The effect of social alienation on stigma among in-patients with stroke: A cross-sectional study

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The study aims to investigate the influencing factors of stigma. Methods The study design is a cross-sectional survey. A total of 220 in-patients with stroke completed demographic information, 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 findings indicate that there were moderate scores on stigma among in-patients with stroke. 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 patients with stroke. Conclusions To address stigma among in-patients with stroke, efforts should be directed towards reducing social alienation among younger patients and those with higher levels of education. Stigma Social alienation Cross-sectional Stroke Introduction According to the Global epidemiological data, approximately 16.9 million people suffer a stroke each year, resulting in a global incidence rate of 258 per 100,000 individuals [ 1 ] . Stroke is the second-leading Level 3 cause of death after ischaemic heart disease worldside [ 2 ] . Stroke is one of the most common chronic and disabling neurological diseases in China [ 3 ] , which contains two main subcategories: ischemic stroke (that is, cerebral infarction) and hemorrhagic stroke (that is, cerebral hemorrhage) [ 4 ] . According to research, more than half of individuals who have experienced a stroke will suffer from cognitive impairment, aphasia, dysphagia, hemiplegia, emotional instability, and other related conditions [ 5 ] . Consequently, this leads to a feeling of social disgrace among stroke patients. Stigma is a common phenomenon that most stroke survivors struggle with [ 6 ] . Stigma is an established construct in the social sciences that describes the shame of patients doubting their values and creating stereotypes due to the original disease [ 7 ] . Stigma can adversely affect the rehabilitation among in-patients with stroke, which decreases motivation and functional improvement during rehabilitation in patients with stroke. Previous studies have shown that gender [ 8 ] , age [ 8 , 9 ] , level of education [ 8 ] , caregiver [ 9 , 10 ] , income [ 9 , 10 ] and other factors can affect stigma in patients with stroke. In addition, Lin Zhang et al. [ 11 ] found that social alienation is related to stigma. Due to the potential influence of various reasons on the social behavior of patients, patients have the psychological and behavioral manifestation of automatic alienation and isolation, which is social alienation [ 12 ] . Social alienation not only alienates patients from family and friends, making it difficult for them to integrate into family and society, but also increases the risk of cognitive impairment and cardiovascular disease and aggravates the stigma of patients [ 13 ] . The social cognitive processing model, proposed by Lepore in 2001 [ 14 ] , emphasizes that social constraints affect the social-psychological adjustment of patients by prolonging cognitive processing. According to the social cognitive processing model, when an individual has social constraints, cognitive processing is thwarted or delayed, maintaining disease-related distress and hindering adjustment [ 15 ] . Social constraints reflect the perception that one cannot share disease-related concerns with others. In this study, social alienation was used to assess social constraint, and stigma was used to assess social-psychological adjustment after cognitive processing. However, most of the current studies focus on the investigation of stigma among patients with stroke in the community. To our knowledge, no study has investigated the impact of social alienation on the stigma of in-patients with stroke. Thus, the purpose of this study is to explore the factors of demographic data and social alienation on stigma among in-patients with stroke. Methods Study Design and Sample This study utilized a cross-sectional design and adopted a convenient sampling technique. The study was conducted at a hospital for rehabilitation in Beijing, China, between July and December 2023. Before the investigation, patients were provided with information regarding the aim of the study and then signed a document indicating their informed consent. The hospital's Institutional Review Board, where the patients were receiving care (2022-133-01), approved this investigation. The inclusion criteria are as follows: (1) first clinical diagnosis of stroke[confirmed by head Computed Tomography (CT) or Magnetic Resonance Imaging (MRI)]; (2) onset of 1 to 6 months; (3) complete questionnaires. Patients were excluded from this study if they (1) did not finish the questions due to serious dysphasia or aphasia and (2) had cognitive impairment or mental illnesses. According to the sample size calculation method of the cross-sectional study, the sample size was decided to be ten times the maximum number of questionnaire items [ 16 ] . Considering the maximum number of questionnaire items (The items on the Stroke Stigma Scale were 