Table 2.
Study | Design (Level of evidence) | Participants | Study factors/Patient groups | Outcomes | Comments and quality |
---|---|---|---|---|---|
LoConte 2008: Else-Quest 2009, Wisconsin USA |
Cohort |
NSCLC, breast or prostate cancer |
Lung cancer (N = 96) vs breast cancer |
Guilt and shame (SSGS) |
Primary endpoint = SSGS |
Mailed patient self report survey (Level IV as only cross-sectional baseline data were relevant) |
Stage IV |
(N = 30) or prostate cancer |
Perceived cancer related stigma |
Target sample size lung cancer |
|
Fluent and able to complete survey in English |
(N = 46) |
Perceived stigma |
N = 94, breast cancer N = 47, prostate cancer N = 47 to detect anticipated difference of > 0.75 points in mean SSGS scores with 80% power for a 2-sided significance level of 0.05 |
||
Recruited from 3 oncology clinics |
Study closed prematurely because of poor accrual among breast cancer patients |
||||
Mean age, years (SD) | |||||
Lung cancer = 65.6 (11) | |||||
Breast cancer = 61.8 (9.8) | |||||
Prostate cancer = 72.9 (9.2) | |||||
200/237 recruited | |||||
172/200 (86%) completed at least 1 questionnaire | |||||
Cross sectional |
Study quality |
||||
Mailed patient self report survey (Level IV) |
Lung cancer patients |
Current or former smokers (N = 88) vs never smokers |
Guilt and shame |
Subject selection 0 |
|
(n = 96) |
(N = 8) |
Perceived cancer |
Group comparability 0 |
||
49% women |
Perceived stigma |
related stigma |
Participation rate 0 |
||
Guilt and shame |
Anxiety |
||||
Anger | |||||
Depression | |||||
Self esteem | |||||
Cataldo 2011, USA |
Cross sectional |
Lung cancer all types and stages |
Lung cancer stigma |
Depression |
Outcomes used to validate lung cancer stigma scale |
Patient self report online survey (Level IV) |
Convenience sample |
Self esteem |
|||
Recruited via websites frequented by potential study participants |
Social support |
||||
70% female |
Social conflict |
Study quality |
|||
21% never smoked |
Quality of life |
Subject selection 0 |
|||
Mean age, years (SD) = 55 (13.7) |
Group comparability NA |
||||
186/200 completed all stigma items |
Participation rate 0 |
||||
Devitt 2010, Victoria, Australia |
Cross sectional |
|
Shame about lung cancer as a potential barrier to participating in a support group |
|
12% of participants reported attending a face-to-face support group |
Patient self report survey (Level IV) |
Lung cancer (74% NSCLC, 16% SCLC, 5% mesothelioma, 5% presumed lung cancer) |
53% of participants indicated they would be likely or very likely to attend a support group for lung cancer patients |
|||
42% Stage IV |
Also surveyed support group facilitators |
||||
Able to complete survey in English |
|
||||
Consecutive lung cancer patients attending multidisciplinary outpatient clinics at a cancer centre subsequent to initial consultation |
Study quality |
||||
Excluded those with cognitive impairment or ECOG performance status > 2 |
Subject selection 0 |
||||
12% current smokers |
Group comparability NA |
||||
Median age, years = 68 |
Participation rate 0 |
||||
42% female | |||||
Response rate = 101/172 (59%) | |||||
Lobchuk 2008b, Canada |
Cross sectional |
Primary caregivers of lung cancer patients (76% NSCLC) |
Primary caregiver blame re patient’s efforts to control the disease |
Primary caregiver assistance in coping with lung cancer and its symptoms |
|
Preliminary sample |
58% diagnosed with advanced disease |
Study quality |
|||
Primary caregiver self report survey (Level IV) |
Able to speak, read and write in English and cognitively competent |
Subject selection 0 |
|||
Convenience sample recruited from 5 outpatient cancer clinics |
Group comparability 0 |
||||
Patients |
current (N = 25) vs former (N = 66) vs never (N = 9) smokers |
Primary caregiver blame re patient’s efforts to control the disease |
Participation rate 0 |
||
9% never smokers | |||||
Mean age, years (SD) = 64 (8.0) | |||||
62% female | |||||
Response rate = 100/350 (29%) | |||||
Siminoff 2010, USA, Ohio | Cross sectional |
Lung cancer patients with a primary caregiver |
Family blames the cancer on the patient for not taking better care of themselves |
Patient depression | |
Patient and their primary caregiver semi- structured interview, (Level IV) | Stage III or IV NSCLC |
Patient and caregiver perceptions |
Study quality |
||
Recruited from a comprehensive cancer centre and its community affiliates – identified by their physicians |
Subject selection 0 |
||||
92% smokers |
Group comparability 1 |
||||
Mean age, years (SD) = 65 (9.7) |
(adjusted for age and sex) |
||||
45% female |
Participation rate 0 | ||||
Response rate = 76% | |||||
N = 190 patients + caregivers |
ECOG = Eastern Co-operative Oncology Group; NSCLC = Non small cell lung cancer; SCLC = Small cell lung cancer; SSGS = State Shame and Guilt Scale; NA = Not applicable (only within individual correlations were reported so comparability of groups was not assessed).