title: Disease stigma and its mediating effect on the relationship between symptom severity and quality of life among community-dwelling women with stress urinary incontinence: a study from a Chinese city.
abstract: OBJECTIVE
  To examine the association between disease stigma and quality of life and whether disease stigma mediates the relationship between symptom severity and quality of life among community-dwelling women with stress urinary incontinence in China.
  
  
  BACKGROUND
  Urinary incontinent patients perceived great stigma, which inhibited from seeking medical help. There is evidence that stigma associated with some other diseases had a complex relationship with illness severity and quality of life. However, little empirical research has examined the role that stigma plays among urinary incontinent population.
  
  
  METHODS
  A cross-sectional, descriptive design was used.
  
  
  METHODS
  A purposive sample of 333 women with stress urinary incontinence from a Chinese city was enrolled. Data were collected on symptom severity, disease stigma and quality of life using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, Social Impact Scale and Incontinence Quality-of-Life Measure, respectively. The mediate effect of disease stigma was analysed using a series of hierarchical regression models.
  
  
  RESULTS
  Disease stigma negatively correlated with quality of life among stress urinary incontinent women. Social isolation and internalised shame, but not social rejection, the domains of disease stigma, partially mediated the effect of symptom severity on quality of life, attenuating the effect by 34·3% together.
  
  
  CONCLUSIONS
  Disease stigma impairs quality of life of women with stress urinary incontinence and mediates the association between symptom severity and quality of life. Health workers may improve their quality of life by addressing perceived stigma.
  
  
  CONCLUSIONS
  Our findings suggest that in clinical practice, stigma reduction may have the potential to not only improve quality of life, but also mitigate the impact of the severity on quality of life among urinary incontinent women. Social isolation and internalised shame should be more concerned in targeted interventions.
authors.affiliation: School of Nursing, Shandong University, Jinan, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Wan
authors.forename: Cuili
authors.initials: C
authors.lastname: Wang
authors.forename: Dongjuan
authors.initials: D
authors.lastname: Xu
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Guan
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
authors.forename: Kefang
authors.initials: K
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D002947:Cities; D003152:Community Health Nursing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009735:Nursing Homes; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D012720:Severity of Illness Index; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000451:nursing / Q000523:psychology*; D055815:Young Adult
keywords: disease stigma; quality of life; stress urinary incontinence; symptom severity; women