Data from: How self-stigma affects patient activation in persons with type 2 diabetes

<p><span><span><span><b><span>Objectives</span></b></span></span></span></p> <p><span><span><span><span>Self-stigma is associated with lower patient activation levels for self-care in persons with type 2 diabetes mellitus (T2DM). However, the causal pathway linking self-stigma with patient activation for self-care has not been shown. In order to determine how self-stigma affects patient activation for self-care, we tested a two-path hypothetical model both directly and as mediated by self-esteem and self-efficacy.</span></span></span></span></p> <p><span><span><span><b><span>Design</span></b></span></span></span></p> <p><span><span><span><span>A cross-sectional study</span></span></span></span></p> <p><span><span><span><b><span>Setting</span></b></span></span></span></p> <p><span><span><span><span>2 university hospitals, 1 general hospital, and 1 clinic in Japan</span></span></span></span></p> <p><span><span><span><b><span>Participants</span></b></span></span></span></p> <p><span><span><span><span>T2DM outpatients receiving treatment (n = 209) completed a self-administered questionnaire comprising the Self-Stigma Scale, Patient Activation Measure, Rosenberg Self-Esteem Scale, General Self-Efficacy Scale, Patient Health Questionnaire, hemoglobin A1c test, age, sex, and BMI.</span></span></span></span></p> <p><span><span><span><b><span>Primary and Secondary Outcome Measures</span></b></span></span></span></p> <p><span><span><span><span>Self-stigma levels were measured by using the Self-Stigma Scale. Patient activation levels were measured by the Patient Activation Measure.</span></span></span></span></p> <p><span><span><span><b><span>Results</span></b></span></span></span></p> <p><span><span><span><span>Path analysis showed a strong relationship between self-stigma and patient activation (χ²= 27.55, <i>p</i> = 0.120; GFI = 0.97; AGFI = 0.94; CFI = 0.98; RMSEA = 0.04). Self-stigma had a direct effect on patient activation (β = −0.20; <i>p</i> = 0.002). Indirectly, self-stigma affected patient activation along two paths (β = 0.31; <i>p</i> &lt; 0.001) by reducing self-esteem (β = −0.22; p &lt; 0.001) and self-efficacy (β = −0.36; p &lt; 0.001).</span></span></span></span></p> <p><span><span><span><b><span>Conclusions</span></b></span></span></span></p> <p><span>Due to the cross-sectional design of the study, longitudinal changes between all the variables cannot be established. However, the findings indicate that self-stigma affected patient activation for self-care, both directly and as mediated by self-esteem and self-efficacy. Interventions that increase self-esteem and self-efficacy may decrease self-stigma in T2DM patients, thus increasing patient activation for self-care.</span></p>