attached to cancer. Denial, fear and suppression happen once to a person who is detected with cancer. There is a need to create the right kind of awareness about cancer.¹

People believe that Cancer is dark and evil, mysterious and malevolent. It is always fatal. Somehow the person, however innocent, feels as if he did something wrong to deserve or create the cancer. Such myths convince patients that it is futile even to try to overcome the cancer. The will to live is drained of any vital juice.²

Some cultures believe cancer bring shame on their family or that it is contagious, others avoid speaking of the disease, altogether referring to it as ‘that terrible illness’ and some believe that cancer diagnosis is closely linked to concepts of ‘Karma’, retribution and fate. These beliefs mostly lead to delay in seeking medical treatment, thereby prolonging the interval between the first appearance of symptoms and the first visit to doctor.³

Negative myths regarding specific cancer treatments can hinder individuals from obtaining appropriate treatment. A recent survey of older people in United States found that 50% believed cancer treatments are worse than the disease. There are myths that surgery always causes metastasis, that exposing a tumor to air during surgery causes cancer to spread.⁴

Kishore J. et al (2008) undertook a study in New Delhi on beliefs and perceptions about cancer among patients that revealed myths and misconceptions were widely prevalent among cancer patients in India. They concluded that the perception regarding causation of cancer among cancer patients varied from curses, evil eye and spirits to past sins. The findings reported that 27.4% of the patients believed that cancer is infectious and more than half (57%) of these patients believed that since they had a close contact with a cancer patient, it might be the reason for their present illness. Amongst those who believed that cancer is contagious, 78.3% were illiterate, 65.2% were women and 82.6% were in semi-skilled/unskilled occupational class. 42.1% of the patients believed that cancer is not contagious.³

Due to lack of awareness Cancer in India in most of the cases are detected late. On the occasion of World Cancer Day, a cancer awareness campaign was organized on 4th February 2010, to keep the public informed about the reality, myths and misconceptions about cancer.

Nurses are in the prime position to assist the patients by providing accurate information and emotional support about cancer. Nurses must make efforts to ask patients about their beliefs about cancer and provide suggestions accordingly, as nurses spend more time with patients than does any other health professional. It is of utmost importance that the nurses should be aware of the beliefs and misconceptions of cancer patients to overcome barriers in providing care to the patients. She is often in the best position to acknowledge patient’s fears and to correct their misconceptions.

RESEARCH METHODOLOGY:

Research Approach and Design

A non experimental qualitative exploratory and descriptive research approach has been employed to conduct the present study.

Research Setting

This study has been conducted in Adesh Charitable Cancer Hospital, Muktsar and Mohan Dai Oswal Cancer Treatment and Research Foundation, Ludhiana.

Target Population

Target population included all the cancer patients available in the month of April, 2010 in selected cancer hospitals of Punjab.

Sample Size

The sample size of the study consisted of 100 cancer patients from selected cancer hospitals of Punjab.

Criteria for Sample Selection

1. Cancer patients who were available during the period of study in selected cancer hospitals of Punjab.

2. Cancer patients who were diagnosed with cancer by the qualified oncologists.

3. Cancer patients who were aware of their diagnosis of cancer.

4. Cancer patients who were willing to participate.

5. Cancer patients who could converse in Punjabi and English.

Sampling Technique

Convenient sampling technique was employed in the selection of sample.

RESEARCH TOOL/ INSTRUMENT

A semi-structured interview schedule was prepared to assess the perceptions, beliefs, and misconceptions about cancer among cancer patients in selected cancer hospitals of Punjab.

SCORING:

Each item of the interview schedule was scored. Each correct belief response by the study subjects was scored (0) and with misconception was scored (1). The total score ranged from 0 to123.

VALIDITY OF THE RESEARCH TOOL

Content validity of the tool was established by circulating the tool among the experts in the field of oncology, nursing, and clinical psychology to get their valuable suggestions and thereafter necessary modifications were made.

RELIABILITY OF THE RESEARCH TOOL

Reliability of the tool was established by test-retest method. Test-retest was conducted on five subjects. The correlation was determined by using Karl Pearson’s coefficient of correlation. On the whole reliability was found to be significant (r= 0.92) and satisfactory.

METHOD OF DATA COLLECTION

Steps:

· Written permission was obtained from the Head of the Departments for conducting the study.

· Data was collected from Monday to Saturday in the month of April, 2010 in radiotherapy department, general and private wards and OPDs of the selected cancer hospitals of Punjab.

· After explaining the purpose and method of study, informed written consent was obtained from each study subject for their willingness to participate in the study. The subjects were assured of maintaining anonymity of their identities and confidentiality of the data obtained from them.

· Study subjects were interviewed personally by the researcher using semi-structured interview schedule to assess the perceptions, beliefs, and misconceptions about cancer among cancer patients in selected cancer hospitals of Punjab.

· It took approximately 20 minutes to interview each study subject.

