Correlation Between Alexithymia, Illness-Related Stigma, and Self-Esteem in Patients With Lymphedema: A...

This study examined alexithymia, illness-related stigma, and self-esteem among patients with lymphedema to provide evidence for improving self-esteem, enhancing emotional expression, and reducing stigma.

To describe levels of alexithymia, illness-related stigma, and self-esteem in patients with lymphedema; examine demographic differences; and test prespecified associations among these variables.

This was a cross-sectional, questionnaire-based study. A convenience sample of 195 patients with lymphedema receiving treatment at a tertiary oncology hospital in southern China completed questionnaires between October 2020 and February 2021. Instruments included the Toronto Alexithymia Scale, Social Impact Scale, and Rosenberg Self-Esteem Scale. Descriptive statistics summarized patient characteristics and scores. Group differences were tested with t-tests, analysis of variance, and rank-sum tests.

The mean alexithymia score was 56.53 ± 8.43, with externally oriented thinking highest and difficulty describing emotions lowest. Alexithymia differed by education, marital status, residence, income, and activity after onset (p < .05). The mean stigma score was 60.36 ± 11.08, highest for social exclusion and lowest for internalized shame, differing by income, personality, and family relationships (p < .05). The mean self-esteem score was 27.84 ± 4.07, differing by education, employment, residence, income, personality, activity, and family relationships (p < .05). Alexithymia correlated positively with stigma (r = .51, p < .01) and negatively with self-esteem (r = -.65, p < .01). Stigma correlated negatively with self-esteem (r = -.60, p < .01).

Economic discrimination was the strongest correlate of stigma, and income and family relationships were key associated factors. Interventions targeting emotional expression and self-esteem may be relevant for psychosocial support in this population.