16) and the invalid response rate of 20%, the sample size of this study was 192. A total of 220 in-patients with stroke were recruited. Measures Demographic information The patients were collected for demographic information based on previous studies, including gender, body mass index, age, level of education, marital status, primary caregiver, and average monthly family income. Social alienation Social alienation was measured by the Generalized Social Alienation Scale, developed by Jessor R & Jessor S and translated by Shuang Wu et al [ 17 ] . The Generalized Social Alienation Scale was divided into four dimensions: social isolation (5 items), powerlessness (4 items), self-alienation (3 items), and meaninglessness (3 items). Each item is answered on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with a higher score indicating a higher level of social alienation. The Generalized Social Alienation Scale has been validated in older adults and confirmed good reliability (Cronbach’s α coefficient was 0.77). Stigma The Stroke Stigma Scale, developed by Minfang Zhu et al. [ 18 ] , was used to assess stigma. The Stroke Stigma Scale contains four dimensions: self-perception (5 items), somatic impairment (4 items), discrimination experience (4 items), and social interaction (3 items). It consists of 16 items with scoring using a Likert 5-point scale, each rated from 1 (never) to 5 (always), with a higher score indicating more severe stigma. The Stroke Stigma Scale has been verified with good reliability, with Cronbach’s α = 0.916. Statistical analysis SPSS version 21.0 was used for data analysis. Descriptive statistics for variables regarding demographics were performed for the in-patients with stroke. The mean and standard deviation for continuous data were calculated, whereas frequencies and percentages were utilized for categorical variables. The t-test or analysis of variance (ANOVA) was applied to data where the distributions met parametric assumptions, while the Mann-Whitney U test was used for data where the distributions did not. Pearson correlation analysis was used to explore the correlation between stigma and social alienation. Multiple linear regression analysis was used to evaluate the impact of the diverse factors on stigma. The results were considered statistically significant when p < 0.05. Results Table 1 shows the characteristics of patients and their different distribution of stigma. A total of 198 patients with stroke completed the survey and were included in the study. The mean age of patients was 61.48±12.17. Of the 198 patients, 143(72.2%) were male, and 55(27.8%) were female. Level of education among them included primary school or lower(17.7%), junior high school(13.1%), senior high school or technical secondary school(30.3%), undergraduate or junior college(29.8%), and graduate(9.1%). Stigma was distributed differently according to age and level of education( P < 0.001). Table 1 The characteristics of participants and results of one-way ANOVA and t -test (N = 198) Variables Category N/% Stigma (Mean±SD) Statistic P Gender Male 143(72.2) 47.65±4.34 1.554 1) 0.122 Female 55(27.8) 46.60±4.04 Body mass index < 18.5 4(2.0) 44.00±2.71 2.254 2) 0.083 18.5 ~ 23.9 108(54.5) 47.47±4.26 24 ~ 27.9 71(35.9) 46.94±4.23 ≥ 28 15(7.6) 49.40±4.36 Age < 60 75(37.9) 50.55±3.06 43.345 2) < 0.001 60 ~ 70 70(35.4) 46.57±3.74 71 ~ 79 46(23.2) 43.89±3.08 ≥ 80 7(3.5) 43.86±3.39 Level of education Primary school or lower 35(17.7) 43.26±3.51 27.993 2) < 0.001 Junior high school 26(13.1) 44.38±2.32 Senior high school or technical secondary school 60(30.3) 48.43±3.29 Undergraduate or junior college 59(29.8) 48.71±3.49 Graduate 18(9.1) 51.61±4.73 Marital status Unmarried 10(5.1) 47.20±4.57 0.514 2) 0.599 Married 184(92.9) 47.32±4.27 Others 4(2.0) 49.50±4.12 Primary caregiver Spouse 63(31.8) 47.71±4.84 0.426 2) 0.735 Offspring 11(5.6) 46.82±3.76 Nursing assistant 101(51.0) 47.09±3.86 Others 23(11.6) 47.83±4.78 Average monthly family income ≤ 3000 14(7.1) 47.43±3.11 0.443 2) 0.723 3001 ~ 5000 23(11.6) 46.39±4.89 5001 ~ 7000 82(41.4) 47.51±4.36 ≥ 7001 79(39.9) 47.36±4.28 1) t; 2) F Abbreviations: Standard Deviation. The results of stigma and social alienation are shown in Table 2 . The score of stigma is 47.36±4.28, with the highest score being self-perception(15.27±1.59) and the lowest being discrimination experience(7.92±2.92). The score of social alienation is 34.37±5.33, with the highest score being powerlessness(9.75±2.74) and the lowest being self-alienation(6.51±1.61). Table 2 The total and dimension scores of stigma and social alienation (N = 198) Variables Item Score range Mean SD Stigma 16 16 ~ 80 47.36 4.28 Self-perception 5 5 ~ 25 15.27 1.59 Somatic impairment 4 4 ~ 20 13.35 1.86 Discrimination experience 4 4 ~ 20 7.92 2.92 Social interaction 3 3 ~ 15 10.81 1.43 Social alienation 15 15 ~ 60 34.37 5.33 Social isolation 5 5 ~ 20 9.43 2.94 Powerlessness 4 4 ~ 16 9.75 2.74 Self-alienation 3 3 ~ 12 6.51 1.61 Meaninglessness 3 3 ~ 12 8.68 1.77 Abbreviations: Standard