Evidence map›Paper›PMID 41556721›Full record

ArticlePsycho-oncology2026

Association of Multi-Level LGBTQ+ Stigma and Hypervigilance With Health Outcomes Among LGBTQ+ Cancer Caregivers.

Austin R Waters, Brittany M Charlton, Camille R Murray, Shaun R Jones, Echo L Warner, Lorinda A Coombs, Heidi S Donovan, Zhirui Deng, Dianxu Ren, Barbara L Fredrickson and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psycho-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Austin R WatersDivision of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9947-8535
Brittany M CharltonDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Camille R MurrayHealth Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Shaun R JonesDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Echo L WarnerCollege of Nursing, University of Utah, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0002-5998-9744
Lorinda A CoombsLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-1096-8974
Heidi S DonovanDepartment of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Zhirui DengOffice of Research and Scholarship, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Dianxu RenDepartment of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Barbara L FredricksonLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Hazel B NicholsLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Erin E KentHealth Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Kelly R TanDepartment of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-4289-3188

Funding

Cancer Control Education ProgramT32CA057726 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Melissa B Gilkey, Melissa A. Troester · 2017 to 2026
$3.7M
Emotional Well-Being and Economic Burden Research NetworkU24AT011310 · NCCIH · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARTIN, MICHELLE Y, PISU, MARIA · 2021 to 2024
$2.4M
AHRQ HHS R36 HS030175AHRQ HHS R36HS030175Emotional Well-being and Economic Burden Research Network U24AT011310-01NCCIH NIH HHS U24 AT011310NCI NIH HHS T32 CA057726
6 · The paper itself

Abstract

backgroundLesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals in the US face significant health inequities driven by structural stigma. However, the health impacts of LGBTQ+ stigma and hypervigilance among LGBTQ+ individuals who are also a cancer caregiver are understudied.

methodsLGBTQ+ adults in the US who provided unpaid care to a cancer patient (

resultsAmong 332 LGBTQ+ cancer caregivers, LCA identified four distinct classes: 1. Low stigma and hypervigilance (31.0%), 2. Moderate stigma and behavioral hypervigilance (21.7%), 3. Moderate contextual hypervigilance and scanning (19.3%), and 4. High stigma and hypervigilance (28.0%). In multivariable linear regression models, class 4 was associated with a 10.43-unit higher anxiety T-score (95% CI: 7.75-13.11), a 9.61 unit higher depression T-score (95% CI: 6.67-12.54), a 9.50-unit higher sleep disturbance T-score (95% CI: 7.02-11.98), and a 12.11-unit higher fatigue T-score (95% CI: 8.88-15.35) in comparison to class 1. Similar, but lower magnitude, trends were seen across the associations of classes 2 and 3.

conclusionsThe findings of this study algin with the LGBTQ+ literature and suggest that among LGBTQ+ cancer caregivers, increased levels of LGBTQ+ stigma and the resulting hypervigilance drive health inequities.

Indexed as

AnxietyCaregiversDepressionNeoplasmsSexual and Gender MinoritiesSocial StigmaAdultAgedFatigueFemaleHumansLatent Class AnalysisMaleMiddle AgedSleep Wake DisordersSurveys and Questionnaires

Identifiers

PMID41556721
PMCPMC12818097

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.