"Shame on Me": Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong.

Autor: Yeung NCY; JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. nelsonyeung@cuhk.edu.hk.; Jockey Club School of Public Health and Primary Care, Room 508, Postgraduate Education Centre, Prince of Wales Hospital, School of Medicine, The Chinese University of Hong Kong, Hong Kong, China. nelsonyeung@cuhk.edu.hk., Lee EKP; JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Kong APS; Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China., Leung MKW; New Territories East Cluster, Hospital Authority, Hong Kong, China.
Jazyk: angličtina
Zdroj: International journal of behavioral medicine [Int J Behav Med] 2024 Apr; Vol. 31 (2), pp. 241-251. Date of Electronic Publication: 2023 Apr 03.
DOI: 10.1007/s12529-023-10176-z
Abstrakt: Background: Studies have suggested that type 2 diabetes mellitus (T2DM) are at risk of self-stigmatization (i.e., internalized sense of shame about having diabetes). Self-stigma has been found to be associated with poorer psychological outcomes among chronic disease patients; relevant studies examining such an association and its psychosocial mechanisms are scarce among Chinese T2DM patients. This study aimed to examine the association between self-stigma and psychological outcomes among T2DM patients in Hong Kong. Self-stigma was hypothesized to be associated with higher psychological distress and lower quality of life (QoL). Such associations were also hypothesized to be mediated by lower perceived social support, lower self-care self-efficacy, plus higher self-perceived burden to significant others.
Methods: T2DM patients (N = 206) recruited from hospitals and clinics in Hong Kong were invited to complete a cross-sectional survey measuring the aforementioned variables.
Results: After controlling for covariates, multiple mediation analysis results indicated the indirect effects from self-stigma to psychological distress via increased self-perceived burden (β = 0.07; 95% CI = 0.02, 0.15) and decreased self-care self-efficacy (β = 0.05; 95% CI = 0.01, 0.11) were significant. Moreover, the indirect effect from self-stigma to QoL via decreased self-care self-efficacy was also significant (β = -0.07; 95% CI = -0.14, -0.02). After considering the mediators, the direct effects from self-stigma to higher psychological distress and lower QoL remained significant (βs = 0.15 and -0.15 respectively, ps < .05).
Conclusions: Self-stigma could be linked to poorer psychological outcomes through increased self-perceived burden and decreased self-care self-efficacy among T2DM patients. Targeting those variables when designing interventions might facilitate those patients' psychological adjustments.
(© 2023. International Society of Behavioral Medicine.)
Databáze: MEDLINE
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