Table 2.
Definitions of stigma used in the studies.
| Study | n | Quality Score | Type of Study | Type of Stigma Studied | Definition of Stated Stigma in the Study |
|---|---|---|---|---|---|
| CRD—COPD | |||||
| Berger et al. (2011) | 18 | 0.60 | Qualitative | Perceived stigma | * Not explicitly stated. |
| Halding et al. (2011) | 18 | 0.65 | Qualitative | Self-blame and stigmatization | ** “Stigmatization is a lack of social acceptance by broader society because of being different. Stigma is socially constructed, imposing attitudes on all members in a society. A mark of discredit is extremely powerful when it communicates highly valued beliefs in a particular society.” |
| CRD—Asthma | |||||
| Andrews et al. (2013) | 72 | 0.63 | Quantitative | Perceived stigma | * Not explicitly stated. |
| CVD—Stroke | |||||
| Sarfo et al. (2017) | 200 | 0.63 | Quantitative | Enacted stigma and felt stigma (personal stigma; family stigma; community/social stigma) | *** “Enacted stigma represents discrimination against the stigmatized person that is imposed by others; internalized or felt stigma is the fear of “enacted” stigma experienced by the stigmatized person; others—not stated.” |
| Diabetes Type 1 | |||||
| Browne et al. (2014) | 27 | 0.65 | Qualitative | Perception of diabetes-related stigma | * Not explicitly stated. |
| Nishio et al. (2017) | 24 | 0.70 | Qualitative | Stigma (diabetes-specific) | **** “Negative impression and sense of shame for being a diabetes patient due to negative responses of others and their own sense of values.” |
| Diabetes Type 2 | |||||
| Browne et al. (2013) | 26 | 0.80 | Qualitative | Perceived and experienced diabetes-related stigma | * Not explicitly stated. |
| Gredig et al. (2017) | 3347 | 0.63 | Quantitative | Perceived and experienced | *** “Perceived stigma means the perception of stereotypes linked with labeling. Experienced stigma—also referred to in the literature as enacted stigma—means the discrimination and exclusion experienced by those affected.” |
| Kato et al. (2017) | 209 | 0.67 | Quantitative | Internalized stigma | *** “Internalization of society’s negative perceptions towards an illness by someone who has that particular illness.” |
| Kato et al. (2016) | 26 | 0.60 | Qualitative | Internalized stigma | *** “Internalized stigma refers to the negative attitudes individuals hold toward themselves on account of their condition and/or the negative reactions of others.” |
| Lee et al. (2015) | 125 | 0.63 | Quantitative | Perceived stigma | * Not explicitly stated. |
| Cancer—Miscellaneous | |||||
| Cho et al. (2013) | 466 | 0.63 | Quantitative | Enacted stigma (social discrimination) | *** “Disqualification of individuals and groups who have particular health problems.” |
| Gupta et al. (2015) | 39 | 0.60 | Qualitative | Perceived and internalized stigma | *** “Perceived stigma refers to the shame associated with having a condition and to the fear of being discriminated and denied basic welfare rights leading to social exclusion. Actual stigma refers to obvious discrimination, which may lead to feelings of guilt, shame and threatens one’s own identity.” |
| Park et al. (2010) | 748 | 0.67 | Quantitative | Enacted stigma (work-related discrimination) | *** “Discrimination was defined as the experience of any of the following: reduction in salary, denial of a promotion, loss of an opportunity to demonstrate one’s ability, change of an assignment without the employee’s agreement, being treated as if one no longer has the ability to work, difficulty in revealing the cancer diagnosis to one’s employer, or pressure from the employer to quit, retire, or change jobs.” |
| Stergiou-Kita et al. (2016) | 40 | 0.80 | Qualitative | Stigma (unspecific) | ** “Stigma is defined as both a process and an attribute. The process of stigmatization has been described by Link and Phelan as involving three key actions. First, specific human differences are labeled as negative. Second, negative differences are linked to negative social stereotypes, and third such stereotypes are used to distinguish stigmatized individuals as “bothers” within society, resulting in separation, status loss, and discrimination. As an attribute, stigma has been characterized as a label or mark that is placed on individuals (or a group), who deviate from the norm or do not comply with established behavior rules.” |
