The Effect of Stigmatization on Working Nurses' Willingness to Care for Patients with Psoriasis and Its Mediating Factors.

Abstract

Psoriasis-related stigmatization affects nurses' willingness to provide care, potentially compromising patient outcomes. However, limited research has examined this issue. A cross-sectional survey of 1,873 nurses was conducted, which assessed 4 stigmatization dimensions and their correlation with the willingness to care for patients with psoriasis, and explored the roles of education, working environment, and self-reported psoriasis knowledge. Structural equation modelling and regression analyses were conducted. The results revealed that stigmatization negatively impacted nurses' willingness to provide care (p < 0.001), with social distance exhibiting the strongest effect (r = -0.476, OR = 0.87, 95% CI: 0.85-0.88, p < 0.001). A significant dose-response relationship was observed, where higher stigmatization levels corresponded to lower care willingness (overall trend test: p < 0.001; nonlinear trend test: p < 0.001). Nurses with higher education levels (p < 0.001) or those working in tertiary hospitals (p < 0.001) demonstrated lower willingness to provide care. Interestingly, greater self-reported psoriasis knowledge was associated with increased stigmatization, which in turn reduced care willingness (direct effect: -0.618; 95% CI: -0.814, -0.422; proportion mediated: 29.0%, 95% CI: 0.094, 0.486). These findings underscore the need for targeted training programmes, improved work environments, and stigma-reduction initiatives to enhance nurses' willingness to care for patients with psoriasis.