Table 7.
Results of quantitative studies examining effects of stigma-related negative evaluations on psychosocial outcomes
| Study | Participants | Study Factor(s) | Outcome | Main findings |
|---|---|---|---|---|
| LoConte 2008: Else-Quest 2009, USA |
Stage IV NSCLC |
|
|
Association between stigma or self blame and outcomes |
| Perceived stigma | ||||
| (1 item) |
Self esteem (RSES) |
NS** |
||
| Direct effect |
p< 0.01# Negative association |
|||
| Indirect effects via self-blame (SSGS) |
|
|||
| Anxiety (State-Trait Anxiety Inventory) |
p< 0.01**Positive association |
|||
| Direct effect |
p< 0.05# Positive association |
|||
| Indirect effects via self-blame (SSGS) |
|
|||
| Anger (State-Trait Anger Inventory) |
p< 0.01** Positive association |
|||
| Direct effect |
p< 0.01# Positive association |
|||
| Indirect effects via self-blame (SSGS) |
|
|||
| Depression (shortened CES-D) |
p< 0.01** Positive association |
|||
| Direct effect |
p< 0.01# Positive association |
|||
| Indirect effects via self-blame (SSGS) |
|
|||
| Self Blame (SSGS) adjusted for perceived stigma |
Self esteem (RSES) |
p< 0.01** Negative association |
||
| Anxiety (State-Trait Anxiety Inventory) |
p< 0.01** Positive association |
|||
| Anger (State-Trait Anger Inventory) |
p< 0.01** Positive association |
|||
| Depression (shortened CES-D) |
p< 0.01** Positive association |
|||
| Cataldo 2011, USA |
All types and stages of lung cancer |
|
|
|
| Lung cancer stigma scale (Cataldo scale - 43 items) |
Depression (CES-D) |
p< 0.01* Positive association |
||
| Quality of life (Quality of Life Inventory) |
p< 0.01* Negative association |
|||
| Self esteem (RSES) |
p< 0.01* Negative association |
|||
| Social support (Social Support Indices) |
|
|||
| Availability |
p< 0.01* Negative association |
|||
| Validation |
p< 0.01* Negative association |
|||
| Subjective social integration (Social Support Indices) |
p< 0.01* Negative association |
|||
| Social conflict (Social Support Indices) |
p< 0.01* Positive association |
|||
| Lung cancer stigma scale Stigma and shame subscale (19 items) |
Depression (CES-D) |
p< 0.01* Positive association |
||
| Quality of life (Quality of Life Inventory) |
p< 0.01* Negative association |
|||
| Self esteem (RSES) |
p< 0.01* Negative association |
|||
| Social support (Social Support Indices) |
|
|||
| Availability |
p< 0.01* Negative association |
|||
| Validation |
p< 0.01* Negative association |
|||
| Subjective social integration (Social Support Indices) |
p< 0.01* Negative association |
|||
| Social conflict (Social Support Indices) |
p< 0.01* Positive association |
|||
| Devitt 2010, Victoria, Australia |
42% Stage IV 74% NSCLC |
Shame about lung cancer |
Participation in a support group |
10% of patients reported shame as a potential barrier |
| 29% of support group facilitators thought patients’ shame was a potential barrier | ||||
| Lobchuk 2008b, Canada |
Primary caregivers of lung cancer patients |
|
|
Correlation between caregiver blame and caregiver assistance |
| 58% advanced disease |
Primary caregiver blame re patient’s efforts to control the disease (single item) |
Primary caregiver assistance in coping with lung cancer and its symptoms (single item) |
r = 0.044, p = 0.66 |
|
| 76% NSCLC |
|
|||
| Siminoff 2010, USA, Ohio | Stage III or IV NSCLC | Family blames cancer on the patient |
|
Regression coefficient for blame and depression |
| Patient agrees |
Patient Depression (CES-D) |
|
||
| Familial cohesion |
|
p< 0.051 Positive association |
||
| Familial expressiveness |
p< 0.052 Positive association |
|||
| Familial conflict |
p< 0.053 Positive association |
|||
| Caregiver agrees |
Patient Depression (CES-D) | |
||
| Familial cohesion |
p< 0.051 Positive association |
|||
| Familial expressiveness |
p< 0.052 Positive association |
|||
| Familial conflict | p< 0.053 Positive association |
ECOG = Eastern Co-operative Oncology Group; NSCLC = Non small cell lung cancer; SCLC = Small cell lung cancer; SSGS = State Shame and Guilt Scale; CES-D = Center for Epidemiological Studies Depression Scale; NA = Not applicable; NS = Not statistically significantly different; RSES = Rosenberg’s Self-Esteem Scale; r = correlation coefficient; * Two-sided test; ** Multiple regression analyses; # bootstrapping; 1 Multi-level model including age, gender, physical health, relationship of caregiver to patient, familial cohesion; 2 Multi-level model including age, gender, physical health, relationship of caregiver to patient, familial expressiveness; 3 Multi-level model including age, gender, physical health, relationship of caregiver to patient, familial.