A Mixed Study On The Current Status Of Stigma And Related Factors In Kidney Transplant Patients

ObjectiveTo investigate the current status of stigma in kidney transplant patients and analyze its related factors;explore the experience of stigma and coping of kidney transplant patients;explore the effect of stigma on quality of life.Methods(1)Convenience sampling was used in cross-sectional study to recruit 314 patients from the kidney transplant center of a Class A hospital in Hunan,China from June 2021 to December 2021.Participants completed the Social Impact Scale(SIS),Self-Esteem Scale(SES),Hospital Anxiety and Depression Scales(HADS),Social Support Rating Scale(SSRS),Medical Coping Modes Questionnaire(MCMQ)and Quality of Life Scale for Patients of Renal Transplantation(QOL-RT).In this study,SPSS 20.0 was used to create a database,and statistical analysis was performed after data entry by two researchers.Statistical methods included descriptive analysis,independent sample t-test,one-way ANOVA,Pearson correlation analysis,and multiple linear regression analysis.(2)Purposive sampling was used in phenomenological research to conduct semi-structured in-depth interviews with 19 kidney transplant patients,and the interview data were compiled using Nvivo 11.0 software,and the data were analyzed and integrated using the Colaizzi seven-step analysis method to refine themes.Results(1)The total stigma score of kidney transplant patients was(55.61±10.78),of which the economic insecurity score was(7.95±1.90),social exclusion score was(19.43±4.55),social isolation score was(16.24±3.64),and intrinsic stigma score was(12.00±2.55).The results of the univariate analysis showed that there were differences in the stigma of kidney transplant patients with different religious beliefs,occupations,education levels,and monthly family income(P<0.05).The results of Pearson correlation analysis showed that the total score and each dimension score of stigma in kidney transplant patients were negatively correlated with self-esteem and social support(P<0.001),and the total score and each dimension score of stigma in kidney transplant patients were positively correlated with anxiety,depression,avoidance coping and acceptance-resignation coping(P<0.05).The results of multiple linear regression analysis showed that monthly family income,self-esteem,acceptance-resignation coping,anxiety and social support entered the regression equation(P<0.05)and explained 51.5% of the total variance.The results of hierarchical multiple regression showed that stigma independently explained 30.3% of the variation of quality of life(P<0.001).(2)In the qualitative study,kidney transplant patients’ experience of stigma and coping could be grouped into 3 major themes 12 sub-themes:(1)extrinsic stigma: public discrimination due to illness,alienation and rejection in interpersonal interactions,unfair treatment at work,and being treated differently;(2)intrinsic stigma: shame,guilt,low self-esteem,worry and uncertainty;(3)coping: avoidance of social activities,self-regulation,distraction,gratitude and self-growth,self-acceptance and seeking positive support.Conclusion(1)The stigma of kidney transplant patients was moderate;stigma has a negative impact on quality of life.Monthly family income,self-esteem,anxiety,social support,and acceptance-resignation were the main influencing factors of stigma in kidney transplant patients.(2)The stigma experience of kidney transplant patients includes extrinsic stigma and intrinsic stigma;stigma coping: avoidance of social activities,self-regulation,distraction,gratitude and self-growth,self-acceptance,and seeking positive support.Figure 3,Table 20,References 96...