Associations Between Self-Stigma and Health Promotion Behaviors in Overweight/Obese Patients With Type 2 Diabetes: A Cross-Sectional Study

超重/肥胖2型糖尿病患者的自我污名与健康促进行为之间的关联:一项横断面研究

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Abstract

Background: Patients experiencing stigma are more prone to engage in unhealthy behaviors. The correlation between stigma and health-promoting behaviors in overweight/obese T2DM patients is unclear. Therefore, this study aimed to investigate the association between the two in this particular population. Methods: This cross-sectional study, conducted from July 2022 to July 2023 at the Department of Endocrinology and Metabolism of a tertiary general hospital in Chengdu, Sichuan Province, China, used convenience sampling to enroll overweight/obese T2DM patients. A structured questionnaire was used to obtain information on sociodemographic and clinical characteristics. Respondents were assessed for stigma and health-promoting behaviors using the SSCI and T2DHPS scales. Data were analyzed using SPSS version 27.0, with a significance level of p < 0.05. Results: The majority was males (64%). The average BMI of patients was 27.27 ± 3.11 (kg/m(2)), and the average HbA1c was 8.36 ± 1.81 (mmol/mol). The overall stigma score of overweight/obese T2DM patients was 4.19 ± 8.69, and the overall health-promoting behaviors score was 87.75 ± 16.75. Pearson correlation analysis revealed a significant correlation between stigma and the overall score of health promotion behaviors (r = -0.144, p < 0.05). The multiple linear regression analysis showed that the hypoglycemia incidence, patient origin, GLP-1RA use, and stress management explained 23.9% of the patients' feelings of stigma. Conclusions: This study found that there was a correlation between the level of stigma and health-promoting behaviors in overweight/obese patients with T2DM. Hypoglycemia, inpatient, GLP-1RA treatment, and stress management significantly predicted stigma among overweight/obese patients. These findings have implications for healthcare providers, as they can develop intervention strategies by assessing the levels of stigma and stress management in overweight/obese patients with T2DM, to help reduce stigma and promote healthy behaviors among these patients.

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