The effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae: A cross-sectional study

Objective To explore the effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae. Design A cross-sectional survey study. Setting The study was conducted in two community centres in Tianjin, China. Subjects Community-dwelling Chinese patients with stroke sequelae. Measures Chinese version of Stigma Scale for Chronic Illness, Chinese version of Impact on Participation and Autonomy, Modified Barthel index, Self-Rating Depression Scale, Social Support Rating Scale, Medical Coping Modes Questionnaire, background and disease-related questions. Pearson’s correlation coefficients were computed between stigma and social participation. The impact of stigma on social participation was estimated by hierarchical multiple regression analysis after controlling for demographic, physical and psychosocial characteristics. Results In total, 136 patients with stroke sequelae were included in this study, with a mean age of 67.8 years. The Chinese version of the Stigma Scale for Chronic Illness had a mean score of 48.4 (SD 16.9), and the Chinese version of the Impact on Participation and Autonomy was 67.1 (SD 21.1). Significant correlations were found between stigma and social participation. Pearson’s correlation coefficient ranged from 0.354 to 0.605 ( P < 0.01). Enacted stigma provided a significant explanation for the variance of social participation by 1.1% ( P < 0.05). Felt stigma provided a significant explanation for the variance of social participation by 2.9% ( P < 0.001). Conclusion Felt stigma and enacted stigma have independent associations with social participation. Patients with stroke sequelae who reported higher stigma experienced a lower level of social participation.