Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?

Development of a Scale to Assess Cancer Attitude in the Community

AIM

The aim of this study was to develop the Cancer Attitude Scale (CAS) and to evaluate its psychometric properties.

METHODS

The study was conducted in a mixed-methods study. The preliminary version of the CAS was created by developing an item pool, and qualitative interviews. The items' content validity ratio was calculated to assess content validity. Construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Internal consistency and test-retest methods were used to determine the reliability of the scale. The Cancer Information Burden Scale was used to evaluate the convergent validity of the scale. Three hundred twenty-five healthy individuals selected by convenience sampling method were included in this study.

RESULTS

The CAS sub-dimensions were determined as cancer diagnosis, cancer prevention, stigmatization of individuals with cancer, and personal empowerment after cancer. The content validity of the 22-item scale was 0.94 and four factors explaining 56% of the variance. The model fit indices were χ2/df = 1.968, RMSEA = 0.055, SRMR = 0.085, and GFI = 0.904. . Cronbach's α and test-retest reliability coefficients of the total scale are 0.76 and 0.936, respectively. The CAS and Cancer Information Overload Scale showed acceptable convergent validity (r = 0.435, P < .001).

CONCLUSIONS

The Cancer Attitude Scale is a valid and reliable tool that can be applied to assess the attitudes of individuals in the community toward cancer in a multidimensional way.

IMPLICATIONS FOR PRACTICE

Nurses play crucial roles in society, including enhancing cancer awareness, delivering counseling services, and providing health education. Cancer nursing should plan cancer awareness training in line with individuals' attitudes toward cancer and encourage positive attitudes that increase participation in screening programs.

Turkish validity and reliability of the Cancer Stigma Scale (CASS-T)

OBJECTIVES

This study is aimed to evaluate the validity and reliability of the Cancer Stigma Scale for the Turkish population (CASS-T).

METHODS

The sample of the study consisted of 412 students of a foundation university located in Ankara, Turkey. The reliability of the CASS was evaluated using the Cronbach alpha reliability coefficient and item-total score correlations. Exploratory factor analyses were applied to examine the factor structure of the scale and its construct validity. To test the time invariance of the scale, the relationships between the scores obtained from the first and second applications were examined using the intraclass correlation coefficient (ICC).

RESULTS

The Cronbach's alpha coefficient of CASS-T was 0.83. In the factor analysis, it was confirmed that the scale has a six-dimensional structure in parallel to original version, namely Avoidance, Severity, Responsibility, Policy opposition, Awkwardness, and Discrimination. The ICC values all remained in the range that indicates the reliability of the 0.63-0.71 to be substantial. The contribution of the six factors of the CASS-T scale to the variance is 57.8.

SIGNIFICANCE IN RESULTS

The Turkish version of the CASS was confirmed to have good reliability and validity for evaluating stigma toward cancer in Turkish society.

Correlates of stigma for patients with cancer: a systematic review and meta-analysis

OBJECTIVE

The systematic review and meta-analysis was performed to summarize the available evidence and identify the correlates of cancer stigma.

METHODS

PubMed, EMBASE, Web of Science, the Cochrane Library, and PsycINFO were electronically searched to identify eligible studies about correlates of stigma for patients with cancer. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies. A meta-analysis was performed using the statistical program R.

RESULTS

Thirty-one studies involving a total of 7114 patients were included in the systematic review and meta-analysis. The results of the meta-analysis showed that cancer stigma shared positive associations with male gender, symptoms, depression, anxiety, body image loss, self-blame, social constraint, intrusive thoughts, and ambivalence over emotional expression, and negative associations with income, NK cell subsets, QOL, self-esteem, self-efficacy, cancer screening attendance, doctor's empathy, and medical satisfaction. The results of the descriptive analysis indicated that cancer stigma was positively associated with self-perception of aging, anger, internal attributions, stressful life events, self-perceived burden, and sleep dysfunction, while negatively associated with patient-provider communication and sleep quality.

CONCLUSION

Healthcare staff should pay attention to the identified correlates of cancer stigma. The results of our research can inform the design of interventions to reduce stigma and to improve clinical outcomes in people with cancer.