This study aimed to analyze the potential categories and influencing factors of stigma in stroke patients and to provide a basis for precise intervention. The study included 342 hospitalized stroke patients collected by the group from May to October 2024 in a tertiary hospital in Baoding. The latent class analysis (LCA) method was applied to analyze the characteristics of potential categories of stigma in stroke patients. Multicategorical logistic regression was adopted to analyze the influencing factors of different potential categories of stroke. Stigma in stroke patients included three potential categories: high stigma (42.9%), medium stigma (46.6%), and low stigma (10.5%). The multicategorical logistic regression showed that patients with medium stigma were positively correlated with harming cognitive evaluation (OR=1.237, P=0.000) and threatening cognitive evaluation (OR=1.171, P=0.029) and negatively associated with irrelevant/beneficial cognitive evaluation (OR=0.810, P=0.008) and yielding coping style (OR=0.850, P=0.023). High stigma was positively associated with threatening cognitive evaluation (OR=1.201, P=0.025) and negatively associated with challenging cognitive evaluation (OR=0.810, P=0.036) and avoidance coping style (OR=0.793, P=0.005). Patients with stroke stigma have prominent latent category characteristics. Patients with different potential categories of stigma take different cognitive evaluations and coping styles. Patients with moderate stigma are more inclined to injury/loss and threatening cognitive evaluation. Patients with high stigma are more inclined to threatening cognitive evaluation, and patients with low stigma are more inclined to irrelevant/beneficial cognitive evaluation and challenge cognitive evaluation. Avoidance and yielding negative coping styles have a specific protective effect on the stigma of stroke patients. This suggests that interventions should be targeted to different potential categories of stigma in stroke patients.

Xinying Zhang, Kangjia Li. Study on the Potential Categories and Influencing Factors of Stigma in Stroke Patients. Academic Journal of Medicine & Health Sciences (2026), Vol. 7, Issue 3: 48-57. https://doi.org/10.25236/AJMHS.2026.070307.

[1] Writing Committee of China Stroke Prevention and Control Report. Summary of the China Stroke Prevention and Control Report 2019[J]. Chinese Journal of Cerebrovascular Diseases, 2020, 17(05):272-281.

[2] Tang XJ, Huang Q, Zhu HP. Progress of research on stigma in stroke patients[J]. Chinese General Practice Nursing,2019,17(17):2091-2095.

[3] Deng CY, Zhao Y, Lu Q. Research progress of stigma in stroke patients[J]. Chinese Journal of Nursing, 2016,51(06):733-737.

[4] Goffman. Stigma: Notes on The Management of A Spoiled Identity[J].American Sociological Review, 1986,29(05):120-135.

[5] Kitara DL, Aloyo J. HIV/AIDS Stigmatization, the Reason for Poor Access to HIV Counseling and Testing (HCT) Among the Youths in Gulu (Uganda)[J]. Afr J Infect Dis. 2012;6(1):12-20. 

[6] Deaux K, Reid A, Mizrahi K, et al. Parameters of social identity[J]. Journal of Personality & Social Psychology, 1995,68(68):280-291.

[7] Jones EE, Farina A, Hastorf A, et al. Social stigma: the psychology of marked relationships[M]. New York: Freeman and Company, 1984.

[8] Link BG, Phelan JC. Stigma and its public health implications. The Lancet, 2006,367(9509): 528.

[9] Rao D, Choi S W, Victorson D, et al. Measuring stigma across neurological conditions: the development of the stigma scale for chronic illness (SSCI)[J].Qual Life Res,2009,18(05):585-595.

[10] Molina Y, Choi S W, Cella D, et al. The stigma scale for chronic illnesses 8-item version (SSCI-8): development, validation and use across neurological conditions[J].Int J Behav Med, 2013, 20(03):450-460.

[11] Fife BL, Wright ER.The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancers[J]. J Healthy SOC Behave, 2000, 41 (01):50-67.

[12] Pan AW, Chung LI, Fife BL, et al. Evaluation of the psychometrics of the social impact scale: a measure of stigmatization[J].Int J Rehabil Res, 2007, 30 (03) :235-238.

[13] Zhu MF, Zhou HZ, Deng EY, et al. Development, reliability and validity testing of the Stigma Scale for Stroke Patients[J]. Journal of Nursing Science,2019,34(01):70-73.

[14] Zhu MF, Zhou HZ, Zhang WB, et al. The Stroke Stigma Scale: a reliable and valid stigma measure in patients with stroke[J].Clinical Rehabilitation,2019,33(11):1800.

[15] Folkman S, Lazarus RS, Dunkel-Schetter C, et al. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes[J]. Journal of personality and social psychology, 1986, 50(5): 992-1003.

[16] Chen HM. Study the relationship between poststroke fatigue and stigma in patients with ischemic stroke [ D ]. Yangzhou University, 2020.

[17] Bucki B, Spitz E, Baumann M. Emotional and social repercussions of stroke on patient-family caregiver dyads: Analysis of diverging attitudes and profiles of the differing dyads[J]. PLoS One. 2019,14(4): e0215425.

[18] Ge C, Zhang H, Zhu G, et al. Intervention study of Snyder's hope theory on the stigma of stroke in young and middle-aged patients: a randomized trial[J]. Ann Palliat Med. 2021,10(5):5721-5728.

[19] Kessler T A. The cognitive appraisal of health scale: Development and psychometric evaluation[J]. Research in Nursing & Health, 1998, 21(01): 73-82.

[20] Lin XH, Peng X, Zhang WX, et al. Survey on health perception evaluation and coping styles of renal transplant recipients[J]. Journal of Nursing Science, 2015, 30(18):9-12.

[21] Feifel H, Strack S, Nagy V T. Coping strategies and associated features of medically ill patients.[J]. Psychosomatic Medicine, 1987, 49(6): 616-625.

[22] Shen XH, Jiang QJ. Report on the 701 case test of the Chinese version of the Medical Coping Style Questionnaire[J]. Chinese Journal of Behavioral Medicine and Brain Science,2000(01):22-24.

[23] Wang Y, Liu HW, Zhang SH, et al. Correlation analysis of self-concept and stigma in 523 hospitalized stroke patients [J].Journal of Nursing(China), 2020,27 (21): 61-63.

[24] Tsang HW, Ching SC, Tang KH, et al. Therapeutic intervention for internalized stigma of severe mental illness: a systematic review and meta-analysis[J]Schizophr Res, 2016, 173(1/2): 45-53. 

[25] Myers S B, Manne S L, Kissane D W, et al. Social–cognitive processes associated with fear of recurrence among women newly diagnosed with gynecological cancers[J].Gynecologic oncology, 2013(No.1):120–127.

[26] Tan JH. Correlation analysis between stigma and coping style in patients with schizophrenia[J]. Anhui Medical and Pharmaceutical Journal, 2019,23 (08): 1536–1538.