Stigma towards functional disability and anxiety among patients with cancer: The moderating role of physicians’ behaviors

Objective: To explore the moderating role of physicians' behaviors in medical encounters with cancer patients in the association between physicians’ public stigma towards functional disability and post-meeting patient anxiety. Methods: A three time-point prospective nested study was conducted between November 2019 and July 2022 in two medical centres. Before the medical encounters, 32 physicians completed the Disability Attitudes in Health Care Scale, and 150 adult cancer patients completed the State-Trait Anxiety Inventory (STAI), pre and post medical encounters. During the medical encounters, structured ‘real-time’ observations of the physicians’ behaviors were recorded using the Four Habits Coding Scheme. Results: The mixed linear analysis model revealed that the two-way interaction between stigma towards functional disability and physicians’ communication behaviors was significantly associated with post-meeting anxiety (b=.161, p < .05). When physicians’ behaviors were more negative, the association between physicians’ stigma and patients’ post-meeting anxiety was stronger. Additionally, pre-meeting anxiety was positively associated with post-meeting anxiety (b=.578, p < .01). Conclusions: The findings highlight the positive effect of stigma and the importance of physicians' communication behaviors in alleviating patients’ anxiety associated stigma towards functional disability. Practice implications: Healthcare training programs should address stigma and develop protocols encouraging healthcare professionals to request patients' to share their specific needs.