Stigma, Anxiety, Depression, and Quality of Life Among Patients With Hepatitis C in Iran

M. Movahedi, Shiva Moshirpanahi, Y. Mokhayeri, M. Almasian, Fatemeh Bastami
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Abstract

Background: Hepatitis C is one of the most challenging viral infections worldwide. Patients with hepatitis C may experience some disease-related stigma. Objectives: The aim of this study was to evaluate perceived stigma and its role in predicting anxiety, depression, and quality of life among patients with hepatitis C. Materials & Methods: This cross-sectional analytic study was conducted in behavioral counseling centers of three cities, i.e., Khorramabad, Boroujerd and Noorabad, located in the western part of Iran, from May to August 2019. Stratified multistage sampling was used to select 144 patients diagnosed with hepatitis C. The WHOQOL-BREF Scale, Stigma Impact Scale (SIS), Beck Depression Inventory, Second Edition (BDI-II), and Beck Anxiety Inventory, Second Edition (BAI) were used to collect the data. Univariate and multivariate linear regression models were used to estimate the association of covariates on stigma and quality of life. The Stata 16 software was used to analyze the data at the significance level of 0.05. Results: The mean perceived stigma was 66.805 ± 1.291 with social rejection and social isolation achieving the highest scores (23.409 ± 0.551, 20.208 ± 0.437). In the multivariate regression model, depression (B=0.7, 95%; CI: 0.5, 0.89) and anxiety (B=0.21, 95%; CI: 0.02, 0.41) had direct significant associations with stigma independent of age, sex, marital status, and occupation. Depression (B=-0.27, 95%; CI:-0.47, -0.07), anxiety (B=-0.33, 95%; CI: -0.5, -0.16), and stigma (B=-0.41, 95%; CI: -0.56, -0.26) were inversely associated with patients’ quality of life. Conclusion: This study found a high perceived stigma score among HCV patients. Depression and anxiety were significantly associated with stigma. The quality of life of HCV patients were inversely associated with depression, anxiety, and stigma scores.
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伊朗丙型肝炎患者的耻辱感、焦虑、抑郁和生活质量
背景:丙型肝炎是全球最具挑战性的病毒性感染之一。丙型肝炎患者可能会经历一些与疾病相关的耻辱。目的:本研究旨在评估感知耻辱感及其在预测c型肝炎患者焦虑、抑郁和生活质量中的作用。材料与方法:本横断面分析研究于2019年5月至8月在伊朗西部霍拉马巴德、博鲁杰德和诺拉巴德三个城市的行为咨询中心进行。采用分层多阶段抽样方法,选取144例丙型肝炎患者,采用WHOQOL-BREF量表、病耻感影响量表(SIS)、Beck抑郁量表第二版(BDI-II)和Beck焦虑量表第二版(BAI)进行数据采集。使用单变量和多变量线性回归模型来估计病耻感和生活质量的协变量的相关性。采用Stata 16软件进行数据分析,显著性水平为0.05。结果:耻感均值为66.805±1.291,其中社会排斥和社会孤立得分最高,分别为23.409±0.551、20.208±0.437;在多元回归模型中,抑郁症(B=0.7, 95%;CI: 0.5, 0.89)和焦虑(B=0.21, 95%;CI: 0.02, 0.41)与病耻感有直接显著相关,与年龄、性别、婚姻状况和职业无关。抑郁症(B=-0.27, 95%;CI:-0.47, -0.07),焦虑(B=-0.33, 95%;CI: -0.5, -0.16)和柱头(B=-0.41, 95%;CI: -0.56, -0.26)与患者生活质量呈负相关。结论:本研究发现HCV患者存在较高的感知污名得分。抑郁和焦虑与病耻感显著相关。HCV患者的生活质量与抑郁、焦虑和污名得分呈负相关。
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