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 | ||||
Anger | |||||
Depression | |||||
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 | Â | Shame about lung cancer as a potential barrier to participating in a support group | Â | 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 | Â | ||||
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 | Â |
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 |