Stigma and Its Influencing Factors Among Chinese Patients with Thyroid-Associated Ophthalmopathy: A Cross-Sectional Study

Jia Li, Xin Zhang, Jie Ren Department of Ophthalmology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Jie Ren, Department of Ophthalmology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China, Email [email protected]: To understand the current situation of stigma among patients with thyroid-associated ophthalmopathy (TAO) in China and analyze its influencing factors, to provide a theoretical basis for medical staff to provide targeted intervention measures.Patients and Methods: From March to December 2024, 217 patients with TAO were recruited from a tertiary care general hospital in Sichuan Province, China, using a convenience sampling method. Participants completed several assessments, including a general information questionnaire, the Chinese version of the Stigma Scale for Chronic Illness (SSCI), the Medical Coping Modes Questionnaire (MCMQ), and the Huaxi Emotional Distress Index (HEI). Statistical analysis was performed using SPSS 27.0. A generalized linear model was constructed to analyze the factors influencing stigma in TAO patients, using general demographic characteristics, medical coping style scores, and emotional distress scores as independent variables, and stigma scores as the dependent variable.Results: This cross-sectional study included 217 TAO patients, predominantly female (72.4%), with an average age of 45.06± 11.92 years. The stigma score among TAO patients in China was 34.00 (26.00, 47.00). Univariate analysis and multivariate analysis showed that male gender (B=− 3.736, 95% CI: − 6.755, − 0.717), aged 18– 35 years (B=9.182, 95% CI: 1.899, 16.464), with a junior secondary school education (B=6.510, 95% CI: 2.434, 10.587), less than 5 ophthalmology visits within a year (B=− 6.730, 95% CI: − 11.631, − 1.829), mild (B=− 10.098, 95% CI: − 15.482, − 4.715) and moderately severe (B=− 7.406, 95% CI: − 12.469, − 2.343) TAO grading, resignation coping (B=1.029, 95% CI: 0.407, 1.651), and emotional distress (B=0.405, 95% CI: 0.129, 0.682) had significant difference on stigma (P< 0.05). The gender-stratified analysis revealed heterogeneity in the factors influencing stigma between men and women, indicating a need for precise, group-specific intervention strategies.Conclusion: Gender, age, education level, number of ophthalmology visits within a year, classification of TAO, resignation coping, and emotional distress are the influencing factors of stigma for TAO patients in China. It is suggested that medical staff should incorporate stigma assessment into clinical routine screening of TAO patients, and pay attention to the emotional state of high-risk groups, so as to identify individuals with high stigma level in time and provide necessary psychological support and intervention.Keywords: thyroid-associated ophthalmopathy, stigma, resignation coping, emotional distress, influencing factors