Measuring stigma in people with lung cancer: psychometric testing of the cataldo lung cancer stigma scale

Abstract

Purpose/objectives: to develop an instrument to measure the stigma perceived by people with lung cancer based on the HIV Stigma Scale.

Design: psychometric analysis.

Setting: online survey.

Sample: 186 patients with lung cancer.

Methods: an exploratory factor analysis with a common factor model using alpha factor extraction.

Main research variables: lung cancer stigma, depression, and quality of life.

Findings: four factors emerged: stigma and shame, social isolation, discrimination, and smoking. Inspection of unrotated first-factor loadings showed support for a general stigma factor. Construct validity was supported by relationships with related constructs: self-esteem, depression, social support, and social conflict. Coefficient alphas ranging from 0.75-0.97 for the subscales (0.96 for stigma and shame, 0.97 for social isolation, 0.9 for discrimination, and 0.75 for smoking) and 0.98 for the 43-item Cataldo Lung Cancer Stigma Scale (CLCSS) provided evidence of reliability. The final version of the CLCSS was 31 items. Coefficient alpha was recalculated for the total stigma scale (0.96) and the four subscales (0.97 for stigma and shame, 0.96 for social isolation, 0.92 for discrimination, and 0.75 for smoking).

Conclusions: the CLCSS is a reliable and valid measure of health-related stigma in this sample of people with lung cancer.

Implications for nursing: the CLCSS can be used to identify the presence and impact of lung cancer stigma and allow for the development of effective stigma interventions for patients with lung cancer.

Figure 1. Model of Health-Related Stigma in Patients With Lung Cancer

Note. From “Measuring Stigma in People With HIV: Psychometric Assessment of the HIV Stigma Scale,” by B. Berger, C. Ferrans, and F. Lashley, 2001, Research in Nursing and Health, 24, p. 520. Copyright 2001 by John Wiley and Sons. Adapted with permission.