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V. Knott



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    O25 - Stigma and Nihilism (ID 139)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Nurses
    • Presentations: 1
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      O25.02 - The Social Stigma of Lung Cancer: Death Anxiety and Health Beliefs as Antecedent Variables (ID 2015)

      16:15 - 17:45  |  Author(s): V. Knott

      • Abstract
      • Presentation
      • Slides

      Background
      Lung cancer patients in Australia report a profound experience of stigma. Therapeutic nihilism, differences in chemotherapy treatment options compared to other cancers, and the onset controllability of the disease are some of the contributing factors to the stigma and its effects on the patient, such as poor psychosocial and quality of life outcomes. This is the first known study to investigate the constructs underlying the community’s views on lung cancer through the lens of a prominent social stigma model. This model explores three domains of stigma; enforcement of social norms, avoidance of disease and exploitation of the stigmatised group. Health Locus of Control Theory and Terror Management Theory explore the role of health beliefs and death anxiety as antecedent variables to the social stigma of lung cancer.

      Methods
      A total of 211 university students (males = 56, females = 155) (64% undertaking a health degree) completed an online survey containing the Cataldo Lung Cancer Stigma Scale (CLCSS), the Death Anxiety Inventory (DAI) and the Internal and Chance subscales of the Multidimensional Health Locus of Control scale (MHLC). Approximately 65% of participants were 18-25 years of age and “never smokers”. Approximately 40% had current or previous contact with a person suffering lung cancer.

      Results
      The underlying structure of the CLCSS was investigated using principal axis factoring with varimax rotation. Four factors accounted for 61% of variance in lung cancer stigma. To test the hypothesis that the fear of death and health beliefs respectively account for a portion of variance in lung cancer stigma, a hierarchical multiple regression analysis (MRA) was employed. On step 1, demographic variables, smoking status, family smoking history and contact with lung cancer accounted for a significant 10% of the variance in lung cancer stigma, R[2 ]=.10, F(7, 201) = 3.03, p =.005. Entering death anxiety and health beliefs respectively at step two explained an additional 4% variance in lung cancer stigma, ∆R[2 ]=.14, ∆F(3, 198) = 3.16, p =.001. A combined effect of this magnitude can be considered “medium” (f [2] = .16). Smoking status (sr[2] = .03) and fear of death (sr[2] = .03) were significant predictors of lung cancer stigma. Health beliefs were non-significant predictors.

      Conclusion
      A lung cancer patient is likely to evoke emotions associated with a fear of death for community members who are high on death anxiety. This result aligns with the social stigma model; empathy for the patient is replaced with avoidance of the diseased person. This has implications for media and research representations which focus on the high mortality rate and the “ugly” nature of the disease. The 60% variance in social stigma explained by the CLCSS conceptually aligns with domains of lung cancer stigma identified in the theoretical model. However, for the remaining variance, health beliefs were non-significant predictors of stigmatising norms against lung cancer patients. This suggests the moral dimensions underpinning the social stigma of lung cancer may warrant further investigation, particularly in relation to smoking behaviours.

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