Anticipated stigma and healthcare utilization in COPD and neurological disorders

This descriptive correlational study explored the experience of anticipated stigma and its association with health-seeking behavior in individuals with COPD or a neurological disorder. Participants with COPD (n = 38) or neurological disorders (n = 39) were recruited from specialty practices. The Chronic Illness Anticipated Stigma Scale (CIASS) and Healthcare Access Measure (HAM) were used to measure stigma and healthcare utilization in this population. Socio-demographic and illness-related data were entered into a hierarchical regression analysis to identify variables that contribute to anticipated stigma from three sources. The mean scores of anticipated stigma by family and friends, coworkers, and healthcare workers were low to moderate at 7.96, 11.68 and 7.94 respectively. Mean score on the HAM was 12.94, indicating moderate delay, in healthcare utilization. The HAM was correlated with anticipated stigma by family and friends and healthcare provider subscales (r = .293, p = .010; r = .449 p = .000), indicating a relationship between higher levels of anticipated stigma in these areas and lower levels of healthcare utilization. Anticipated stigma by coworkers was correlated with neurological disorders (r = .257, p = .048). In a final model, 20%, 35.4% and 16.8% of the variance of anticipated stigma from 3 sources can be explained in the final model. Findings from this study describe low to moderate levels of anticipated stigma from three sources is experienced in individuals with COPD and neurological disorders and lends new understanding about the association of stigma to healthcare utilization behavior in this population. Strategies are needed to mitigate the effects of stigma on healthcare utilization.