Grant Number:	5R03CA193986-02 Interpret this number
Primary Investigator:	Ostroff, Jamie
Organization:	Sloan-Kettering Inst Can Research
Project Title:	Empathic Physician Communication and Stigma in Lung Cancer Patients
Fiscal Year:	2016

¿ DESCRIPTION (provided by applicant): The majority (95 percent) of lung cancer patients report experiencing lung cancer stigma from their family, friends, and medical providers, with 48 percent specifically reporting experiencing stigma from their medical providers. This stigma has negative effects on patients' psychological well-being as well as their medical outcomes. This perceived stigma may be exacerbated within the context of clinical consultations in which physicians routinely probe about patients' smoking behaviors. As such, empathic communication between patients and physicians during these clinical encounters may be critical to reduce patient's perceived stigma and thus improve the patient-physician relationship. This, in turn, may lead patients to report less psychological distress, be more honest with their physicians, and accept their physicians' advice and assistance to quit smoking. Despite the need for an intervention to improve these interactions, there is little research to examine ways that patients' perceived stigma could be reduced. The goals of this study are to: 1) describe empathic communication between oncologists and lung cancer patients during a clinical consultation of a newly diagnosed patient and 2) examine the association between oncologists' empathic communication and patients' perceived stigma, satisfaction with communication, psychological distress, intent to quit smoking, and acceptance of physicians' advice and assistance to quit smoking. To meet these goals, 55 lung cancer patients' clinical consultations with their physicians will be audio recorded. After their consultation, patients will fill out a bref questionnaire that includes questions about their perceived stigma, satisfaction with communication, and psychological distress. They will also participate in a brief (15-20 minute) interview asking about their perceptions of stigma within their clinical consultation. Analyses wil be two-fold and will focus both on how empathic communication occurs between physicians and patients (e.g., how many missed opportunities, degree of empathic communication, ways they respond to patients' anxieties, guilt, fear, etc.) as well as examine if empathic communication is associated with patients' decreased stigma, decreased psychological distress, and improved satisfaction with communication and adherence to referral for a Tobacco Cessation Program. It is expected that these results will provide preliminary evidence for the development of a communication intervention to improve empathic communication within potentially stigmatizing interactions.




Reducing stigma triggered by assessing smoking status among patients diagnosed with lung cancer: De-stigmatizing do and don't lessons learned from qualitative interviews.
Authors: Ostroff J.S. , Banerjee S.C. , Lynch K. , Shen M.J. , Williamson T.J. , Haque N. , Riley K. , Hamann H.A. , Rigney M. , Park B. .
Source: PEC innovation, 2022 Dec; 1, .
EPub date: 2022-03-04.
PMID: 36865902
Related Citations

Identifying Barriers to Advocacy Among Patients With Lung Cancer: The Role of Stigma-Related Interpersonal Constraint.
Authors: Price S.N. , Shen M. , Rigney M. , Ostroff J.S. , Hamann H.A. .
Source: Oncology nursing forum, 2022-10-20; 49(6), p. 553-563.
PMID: 36413734
Related Citations

Evaluating relationships between lung cancer stigma, anxiety, and depressive symptoms and the absence of empathic opportunities presented during routine clinical consultations.
Authors: Williamson T.J. , Ostroff J.S. , Martin C.M. , Banerjee S.C. , Bylund C.L. , Hamann H.A. , Shen M.J. .
Source: Patient education and counseling, 2021 Feb; 104(2), p. 322-328.
EPub date: 2020-08-11.
PMID: 32859447
Related Citations

Dispositional shame and guilt as predictors of depressive symptoms and anxiety among adults with lung cancer: The mediational role of internalized stigma.
Authors: Williamson T.J. , Ostroff J.S. , Haque N. , Martin C.M. , Hamann H.A. , Banerjee S.C. , Shen M.J. .
Source: Stigma and health, 2020 Nov; 5(4), p. 425-433.
EPub date: 2020-01-16.
PMID: 34027060
Related Citations

Lung Cancer Stigma: Does Smoking History Matter?
Authors: Williamson T.J. , Kwon D.M. , Riley K.E. , Shen M.J. , Hamann H.A. , Ostroff J.S. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2020-06-12; 54(7), p. 535-540.
PMID: 31942920
Related Citations

Lung cancer stigma and depression: Validation of the Lung Cancer Stigma Inventory.
Authors: Ostroff J.S. , Riley K.E. , Shen M.J. , Atkinson T.M. , Williamson T.J. , Hamann H.A. .
Source: Psycho-oncology, 2019 May; 28(5), p. 1011-1017.
EPub date: 2019-04-16.
PMID: 30779396
Related Citations

Structured Analysis of Empathic Opportunities and Physician Responses during Lung Cancer Patient-Physician Consultations.
Authors: Johnson Shen M. , Ostroff J.S. , Hamann H.A. , Haque N. , Banerjee S.C. , McFarland D.C. , Molena D. , Bylund C.L. .
Source: Journal of health communication, 2019; 24(9), p. 711-718.
EPub date: 2019-09-16.
PMID: 31525115
Related Citations

Development and Preliminary Psychometric Evaluation of a Patient-Reported Outcome Measure for Lung Cancer Stigma: The Lung Cancer Stigma Inventory (LCSI).
Authors: Hamann H.A. , Shen M.J. , Thomas A.J. , Craddock Lee S.J. , Ostroff J.S. .
Source: Stigma and health, 2018 Aug; 3(3), p. 195-203.
EPub date: 2017-04-06.
PMID: 30393760
Related Citations

Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care.
Authors: Riley K.E. , Ulrich M.R. , Hamann H.A. , Ostroff J.S. .
Source: AMA journal of ethics, 2017-05-01; 19(5), p. 475-485.
EPub date: 2017-05-01.
PMID: 28553905
Related Citations

Association between patient-provider communication and lung cancer stigma.
Authors: Shen M.J. , Hamann H.A. , Thomas A.J. , Ostroff J.S. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016 May; 24(5), p. 2093-2099.
EPub date: 2015-11-09.
PMID: 26553030
Related Citations