Stigmatization and perception of discrimination in colorectal cancer patients: a scale development study

Objective: The objective of this methodological and descriptive research study was to develop the "Colorectal Cancer Patients' Stigmatization and Discrimination Perception Scale." Materials and Methods: The study was conducted over a period spanning from June 1st, 2022 to September 10th, 2023, involving colorectal cancer patients who visited the chemotherapy center of a university hospital on an outpatient basis. A nested mixed-method approach was adopted, intertwining both qualitative and quantitative research techniques. During the initial qualitative phase, phenomenological interviews were carried out with 25 colorectal cancer patients. A scale item pool was created after reviewing the literature on this subject and interviews with colorectal cancer patients. In the subsequent quantitative phase, the preliminary "Colorectal Cancer Patients' Stigmatization and Discrimination Perception Scale" was administered to 357 colorectal cancer patients. Subsequently, its validity and reliability were scrutinized. For quantitative data analysis, SPSS 28.0 and IBM SPSS AMOS 21.0 software were employed, while qualitative data was examined using the MAXQDA 22 program. Findings: Following expert consultation, the Content Validity Index for the Colorectal Cancer Patients' Stigmatization and Discrimination Perception Scale was ascertained to be 0,94. Post-confirmatory factor analysis, this scale was finalized, encompassing 19 items segregated into 5 sub-dimensions: Body image, Prejudice, Hiding the disease, Discrimination, and Guilt. The scale's goodness of fit indices were determined as follows: χ²/sd at 2,543; GFI at 0,906; AGFI at 0,872; CFI at 0,919; RMSEA at 0,066; and SRMR at 0,061. To assess the scale's temporal reliability, the test-retest methodology was employed, revealing a commendably strong correlation between responses (ICC: 0,995; p<0.001). The scale's Cronbach Alpha reliability coefficient stood at 0,837, while that of its sub-dimensions fluctuated between 0,650 and 0,902. As a result of qualitative data analysis, 2 themes and 9 sub-themes were determined. Result: This research ascertained that the Colorectal Cancer Patients' Stigmatization and Discrimination Perception Scale was a credible and dependable instrument for measurement. Keywords: Discrimination, Colorectal Cancer, Stigmatization