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Anticipated stigma in chronic illness patients in Cambodia, Myanmar and Vietnam
11ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; Department of Research Innovation and Development, University of Limpopo, Turfloop Campus, Sovenga, South Africa; HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
Insights
Over 20% of chronic disease patients in Southeast Asia anticipate stigma, linked to factors like age, education, and health behaviors. Understanding these factors is key to developing effective interventions for chronic illness stigma.
Area of Science:
- Public Health
- Social Sciences
- Health Psychology
Background:
- Chronic diseases affect millions globally, necessitating research into psychosocial factors impacting patient well-being.
- Stigma associated with chronic illness can significantly influence patient health outcomes and healthcare engagement.
- Limited research exists on anticipated chronic illness stigma in Southeast Asian populations.
Purpose of the Study:
- To investigate the prevalence of anticipated chronic illness stigma among adult patients with chronic diseases in Cambodia, Myanmar, and Vietnam.
- To identify sociodemographic, health status, and behavioral factors associated with anticipated chronic disease stigma.
- To inform the development of targeted interventions to mitigate stigma in this population.
Main Methods:
- A cross-sectional survey was administered to 4,803 adult patients with chronic diseases across health facilities in three Southeast Asian countries.
- Data collected included sociodemographics, health status, quality of life, health risk behaviors, medication adherence, and anticipated chronic disease stigma using a 12-item scale.
- Multivariate analysis was employed to identify factors associated with anticipated chronic disease stigma.
Main Results:
- 20.7% of patients reported anticipating chronic disease stigma.
- Factors associated with higher anticipated stigma included older age, higher education, origin from Myanmar or Vietnam, single/divorced/widowed status, rural residence, having multiple chronic conditions, engaging in health risk behaviors, and lower medication adherence.
- Lower quality of life was also associated with anticipated stigma.
Conclusions:
- Anticipated chronic illness stigma is a significant issue for a substantial proportion of chronic disease patients in Southeast Asia.
- Sociodemographic, health, and behavioral factors play a crucial role in the experience of anticipated stigma.
- Findings highlight the need for culturally sensitive interventions to reduce anticipated stigma and improve the lives of individuals living with chronic diseases.
Abstract:
The aim of this study was to explore the prevalence and relationship of anticipated chronic illness stigma among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam). A cross-sectional survey was conducted in 4,803 adult chronic disease patients (mean age 49.3 years; SD=16.5) recruited systematically from health facilities. Overall, the results indicate that 20.7% of patients reported that for any of the 12 stigma items, they anticipated they were likely or very likely to experience chronic disease stigma. A multivariate analysis of sociodemographics revealed the following were associated with anticipated chronic disease stigma: older versus younger age, OR (odds ratio) = 0.71; 95% Confidence Interval (CI) [0.58, 0.87]; higher versus lower education, OR = 2.23; 95% CI [1.81, 2.75]; origin from Myanmar or Vietnam, being single, divorced or widowed, rural residence, and health status (having three or more chronic conditions versus having one chronic condition), OR = 1.93; 95% CI [1.58, 2.35]; lower versus higher quality of life, OR = 0.73; 95% CI [0.63, 0.85]); health risk behavior (physical inactivity, poor diet, current smoking, and problem drinking) and low versus medium or high medication adherence (OR = 0.69; 95% CI [0.55,0.86]). This study demonstrated the possible consequences of anticipated stigma on the health and behavior of people living with chronic diseases, and several factors for chronic disease stigma were identified that can help guide interventions to reduce chronic illness stigma in this population.
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