Breast Cancer Stigma Scale: A Reliable and Valid Stigma Measure for Patients With Breast Cancer

Xiaofan Bu; Shuangshuang Li; Andy S K Cheng; Peter H F Ng; Xianghua Xu; Yimin Xia; Xiangyu Liu

doi:10.3389/fpsyg.2022.841280

Breast Cancer Stigma Scale: A Reliable and Valid Stigma Measure for Patients With Breast Cancer

Front Psychol. 2022 Jun 10:13:841280. doi: 10.3389/fpsyg.2022.841280. eCollection 2022.

Authors

Xiaofan Bu¹, Shuangshuang Li², Andy S K Cheng³, Peter H F Ng⁴, Xianghua Xu⁵, Yimin Xia⁵, Xiangyu Liu⁵

Affiliations

¹ Nursing Teaching and Research Section, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
² Department of Nursing, The Second Xiangya Hospital of Central South University, Changsha, China.
³ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
⁴ Department of Computing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
⁵ Department of Health Service Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.

Abstract

Purpose: This study aims to develop and validate a stigma scale for Chinese patients with breast cancer.

Methods: Patients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale's content validity was assessed by a Delphi study (n = 15) and feedback from patients with breast cancer (n = 10); exploratory factor analysis (n = 200) was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale (n = 50); internal consistency Cronbach's α (n = 200), split-half reliability (n = 200), and test-retest reliability (N = 50) were used to identify the reliability of the scale.

Results: The final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale (ρ = 0.641, P < 0.001). Exploratory factor analysis (EFA) revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach's α for the total scale was 0.86, and each subscale was 0.75-0.882. The test-retest reliability with intra-class correlation coefficients of the total scale was 0.947 (P < 0.001), and split-half reliability with intra-class correlation coefficients of the total scale was 0.911 (P < 0.001). The content validity index (CVI) was 0.73-1.0.

Conclusion: The newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China.

Keywords: breast cancer; development; reliability; scale; stigma; validation.