Stigma experienced by Chinese patients with stroke during inpatient rehabilitation and its correlated factors: a cross-sectional study

ABSTRACT

Background: Stroke-related stigma can have a negative effect on patients, and is associated with stereotyping, prejudice, and discrimination; however, the exact stigma experienced by patients remains ambiguous.

Objectives: To evaluate the stigma experienced by patients with stroke, determine associated factors, and explore relationships between stigma and early rehabilitation.

Methods: Overall, we examined 288 patients with stroke. Patient characteristics were determined through medical records and investigations, while stigma status (comprising total stigma, internalized stigma, and enacted stigma), depression level, functional independence, and functional outcome were also assessed. Demographic and clinical characteristics were evaluated through univariate analysis, and significant variables were further analyzed through linear regression. The relationships between stigma and early rehabilitation (depression, functional independence, and functional outcomes) were also analyzed.

Results: The sample’s total stigma, internalized stigma, and enacted stigma scores were 47.76 ± 18.00, 30.07 ± 12.25, and 17.69 ± 6.37, respectively. Employment status before stroke, caregivers, physical impairment, and number of impairments were all relevant to all types of stigma (P< .05). The regression analysis showed that caregivers and physical impairment are the two main predictors of total, internalized, and enacted stigma (P< .01). The correlation analysis revealed that stigma is associated with depression (r = 0.671 ~ 0.690, P< .001), functional independence (r = −0.562~−0.707, P< .001), and functional outcomes (r = 0.436 ~ 0.637, P< .001).

Conclusions: Stigma was moderate, and internalized stigma may be more apparent; therefore, physicians should pay more attention to patients who report or show signs of experiencing stroke-related stigma.

KEYWORDS:

• Depression
• functional independence
• functional outcomes
• inpatient rehabilitation
• stigma
• stigma scale for chronic illness
• stroke

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Science and Technology Program of Guangzhou, China under Grant number [201803010084].