2 results
Cross-cultural validation of the Cancer Stigma Scale in the general Japanese population
- Emi Takeuchi, Daisuke Fujisawa, Rina Miyawaki, Hiroko Yako-Suketomo, Koichiro Oka, Masaru Mimura, Miyako Takahashi
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- Journal:
- Palliative & Supportive Care / Volume 19 / Issue 1 / February 2021
- Published online by Cambridge University Press:
- 01 July 2020, pp. 75-81
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- Article
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Background
The stigma associated with cancer has negative impacts on cancer patients as well as the general public, who have a potential risk of cancer. To the best of our knowledge, a validated measure to assess cancer stigma among the general Japanese population does not exist.
MethodWe translated the Cancer Stigma Scale (CASS) — a 25-item self-administered scale to evaluate stigma related to cancer — into Japanese and examined its psychometric properties. The Japanese version of CASS (J-CASS) was validated among a sample of the general Japanese population through an online survey to validate its test–retest reliability, internal consistency, and concurrent validity.
ResultsA total of 319 responses were included in the analysis. An exploratory factor analysis eliminated two original items but showed a six-factor model (Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility, and Financial Discrimination), which was similar to the original scale. Cronbach's alpha for each factor was satisfactory, ranging from 0.81 to 0.91. The internal correlation coefficients were above 0.70, except for Policy Opposition. The total and subtotal scores of each factor of the J-CASS were significantly associated with respondents’ age, gender, familiarity with cancer patients, and social desirability, demonstrating the scales’ good concurrent validity. A substantial proportion of the participants selected “unsure” for some items of the scale, suggesting a further need for refining the scale.
Significance of resultsThis study demonstrated that J-CASS is a reliable and valid measure for evaluating misconceptions and stigma toward cancer in the general Japanese population.
twelve - Women and health in Japan: sexuality after breast cancer
- Edited by Misa Izuhara
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- Book:
- Comparing Social Policies
- Published by:
- Bristol University Press
- Published online:
- 20 January 2022
- Print publication:
- 26 February 2003, pp 227-244
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- Chapter
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Summary
Introduction
Cancer has been the primary cause of death in Japan since 1981 (Ministry of Health, Labour and Welfare, 2000). The Japanese word for cancer – gan – was once associated with the image of death, or with severe physical and psychological distress. However, thanks to the recent development of medical technology and treatment, patients’ survival rates have been dramatically improved and the diagnosis of cancer is no longer regarded as a virtual death sentence. This fact has directed people's attention from mere survival to how to achieve a better quality of life (QOL) following a cancer diagnosis (Osoba, 1991; Kawano, 1995).
In spite of the fact that cancer survival rates have increased, sexuality after having cancer remains a taboo topic in both the clinical and research setting of many countries. Research on sexuality after cancer in the context of psychosocial rehabilitation began in the 1980s (Andersen, 1985; Schain, 1988; Burbie and Polinski, 1992). In Japan, the reluctance to raise the topic seems to be even greater. There, sexuality was rarely included in cancer QOL scales. Also, when sexuality was discussed in the clinical setting, it was always related to pathological aspects, such as an infection route of sexually transmissible infections, or impotence as a complication of diabetes. Sex after having specific illnesses was rarely discussed in the context of pleasure or undergoing post-treatment rehabilitation.
This chapter focuses primarily on women's sexuality after having breast cancer, and discusses how this long-neglected issue is influenced by both the socio-cultural context and the health care system in Japan. However, the chapter first presents an overview of the health status of Japanese people and the Japanese health care system in general.
Overview of health status and health care system in Japan
Health status of people in Japan
The current life expectancy of people in Japan is the longest in the world. As of 1999, the average life expectancy at birth was 77.1 years for men and 84.0 years for women (Ministry of Health, Labour and Welfare, 2000). Figure 12.1 shows the changes in mortality rates according to the cause of death in Japan since 1950. After infectious diseases such as tuberculosis were successfully controlled in the 1920s and 1930s, cerebro-vascular diseases (CVD), heart diseases and malignant tumours have been the three major causes of death.