PILOT STUDY

Pilot study was conducted on 10% of the sample i.e 10 cancer patients during the first week of March to find out the feasibility and practicability of the tool and thereafter necessary modifications in the tool were made.

RESULTS

Table 1: Level of misconceptions about cancer among cancer patients N =100

Level of Misconceptions	Scores	f	%age
Low	Upto 41	98	98.00
Average	42-83	2	2.00
High	>83	0	0.00

Table 1 and figure 1 reveal the level of misconceptions about cancer among cancer patients and it was found that vast majority 98 (98%) of study subjects were having low level of misconceptions and only 2 (2%) subjects were having average number of misconceptions.

The following conclusions were drawn from the findings of the present study:

i. The highest mean (42.82%) score was obtained on the cancer patients’ reactions about the diagnosis and the lowest mean (0.29%) score was obtained at the time of seeking cancer treatment. The intergroup comparison was found to be statistically highly significant (p<0.01).

ii. Out of 100 study subjects, majority 81 (81%) of subjects experienced anxiety when they came to know about their cancer diagnosis and 67 (67%) had lost their hope of being treated.

iii. In relation to causes of cancer, 58 (58%) number of subjects believed that cancer occurs due to one’s past or present sins. Also 53 (53%) were unaware about the risk factors of cancer i.e. smoking, tobacco chewing, consumption of alcohol, and thus believed that cancer can not be prevented by avoiding these. Majority 40 (40%) of the study subjects believed that cancer can be transmitted by eating from common utensils.

iv. As far as the symptoms of cancer are concerned, majority 36 (36%) of the study subjects believed that weakness is the common symptom of cancer. It was revealed that majority of the subjects were having inadequate knowledge about the symptoms of cancer.

v. Majority 44 (44%) of the subjects believed that religious persons can cope better with cancer than the non religious ones.

vi. Greater number 24 (24%) of subjects believed that cancer metastasizes in the body due to surgical intervention of malignant tumor.

vii. Majority 59 (59%) of the study subjects did not agree with the statement that cancer is curable upto certain stage and 45 (45%) subjects believed that cancer can be cured by yoga and meditation. Also 48 (48%) of the subjects believed that cancer patients are unable to produce children.

viii.In regard to radiation treatment 25 (25%) subjects believed that it can burn the cancer patients, followed by 14 (14%) expressed fear of electric shock and 4 (4%) voiced fear of death.

ix.The relationship of age, gender, religion, marital status, family monthly income, duration of treatment received from selected cancer hospitals with the misconceptions did not reach the level of significance (p>0.05).

x.There was statistically significant (p<0.05) relationship of the habitat, education, occupation, duration of illness, previous treatment sought for cancer, and family history of cancer with the misconceptions of study subjects. This showed that the subjects who hailed from rural area were having higher misconception level than those who belonged to urban and suburban areas; primary education group was having more misconceptions than others. Hence, we can say that little knowledge is a dangerous thing.

DISCUSSION

The reaction about hope was also highlighted in the study conducted by Kishore J. et al (2008), where it was reported that nearly all the patients responded with a feeling of hopelessness when asked about their disease.³ The study of Ray and Mandal (2004) again supported that about 21% of people in their study thought that cancer is a communicable disease.⁵However, in a study conducted by Carlsson ME. et al (2002), everyone considered cancer to be non contagious.⁶Pahwa M. et al (2005)reported in a study conducted among cancer patients that many patients viewed their disease to be due to bad ‘karma’ (action) which supported the findings of this study.⁷ The study conducted by Jagannathan A. et al (2009) highlighted that the spiritual methods of coping (such as prayer) was the most frequently used mainstream coping strategy.⁸

CONCLUSION:

It is concluded that the study subjects were having overall low level of misconceptions. Numerous factors can influence the perceptions of cancer patients’ e.g. exposure to hospitals, contacts with the oncologists and other cancer patients etc. However, still there are some misconceptions which are widely prevalent among cancer patients. This is an indicator of public unawareness about cancer. Nurses must constantly focus their efforts to regularly organize public health education and awareness programs about various aspects of cancer.

REFERENCES

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3. Kishore J, Ahmad I, Kaur R, Mohanta PK. Misconceptions about Cancers among Indian Patients Asian Pac J Cancer Prev. 2008 Jan-Mar;9(1):155-8

4. Dinshaw KA, Rao DN, Ganesh B. Tata Memorial Hospital Cancer Registry Annual Report, Mumbai, India: 1999.

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8. Jagannathan A and Juvva S. Life After Cancer in India: Coping with Side Effects and Cancer Pain. Journal of Psychosocial Oncology. [serial online] 2009;27(3):344-360. Available from: URL:http://www.informaworld.com/smpp/content~content=a912535890&db=all

Received on 20.07.2014 Modified on 12.08.2014

Int. J. Adv. Nur. Management 2(3): July-Sept.,2014; Page 152-155