Study On The Status Of Stigma And Its Relationship With Social Support And Self-esteem In Chronic Hepatitis B Virus Infectors

Objectives:This reseasch combined quanlitative study with quatitative study to explore the status of stigma and its relationship with social support and self-esteem in chronic hepatitis B virus infectors,which in order to understand the status of stigma and real experience and its correlation with social support and self-esteem in chronic hepatitis B virus infectors.This research put forward the corresponding intervention strategies and provided the basis for the future of China’s further research of chronic hepatitis B virus infectors with stigma.Methods:1.Quantitative study: 300 chronic hepatitis B virus infectors in Jilin Provincial Hospital for Hepatobiliary were surveyed during June to November 2016.The research subjects were extracted by convenience sampling.The questionnaire consisted of four parts: General Information Questionnaire,Chronic hepatitis B virus Infectors’ Discrimination Measurement Scale,Social Support Rating Scale and Rosenberg Self-Esteem Scale.Epidata3.1 was used to establish the database and record the data.The data were analyzed by SPSS17.0 statistical software.In descriptive analysis,measurement data is presented in(±S),and count data ispresented in frequency and percentage.Rank sum test was used for statistical analysis,and correlation analysis of Spearman coefficient method was used to elaborate the relationship between stigma and social support and self-esteem with chronic hepatitis B virus infectors.Multiple stepwise regression analysis was used to analyze general information and social support and self-esteem scores impact on the stigma of chronic hepatitis B virus infectors.2.Qualitative study: 300 chronic hepatitis B virus infectors in Jilin Provincial Hospital for Hepatobiliary were surveyed during June to November 2016.The research subjects were extracted using objective sampling method.Data werecollected by semi-structured in-depth interview method,and the data were analyzed by Colaizzi seven step analysis method.Results:1.Chronic hepatitis B virus infectors’ stigma total score was(67.53 ± 16.72),and five dimensions including external discrimination and negative self-evaluation and perceived stigma and confidentiality and secondary discrimination average scores were(2.824 ± 0.82),2.95 ± 0.87),(2.98 ± 0.81),(3.19 ± 0.86)and(2.823 ± 0.93).The highest average score was confidentiality.The lowest average score was secondary discrimination.2.The total score of social support for Chronic hepatitis B virus infectors was(38.43 ±6.89).The objective support score was(7.27 ± 2.53),and the subjective support score was(24.18 ± 4.61),and the utility of support score was(6.98 ± 2.27).The total score of self-esteem for Chronic hepatitis B virus infectors was(28.75 ±3.89).3.Perceiving discrimination of hepatitis B status influenced chronic hepatitis B virus infectors’ stigma,external discrimination,negative self-evaluation,perceived stigma,confidentiality and secondary discrimination,and the difference was statistically significant(P<0.01).The satisfaction of family or friends support influenced chronic hepatitis B virus infectors’ perceived stigma and secondary discrimination,and the difference was statistically significant(P<0.05).The current status of hepatitis B infection had an effect on chronic hepatitis B virus infectors’ confidentiality,and the difference was statistically significant(P<0.05).The stepwise regression analysis showed that perceiving discrimination of hepatitis B status was the most important factor affecting chronic hepatitis B virus infectors’ stigma,external discrimination,negative self-evaluation,perceived stigma and secondary discrimination.Perceiving discrimination of hepatitis B status was the main factor affecting chronic hepatitis B virus infectors’ confidentiality.Hepatitis B liver cirrhosis was the most important factor affecting chronic hepatitis B virus infectors’ confidentiality.4.Chronic hepatitis B virus infectors’ stigma total score and five dimensions including external discrimination and negative self-evaluation and perceived stigma and confidentiality and secondary discrimination scores were negatively correlated to the scores of social support and subjective support and utility of support(P<0.05).Chronic hepatitis B virus infectors’ stigma total score and five dimensions including external discrimination and negative self-evaluation and perceived stigma and confidentiality and secondary discrimination scores were negatively correlated to the total score of self-esteem(P<0.05).The stepwise regression analysis showed that the subjective support was the main factor affecting chronic hepatitis B virus infectors’ external discrimination and negative self-evaluation and perceived stigma and confidentiality and secondary discrimination.The utility of support was the main factor affecting chronic hepatitis B virus infectors’ negative self-evaluation and perceived stigma.The self-esteem was the main factor affecting chronic hepatitis B virus infectors’ secondary discrimination.5.The results of qualitative study showed that the six subjects of chronic hepatitis B virus infectors who real experience of stigma were the psychological course after illness,discrimination-related experiences,heavy financial burden,weak support system,changing lifestyles and coping ways to avoid discrimination.Conclusions:1.Chronic hepatitis B virus infectors suffered from stigma,and the infectors had obvious confidentiality,internal discrimination(perceived stigma)and negative self-evaluation;and the infectors’ level of social support was higher than that of the normal.There was no difference between the infectors’ level of self-esteem and the normal people’s level of self-esteem.Quantitative study found that social support level of infectors are relatively high than normal people,but the qualitative study found that infectors’ support system is weak,objective support and utilization of support of infectors’ is low;quantitative research found that the level of self-esteem in infectors and normal people had no significant difference,but the qualitative research found that infectors had low self-esteem,self blame and other negative emotions,and infectors’ self-esteem level is low.2.Study found that perceiving discrimination of hepatitis B status and the satisfaction of family or friends support and the current status of hepatitis B infection had effect on chronic hepatitis B virus infectors’ stigma.3.Quantitative study found that improving the level of infectors’ social support and self-esteem can reduce their stigma.4.Qualitative research found chronic hepatitis B virus infectors had heavy economic burden,and their experiences of discrimination mainly from employment,education,dining and etc.They need for psychological guidance in interpersonal communication aspect.