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.

Chambers et al.

Chambers et al. BMC Cancer 2012 12:184   doi:10.1186/1471-2407-12-184

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