| Objective:To investigate the current status of psycho-social adjustment and stigma in patients with inflammatory bowel disease(IBD),discuss relevant influencing factors of psycho-social adjustment,and analyze the relationships between stigma,social support,coping styles and psycho-social adjustment.To explore whether social support and coping styles play a mediating role in the relationship between stigma and psychosocial adjustment in patients with IBD,so as to provide theoretical basis and guidance for improving patients’psychosocial adjustment and formulating clinical intervention programs.Methods:From July to October 2022,a total of 250 patients with IBD who were outpatients and inpatients in two grade-Ⅲ Class A hospitals in Shandong Province were selected as the research objects.A cross-section survey was conducted using the general data questionnaire,the psychosocial adjustment questionnaire for inflammatory bowel disease,the chronic disease Stigma Scale,the medical social Support Scale,and the medical coping style questionnaire.Description analysis,independent sample t test,single factor analysis of variance,Pearson correlation analysis,multiple linear stepwise regression analysis were performed on the collected data by SPSS21.0,and structural equation model was constructed by AMOS26.0.Results:1.The psycho-social adjustment score of IBD patients ranged from 53 to 138points,with the total average score(97.98±16.08)and the average score of each dimension was body image(3.78±0.69),anxiety/depression(3.42±0.66),sleep disorder(3.36±0.76),attitude(3.29±0.70),self-efficacy(3.24±0.52)and social support(3.21±0.80).2.Independent sample T-test and univariate analysis showed that educational level,marital status,disease type and disease course had statistical significance in psychosocial adjustment scores of IBD patients(P<0.05).3.The total mean score of stigma in IBD patients was(62.18±11.19),and the mean score of internal stigma dimension(3.16±0.54)was higher than that of external stigma dimension(1.92±0.51).The scores of each dimension of coping style of IBD patients from high to low were yield(3.20±2.16),face(2.73±0.33),avoidance(2.40±0.28).The total mean score of medical and social support for IBD patients was(62.17±14.73).4.Pearson correlation results showed that psychosocial adjustment of IBD patients was negatively correlated with stigma,avoidance and submission coping style(P<0.05,P<0.01),and positively correlated with medical support and coping style(P<0.05,P<0.01).5.The results of multiple linear stepwise regression analysis showed that education level,yielding coping style,facing coping style,internal stigma,external stigma and disease course were significant predictors of psychosocial adjustment in patients with IBD,accounting for 69.1%of the total variation in psychosocial adjustment.6.Structural equation was used to explore the mediating role of social support and coping style.The results showed that social support played an insignificant role in the pathway,while coping style played a partial mediating role in the relationship between stigma and psychosocial adjustment.χ~2=47.888,χ~2/df=1.596,GFI=0.960,AGFI=0.926,NFI=0.961,TLI=0.977,CFI=0.985,IFI=0.985,RFI=0.941,RMSEA=0.051.The total effect of stigma on psychosocial adjustment was 0.8476 and the mediating effect was0.1976,accounting for 23.31%of the total effect.Conclusion:1.The psychosocial adjustment of IBD patients is at a low level,and is affected by education level,marital status,disease type and course,and is related to the patient’s self adjustment and partner support related to the disease.2.Patients with IBD have a high level of stigma,a high level of practical support in social support,a low level of emotional support,and a high level of yielding coping styles,followed by facing coping styles.3.Psychosocial adjustment of IBD patients was significantly negatively correlated with stigma,submission coping style and avoidance coping style,and significantly positively correlated with social support and coping with facing.4.The results of multiple linear stepwise regression showed that education level,yielding coping style,facing coping style,internal stigma,external stigma and disease course were important predictors of psychosocial adjustment in patients with IBD.5.Social support of IBD patients had no significant effect on stigma and psychosocial adjustment,and did not play a mediating effect;Coping style has a chain mediating effect between stigma and psychosocial adjustment,that is,stigma can directly affect psychosocial adjustment and indirectly affect psychosocial adjustment through coping style. |
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