尼日利亚拉各斯耐多药结核病患者经历污名、焦虑、抑郁和孤独之间的关联：社会支持的调节作用。

Association between experienced stigma, anxiety, depression and loneliness among people with drug-resistant tuberculosis in Lagos Nigeria: The moderating role of social support.

机构信息

Mainland Hospital Yaba, Lagos, Nigeria.

Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa.

出版信息

Trop Med Int Health. 2024 Oct;29(10):882-894. doi: 10.1111/tmi.14046. Epub 2024 Sep 5.

DOI:10.1111/tmi.14046

PMID:39233632

Abstract

BACKGROUND

This study assessed the moderating effect of social support on the association between experienced stigma versus anxiety, depression and loneliness among people with drug-resistant tuberculosis.

METHODS

A descriptive cross-sectional study was conducted among 203 adults on treatment for drug-resistant tuberculosis for at least 8 weeks. Validated scales were used to assess experienced stigma, anxiety, depression, loneliness and social support. Partial correlations and hierarchical multiple regression were used to determine the moderating effect of social support on the association between experienced stigma versus anxiety, depression and loneliness. The interaction was visualised using slope analysis.

RESULTS

Anxiety, loneliness and depression were reported by 148 (72.9%), 114 (56.2%) and 128 (63.1%) of the 203 participants, respectively. Experienced stigma was positively associated with depression (B = 0.428, p < 0.001), anxiety (B = 0.374, p < 0.001) and loneliness (B = 0.285, p = 0.001). Social support was negatively associated with depression (B = -0.255, p < 0.001), anxiety (B = -0.406, p < 0.001) and loneliness (B = -0.270, p = 0.001). The impact of experienced stigma on depression was different at low (B = 0.567, SE = 0.115, p < 0.001) and high (B = 0.275, SE = 0.253, p = 0.024) groups of social support. Similarly, at low social support, the effect of experienced stigma on loneliness (B = 0.491, SE = 0.250, p < 0.001) and anxiety (B = 0.254, SE = 0.060, p = 0.044) was different compared to the effect of experienced stigma on loneliness (B = 0.275, SE = 0.253, p = 0.024) and anxiety (B = 0.127, SE = 0.094, p = 0.307) at high group of social support.

CONCLUSION

In this study, social support reduced the effects of experienced stigma on anxiety, depression and loneliness suggesting that improving social support among people with drug-resistant tuberculosis is crucial in reducing the negative effects of stigma on anxiety, depression and loneliness.

摘要

背景

本研究评估了社会支持对耐多药结核病患者经历的污名与焦虑、抑郁和孤独之间关联的调节作用。

方法

对 203 名至少接受 8 周耐多药结核病治疗的成年人进行了描述性横断面研究。使用经过验证的量表评估经历的污名、焦虑、抑郁、孤独和社会支持。采用偏相关和分层多元回归分析确定社会支持对经历的污名与焦虑、抑郁和孤独之间关联的调节作用。使用斜率分析来可视化交互作用。

结果

203 名参与者中，分别有 148 人（72.9%）、114 人（56.2%）和 128 人（63.1%）报告有焦虑、孤独和抑郁。经历的污名与抑郁（B=0.428，p<0.001）、焦虑（B=0.374，p<0.001）和孤独（B=0.285，p=0.001）呈正相关。社会支持与抑郁（B=-0.255，p<0.001）、焦虑（B=-0.406，p<0.001）和孤独（B=-0.270，p=0.001）呈负相关。经历的污名对抑郁的影响在低（B=0.567，SE=0.115，p<0.001）和高（B=0.275，SE=0.253，p=0.024）社会支持组之间存在差异。同样，在低社会支持水平下，经历的污名对孤独（B=0.491，SE=0.250，p<0.001）和焦虑（B=0.254，SE=0.060，p=0.044）的影响与经历的污名对孤独（B=0.275，SE=0.253，p=0.024）和焦虑（B=0.127，SE=0.094，p=0.307）的影响在高社会支持组之间存在差异。