Marlow Laura A V, Wardle Jane
Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK.
BMC Cancer. 2014 Apr 23;14:285. doi: 10.1186/1471-2407-14-285.
Illness-related stigma has attracted considerable research interest, but few studies have specifically examined stigmatisation of cancer in the non-patient population. The present study developed and validated a Cancer Stigma Scale (CASS) for use in the general population.
An item pool was developed on the basis of previous research into illness-related stigma in the general population and patients with cancer. Two studies were carried out. The first study used Exploratory factor analysis to explore the structure of items in a sample of 462 postgraduate students recruited through a London university. The second study used Confirmatory factor analysis to confirm the structure among 238 adults recruited through an online market research panel. Internal reliability, test-retest reliability and construct validity were also assessed.
Exploratory factor analysis suggested six subscales, representing: Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility and Financial Discrimination. Confirmatory factor analysis confirmed this structure with a 25-item scale. All subscales showed adequate to good internal and test-retest reliability in both samples. Construct validity was also good, with mean scores for each subscale varying in the expected directions by age, gender, experience of cancer, awareness of lifestyle risk factors for cancer, and social desirability. Means for the subscales were consistent across the two samples.
These findings highlight the complexity of cancer stigma and provide the Cancer Stigma Scale (CASS) which can be used to compare populations, types of cancer and evaluate the effects of interventions designed to reduce cancer stigma in non-patient populations.
与疾病相关的污名化已引起了相当多的研究关注，但很少有研究专门考察非患者人群中对癌症的污名化情况。本研究开发并验证了一种用于普通人群的癌症污名量表（CASS）。
基于先前对普通人群和癌症患者中与疾病相关污名的研究，开发了一个项目池。进行了两项研究。第一项研究使用探索性因素分析来探究通过伦敦一所大学招募的462名研究生样本中项目的结构。第二项研究使用验证性因素分析来确认通过在线市场研究小组招募的238名成年人中的结构。还评估了内部信度、重测信度和结构效度。
探索性因素分析表明有六个子量表，分别代表：尴尬、严重性、回避、政策反对、个人责任和经济歧视。验证性因素分析用一个包含25个条目的量表确认了该结构。在两个样本中，所有子量表均显示出足够好的内部信度和重测信度。结构效度也良好，每个子量表的平均得分在年龄、性别、癌症经历、对癌症生活方式风险因素的认知以及社会期望等方面按预期方向变化。两个样本中子量表的均值一致。
这些发现突出了癌症污名的复杂性，并提供了癌症污名量表（CASS），该量表可用于比较不同人群、癌症类型，并评估旨在减少非患者人群中癌症污名的干预措施效果。
