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  1. Fulltext Validation of the Malay Version of the Shame and Stigma Scale among Cancer Patients in Malaysia
    Zhang Z, Azman N, Eyu HT, Nik Jaafar NR, Mohd Salleh Sahimi H, Mohamad Yunus MR, et al.
    Int J Environ Res Public Health, 2022 Nov 01;19(21).
    PMID: 36361144 DOI: 10.3390/ijerph192114266
    The assessment of stigma among cancer patients is of the utmost importance as stigma may lead to various psychological sequelae and a lower quality of life. This study aimed to translate the English version of the Shame and Stigma Scale (SSS) into Malay and validate the Malay version of the SSS (SSS-M) to assess the degree of stigma among cancer patients in Malaysia. Initially, the concurrent translation and back translation of the SSS-M were performed, and the face and content validity were assessed. Subsequently, the SSS-M was administered to a total of 234 patients with mixed types of cancer to assess its reliability (internal consistency and test-retest reliability), construct validity (convergent and discriminant validity), and conduct an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). The SSS-M total score registered a good internal consistency (a Cronbach's α of 0.881) and test-retest reliability (an intraclass correlation coefficient of 0.876, p < 0.001). The EFA and CFA confirmed that the SSS-M consisted of 16 items in 3 domains. Its convergent and discriminant validity were achieved. Hence, the SSS-M demonstrated good psychometric properties and is available for use to assess stigma among cancer patients in Malaysia.
  2. Perceived Shame and Stigma, and Other Psychosocial Predictors of Psychological Distress Among Cancer Patients in Malaysia
    Eyu HT, Nik Jaafar NR, Leong Abdullah MFI, Salleh Salimi HM, Mohamad Yunus MR, Ismail F, et al.
    Psychooncology, 2024 Dec;33(12):e70020.
    PMID: 39663181 DOI: 10.1002/pon.70020
    BACKGROUND: Patients' sociodemographic factors, clinical characteristics, distress factors, perceived shame and stigma may give rise to psychological distress in cancer patients that bring about further psychosocial impact.

    AIMS: (1) to determine the degrees of shame and stigma towards cancer and psychological distress among cancer patients in Malaysia and (2) to examine the clinical and psychosocial predictors of psychological distress.

    METHODS: This cross-sectional study recruited a total of 217 cancer patients. The participants were administered the sociodemographic and clinical characteristics questionnaires, the Malay version of the Shame and Stigma Scale (SSS-M) to assess for the degree of cancer shame and stigma, and the Malay version of the Distress Thermometer and Problem List to assess for presence of psychological distress and identify its sources.

    RESULTS: There was a significant level of shame and stigma among cancer patients with the total mean SSS-M score of 12.08 (SD = 6.09). Anger (adjusted odds ratio [AOR] = 11.97, 95% confidence interval [CI] = 2.96-86.8, p = 0.001), loss of interest or enjoyment (AOR = 14.84, 95% CI = 2.93-75.20, p = 0.001), loneliness (AOR = 8.10, 95% CI = 1.13-58.02, p = 0.001), feeling of worthlessness or being a burden (AOR = 6.24, 95% CI = 1.32-29.59, p = 0.021), fear (AOR = 4.52, 95% CI = 1.79-11.43, p = 0.001), pain (AOR = 4.07, 95% CI = 1.53-10.82, p = 0.005), financial constraint (AOR = 2.95, 95% CI = 1.22-7.13, p = 0.016), and having regret (AOR = 1.89, 95% CI = 1.03-3.79, p = 0.039) increased the odds of developing psychological distress.

    CONCLUSION: Treating clinicians should monitor for and provide psychosocial interventions for the biopsychosocial factors which may worsen psychological distress among cancer patients.

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