title: Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: implications for healthcare providers.
abstract: There is a growing body of scientific evidence that stigma represents a reality for many people living with diabetes (PWD). However, little is known about the impact of experienced stigma. Against this background, the present study aimed to establish, by means of an in-depth consideration of the situation in Switzerland, whether and how experienced and perceived stigma impact the quality of life of those PWD affected. In this cross-sectional study, an anonymous paper-and-pencil self-administered questionnaire (SAQ) was used for data collection. The SAQ drew on a qualitative elicitation study and was distributed in 2013 to the readers of a Swiss journal destined to people living with diabetes. Data were analysed using descriptive statistics and structural equation modelling. The sample included 3347 people (response rate of 16%) with type 1 and 2 diabetes, aged 16-96. Respondents who reported higher levels of perceived stigma reported higher levels of psychological distress (β = 0.37), more pronounced depressive symptoms (β = 0.33) and less social support (β = -0.22). Higher psychological distress (β = -0.29) and more pronounced depressive symptoms (β = -0.28), in turn, predicted lower quality of life. Findings suggest that stigma should be considered as an additional predictor of quality of life in PWD. Therefore, healthcare providers should support PWD's fight against stigma. Especially, social workers are called to engage in advocacy to reduce discrimination against PWD and claim equal chances for them. They are also called to develop and implement interventions to correct stereotypes about PWD.
authors.affiliation: School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gredig
authors.affiliation: School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Bartelsen-Raemy
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D057545:Social Stigma; D012944:Social Support; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: diabetes; discrimination; quality of life; stereotypes; stigma