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

Aims and objectives: 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.

Design: 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.

Relevance to clinical practice: 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.