Page 19 - JCBP-2-4

Journal of Clinical and
Basic Psychosomatics Stigma in maintenance hemodialysis patients

Table 1. (Continued) Table 2. Stigma scores in MHD patients
Variables Mean±SD/n (%) Variables Values (mean±SD)
Serum phosphorus (mmol/L) 2.12±0.68 Stigma (total) 43.09±14.95
Parathyroid hormone (pg/mL) 342.39±290.38 Internalized stigma 25.91±9.26
Albumin (g/L) 38.41±2.93 Enacted stigma 17.19±6.72
Prealbumin (g/L) 321.92±66.28 Abbreviations: MHD: Maintenance hemodialysis; SD: Standard
Triglyceride (mmol/L) 1.99±1.57 deviation.
Cholesterol (mmol/L) 3.74±1.20
Table 3. Correlation between the total score of stigma and
Dialysis adequacy indicators
each domain of the short‑form health survey (SF‑36)
Kt/V 1.27±0.25
Domains r P
URR 68.13±7.09
Physical functioning −0.078 0.406
BDI 18.11±12.15
BAI 9.41±9.85 Role-physical −0.140 0.134
Bodily pain −0.212 0.023*
Note: Data are presented as mean±standard deviation (SD) or n (%).
Abbreviations: BAI: Beck Anxiety Inventory; BDI: Beck Depression General health −0.232 0.012*
Inventory; URR: Urea reduction ratio. Vitality −0.231 0.013*
Social functioning −0.319 0.000*
The average score of the SSCI was 43.09 ± 14.95. Within
the SSCI, the scores for internalized stigma and enacted Role-emotional −0.308 0.001*
stigma were 25.91 ± 9.26 and 17.19 ± 6.72, respectively Mental health −0.332 0.000*
(Table 2). Correlation analysis indicated that the total Note: *P<0.05.
score of the SSCI was negatively related to all modules of
the SF-36. Specifically, bodily pain, general health, vitality, Table 4. Factors associated with internalized stigma in MHD
social functioning, role-emotional, and mental health patients
revealed significant relationships (P < 0.05) (Table 3). Variables β 95% CI t P
Multivariate linear regression analysis revealed that Uremic pruritus 4.113 1.723 – 6.503 3.413 0.001*
internalized stigma was significantly associated with Duration of hemodialysis −0.018 −0.001 – −0.036 2.060 0.042*
uremic pruritus (β = 4.113; 95% confidence interval Note: *P<0.05.
[CI]: 1.723 – 6.503; P = 0.001) and duration of hemodialysis Abbreviations: CI: Confidence interval; MHD: Maintenance
(β = −0.018; 95% CI: -0.001 – (−0.036); P = 0.042) (Table 4). hemodialysis; SD: Standard deviation.
Enacted stigma was significantly associated with uremic
pruritus (β = 2.941; 95% CI: 0.626 – 5.256; P = 0.013), BDI Table 5. Factors associated with enacted stigma in MHD
score (β = 0.153; 95% CI: 0.051 – 0.255; P = 0.004), and patients
BAI score (β = 0.149; 95% CI: 0.024 – 0.274; P = 0.020)
(Table 5). Variables β 95% CI t P
Uremic pruritus 2.941 0.626 – 5.256 2.521 0.013*
4. Discussion BDI 0.153 0.051 – 0.255 2.986 0.004*
Stigma is a common phenomenon concomitant with BAI 0.149 0.024 – 0.274 2.374 0.020*
different chronic illnesses, disabilities, and contagious Note: *P<0.05.
diseases, causing much distress to those who are Abbreviations: BAI: Beck Anxiety Inventory; BDI: Beck Depression
stigmatized. 17,18 Moreover, stigma poses indirect but Inventory; CI: Confidence interval; MHD: Maintenance hemodialysis;
adverse implications for public health efforts aimed at SD: Standard deviation.
combating the diseases or conditions concerned. The
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consequences for the affected patients may manifest as depending on hemodialysis for survival becomes a focal
psychological stress, social isolation, and an increased risk point of stigma.
of disability and disease progression. 20,21 Enacted stigma The quality of life of maintenance hemodialysis patients
affects self-perception and anticipation of discrimination, is also a field that nephrologists should actively pay attention
while internalized stigma involves internalizing negative to. Our findings suggested that stigma is negatively
stereotypes, resulting in low self-esteem and behavioral correlated with all modules of quality of life in maintenance
futility. For ESRD patients, losing renal function and hemodialysis patients. Beyond physical suffering, these
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Volume 2 Issue 4 (2024) 4 doi: 10.36922/jcbp.2181