Stigma and self-esteem in patients with bronchial asthma

Asthma is a debilitating chronic disease that renders individuals physically as well as mentally sick. The perception of stigmatization further leads to inappropriate control of asthma, resulting in a bidirectional relationship. A prospective, cross-sectional study was conducted in a tertiary care center of a semi-urban area of north India during 2021-2022. A total of 300 cases of bronchial asthma and 50 healthy controls were enrolled. The asthma control test (ACT) was used to evaluate the control of asthma. Stigma and self-esteem were measured with the use of a 28-item self-stigma scale, the Rosenberg's self-esteem scale, and the stigma-related social problem scale (SSPS). The impact of sociodemographic and clinical profiles on stigma and self-esteem was evaluated. Correlation of different scales with each other was done along with. The mean age of asthmatic patients was 47.41±15.507 years, with 56% of patients being females; 49.3% of patients were well-controlled, and 36.3% were partly controlled. Positive subscales of the 28-item self-stigma scale, Rosenberg's self-esteem scale, and SSPS showed statistically significant differences between cases and controls (p<0.001). ACT significantly correlated with the 28-item self-stigma scale, Rosenberg's self-esteem scale, and SSPS, and all three stigma and self-esteem scales correlated significantly with each other. Stigma and low self-esteem were found to be significantly higher in asthmatic patients than healthy controls. This needs to be addressed as a priority, as it can contribute to poor mental health and poor asthma outcomes.