Frontiers in public health · 2026
The chain mediating roles of stigma and health-promoting lifestyle in the relationship between disability index and posttraumatic growth among patients with inflammatory bowel disease.
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Wang Yi, Chen Yamei, Gao Xinyi, Xun Linjuan, Jiang Baixue, Jin Xiaoping
Аннотация
OBJECTIVE: To explore the levels of disability, Health-Promoting Lifestyle Profile II (HPLP-II), illness-related stigma, and posttraumatic growth (PTG) in patients with inflammatory bowel disease (IBD), and to examine the chain mediating roles of HPLP-II and illness-related stigma in the association between disability and PTG.
METHODS: A cross-sectional survey was performed among 311 IBD patients recruited from three tertiary hospitals in Shanghai between August 2022 and April 2023. All participants completed standardized questionnaires, including general information scale, IBD Disability Index (IBD-DI), PTG Inventory (PTGI), HPLP-II and Stigma Scale for Chronic Illness (SSCI). SPSS 26.0 and Hayes' PROCESS macro (Model 6, 5,000 bootstrap resamples) were adopted for data analysis. Disease activity and disability severity were set as covariates in the mediation model.
RESULTS: The mean scores of PTGI, IBD-DI, HPLP-II and SSCI were 70.84 ± 25.65, 28.39 ± 12.98, 148.61 ± 36.84 and 69.24 ± 29.33, respectively. IBD-DI was negatively correlated with HPLP-II and PTGI, and positively correlated with SSCI; SSCI was negatively correlated with HPLP-II and PTGI, while HPLP-II was positively correlated with PTGI (all p < 0.001). Chain mediation analysis showed no significant direct effect between IBD-DI and PTG (β = 0.042, p = 0.539). HPLP-II and illness-related stigma exerted independent and chain mediating effects in this association. The total indirect effect was -1.019. The chain mediation pathway, independent pathway of HPLP-II and illness-related stigma accounted for 25.87%, 64.71%, and 9.42% of the total association, respectively.
CONCLUSION: Disability is not directly correlated with PTG in IBD patients. Its negative linkage with PTG is mediated by the chain pathway of impaired health-promoting lifestyle and elevated illness-related stigma. Targeted interventions to reduce stigma and optimize health-promoting lifestyle may help improve PTG and promote psychological rehabilitation among IBD patients.
METHODS: A cross-sectional survey was performed among 311 IBD patients recruited from three tertiary hospitals in Shanghai between August 2022 and April 2023. All participants completed standardized questionnaires, including general information scale, IBD Disability Index (IBD-DI), PTG Inventory (PTGI), HPLP-II and Stigma Scale for Chronic Illness (SSCI). SPSS 26.0 and Hayes' PROCESS macro (Model 6, 5,000 bootstrap resamples) were adopted for data analysis. Disease activity and disability severity were set as covariates in the mediation model.
RESULTS: The mean scores of PTGI, IBD-DI, HPLP-II and SSCI were 70.84 ± 25.65, 28.39 ± 12.98, 148.61 ± 36.84 and 69.24 ± 29.33, respectively. IBD-DI was negatively correlated with HPLP-II and PTGI, and positively correlated with SSCI; SSCI was negatively correlated with HPLP-II and PTGI, while HPLP-II was positively correlated with PTGI (all p < 0.001). Chain mediation analysis showed no significant direct effect between IBD-DI and PTG (β = 0.042, p = 0.539). HPLP-II and illness-related stigma exerted independent and chain mediating effects in this association. The total indirect effect was -1.019. The chain mediation pathway, independent pathway of HPLP-II and illness-related stigma accounted for 25.87%, 64.71%, and 9.42% of the total association, respectively.
CONCLUSION: Disability is not directly correlated with PTG in IBD patients. Its negative linkage with PTG is mediated by the chain pathway of impaired health-promoting lifestyle and elevated illness-related stigma. Targeted interventions to reduce stigma and optimize health-promoting lifestyle may help improve PTG and promote psychological rehabilitation among IBD patients.