Stigma in patients with rectal cancer: a community study

Abstract

A self-rating measure of stigma and several supplementary questions were devised in order to assess perceived stigma in a community survey of the quality of life in 420 rectal cancer patients, of whom 265 had a permanent colostomy. Half the patients felt stigmatised, higher proportions being observed among younger patients and among those with a colostomy. Feelings of stigma were associated with poor health, particularly emotional disorders, with the presence of other medical problems, and with disablement. Patients who perceived stigma made more use of medical services but were less satisfied with them, particularly with regard to communication with health professionals. Socio-economic factors, such as employment status, higher income, and higher social and housing class, did not protect patients against feeling stigmatised by cancer or by colostomy. Most patients, with or without stigma, enjoyed close relationships with intimates, but the stigmatised were more likely to have withdrawn from participation in social activities. Assessing stigma by self-rating gives information which adds to that obtained by the usual methods of assessing quality of life.