Correlation of internalized stigma with self‐esteem, social support and coping styles in patients with rheumatoid arthritis: A cross‐sectional study

Abstract

AbstractAimTo understand the status of internalized stigma in patients with rheumatoid arthritis (RA) and explore its relationship with self‐esteem, social support, and coping style.MethodsThis cross‐sectional study selected patients with RA who visited the Rheumatology and Immunology Department of a tertiary hospital from May 2022 to May 2023. The Chinese versions of the Internalized Stigma of Mental Illness Scale‐Rheumatoid Arthritis (ISMI‐RA), Social Support Rating Scale, Rosenberg Self‐Esteem Scale, and Medical Coping Style Questionnaire were administered to assess the internalized stigma, social support, self‐esteem, and coping styles, respectively. The Pearson correlation test or Spearman rank correlation was then used to analyze the correlation between these measures.ResultsOverall, 69.5% participants reported high level of internalized stigma. The average age of the 174 participants was 52.67 ± 12.24 years, with 87.36 per cent female patients. The mean ISMI‐RA score was 54.49 ± 9.62, and the ISMI‐RA subscale with the highest average score was alienation. The Pearson's correlations show that internalized stigma was positively associated with the coping styles of avoidance (r = .212, p < .01) and acceptance (r = .560, p < .01), and that internalized stigma was negatively associated with the coping styles of confrontation (r = −.479, p < .01), social support (r = −.570, p < .01), and self‐esteem(r = −.512, p < .05).ConclusionThe high level of internalized stigma in RA patients suggests that we should develop interventions to improve patients' self‐esteem, encourage them to adopt positive coping styles, and gain more social support for them, so as to alleviate their internalized stigma.