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Table 2 Table of characteristics of included quantitative studies of patients’ perceptions and caregivers’ attitudes

From: A systematic review of the impact of stigma and nihilism on lung cancer outcomes

Study Design (Level of evidence) Participants Study factors/Patient groups Outcomes Comments and quality
LoConte 2008: Else-Quest 2009, Wisconsin USA Cohort NSCLC, breast or prostate cancer Lung cancer (N = 96) vs breast cancer Guilt and shame (SSGS) Primary endpoint = SSGS
Mailed patient self report survey (Level IV as only cross-sectional baseline data were relevant) Stage IV (N = 30) or prostate cancer Perceived cancer related stigma Target sample size lung cancer
Fluent and able to complete survey in English (N = 46) Perceived stigma N = 94, breast cancer N = 47, prostate cancer N = 47 to detect anticipated difference of > 0.75 points in mean SSGS scores with 80% power for a 2-sided significance level of 0.05
Recruited from 3 oncology clinics Study closed prematurely because of poor accrual among breast cancer patients
Mean age, years (SD)
Lung cancer = 65.6 (11)
Breast cancer = 61.8 (9.8)
Prostate cancer = 72.9 (9.2)
200/237 recruited
172/200 (86%) completed at least 1 questionnaire
Cross sectional Study quality
Mailed patient self report survey (Level IV) Lung cancer patients Current or former smokers (N = 88) vs never smokers Guilt and shame Subject selection0
(n = 96) (N = 8) Perceived cancer Group comparability0
49% women Perceived stigma related stigma Participation rate0
Guilt and shame Anxiety
Self esteem
Cataldo 2011, USA Cross sectional Lung cancer all types and stages Lung cancer stigma Depression Outcomes used to validate lung cancer stigma scale
Patient self report online survey (Level IV) Convenience sample Self esteem
Recruited via websites frequented by potential study participants Social support
70% female Social conflict Study quality
21% never smoked Quality of life Subject selection0
Mean age, years (SD) = 55 (13.7) Group comparabilityNA
186/200 completed all stigma items Participation rate0
Devitt 2010, Victoria, Australia Cross sectional   Shame about lung cancer as a potential barrier to participating in a support group   12% of participants reported attending a face-to-face support group
Patient self report survey (Level IV) Lung cancer (74% NSCLC, 16% SCLC, 5% mesothelioma, 5% presumed lung cancer) 53% of participants indicated they would be likely or very likely to attend a support group for lung cancer patients
42% Stage IV Also surveyed support group facilitators
Able to complete survey in English  
Consecutive lung cancer patients attending multidisciplinary outpatient clinics at a cancer centre subsequent to initial consultation Study quality
Excluded those with cognitive impairment or ECOG performance status > 2 Subject selection0
12% current smokers Group comparabilityNA
Median age, years = 68 Participation rate0
42% female
Response rate = 101/172 (59%)
Lobchuk 2008b, Canada Cross sectional Primary caregivers of lung cancer patients (76% NSCLC) Primary caregiver blame re patient’s efforts to control the disease Primary caregiver assistance in coping with lung cancer and its symptoms  
Preliminary sample 58% diagnosed with advanced disease Study quality
Primary caregiver self report survey (Level IV) Able to speak, read and write in English and cognitively competent Subject selection0
Convenience sample recruited from 5 outpatient cancer clinics Group comparability0
Patients current (N = 25) vs former (N = 66) vs never (N = 9) smokers Primary caregiver blame re patient’s efforts to control the disease Participation rate0
9% never smokers
Mean age, years (SD) = 64 (8.0)
62% female
Response rate = 100/350 (29%)
Siminoff 2010, USA, Ohio Cross sectional Lung cancer patients with a primary caregiver Family blames the cancer on the patient for not taking better care of themselves Patient depression  
Patient and their primary caregiver semi- structured interview, (Level IV) Stage III or IV NSCLC Patient and caregiver perceptions Study quality
Recruited from a comprehensive cancer centre and its community affiliates – identified by their physicians Subject selection0
92% smokers Group comparability1
Mean age, years (SD) = 65 (9.7) (adjusted for age and sex)
45% female Participation rate0
Response rate = 76%
N = 190 patients + caregivers
  1. ECOG = Eastern Co-operative Oncology Group; NSCLC = Non small cell lung cancer; SCLC = Small cell lung cancer; SSGS = State Shame and Guilt Scale; NA = Not applicable (only within individual correlations were reported so comparability of groups was not assessed).