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Cross-cultural validation of the Cancer Stigma Scale in the general Japanese population

Published online by Cambridge University Press:  01 July 2020

Emi Takeuchi Open the ORCID record for Emi Takeuchi [Opens in a new window] ,
Daisuke Fujisawa Open the ORCID record for Daisuke Fujisawa [Opens in a new window] ,
Rina Miyawaki ,
Hiroko Yako-Suketomo ,
Koichiro Oka ,
Masaru Mimura  and
Miyako Takahashi
Emi Takeuchi*
Affiliation:
School of Medicine, Department of Neuropsychiatry, Keio University Tokyo, Tokyo, Japan Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
Daisuke Fujisawa
Affiliation:
School of Medicine, Department of Neuropsychiatry, Keio University Tokyo, Tokyo, Japan
Rina Miyawaki
Affiliation:
School of Arts and Letters, Meiji University, Tokyo, Japan
Hiroko Yako-Suketomo
Affiliation:
Japan Women's College of Physical Education, Tokyo, Japan
Koichiro Oka
Affiliation:
Faculty of Sport Sciences, Waseda University, Saitama, Japan
Masaru Mimura
Affiliation:
School of Medicine, Department of Neuropsychiatry, Keio University Tokyo, Tokyo, Japan
Miyako Takahashi
Affiliation:
Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
*
Author for correspondence: Emi Takeuchi, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: etakeuch@ncc.go.jp
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Abstract

Background

The stigma associated with cancer has negative impacts on cancer patients as well as the general public, who have a potential risk of cancer. To the best of our knowledge, a validated measure to assess cancer stigma among the general Japanese population does not exist.

Method

We translated the Cancer Stigma Scale (CASS) — a 25-item self-administered scale to evaluate stigma related to cancer — into Japanese and examined its psychometric properties. The Japanese version of CASS (J-CASS) was validated among a sample of the general Japanese population through an online survey to validate its test–retest reliability, internal consistency, and concurrent validity.

Results

A total of 319 responses were included in the analysis. An exploratory factor analysis eliminated two original items but showed a six-factor model (Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility, and Financial Discrimination), which was similar to the original scale. Cronbach's alpha for each factor was satisfactory, ranging from 0.81 to 0.91. The internal correlation coefficients were above 0.70, except for Policy Opposition. The total and subtotal scores of each factor of the J-CASS were significantly associated with respondents’ age, gender, familiarity with cancer patients, and social desirability, demonstrating the scales’ good concurrent validity. A substantial proportion of the participants selected “unsure” for some items of the scale, suggesting a further need for refining the scale.

Significance of results

This study demonstrated that J-CASS is a reliable and valid measure for evaluating misconceptions and stigma toward cancer in the general Japanese population.

Keywords

CancerDiscriminationJapanStereotypeStigma
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 1 , February 2021 , pp. 75 - 81
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

