Mindful self-compassion for lung cancer (MSC-LC): Incorporating perspectives of lung cancer patients, clinicians, and researchers to create an adapted intervention to reduce lung cancer stigma.

Background: Stigma is a pervasive and distressing problem experienced frequently by lung cancer patients, and there is a lack of psychosocial interventions that target the reduction of lung cancer stigma. Mindful self-compassion (MSC) is an empirically supported intervention demonstrated to increase self-compassion and reduce feelings of shame and distress in non-cancer populations. However, there are several anticipated challenges for delivering MSC to lung cancer patients, and modifications may be needed to improve acceptability, appropriateness, and feasibility.

Purpose: To gather feedback from lung cancer patients, psycho-oncology researchers, expert MSC teachers, and oncology clinicians to identify themes supporting the adaptation of MSC to reduce lung cancer stigma.

Methods: We conducted a two-phase process of stakeholder focus groups with researchers and clinicians (n=12) and semi-structured interviews with lung cancer patients (n=14) with elevated stigma. Transcripts were analyzed using thematic content analysis.

Results: Five themes were identified: (i) Patients expressed a desire for an intervention that bolstered self-compassion and addressed stigma; (ii) Intervention instructions were acceptable and understood clearly; (iii) Patients preferred intervention content to directly address lung cancer and stigma yet mentioned that doing so should be done with sensitivity; (iv) Ambivalence about delivering the intervention in person or remotely; (v) Acceptance for an intervention of 8-weeks (or longer) with 90-minute sessions and a group size of ≤ 15.

Conclusions: Findings informed the development of an adapted clinical protocol for MSC for lung cancer (MSC-LC), which can be pilot tested to determine implementation outcomes (e.g. acceptability, feasibility, efficacy).