Study On Stigma And Influencing Factors Among Diabetic Foot Inpatients

Objectives To describe the status of stigma,as well as to investigate the level of self-esteem and social support among diabetic foot inpatients,to analyze the influencing factors that might have an effect on the stigma of diabetic foot inpatients,and to explore the relationship between stigma and self-esteem,social support.Therefore,the theoretical basis was provided for taking corresponding clinical nursing intervention measures in order to reduce stigma among diabetic foot inpatients.Methods Using the cross-sectional research method,the survey was conducted among 188 cases of diabetic foot inpatients who came from 4 campus of 2 first-class tertiary hospitals in Jinan from May to December in 2017.The questionnaires included general information questionnaire,Self-Esteem Scale,Social Support Rating Scale and Link stigma series scales that were made up of Perceived Devaluation-Discrimination,Coping Orientations and Stigma-Related Feelings Scales.The SPSS 21.0 software was applied for statistical analysis of data.Specific methods included the descriptive statistics,one-way ANOVA,T test,Pearson correlation analysis and stepwise multiple linear regression analysis.Results 1.A total of 190 questionnaires were distributed,188 valid questionnaires were returned,and effective return ratio is 98.9%.2.The average score of the denigration-discrimination perception dimension among diabetic foot inpatients was(2.74�0.42).The average score of 5 dimensions with coping strategies from large to small was education(2.95�0.53),challenging(2.93�0.51),separation(2.51�0.54),secrecy(2.41�0.54),withdrawal(2.38�0.41).In the aspect of emotional experience,the average score of two dimensions(misunderstanding and different/shame)respectively was(3.36�0.55)and(1.97�0.49).Compared with the scale midpoint at 2.50,the score of four dimensions(denigration-discrimination perception,education,challenging,misunderstanding)was significantly higher(P<0.01),the score of three dimensions(secrecy,withdrawal,different/shame)was significantly lower(P<0.01),the score of separation dimension was higher(P>0.05).3.The total score of self-esteem among diabetic foot inpatients was(22.87�4.93),which was significantly lower than the national norm(P<0.01).4.The total score of social support among diabetic foot inpatients was(36.27�7.47),three dimensions' score of subjective support,objective support,availability of social support respectively was(20.13�5.18),(9.45�1.91),(6.68�1.74),which were significantly lower than the national norm(P<0.01).5.Result from single factor variance analysis of stigma among diabetic foot inpatients showed that there were statistical significance in age,sex,occupation,the number of hospitalized diabetic foot,self-care ability,with or without amputation(toe)and the grade of Wagner(P<0.01,P<0.05),But there were not statistical significance in the cultural degree,marital status,homeplace,family per capita monthly income,the main source of medical expenses,living state,course of the disease and the number of complications(P>0.05).6.Correlation analysis showed that self-esteem among diabetic foot inpatients was negatively related to five dimensions of stigma including misunderstanding,denigration-discrimination perception,different/shame secrecy,withdrawal(r=-0.187~-0.820,P<0.01,P<0.05)and was significantly positively related to three dimensions of stigma including challenging,education,separation(r=0.248~0.307,P<0.01);social support among diabetic foot inpatients was significantly negatively related to four dimensions of stigma including misunderstanding,denigrationdiscrimination perception,withdrawal,different/shame(r=-0.227~-0.531,P<0.01)and was significantly positively related to three dimensions of stigma including challenging,education,separation(r=0.254~0.543,P<0.01).7.Stepwise multiple linear regression analysis showed that self-esteem,age,sex,the grade of wagner and availability of social support came into the regression model,which fitted well(R2 =0.669,F=76.503,P=0.000).These factors could explain 66.9% of the total variance of stigma.According to the standardized coefficient,the degree of impact on stigma from big to small was age,availability of social support,self-esteem,sex,the grade of wagner.Sex and the grade of wagner positively predicted stigma(P<0.01),Besides,self-esteem,age and availability of social support negatively predicted stigma(P<0.01).Conclusion 1.Stigma was common among diabetic foot inpatients who came from 4 campus of 2 first-class tertiary hospitals in Jinan.2.Diabetic foot inpatients who came from 4 campus of 2 first-class tertiary hospitals in Jinan had low level of both self-esteem and social support.3.Self-esteem,age,sex,the grade of wagner and availability of social support were factors predicting stigma among diabetic foot inpatients.Women? high the grade of wagner? young? low self-esteem and availability of social support could significantly enhance stigma.