Factors associated with stigma in community-dwelling stroke survivors in China: A cross-sectional study

Published:September 12, 2019DOI:https://doi.org/10.1016/j.jns.2019.116459


      • The stigma level among stroke patients in China was in mild-moderate degree of the total score.
      • Felt stigma was more prevalent that enacted stigma
      • Among stroke patients, a higher level of stigma was influenced by a higher degree of depression, lower functional ability, a higher degree of an avoiding coping strategy, lower subjective support and recurrence of stroke. Depression was the most significant predictor of stigma.
      • Further work should focus on developing intervention strategies to decrease the amount of stigma and promoting quality of life as well as psychosocial rehabilitation among stroke patients.



      Although stigma is considered to be present in stroke patients, the factors that influence its level are ambiguous. The aim of this study was to investigate whether certain demographic, clinical, and psychosocial characteristics are related to higher levels of stigma among stroke patients in China.


      A total of 200 stroke patients in the community were investigated using the Stigma Scale for Chronic Illness (SSCI), Barthel Index, Self-Rating Depression Scale, Medical Moping Questionnaire, and Social Support Rating Scale. Potential determinants were evaluated with univariate statistical analyses for their contributions to total, felt and enacted stigma. Important findings were further evaluated with multiple regression models.


      The mean total stigma, felt stigma, and enacted stigma scores were 45.21 ± 16.68, 27.93 ± 10.95, and 17.27 ± 6.93, respectively. Most participants reported experiencing felt stigma (90%), while 72.5% reported experiencing enacted stigma. Multiple regression analysis showed that stroke patients' depression, functional status, an avoiding coping strategy, subjective support and recurrence of stroke were factors impacting the SSCI score.


      The stigma level among stroke patients in China was of a mild-moderate degree. Among stroke patients, a higher level of stigma was influenced by a higher degree of depression, a higher degree of an avoiding coping strategy, lower functional ability, lower subjective support and recurrence of stroke. Further work should focus on developing intervention strategies to decrease the amount of stigma and promote quality of life as well as psychosocial rehabilitation among stroke patients.


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