Correlates of stigma for poststroke patients: A meta‐analysis

Abstract

Aims A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population.

The unique role of stigma in migraine‐related disability and quality of life

“…Depressive symptoms mediated the relationship between stigma and migraine‐related role restriction and role prevention. Stigma has demonstrated a consistent relationship with depressive symptoms in other neurologic diseases including migraine 14,34 . The directionality of the stigma–depression relationship is not clear; feelings of helplessness and hopelessness could arise when confronted with a personal characteristic (migraine) that is associated with discrediting or devaluing societal attitudes (stigma), while people with higher levels of depressive symptoms may be more vulnerable to real or perceived stigmatizing attitudes espoused by their social network.…”

An investigation of the level of stigma and the factors influencing it in the rehabilitation of young and middle-aged stroke patients

“…After stroke, patients are prone to different degrees of stigma, such as sensitivity, low self-esteem, and frustration. Stigma leads to loneliness and social isolation [10] , decreases motivation and initiative for rehabilitation treatment, hinders the process of rehabilitation [11] , greatly affects patients' physical and mental health and quality of life [12,13] , and brings a heavy burden to families and society.…”

The cognitive appraisal path of stroke knowledge, coping traits, family functioning and stigma among stroke patients: A moderated parallel mediation model

“…For stroke-related stigma, it is more clinically significant to operationalise abstract theoretical components into practical elements and to gauge their impacts on stigma. Although the original theory does not clearly define and sequence them (Jiang & Wang, 2022), empirical research from different groups has implied some correlations between stroke knowledge, coping traits, family functioning and stigma (Deng et al, 2019;Fang et al, 2021;Li et al, 2022;Yang et al, 2020Yang et al, , 2021.…”

“…However, current research on factors influencing stroke‐related stigma is still insufficient, because connotations of some known influencing factors are rather extensive and lack specificity with theoretical support. Furthermore, the absence of an in‐depth exploration of cognitive pathway mechanisms is not conducive to guiding clinical nursing practices (Li et al., 2022).…”

“…In addition to the patients themselves, stigma is specifically dependent on the moderation of sociocultural contexts (Li et al., 2022). Social support has an indirect buffer effect on emotional experience and mental health.…”