| Cancer—Lung | |||||
| Brown et al. (2014) | 149 | 0.71 | Quantitative | Lung cancer stigma/perceived health-related stigma | **** “Lung cancer stigma (LCS) is a perceived health-related stigma that results from negative perceptions about the causal relationship between smoking and lung cancer.” |
| Cataldo et al. (2013) | 144 | 0.83 | Quantitative | Lung cancer stigma/perceived health-related stigma | **** “LCS is a perceived stigma and refers to the anticipation or fear of discrimination and an awareness of negative attitudes and actions related to lung cancer. It is a perceived HRS that is defined as a personal experience characterized by exclusion, rejection, blame, or devaluation that results from anticipation of an adverse judgment related to lung cancer.” |
| Chappel et al. (2004) | 45 | 0.60 | Qualitative | Felt and enacted stigma | *** “Stigma occurs when society labels someone as tainted, less desirable, or handicapped. This negative evaluation may be “felt” or “enacted.”—a felt negative evaluation refers to the shame associated with having a condition and to the fear of being discriminated against on the grounds of imputed inferiority or social unacceptability—an enacted negative evaluation refers to actual discrimination of this kind.” |
| Gonzalez et al. (2012) | 95 | 0.67 | Quantitative | Perceived stigma | * Not explicitly stated. |
| Cancer—Breast | |||||
| Meacham et al. (2016) | 20 | 0.60 | Qualitative | Internalized stigma | *** “Internalized stigma or self-stigma, is when a person with a stigmatized disease applies the negative public stigma associated with the disease to his/herself.” |
| Suwakhong et al. (2016) | 20 | 0.80 | Qualitative | Stigma (unspecific) | ** “Stigma is constructed in order to give reasons for the stigmatized person’s inferiority and to justify perceptions of the stigmatized as a threat or to be feared by others. Stigma is a mark or sign of disgrace usually eliciting negative attitudes toward the stigmatized.” |
| Trusson et al. (2017) | 24 | 0.65 | Qualitative | Stigma (unspecific) | ** “Stigma is the situation of the individual who is disqualified from full social acceptance.” |
| Cancer—Breast and Cervical | |||||
| Nyblade et al. (2017) | 59 | 0.70 | Qualitative | Anticipated stigma and experienced (enacted stigma) | *** “Anticipated: fear of stigma, whether or not it is actually experienced; experienced: stigma that is enacted through interpersonal acts of discrimination.” |
| Cancer-Cervical | |||||
| Dyer et al. (2010) | 19 | 0.60 | Qualitative | Perceived and experienced stigma | * Not explicitly stated. |
| Cancer—Prostate | |||||
| Wood et al. (2017) | 85 | 0.63 | Quantitative | Social and internalized stigma | *** “Social stigma is the most common form of experienced and researched stigma, and it exists when the larger society expresses a sense of “otherness” toward individuals due to specific characteristics (e.g., physical deformities). Internalized social stigma, wherein the opinions and views expressed in social stigma are taken in by the stigmatized and become part of their self-concept.” |
| Cancer—Head and Neck | |||||
| Bonanno et al. (2012) | 19 | 0.70 | Qualitative | Felt stigma and enacted stigma (disease-specific) | **** “Felt stigma indicates the patients’ own shame about her/his disfigurement and the fear of actions of discrimination against her/him. It further indicates the fact that interaction was bothersome to patients; enacted stigma refers to episodes of discrimination against patients related to the disfigurement.” |
* definitions not explicitly stated; ** use of existing generic definition of stigma; *** use of existing definition of specific stigma type; **** use of self-developed disease-specific definition.