Examining evidence of lung cancer stigma among health-care trainees

Author:

Studts Jamie L1ORCID,Deffendall Catherine M2,McCubbin Shelby L3,Hamann Heidi A4,Hoover Kaitlyn5ORCID,Brymwitt Whitney M6,Williamson Timothy J6ORCID

Affiliation:

1. Department of Medicine, University of Colorado School of Medicine , Aurora, CO, USA

2. Department of Medicine, Vanderbilt University Medical Center , Nashville, TN, USA

3. University of Kentucky College of Medicine , Lexington, KY, USA

4. Department of Psychology, University of Arizona , Tucson, AZ, USA

5. Population Health Shared Resource, University of Colorado Cancer Center , Aurora, CO, USA

6. Department of Psychological Science, Loyola Marymount University , Los Angeles, CA, USA

Abstract

Abstract Background Innovations in lung cancer control and care have started to transform the landscape of lung cancer outcomes, but lung cancer stigma and biases have been implicated as a deterrent to realizing the promise of these innovations. Research has documented lung cancer stigma among the general public and lung cancer survivors (self-blame), as well as clinicians across many disciplines. However, studies have not explored lung cancer stigma in health-care trainees. These data seek to address that gap and inform efforts to prevent the emergence or mitigate the presence of lung cancer stigma among future clinicians. Methods Using clinical vignettes and a 2x2 factorial design, this investigation evaluated the impact of a history of smoking (yes vs no) and cancer diagnosis (lung vs colorectal) on perceptions of the described patient among 2 groups of preclinical health-care trainees (medical = 94 and nursing = 138). A charitable giving paradigm also asked participants to donate provided funds to 1 of 2 cancer advocacy organizations: one serving the lung cancer community and one serving the colorectal cancer community. Results In study 1, results revealed a consistent pattern of statistically significant and medium to large effect size differences regarding stigmatized perceptions (eg, higher stigmatizing behavior, increased pity, greater anger, and less helping) for individuals with a history of smoking but no reliable differences regarding cancer diagnosis. Analysis of data from nursing trainees in study 2 showed a similar pattern of statistically significant and medium to large effects pertaining to stigma behavior and perceptions of individuals who had a history of smoking depicted in the vignettes. The charitable giving paradigm did not identify any reliable difference between the groups in either study. Conclusions Findings revealed a consistent pattern of health-care trainee perceptions that varied by smoking status but much less evidence that the cancer diagnosis contributed to different perceptions. This suggests that efforts to integrate consideration of stigma and biases in health-care training needs to adopt an approach that seeks to mitigate or eliminate stigmatizing perceptions and behaviors toward individuals with a history of smoking.

Funder

University of Kentucky

Genentech

National Cancer Institute

National Institutes of Health

Department of Health and Human Services

NIH

National Center for Advancing Translational Sciences

University of Kentucky Center for Clinical and Translational Science

Population Health Shared Resource

University of Colorado Cancer Center

Publisher

Oxford University Press (OUP)

Reference72 articles.

1. Cancer statistics, 2023;Siegel;CA Cancer J Clin,2023

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