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缺乏社会支持和感知污名是否会影响运动神经元病相关压力与心理困扰之间的关系?

Does a lack of social support and perceived stigma influence the relationship between motor neurone disease-related stress and psychological distress?

机构信息

Division of Health Research, Lancaster University, UK.

出版信息

Br J Health Psychol. 2021 May;26(2):289-306. doi: 10.1111/bjhp.12476. Epub 2020 Oct 7.

Abstract

OBJECTIVES

This study aimed to investigate the mechanisms through which social support and felt stigma influence the relationship between motor neurone disease (MND)-related stress and psychological distress for people with MND. Although a lack of social support has been identified as a significant predictor of psychological distress for individuals with MND, the mechanisms through which this relationship exists have not been assessed, nor have the predictive nature of stigma. Furthermore, the theoretical model specifying the effects of enacted stigma on self-stigma has not been tested in individuals with MND.

DESIGN

A cross-sectional design utilizing an online survey method was used. It was hypothesized that social support would moderate the relationship between MND-related stress (operationalized as enacted stigma or physical functioning) and psychological distress (operationalized as depression, anxiety, and stress). Furthermore, felt stigma would significantly mediate the relationship between MND-related stress (enacted stigma) and psychological distress.

METHODS

Individuals with a diagnosis of MND were recruited internationally through social media and through various organizations and support services. Seventy-seven participants completed the online survey.

RESULTS

Significant correlations were identified between social support, felt, and enacted stigma and psychological distress. Moderation analysis was not significant. However, the mediation analyses identified felt stigma as a significant mediator of the relationship between enacted stigma and psychological distress. A direct relationship between enacted stigma and stress (but not depression and anxiety) was also evident.

CONCLUSIONS

A comprehensive approach to tackling stigma is important in ameliorating psychological distress for people with MND. Limitations of the current study are discussed, along with implications for clinical practice.

摘要

目的

本研究旨在探讨社会支持和耻辱感如何影响肌萎缩侧索硬化症(MND)相关压力与患者心理困扰之间的关系,以及社会支持和耻辱感的作用机制。尽管缺乏社会支持已被确定为 MND 患者心理困扰的重要预测因素,但尚未评估这种关系存在的机制,也未预测耻辱感的预测性质。此外,指定实施耻辱感对自我耻辱感影响的理论模型尚未在 MND 患者中进行测试。

设计

本研究采用横断面设计,利用在线调查方法。研究假设社会支持会调节 MND 相关压力(表现为实施耻辱感或身体功能)与心理困扰(表现为抑郁、焦虑和压力)之间的关系。此外,耻辱感会显著中介 MND 相关压力(实施耻辱感)与心理困扰之间的关系。

方法

通过社交媒体以及各种组织和支持服务,在国际范围内招募 MND 患者。共有 77 名参与者完成了在线调查。

结果

社会支持、耻辱感和实施耻辱感与心理困扰之间存在显著相关性。调节分析不显著。然而,中介分析表明,耻辱感是实施耻辱感与心理困扰之间关系的重要中介因素。实施耻辱感与压力(而非抑郁和焦虑)之间也存在直接关系。

结论

全面解决耻辱感问题对于改善 MND 患者的心理困扰非常重要。讨论了当前研究的局限性以及对临床实践的影响。

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