REFERENCES

Carter-Harris, L, Hermann, CP, Schreiber, J, et al. (2014) Lung cancer stigma predicts timing of medical help-seeking behavior. Oncology Nursing Forum 41(3), E203–E210. doi:10.1188/14.onf.e203-e210CrossRefGoogle ScholarPubMed
Cataldo, JK, Slaughter, R, Jahan, TM, et al. (2011) Measuring stigma in people with lung cancer: Psychometric testing of the Cataldo Lung Cancer Stigma Scale. Oncology Nursing Forum 38, E46–E54. doi:10.1188/11.onf.e46-e54CrossRefGoogle ScholarPubMed
Cho, J, Smith, K, Choi, EK, et al. (2013) Public attitudes toward cancer and cancer patients: A national survey in Korea. Psycho-Oncology 22, 605–613. doi:10.1002/pon.3041CrossRefGoogle ScholarPubMed
Crowne, DP and Marlowe, D (1960) A new scale of social desirability independent of psychopathology. Journal of Consulting and Clinical Psychology 24(4), 349.CrossRefGoogle ScholarPubMed
Daher, M (2012) Cultural beliefs and values in cancer patients. Annals of Oncology 23(Suppl 3), 66–69. doi:10.1093/annonc/mds091CrossRefGoogle ScholarPubMed
Ferlay, J, Soerjomataram, I, Dikshit, R, et al. (2015) Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer 136(5), E359–E386. doi:10.1002/ijc.29210CrossRefGoogle ScholarPubMed
Fujisawa, D and Hagiwara, N (2007) Cancer stigma and its health consequences. Current Breast Cancer Reports 7(3), 143–150. doi:10.1007/s12609-015-0185-0CrossRefGoogle Scholar
Fujisawa, D, Umezawa, S, Fujimori, M, et al. (2014). Who are at risk for cancer-related stigma? In: 16th World Congress of Psycho-oncology, Lisbon, Portugal.Google Scholar
Goffman, E (1963) Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Hair, JFBW, Babin, BJ and Anderson, RE (2014). Multivariate Data Analysis, 7th ed. England: Pearson.Google Scholar
Hunter, L (2012) Challenging the reported disadvantages of e-questionnaires and addressing methodological issues of online data collection. Nursing Research 20, 11–20. doi:10.7748/nr2012.09.20.1.11.c9303Google ScholarPubMed
Ishida, K (2016) What do “neither/nor” and “I don't know” mean? A case of the attitude toward accepting immigrants in Japan. Institute of Social Science University of Tokyo 97, 1–18.Google Scholar
Ishiyaku, B, Kasim, R and Harir, A (2017) Confirmatory factoral validity of public housing satisfaction constructs. Cogent Business & Management 4(1), 1359458. doi:10.1080/23311975.2017.1359458CrossRefGoogle Scholar
Kissane, DW, Patel, SG, Baser, RE, et al. (2013) Preliminary evaluation of the reliability and validity of the Shame and Stigma Scale in head and neck cancer. Head & Neck 35, 172–183. doi:10.1002/hed.22943CrossRefGoogle ScholarPubMed
Kitamura, T and Suzuki, T (1986) Japanese version of Social Desirability Scale. Japan Journal of Social Psychiatry 9, 173–180.Google Scholar
Koo, TK and Li, MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine 15, 155–163. doi:10.1016/j.jcm.2016.02.012CrossRefGoogle ScholarPubMed
Liu, H, Yang, Q, Narsavage, GL, et al. (2015) Coping with stigma: The experiences of Chinese patients living with lung cancer. SpringerPlus 5, 1790. doi:10.1186/s40064-016-3486-5CrossRefGoogle Scholar
Marlow, LA and Wardle, J (2014) Development of a scale to assess cancer stigma in the non-patient population. BMC Cancer 14, 285. doi:10.1186/1471-2407-14-285CrossRefGoogle ScholarPubMed
Marlow, LAV, Waller, J and Wardle, J (2015) Does lung cancer attract greater stigma than other cancer types? Lung Cancer 88(1), 104–107. doi:10.1016/j.lungcan.2015.01.024CrossRefGoogle ScholarPubMed
Meacham, E, Orem, J, Nakigudde, G, et al. (2016) Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda. Psycho-Oncology 25, 1206–1211. doi:10.1002/pon.4215CrossRefGoogle ScholarPubMed
Mlhw.go.jp (2018) Overview of the Basic Plan to Promote Cancer Control Programs. Available at: http://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000183313.html (accessed March 30, 2019).Google Scholar
Peters-Golden, H (1982) Breast cancer: Varied perceptions of social support in the illness experience. Social Science & Medicine 16, 483–491. doi:10.1016/0277-9536(82)90057-0CrossRefGoogle ScholarPubMed
Reynolds, WM (1982) Development of reliable and valid short forms of the Marlowe-Crowne social desirability scale. Journal of Clinical Psychology 38, 19–125. doi:10.1002/1097-4679(198201)38:1<119::AID-JCLP2270380118>3.0.CO;2-I3.0.CO;2-I>CrossRefGoogle Scholar
Shim, HY, Shin, JY, Kim, JH, et al. (2016) Negative public attitudes toward cancer survivors returning to work: A nationwide survey in Korea. Cancer Research and Treatment 48, 815–824. doi:10.4143/crt.2015.094CrossRefGoogle Scholar
Stump, TK, LaPergola, CC, Cross, NA, et al. (2016) The measure of disease-related stigma: Construction, validation, and application across three disease contexts. Stigma and Health 1, 87–100.CrossRefGoogle Scholar
Suwankhong, D and Liamputtong, P (2016) Breast cancer treatment: Experiences of changes and social stigma among Thai women in southern Thailand. Cancer Nursing 39, 213–220. doi:10.1097/ncc.0000000000000255CrossRefGoogle ScholarPubMed
Tang, PL, Mayer, DK, Chou, FH, et al. (2016) The experience of cancer stigma in Taiwan: A qualitative study of female cancer patients. Archives of Psychiatric Nursing 30, 204–209. doi:10.1016/j.apnu.2015.08.015CrossRefGoogle ScholarPubMed
Tsuchiya, M, Horn, S and Ingham, R (2012) Development of the Psycho-social Discomfort Scale (PsDS): Investigation of psychometric properties among Japanese breast cancer survivors. Psycho-Oncology 21, 161–167. doi:10.1002/pon.1880CrossRefGoogle ScholarPubMed
Vrinten, C, Gallagher, A, Waller, J, et al. (2019) Cancer stigma and cancer screening attendance: A population based survey in England. BMC Cancer 19(1), 566. doi:10.1186/s12885-019-5787-xCrossRefGoogle ScholarPubMed
World Health Organization (2020) Process of Translation and Adaptation of Instruments. Available at: https://www.who.int/substance_abuse/research_tools/translation/en/ (accessed February 13, 2020).Google Scholar
Yako-Suketomo, H, Katanoda, K, Kawamura, Y, et al. (2019) Children's knowledge of cancer prevention and perceptions of cancer patients: Comparison before and after cancer education with the presence of visiting lecturer-guided class. Journal of Cancer Education 34(6), 1059–1066. doi:10.1007/s13187-018-1408-7CrossRefGoogle ScholarPubMed
Ye, X, Liu, HY, Lu, SR, et al. (2019) Translation and validation of the Chinese version of the Cancer Stigma Scale. Journal of Oncology Pharmacy Practice 25(7), 1622–1630. doi:10.1177/1078155218802627CrossRefGoogle ScholarPubMed