Stigma, self-blame, and satisfaction with care among patients with lung cancer

ABSTRACT

Objective: We sought to understand the experiences of patients with lung cancer and to see if attitudes varied by demographic factors. Methods: We administered a 63-question survey by phone or online among 174 patients with lung cancer. Factor analysis was used to identify two groups of questions with a conceptual relationship and high Cronbach's alphas, stigma and satisfaction with care. We used a multivariable analysis to identify predictors of self-blame and the factors of stigma and satisfaction with care. Results: Patients were satisfied with the quality of their care and treatment choices but did not feel that there is enough public support for or research in lung cancer. Predictors of lower satisfaction with care were never being a smoker, lack of college education, not living in a rural location, refusing to report income, and not knowing/not being sure of stage. Self-blame was modest; in multivariable analysis, predictors of self-blame were believing that smoking was a cause of their lung cancer, younger age, male sex, living in a suburban location, and not knowing/not being sure of the stage of the cancer. Reported stigma was low and the only predictor for stigma was being married. Despite low scores on their personal experience of stigma, patients reported a high degree of stigmatization of lung cancer in general. Smoking was a significant predictor of personal stigma. Conclusion: Despite satisfaction with their treatment and care, lung cancer patients feel that society stigmatizes them as a general population. Patients who smoke are more likely to report that they have personally experienced stigma.

KEYWORDS:

• stigma
• lung cancer
• self-blame
• satisfaction with care
• smoking

Acknowledgments

We very much appreciated the assistance of Antonia Bennett for advice about factor analysis.

Funding

This work was supported by a grant from Astrazeneca to the Lung Cancer Alliance.