J Korean Acad Nurs.  2017 Feb;47(1):121-132. 10.4040/jkan.2017.47.1.121.

Reliability and Validity of the Korean Version of the Cancer Stigma Scale

• So HS
• Chae MJ
• Kim HY

• KMID: 2425942
• DOI: http://doi.org/10.4040/jkan.2017.47.1.121

Abstract

PURPOSE
In this study the reliability and validity of the Korean version of the Cancer Stigma Scale (KCSS) was evaluated.
METHODS
The KCSS was formed through translation and modification of Cataldo Lung Cancer Stigma Scale. The KCSS, Psychological Symptom Inventory (PSI), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30) were administered to 247 men and women diagnosed with one of the five major cancers. Construct validity, item convergent and discriminant validity, concurrent validity, known-group validity, and internal consistency reliability of the KCSS were evaluated.
RESULTS
Exploratory factor analysis supported the construct validity with a six-factor solution; that explained 65.7% of the total variance. The six-factor model was validated by confirmatory factor analysis (Q (χ2/df)= 2.28, GFI=.84, AGFI=.81, NFI=.80, TLI=.86, RMR=.03, and RMSEA=.07). Concurrent validity was demonstrated with the QLQ-C30 (global: r=-.44; functional: r=-.19; symptom: r=.42). The KCSS had known-group validity. Cronbach's alpha coefficient for the 24 items was .89.
CONCLUSION
The results of this study suggest that the 24-item KCSS has relatively acceptable reliability and validity and can be used in clinical research to assess cancer stigma and its impacts on health-related quality of life in Korean cancer patients.

Keyword

Social stigma; Neoplasms; Validity and reliability

MeSH Terms

Adult
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Female
Humans
Male
Middle Aged
Neoplasms/*psychology
Psychometrics
Quality of Life
Reproducibility of Results
Republic of Korea
Social Distance
Social Isolation
*Social Stigma
Social Support
Surveys and Questionnaires
Translating
Young Adult

Reference

1. Ministry of Health & Welfare, Korea Central Cancer Registry, National Cancer Center. Annual report of cancer statistics in Korea in 2013. Seoul: Ministry of Health & Welfare;2015.

2. American Cancer Society. Cancer facts & figures 2016 [Internet]. Atlanta, GA: Author;2016. cited 2016 December 8. Available from: http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf.

3. National Cancer Information Center. Recommendations for distress management in cancer patients [Internet]. Seoul: Ministry for Health, Welfare and Family Affairs;2008. cited 2012 May 20. Available from: http://www.cancer.go.kr/ebook/6/PC/6.html.

4. Cho J, Choi EK, Kim SY, Shin DW, Cho BL, Kim CH, et al. Association between cancer stigma and depression among cancer survivors: A nationwide survey in Korea. Psychooncology. 2013; 22(10):2372–2378. DOI: 10.1002/pon.3302.

5. Phelan SM, Griffin JM, Jackson GL, Zafar SY, Hellerstedt W, Stahre M, et al. Stigma, perceived blame, self-blame, and depressive symptoms in men with colorectal cancer. Psychooncology. 2013; 22(1):65–73. DOI: 10.1002/pon.2048.

6. Pineles SL, Street AE, Koenen KC. The differential relationships of shame–proneness and guilt–proneness to psychological and somatization symptoms. J Soc Clin Psychol. 2006; 25(6):688–704. DOI: 10.1521/jscp.2006.25.6.688.

7. Lee I, Lee E. Concept analysis of stigma. J Korean Rheum Assoc. 2006; 13(1):53–66.

8. Lee JL, Kim KS. The relationships between stigma, distress, and quality of life in patients with lung cancer. J Korean Oncol Nurs. 2011; 11(3):237–246. DOI: 10.5388/jkon.2011.11.3.237.

9. Van Brakel WH. Measuring health-related stigma; A literature review. Psychol Health Med. 2006; 11(3):307–334. DOI: 10.1080/13548500600595160.

