{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:49:40Z","timestamp":1790624980598,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012678","name":"Young Teacher Foundation of Sun Yat-sen University","doi-asserted-by":"publisher","award":["Ref#20ykpy84"],"award-info":[{"award-number":["Ref#20ykpy84"]}],"id":[{"id":"10.13039\/501100012678","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study examined the reliability and validity of a Shame and Stigma Scale (SSS) and assessed shame and stigma among patients with facial disfigurement from nasopharyngeal carcinoma (NPC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data were collected from 218 patients with NPC through a cross-sectional survey between January 14, 2020, and December 1, 2020. The original SSS is a 20-item scale with four dimensions (i.e., shame with appearance, sense of stigma, regret, and social\/speech concern). We used Cronbach\u2019s alpha and McDonald\u2019s omega to assess reliability and exploratory factor analysis (EFA) to assess the factor structure. We also used Pearson correlation analysis to examine the relationship between each item and total score of scale items and convergent validity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The final 18-item SSS had a Cronbach\u2019s alpha coefficient of .89. The EFA revealed that the SSS has a four-factor structure: sense of stigma, social\/speech concern, shame with appearance, and regret. These factors showed satisfactory reliability, with McDonald\u2019s omega coefficients of .87, .77, .86, and .79, respectively. The scale showed significant relationship between each item and total score of scale items with respect to item\u2013total correlations, item\u2013subscale correlations, and item\u2013other-subscale correlations. Convergent validity was supported by the significant positively correlated with the total scores for depression and anxiety.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The SSS is valid and reliable in assessing shame and stigma and monitoring treatment compliance among patients with NPC.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0279290","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T18:38:10Z","timestamp":1671734290000},"page":"e0279290","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Preliminary validation of the Chinese version of the Shame and Stigma Scale among patients with facial disfigurement from nasopharyngeal carcinoma"],"prefix":"10.1371","volume":"17","author":[{"given":"Yuqi","family":"Cai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangnan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengsu","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiqi","family":"Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian Yawei","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8824-8024","authenticated-orcid":true,"given":"Shenghao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-7359","authenticated-orcid":true,"given":"Jinghua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"issue":"4","key":"pone.0279290.ref001","doi-asserted-by":"crossref","first-page":"e13032","DOI":"10.1111\/ecc.13032","article-title":"Characteristics of symptom distress in Chinese nasopharyngeal carcinoma patients and its relation to mood disturbance: A cross-sectional study","volume":"28","author":"Y Chen","year":"2019","journal-title":"European journal of cancer care"},{"issue":"6","key":"pone.0279290.ref002","first-page":"e13487","article-title":"Anxiety and depression status prior to radiotherapy in patients with nasopharyngeal carcinoma and its effect on acute radiation toxicities","volume":"30","author":"R Li","year":"2021","journal-title":"European journal of cancer care"},{"key":"pone.0279290.ref003","author":"WHO","year":"2017","journal-title":"Depression and Other Common Mental Disorders: Global Health Estimates"},{"issue":"2","key":"pone.0279290.ref004","first-page":"340","article-title":"Long-Term Late Toxicity, Quality of Life, and Emotional Distress in Patients With Nasopharyngeal Carcinoma Treated With Intensity Modulated Radiation Therapy. International journal of radiation oncology, biology","volume":"102","author":"LJ McDowell","year":"2018","journal-title":"physics"},{"issue":"10","key":"pone.0279290.ref005","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1002\/pon.3302","article-title":"Association between cancer stigma and depression among cancer survivors: a nationwide survey in Korea.","volume":"22","author":"J Cho","year":"2013","journal-title":"Psycho-oncology"},{"issue":"1","key":"pone.0279290.ref006","article-title":"Suicide among cancer patients","volume":"10","author":"NG Zaorsky","year":"2019","journal-title":"Nature communications"},{"key":"pone.0279290.ref007","first-page":"63","volume-title":"Shame and guilt in neurosis","author":"H. Lewis","year":"1971"},{"key":"pone.0279290.ref008","volume-title":"Stigma: notes on the management of spoiled identity","author":"E. Goffman","year":"1963"},{"issue":"10","key":"pone.0279290.ref009","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1080\/13548506.2020.1734638","article-title":"The role of acculturation in the relationship between self-stigma and psychological distress among Chinese American breast cancer survivors","volume":"25","author":"K Warmoth","year":"2020","journal-title":"Psychology, health & medicine"},{"issue":"8","key":"pone.0279290.ref010","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1080\/08870440802074664","article-title":"Perceived stigma, self-blame, and adjustment among lung, breast and prostate cancer patients.","volume":"24","author":"NM Else-Quest","year":"2009","journal-title":"Psychology & health."},{"issue":"4","key":"pone.0279290.ref011","first-page":"402","article-title":"Exploring Stigma Among Lung Cancer Survivors: A Scoping Literature Review.","volume":"46","author":"LA Webb","year":"2019","journal-title":"Oncology nursing 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