Determination of internalised stigmatisation and discrimination perception in breast cancer patients: A scale development study

Purpose: The aim of this methodological and descriptive study was to develop "Perception of Internalised Stigmatisation and Discrimination in Breast Cancer Patients Scale". Materials ve Methods: The research was carried out from 01/06/2022 to 15/06/2023 at oncology clinics, as well as radiotherapy and chemotherapy units, in a state hospital and a university hospital. A nested mixed design, combining qualitative and quantitative research approaches, was employed for this study. In the firs phase, qualitative research design was utilized, and phenomenological interviews were conducted with 27 breast cancer patients. A scale item pool was created by analysing the interviews with the breast cancer patient and the literature on the topic. In the second stage, in which the quantitative research design was used, the validity and reliability analyzes of the "Perception of Internalised Stigmatisation and Discrimination in Breast Cancer Patients Scale Draft" were applied to 402 breast cancer patients in line with the scale development steps. The quantitative data were analyzed using SPSS 28.0 and IBM SPSS Amos 21.0 software, while qualitative data analysis was performed using MAXQDA 22 software. Findings: The Perception of Internalised Stigmatisation and Discrimination in Breast Cancer Patients Scale, according to the expert opinion, the content validity index of the scale was set at 0.94. After confirmatory factor analysis, the "Perception of Internalised Stigmatisation and Discrimination in Breast Cancer Patients Scale ", comprised of 26 items and 6 sub-dimensions (namely social isolation, discrimination and exclusion, feeling of inadequacy, body image, prejudice, and negative attitude). Goodness of fit values of the scale χ²/sd: 2,906; GFI: 0.868; AGFI: 0.856; CFI: 0.906; RMSEA:0.069; SRMR was determined as 0.065. The reliability of the scale over time was assessed using the test-retest method and it was found that the inter-response agreement was very good (ICC: 0.945; p<0.001). It was found that the Cronbach's alpha reliability coefficient of the scale was 0.892 and the Cronbach's alpha reliability coefficient of the sub-dimensions of the scale ranged from 0.697 to 0.823. As a result of qualitative data analysis, 2 themes and 9 sub-themes were identified. Conclusion: This present study determined that the Perception of Internalised Stigmatisation and Discrimination in Breast Cancer Patients Scale was a valid and reliable scale. Keywords: Discrimination, Internalised stigmatisation, Breast cancer