The effect of social alienation on stigma among stroke inpatients in China: a cross-sectional study

BACKGROUND: Stigma adversely affects the rehabilitation among stroke inpatients, which decreases the motivation and functional improvement. According to prior studies, there was a correlation between social alienation and stigma. This study aimed to investigate the factors influencing stigma among stroke inpatients, providing evidence for future targeted stigma interventions. METHODS: The study was a cross-sectional survey conducted in China from July to November 2023 using a convenience sampling method. Ethical approval for this study was obtained from the Medical Ethics Committee. A total of 220 stroke inpatients completed a demographic questionnaire, the generalized social alienation scale, and the stroke stigma scale. Multiple linear regression analysis was used to evaluate the impact of the diverse factors on stigma. RESULTS: The results showed that the score of stigma among stroke inpatients was 47.36 ± 4.28, indicating a moderate level of stigma. Social alienation was positively correlated with stigma(r = 0.366, P < 0.001), indicating stigma increased with the increase of social alienation. Age(B=-2.105, P < 0.001), level of education[Junior high school(B = 1.545, P = 0.040), senior high school or technical secondary school(B = 3.480, P < 0.001), undergraduate or junior college(B = 3.716, P < 0.001), and graduate(B = 5.483, P < 0.001)], and social alienation(B = 0.158, P < 0.001) were all significantly associated with stigma in stroke inpatients. Among all educational levels, graduate(B = 5.483, P < 0.001) showed the most robust correlation with stigma. The results indicated that stroke inpatients who were younger and had higher levels of education had higher levels of stigma. CONCLUSIONS: Findings suggest that social alienation is a significant contributor to perceived stigma among stroke inpatients, particularly among younger and more educated individuals. Tailored psychosocial interventions that address feelings of social alienation may help reduce stigma in these groups.