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

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.