The relationship among social support, experienced stigma, psychological distress, and quality of life among tuberculosis patients in China

Xu Chen,Haoqiang Ji,Ruiheng Wu,Ling Zhou,Yuanping Pan,Meng Sun,Liang Du,Yuxin Duan,Yunting Chen,Jiawei Wang,Mingcheng Gao,Jia Xu

doi:10.1038/s41598-021-03811-w

Abstract

The complex relationships among social support, experienced stigma, psychological distress, and quality of life (QOL) among tuberculosis (TB) patients are insufficiently understood. The purpose of this study was to explore the interrelationships among social support, experienced stigma, psychological distress, and QOL and to examine whether experienced stigma and psychological distress play a mediating role. A cross-sectional survey was conducted between November 2020 and March 2021 in Dalian, Liaoning Province, Northeast China. Data were obtained from 473 TB patients using a structured questionnaire. Structural equation modelling was used to examine the hypothetical model. The research model provided a good fit to the measured data. All research hypotheses were supported: (1) social support, experienced stigma and psychological distress were associated with QOL; (2) experienced stigma fully mediated the effect of social support on psychological distress; (3) psychological distress fully mediated the effect of experienced stigma on QOL; and (4) experienced stigma and psychological distress were sequential mediators between social support and QOL. This study elucidated the pathways linking social support, experienced stigma, and psychological distress to QOL and provides an empirical basis for improving the QOL of TB patients.

Highlights

The complex relationships among social support, experienced stigma, psychological distress, and quality of life (QOL) among tuberculosis (TB) patients are insufficiently understood
Factor analysis indicated that each construct displayed good reliability and validity, which further verified the stable structure of the scale in TB patients and provides a basis for future studies to measure the social support, experienced stigma, psychological distress, and QOL of TB patients
Our results indicated that experienced stigma and psychological distress are sequential mediators from social support to QOL, a relationship that has not been demonstrated in previous studies

Summary

Introduction

The complex relationships among social support, experienced stigma, psychological distress, and quality of life (QOL) among tuberculosis (TB) patients are insufficiently understood. This study elucidated the pathways linking social support, experienced stigma, and psychological distress to QOL and provides an empirical basis for improving the QOL of TB patients. Tuberculosis (TB) is a major infectious disease that poses a serious threat to human health and has significant negative social and economic c onsequences[1,2] It leads to poor health for millions of people every year and is a major public health p roblem[1]. Previous studies have demonstrated that perceived social support is associated with psychological distress in TB patients during treatment[25]

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