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Determinants of stigma in a cohort of hellenic patients suffering from multiple sclerosis: a cross-sectional study
Maria Anagnostouli1, Serafeim Katsavos2, Artemios Artemiadis2
11st Department of Neurology, Medical School of National and Kapodistrian University of Athens, Aeginition Hospital, Vas.Sophias ave 72-74, Athens, 115-28, Greece. managnost@med.uoa.gr.
Insights
Stigma significantly impacts Multiple Sclerosis (MS) patients
Area of Science:
- Neurology
- Psychiatry
- Social Sciences
Background:
- Stigma is a known issue for patients with Multiple Sclerosis (MS).
- Factors influencing stigma levels in MS patients remain unclear.
- This study investigates stigma determinants and Quality of Life (QoL) in Hellenic MS patients.
Purpose of the Study:
- To identify key determinants of stigma in Greek MS patients.
- To assess the impact of stigma on the Quality of Life (QoL) of MS patients.
- To explore internalized and externalized stigma in this cohort.
Main Methods:
- 342 MS patients participated in the study.
- Data included sociodemographics, disease variables, mental illness assessment, MSQoL-54, and SSCI-24 questionnaires.
- Statistical analyses, including univariate and hierarchical regression, were used to evaluate stigma determinants and QoL correlations.
Main Results:
- Disability level and mental illness were the strongest predictors of stigma across all categories.
- Internalized stigma was also influenced by working and caregiving status.
- Higher stigma levels correlated negatively with all aspects of MS patients' QoL.
Conclusions:
- Stigma is a significant barrier affecting MS patients' QoL and functioning.
- Disability and mental illness are primary drivers of stigma in MS.
- Further research in diverse MS populations is needed for improved patient-centered care.
Background:
Patients suffering from several neurologic disorders may bear the "stigma" of their disease, being disqualified from full social acceptance. Although stigma is considered to be present in Multiple Sclerosis (MS), the factors that influence its levels are ambiguous. Aim of our study was to examine, for the first time in the literature, the basic determinants of stigma in a Hellenic MS-patients cohort, as well as how stigma affects their Quality-of-Life (QoL) profiles.
Methods:
Three hundred forty two patients were recruited in this study. Data collected concerned sociodemographic and disease-related variables, mental illness assessment, Multiple-Sclerosis-QoL-54 (MSQoL-54) and Stigma-Scale-for-Chronic-Illness-24 (SSCI-24) questionnaires. Potential determinants were evaluated with univariate statistical analyses for their contribution to total, internalized (inner-self derived) and externalized (society derived) stigma. Important findings were further evaluated on hierarchical regression models.
Results:
Disability levels were found to be the most powerful predictor in all stigma categories, followed by the presence of mental illness. Working and caregiving status were also ascertained as determinants of internalized stigma. Stigma levels displayed strong negative correlation with all composites of MSQoL-54.
Conclusions:
Stigma is present in the social environment of MS patients and was confirmed as a barrier (according to the International Classification of Functioning, Disability and Health), with detrimental effects on their QoL levels and functioning performances. Disability and mental illness were shown as the principal determinants of stigma, while financial characteristics were not as equally involved. Further validation of these results in other MS populations may provide safer conclusions, towards more efficacious patient-centered care outcomes.
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