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The Effect of Stigmatization on Working Nurses' Willingness to Care for Patients with Psoriasis and Its Mediating
Shuzhen Kong1, Haoru Niu2, Xinyu Xu2
1Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Abstract:
Psoriasis-related stigmatization affects nurses' willingness to provide care, potentially compromising patient outcomes. However, limited research has examined this issue. A cross-sectional survey of 1,873 nurses was conducted, which assessed 4 stigmatization dimensions and their correlation with the willingness to care for patients with psoriasis, and explored the roles of education, working environment, and self-reported psoriasis knowledge. Structural equation modelling and regression analyses were conducted. The results revealed that stigmatization negatively impacted nurses' willingness to provide care (p < 0.001), with social distance exhibiting the strongest effect (r = -0.476, OR = 0.87, 95% CI: 0.85-0.88, p < 0.001). A significant dose-response relationship was observed, where higher stigmatization levels corresponded to lower care willingness (overall trend test: p < 0.001; nonlinear trend test: p < 0.001). Nurses with higher education levels (p < 0.001) or those working in tertiary hospitals (p < 0.001) demonstrated lower willingness to provide care. Interestingly, greater self-reported psoriasis knowledge was associated with increased stigmatization, which in turn reduced care willingness (direct effect: -0.618; 95% CI: -0.814, -0.422; proportion mediated: 29.0%, 95% CI: 0.094, 0.486). These findings underscore the need for targeted training programmes, improved work environments, and stigma-reduction initiatives to enhance nurses' willingness to care for patients with psoriasis.
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