Exploring Breast Cancer Stigma Among Family Caregivers in Indonesia: A Cross-Sectional Study

Dewi Mustikaningsih; Popy Siti Aisyah; Maya Sukmayati

doi:10.56741/IISTR.jphs.002214

Authors

Dewi Mustikaningsih
dewi.mustikaningsih@unisa-bandung.ac.id
Universitas Aisyiyah Bandung https://orcid.org/0000-0001-6601-6409
Popy Siti Aisyah Universitas Aisyiyah Bandung https://orcid.org/0000-0003-2143-8944
Maya Sukmayati Universitas Aisyiyah Bandung

Keywords:

Breast Cancer, Caregiver, Indonesia, Sociodemographic, Stigma

Abstract

Stigma among family-caregivers of women with breast cancer remains a poorly understood barrier to quality care, particularly in low-and middle-income countries (LMICs). Despite their crucial role in supporting patients, evidence on caregiver stigma remains limited. This study aimed to examine stigma among family-caregivers in Indonesia, identify the predominant stigma domains, and explore associated sociodemographic factors. A cross-sectional study was conducted among 92 family-caregivers recruited from 80 Community Health Centers in Bandung, Indonesia. Participants completed a questionnaire on sociodemographic characteristics and the Family Caregiver Stigma Questionnaire, comprising four domains: internal stigma, social isolation, perceived stigma, and reactions. Data were analyzed using descriptive statistics, Friedman and Bonferroni post hoc tests, and multiple linear regression. Overall stigma was high, with a median score of 1.00, 84.6% of the maximum score. Pairwise comparisons showed that internal stigma and social isolation were significantly more prominent than the other stigma domains. No significant differences were found between perceived stigma and reactions or between internal and perceived stigma. Multiple linear regression showed no significant associations between stigma and age, sex, education, or relationship with the patient p > 0.05. These findings indicate that caregiver stigma is primarily characterized by internalized negative beliefs and social isolation rather than demographic characteristics. This study provides novel evidence on the multidimensional nature of caregiver stigma in Indonesia and highlights priority targets for intervention. Culturally appropriate psychoeducational and family-centered strategies should focus on reducing internal stigma and strengthening social connectedness. Future studies should examine psychosocial determinants to develop more targeted anti-stigma interventions.

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Author Biographies

Dewi Mustikaningsih, Universitas Aisyiyah Bandung

earned her Master of Nursing (M.Kep) degree from the Nursing Master Program, Faculty of Medicine, Diponegoro University, Semarang, Indonesia, in 2013. She has three years of experience in palliative and holistic nursing research. Her research interests include nursing management, palliative nursing, health information technology, and health promotion. (Email: dewi.mustikaningsih@unisa-bandung.ac.id).

Popy Siti Aisyah, Universitas Aisyiyah Bandung

is a Doctoral Student, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia, in the Nursing Department, Faculty of Health Science. She is a lecturer at Universitas Aisyiyah Bandung, Indonesia. She has eight years of teaching experience in palliative and end-of-life nursing at Universitas Aisyiyah Bandung. Her research focuses on nursing curriculum, spiritual care in palliative care, and communication in palliative nursing. (Email: popy.aisyah@unisa-bandung.ac.id).

Maya Sukmayati, Universitas Aisyiyah Bandung

earned her Master of Public Health (M.KM) degree from the Health Reproduction Program, Faculty of Public Health, Padjadjaran University, Bandung, Indonesia, in 2015. She has a few years of experience in adolescence, midwifery, menopausal transition, and holistic health research. Her research interests include health, menopausal transition, holistic health, and health promotion. (Email: maya.sukmayati@unisa-bandung.ac.id).

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