The Mediating and Moderating Role of Resilience Between Stigma and Illness Identity Among People with Inflammatory Bowel Disease

Figures & data

Table 1 General Characteristics of the Participants (N=322)

Characteristic	Classification	N(%)
Gender
	Male	219 (68.0)
	Female	103 (32.0)
Age (year)
	18~25	74 (23.0)
	26~45	178 (55.3)
	≥ 46	70 (21.7)
Education level
	Primary education	88 (27.3)
	Secondary education	46 (14.3)
	Higher education	188 (58.4)
Marital status
	Unmarried	118 (36.6)
	Married	194 (60.2)
	Divorced/Widowed	10 (3.1)
Residence
	City/Town	250 (77.6)
	Country	72 (22.4)
Family yearly income (yuan)
	<50, 000	115 (35.7)
	50, 000~100, 000	84 (26.1)
	>100, 000	123 (38.2)
Disease type
	Crohn	234 (72.7)
	Ulcerative colitis	88 (27.3)
Disease duration (year)
	<1	100 (31.1)
	1~5	136 (42.2)
	>5	86 (26.7)
Disease activity
	Remission	237 (73.6)
	Active stage	85 (26.4)
Biological Agents
	Yes	209 (64.9)
	No	113 (35.1)
Abdominal wall stoma
	Yes	9 (2.8)
	No	313 (97.2)
Nasal feeding
	Yes	24 (7.5)
	No	298 (92.5)

Table 2 Correlations Between Study Variables

Variable	Range	Mean (SD)	1	2	3	4	5	6
1. Rejection	5~25	14.01 (4.28)	1
2. Acceptance	4~20	15.13 (2.69)	−0.206**	1
3. Engulfment	8~40	20.53 (7.61)	0.373**	−0.212**	1
4. Enrichment	7~35	26.19 (5.33)	−0.180**	0.415**	−0.203**	1
5. Stigma	24~120	42.71 (16.17)	0.380**	−0.217**	0.707**	−0.205**	1
6. Resilience	25~125	97.87 (15.53)	−0.266**	0.307**	−0.428**	0.530**	−0.483**	1

Note: **p<0.01.

Table 3 Hierarchical Regression Examining the Effect of Resilience on the Relationship Between Stigma and Illness Identity (N=322)

Variable		M (resilience)					Y (rejection)				Y (acceptance)				Y (engulfment)				Y (enrichment)
		b	SE	95% CI	p		b	SE	95% CI	p	b	SE	95% CI	p	b	SE	95% CI	p	b	SE	95% CI	p
X (stigma)	a	−0.464	−0.047	(−0.556, −0.371)	<0.001	c’	0.087	0.016	(0.056, 0.117)	<0.001	−0.015	0.010	(−0.035, 0.005)	0.137	0.307	0.021	(0.265, 0.348)	<0.001	−0.022	0.018	(−0.013, 0.057)	0.220
M (resilience)						b	−0.030	0.016	(−0.062, 0.002)	0.067	0.046	0.011	(0.025, 0.066)	<0.001	−0.056	0.022	(−0.099, −0.012)	0.012	0.193	0.019	(0.156, 0.229)	<0.001
		R^2=0.233					R^2=0.153				R^2=0.100				R^2=0.509				R^2=0.284
		ΔR^2=0.233					ΔR^2=0.009				ΔR^2=0.053				ΔR^2=0.010				ΔR^2=0.242
		F(1,320)=97.286					F(2,319)=28.836				F(2,319)=17.765				F(2,319)=165.492				F(2,319)=63.317
		p<0.001					p<0.001				p<0.001				p<0.001				p<0.001

Note: unstandardized beta coefficients were reported.

Abbreviation: SE, standard error.

Table 4 The Bootstrap Results of Mediation Analysis

	Effects	Engulfment			Acceptance			Enrichment
		Coeff.	SE	95% CI	Coeff.	SE	95% CI	Coeff.	SE	95% CI
Stigma	Total effect	0.504	0.029	(0.448, 0.560)	−0.111	0.028	(−0.165, −0.056)	−0.117	0.031	(−0.179, −0.055)
	Direct effect	0.469	0.032	(0.407, 0.531)	−0.055	0.030	(−0.114, 0.004)	−0.032	0.030	(−0.027, 0.090)
	Indirect effect through resilience	0.035	0.016	(0.006, 0.069)	−0.056	0.016	(−0.089, −0.026)	−0.149	0.025	(−0.202, −0.104)

Abbreviations: Coeff, coefficient; SE, standard error.

Figure 1 The mediation model of stigma, resilience, illness identity (acceptance, enrichment, engulfment). a The effect of stigma on resilience; b The effect of resilience on illness identity; c The total effect of stigma on illness identity; c’ The direct effect of stigma on illness identity; ***p < 0.001, *p<0.05. Unstandardized beta coefficients were reported.

Table 5 The Bootstrap Results of Moderating Effect

	Coeff.	SE	95% CI
Stigma→ Resilience→ Rejection
Index of moderating effect	0.002	0.001	(0.001, 0.003)
Low resilience	0.071	0.017	(0.037, 0.105)
High resilience	0.121	0.023	(0.077, 0.165)

Abbreviations: Coeff, coefficient; SE, standard error.

Figure 2 Moderating effect of resilience on the pathway from stigma to rejection.