PhD in Nursing Science Program

Health-Related Stigma in Advanced Lung Cancer

Dissertation under the direction of Professor Sheila Ridner

Health related stigma (HRS) is a poorly understood phenomenon in patients with advanced lung cancer. Approximately 30% of patients with lung cancer, regardless of smoking status, report feeling stigmatized due to their diagnosis and this may influence outcomes in these patients. Stigma has been linked to poor outcomes in other populations like HIV/AIDS. This is a cross-sectional descriptive study of patients with advanced lung cancer (N=62) that examines associations between internal and external HRS with physical symptoms, psychological symptoms, social support, and quality of life (QOL). In this study, 66.1% reported a smoking history and 33.9% reported feeling there is a stigma associated with lung cancer. External HRS was significantly correlated with distress, support from a main caregiver, general social support, physical, emotional, spiritual, intellectual and overall QOL. Internal HRS was significantly correlated with general social support, physical, emotional, intellectual, and overall QOL. Physical symptoms, depression, and anxiety were not significantly associated with any social support or QOL. Distress, however, was associated with physical, emotional, spiritual, intellectual and overall QOL. Results indicate that external HRS may be more influential on outcomes in patients with advanced lung cancer than internal HRS. Further research is needed to clarify the role of stigma in patients with lung cancer.