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      Reliability and Validity Study of a Tool to Measure Cancer Stigma: Patient Version

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          Abstract

          Objective:

          The aim of this methodological study is to establish the validity and reliability of the Turkish version of “A Questionnaire for Measuring Attitudes toward Cancer (Cancer Stigma) - Patient version.”

          Methods:

          The sample comprised oncology patients who had active cancer treatment. The construct validity was assessed using the confirmatory and exploratory factor analysis.

          Results:

          The mean age of the participants was 54.9±12.3 years. In the confirmatory factor analysis, fit values were determined as comparative fit index = 0.93, goodness of fit index = 0.91, normed-fit index=0.91, and root mean square error of approximation RMSEA = 0.09 ( P <0.05) (Kaiser–Meyer–Olkin = 0.88, χ 2 = 1084.41, Df = 66, and Barletta's test P <0.000). The first factor was “impossibility of recovery and experience of social discrimination” and the second factor was “stereotypes of cancer patients.” The two-factor structure accounted for 56.74% of the variance. The Cronbach's alpha value was determined as 0.88 for the two-factor scale.

          Conclusions:

          “A questionnaire for measuring attitudes toward cancer (cancer stigma) - Patient version” is a reliable and valid questionnaire to assess stigmatization of cancer in cancer patients.

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          Most cited references29

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          The social psychology of stigma.

          This chapter addresses the psychological effects of social stigma. Stigma directly affects the stigmatized via mechanisms of discrimination, expectancy confirmation, and automatic stereotype activation, and indirectly via threats to personal and social identity. We review and organize recent theory and empirical research within an identity threat model of stigma. This model posits that situational cues, collective representations of one's stigma status, and personal beliefs and motives shape appraisals of the significance of stigma-relevant situations for well-being. Identity threat results when stigma-relevant stressors are appraised as potentially harmful to one's social identity and as exceeding one's coping resources. Identity threat creates involuntary stress responses and motivates attempts at threat reduction through coping strategies. Stress responses and coping efforts affect important outcomes such as self-esteem, academic achievement, and health. Identity threat perspectives help to explain the tremendous variability across people, groups, and situations in responses to stigma.
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            Measuring health-related stigma--a literature review.

            Stigma related to chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, mental illness and epilepsy is a global phenomenon with a severe impact on individuals and their families, and on the effectiveness of public health programmes. To compare stigma measurement in different disciplines, a literature review was conducted. References were obtained through a search of literature databases and through examining relevant bibliographies. Sixty-three papers were selected that addressed the issue of measurement of stigma or related constructs and that contained a sample of the instrument or items used. Five unpublished studies were also included in the review. The aspects of health-related stigma used for assessment can be grouped in five categories. First, the experience of actual discrimination and/or participation restrictions on the part of the person affected; second, attitudes towards the people affected; third, perceived or felt stigma; fourth, self or internalized stigma; and fifth, discriminatory and stigmatizing practices in (health) services, legislation, media and educational materials. Within each of these areas, different research methods have been used, including questionnaires, qualitative methods, indicators and scales. The characteristics of the instruments considered most promising are described and compared. The purpose of stigma assessment is to increase our understanding of stigma and its determinants and dynamics, to determine its extent or severity in a given setting or target group and to monitor changes in stigma over time. The conclusions from this review are that (a) the consequences of stigma are remarkably similar in different health conditions, cultures and public health programmes; (b) many instruments have been developed to assess the intensity and qualities of stigma, but often these have been condition-specific; and (c) development of generic instruments to assess health-related stigma may be possible. To achieve this aim, existing instruments should be further validated, developed or adapted for generic use, where possible.
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              Stigma: notes on the management of spoiled identity

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                Author and article information

                Journal
                Asia Pac J Oncol Nurs
                Asia Pac J Oncol Nurs
                APJON
                Asia-Pacific Journal of Oncology Nursing
                Medknow Publications & Media Pvt Ltd (India )
                2347-5625
                2349-6673
                Apr-Jun 2017
                : 4
                : 2
                : 155-161
                Affiliations
                [1 ]Nursing Department, Health Sciences Faculty, Izmir Katip Celebi University, Cigli-Izmir, Turkey
                [2 ]Outpatient Clinic Nurse, Medical Oncology, Atatürk Training and Research Hospital, Izmir Kâtip Celebi University, Cigli-Izmir, Turkey
                [3 ]Education Research Department İzmir Public Association, Izmir Kâtip Celebi University, Cigli-Izmir, Turkey
                [4 ]Medical Oncology Department, Atatürk Training and Research Hospital, Izmir Kâtip Celebi University, Cigli-Izmir, Turkey
                Author notes
                Corresponding author: Medine Yılmaz, Department of Public Health Nursing, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli-Izmir, Turkey Tel: +902323293535-4780; Fax: +902323860888 E-mail: medine1974@ 123456hotmail.com
                Article
                APJON-4-155
                10.4103/apjon.apjon_10_17
                5412154
                28503649
                dbf180e5-2aa1-46eb-9961-e4f0ce1d091b
                Copyright: © 2016 Ann & Joshua Medical Publishing Co. Ltd

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 28 October 2016
                : 12 February 2017
                Categories
                Original Article

                cancer,reliability,stigma,validity
                cancer, reliability, stigma, validity

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