10. Major B, O'Brien LT. The social psychology of stigma. Annu Rev Psychol. 2005; 56:393–421. DOI: 10.1146/annurev.psych.56.091103.070137.

11. Shen MJ, Coups EJ, Li Y, Holland JC, Hamann HA, Ostroff JS. The role of posttraumatic growth and timing of quitting smoking as moderators of the relationship between stigma and psychological distress among lung cancer survivors who are former smokers. Psychooncology. 2015; 24(6):683–690. DOI: 10.1002/pon.3711.

12. Else-Quest NM, LoConte NK, Schiller JH, Hyde JS. Perceived stigma, self-blame, and adjustment among lung, breast and prostate cancer patients. Psychol Health. 2009; 24(8):949–964. DOI: 10.1080/08870440802074664.

13. Cataldo JK, Slaughter R, Jahan TM, Pongquan VL, Hwang WJ. Measuring stigma in people with lung cancer: Psychometric testing of the cataldo lung cancer stigma scale. Oncol Nurs Forum. 2011; 38(1):E46–E54. DOI: 10.1188/11.onf.e46-e54.

14. Chambers SK, Baade P, Youl P, Aitken J, Occhipinti S, Vinod S, et al. Psychological distress and quality of life in lung cancer: The role of health-related stigma, illness appraisals and social constraints. Psychooncology. 2015; 24(11):1569–1577. DOI: 10.1002/pon.3829.

15. Yang QQ, Liu HX, Yang CL, Ji SY, Li L. Reliability and validity of Chinese version of cataldo lung cancer stigma scale. Int J Nurs Sci. 2014; 1(1):23–27. DOI: 10.1016/j.ijnss.2014.02.011.

16. Coates C. The evolution of measuring caring: Moving toward construct validity. In : Watson J, editor. Assessing and measuring caring in nursing and health sciences. 2nd ed. New York, NY: Springer Publishing;2009. p. 261–265.

17. World Health Organization. Process of translation and adaptation of instruments [Internet]. Geneva, CH: Author;2012. cited 2012 May 20. Available from: http://www.who.int/substance_abuse/research_tools/translation/en/.

18. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986; 35(6):382–385.

19. Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res. 2004; 13(4):863–868. DOI: 10.1023/b:qure.0000021692.81214.70.

20. Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. The EORTC QLQ-C30 scoring manual. 3rd ed. Brussels, BE: European Organisation for Research and Treatment of Cancer;2001.

21. Kim GS. Analysis structural equation modeling. Seoul: Hannarae Publishing Co.;2010.

22. Hair JF Jr, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Upper Saddle River, NJ: Pearson Prentice Hall;2010. p. 578–581.

23. Fayers PM, Machin D. Quality of life: The assessment, analysis and reporting of patient-reported outcomes. 3rd ed. Chichester, UK: John Wiley & Sons;2016. p. 134–136.

24. Steiger JH. Tests for comparing elements of a correlation matrix. Psychol Bull. 1980; 87(2):245–251. DOI: 10.1037/0033-2909.87.2.245.

25. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007; 60(1):34–42. DOI: 10.1016/j.jclinepi.2006.03.012.

26. Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York, NY: Guilford Press;2010. p. 54–63.

27. Kaiser G. Phase-space approach to relativistic quantum mechanics. III. Quantization, relativity, localization and gauge freedom. J Math Phys. 2016; 22(4):705. DOI: 10.1063/1.524962.

28. Ware JE Jr, Gandek B. Methods for testing data quality, scaling assumptions, and reliability: The IQOLA project approach. International quality of life assessment. J Clin Epidemiol. 1998; 51(11):945–952. DOI: 10.1016/S0895-4356(98)00085-7.

29. Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York, NY: McGraw-Hill;1994. p. 248.

30. Park HA. Problems and issues in developing measurement scales in nursing. J Nurs Query . 2005; 14(1):46–72.