Nelson C Y Yeung, Eric Kam Pui Lee, Alice Pik Shan Kong, Maria Kwan Wa Leung
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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.</p><p><strong>Methods: </strong>T2DM patients (N = 206) recruited from hospitals and clinics in Hong Kong were invited to complete a cross-sectional survey measuring the aforementioned variables.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"\\\"Shame on Me\\\": Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong.\",\"authors\":\"Nelson C Y Yeung, Eric Kam Pui Lee, Alice Pik Shan Kong, Maria Kwan Wa Leung\",\"doi\":\"10.1007/s12529-023-10176-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>T2DM patients (N = 206) recruited from hospitals and clinics in Hong Kong were invited to complete a cross-sectional survey measuring the aforementioned variables.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Self-stigma could be linked to poorer psychological outcomes through increased self-perceived burden and decreased self-care self-efficacy among T2DM patients. 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引用次数: 0
摘要
背景:研究表明,2 型糖尿病(T2DM)患者有自我污名化(即内化的糖尿病羞耻感)的风险。研究发现,自我污名化与慢性病患者较差的心理预后有关;而在中国的 T2DM 患者中,很少有相关研究探讨这种关联及其社会心理机制。本研究旨在探讨香港 T2DM 患者的自我污名与心理结果之间的关系。假设自我烙印与较高的心理压力和较低的生活质量(QoL)相关。这种关联还被假设为由较低的感知社会支持、较低的自我护理自我效能以及较高的对重要他人的自我感知负担所中介:方法:邀请从香港医院和诊所招募的 T2DM 患者(N = 206)完成一项横断面调查,测量上述变量:在控制了协变量后,多重中介分析结果显示,自我污名通过增加自我认知负担(β = 0.07; 95% CI = 0.02, 0.15)和降低自我护理自我效能(β = 0.05; 95% CI = 0.01, 0.11)对心理困扰的间接影响是显著的。此外,通过自我护理自我效能下降从自我污名到 QoL 的间接效应也是显著的(β = -0.07; 95% CI = -0.14,-0.02)。在考虑了中介因素后,自我污名对较高的心理压力和较低的 QoL 的直接影响仍然显著(βs = 0.15 和 -0.15,Ps 结论:通过增加 T2DM 患者的自我认知负担和降低自我护理自我效能,自我污名可能与较差的心理结果有关。在设计干预措施时,针对这些变量可能会促进这些患者的心理调整。
"Shame on Me": Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong.
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.
期刊介绍:
The International Journal of Behavioral Medicine (IJBM) is the official scientific journal of the International Society for Behavioral Medicine (ISBM). IJBM seeks to present the best theoretically-driven, evidence-based work in the field of behavioral medicine from around the globe. IJBM embraces multiple theoretical perspectives, research methodologies, groups of interest, and levels of analysis. The journal is interested in research across the broad spectrum of behavioral medicine, including health-behavior relationships, the prevention of illness and the promotion of health, the effects of illness on the self and others, the effectiveness of novel interventions, identification of biobehavioral mechanisms, and the influence of social factors on health. We welcome experimental, non-experimental, quantitative, qualitative, and mixed-methods studies as well as implementation and dissemination research, integrative reviews, and meta-analyses.