Internalized stigma among pediatric patients with osteosarcoma and retinoblastoma in Guatemala, Jordan, and Zimbabwe

作者：Anneliese H. Williams, Thelma Velásquez, Inam Chitsike, Hadeel Halalsheh, Ana Cáceres-Serrano, Lucia Fuentes, Nester Chokwenda, Gia Ferrara, Joseph Wardell, Tharwa Bilbeisi, Edith Matsikidze, Nickhill Hitesh Bhakta, Sima C. Jeha, Carlos Rodriguez Galindo, Jennifer W. Mack, V. M. Santana, Sara Malone, D. E. Graetz · 发表于：Frontiers in Oncology · 年份：2026 · DOI：10.3389/fonc.2026.1689051 · 研究领域：Childhood Cancer Survivors' Quality of Life、Acute Lymphoblastic Leukemia research、Cancer survivorship and care

Introduction Internalized stigma adversely impacts childhood cancer survivors, limiting their ability to reintegrate with their communities and maintain social networks. However, the impact of internalized stigma on children undergoing cancer treatment is unknown, and no interventions exist to mitigate it. The Activating Events-Beliefs-Consequences (ABC) model from Cognitive Behavioral Theory (CBT) has been used to analyze internalized stigma and inform interventional work. This study employs the ABC model as a conceptual framework to explore how internalized stigma manifests for children recently diagnosed with osteosarcoma and retinoblastoma in Guatemala, Jordan, and Zimbabwe. Methods We conducted semi-structured interviews with nine adolescent patients (aged 12-18), 28 caregivers, and 19 clinicians at tertiary cancer centers in Guatemala, Jordan, and Zimbabwe. Interviews occurred in Spanish, Arabic, Shona, and English and were transcribed and translated into English for analysis. Two coders independently coded transcripts, resolving disagreements through consensus and third-party adjudication. A framework analysis used the ABC model to understand manifestations of internalized stigma, defined a priori as “a patient’s own adoption of negative societal beliefs or feelings, including changes in self-identification.” Results Patients, caregivers, and clinicians all described internalized stigma in pediatric cancer patients. Cancer-related physical changes and community stigma ...