A qualitative study on the impact of internalized stigma on type 2 diabetes self-management

Kato, Atsushi; Fujimaki, Yuko; Fujimori, Shin; Izumida, Yoshihiko; Suzuki, Ryo; Ueki, Kohjiro; Kadowaki, Tomoko; Hashimoto, Hideki

doi:10.1016/j.pec.2016.02.002

Cited by 55 publications

(67 citation statements)

References 17 publications

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“…In our previous qualitative study,21 we found that psychological and behavioural patterns of stigma varied depending on levels of illness-related self-esteem and attitudes towards social participation in patients with T2DM. For quantitative consistency, in this study we used the SES to measure self-esteem levels and three SF-36 subscales to measure social participation.…”

Section: Methodsmentioning

confidence: 77%

“…In this study, we use the term social participation as it was defined in our previous study; essentially, social participation is defined as the degree to which patients are willing to participate in social life, which is influenced more by public stigma than by physical complications stemming from the severity of their condition 21. Therefore, we intentionally chose these subscales not for the purpose of detecting small changes that were clinically important, but for the purpose of assessing patients' functional states that were influenced by their illness-related negative experiences as well as their illnesses.…”

Section: Methodsmentioning

confidence: 99%

“…In our previous qualitative study,21 we showed that, in regard to responses to diabetes-related stigma, psychological and behavioural patterns of patients with T2DM could be explained by the following two dimensions: (1) a sense of self-esteem in relation to their illness and (2) attitudes towards social participation (for more details, see our previous paper21). These psychological and behavioural patterns can be categorised as follows: group A (high self-esteem/high social participation), group B (high self-esteem/low social participation), group C (low self-esteem/high social participation) and group D (low self-esteem/low social participation).…”

Section: Introductionmentioning

confidence: 94%

“…18–20 Depending on the degree of social participation, adjustment styles to illness differ 1617 For T2DM specifically, Kato et al 21 have found that patients' responses to self-stigma could be associated with social participation, which was defined as the degree to which patients are willing to participate in social life regardless of the severity of their condition.…”

Section: Introductionmentioning

confidence: 99%

“…We qualitatively found that, compared with other groups, groups C and D seemed to develop lower self-esteem as a result of their own negative experiences and perceptions of their illness (stigma). The internalisation of this stigma (self-stigma) was seen as a possible contributing factor to changes in social participation and treatment adherence 21. However, the associations between these distinct psychological and behavioural patterns of stigma (self-esteem and social participation) with self-stigma, patient activation for engaging in self-care and glycaemic control remain unproven quantitatively.…”

Section: Introductionmentioning

confidence: 99%

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Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

et al. 2017

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ObjectivesThe aim of this study was to test the psychological and behavioural patterns of stigma (self-esteem and social participation) and their relationship to self-stigma, patient activation for engaging in self-care and glycaemic control among patients with type 2 diabetes mellitus (T2DM).DesignA cross-sectional study.Setting2 tertiary-level hospitals and 2 secondary-level hospitals in Japan.ParticipantsA consecutive sample of 209 outpatients with T2DM. Inclusion criteria were as follows: presence of T2DM, age 20–74 years, no diagnosis of dementia and/or psychosis, and no need for urgent medical procedures.Outcome measuresStudy measures included a self-administered questionnaire to assess the Rosenberg Self-Esteem Scale (SES), the 3 subscales of 36-question Short Form Health Survey (SF-36; Social Function, Role Physical, Role Emotional), Self-Stigma Scale and Patient Activation Measure (PAM-13). Glycated haemoglobin was obtained from same day blood work. In our previous qualitative study, we found that psychological and behavioural patterns of stigma varied according to patients' levels of illness-related self-esteem as well as attitudes towards social participation. For quantitative consistency, we used the SES scale to measure self-esteem and the SF-36 subscales to measure social participation. We then divided participants into 4 groups by exhibited psychological and behavioural patterns: group A (high SES/high SF-36), group B (high SES/low SF-36), group C (low SES/high SF-36) and group D (low SES/low SF-36).ResultsUsing analysis of covariance after controlling for age and sex, there was a significant difference in self-stigma levels between the four groups (F[3203]=15.70, p<0.001). We observed the highest mean self-stigma levels in group D. Group D also had significantly lower PAM-13 scores than those of groups A (p<0.001) and B (p=0.02).ConclusionsThe psychological and behavioural pattern of group D was found to be associated with higher levels of self-stigma and poorer patient activation for self-care.

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Section: Methodsmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

et al. 2017

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The role of resilience in diabetes stigma among young and middle‐aged patients with type 2 diabetes

et al. 2022

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Aim To explore the prevalence and related factors influencing diabetes stigma among Chinese young and middle‐aged patients with type 2 diabetes. Design A cross‐sectional, quantitative study was conducted through questionnaires. Methods A total of 453 young and middle‐aged patients with type 2 diabetes were recruited. Questionnaire survey was conducted with convenience sampling from September 2019 to December 2020. This included demographic questionnaire, Type 2 Diabetes Stigma Assessment Scale (DSAS‐2) and Connor–Davidson Resilience Scale (CD‐RISC). The STROBE checklist was applied as the reporting guideline for this study. Results The scores of diabetes stigma and resilience of patients were 48.18 ± 14.52 and 66.02 ± 7.18, respectively. Diabetes stigma was negatively correlated with resilience, the correlation coefficient was −0.581. The results showed that the complications, diabetes year, monthly income and insulin treatment are important factors affecting stigma. In addition, it is resilience that was a protective factor of diabetes stigma, explaining 27.2% of the variance in diabetes stigma.

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Social Determinants of Health and Diabetes Outcomes

Hashimoto

2019

The Diabetes Textbook

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A qualitative study on the impact of internalized stigma on type 2 diabetes self-management

Cited by 55 publications

References 17 publications

Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

The role of resilience in diabetes stigma among young and middle‐aged patients with type 2 diabetes

Social Determinants of Health and Diabetes Outcomes

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