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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

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

 

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).