Deviation. Table 3 presents the results of correlation analyses between stigma and social alienation. The total score of stigma and four dimensions (self-perception, somatic impairment, discrimination experience and social interaction) were correlated both overall and with each dimension of social alienation( P < 0.05). Pearson’s correlation coefficient ranged from 0.162 to 0.874. Table 3 The results of Pearson correlation analysis between stigma and social alienation (N = 198) Variables Social alienation Social isolation Power- lessness Self-alienation Meaning- lessness Stigma Self-perception Somatic impairment Discrimination experience Social interaction Social alienation 1 Social isolation 0.874** 1 Powerlessness 0.868** 0.672** 1 Self-alienation 0.763** 0.607** 0.593** 1 Meaninglessness −0.476** −0.621** −0.591** −0.537** 1 Stigma 0.366** 0.327** 0.381** 0.311** −0.313** 1 Self-perception 0.176* 0.167* 0.187** 0.168* −0.189** 0.486** 1 Somatic impairment −0.172* −0.255** −0.162* −0.187** 0.325** 0.345** −0.102 1 Discrimination experience 0.373** 0.392** 0.392** 0.299** −0.406** 0.787** 0.149* 0.022 1 Social interaction 0.358** 0.320** 0.339** 0.372** −0.317** 0.391** 0.170* −0.198** 0.114 1 * P < 0.05; ** P < 0.01. The multiple linear regression analysis was performed with stigma as the dependent variable, the variables with statistical differences in univariate analysis and social alienation as the independent variable. Table 4 shows the assignment of independent variables. In this study, dummy variables were used for the level of education. The results of multiple linear regression analysis in Table 5 show that age( B =−2.105, P < 0.001), the 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) of in-patients with stroke have an impact on stigma. Table 4 The assignment of independent variables Variables Assignment Age “80"=4. Level of education Dummy variable was set with "Primary school or lower" as reference Dummy variable X1: “Junior high school”=1. “Senior high school or technical secondary school”, “Undergraduate or Junior College”, and “Graduate”=0. Dummy variable X2: “Senior high school or technical secondary school”=1. “Junior high school”, “Undergraduate or Junior College”, and “Graduate”=0. Dummy variable X3: “Undergraduate or Junior College”=1. “Junior high school”, “Senior high school or technical secondary school”, and “Graduate”=0. Dummy variable X4: “Graduate”=1. “Junior high school”, “Senior high school or technical secondary school”, and “Undergraduate or Junior College”=0. Social alienation Enter the original value. Table 5 The multivariate linear regression analysis for factors associated with stigma (N = 198) Variables B SE Beta t P Contant 43.102 1.562 27.595 < 0.001 Age −2.105 0.264 −0.427 −7.967 < 0.001 Level of education Junior high school 1.545 0.745 0.122 2.073 0.040 Senior high school or technical secondary school 3.480 0.639 0.375 5.446 < 0.001 Undergraduate or junior college 3.716 0.644 0.399 5.768 < 0.001 Graduate 5.483 0.892 0.370 6.148 < 0.001 Social alienation 0.158 0.040 0.197 3.925 < 0.001 R 2 = 0.562, Adjusted R 2 = 0.548, F = 40.874, P < 0.001. Abbreviations: B = Unstandardized regression coefficient; SE = Standard Error; Beta = Standardized regression coefficient. Discussion We conducted a cross-sectional stigma survey of in-patients with stroke from demographic and social alienation. This study explored the effect of social alienation on stigma among in-patients with stroke and identified possible predictors. The most important finding was that stigma was associated with age and level of education. The level of stigma was moderate among in-patients with stroke. Significant correlations were found between stigma and social alienation. In-patients with sequelae of stroke who reported greater social alienation had a greater level of stigma. In this study, we found that the majority of in-patients with stroke had a moderate level of stigma, which was similar to the results of Fred Stephen Sarfo et al. [ 19 ] , which explored the stigma of consecutive stroke survivors in West Africa. The average score of stigma among these 198 patients was 47.36 ± 4.28. The results of this study showed that the score of self-perception was the highest. In clinical health education, we should focus on introducing related knowledge of stroke so that in-patients have a correct cognition of their condition, which may reduce their level of stigma [ 20 ] . In addition, the discrimination experience score in this study was found to be the lowest, aligning with the findings of Minfang Zhu et al. [ 18 ] . This observation may be related to the infrequent discrimination among doctors, nurses, and patients in hospital settings. Further research is needed to explore the varying experiences of discrimination among stroke patients in diverse settings. Notably, we found that the stigma level in different demographics differed. Younger patients had elevated levels of stigma [ 21 ] , potentially attributable to their perception of experiencing stroke at an early age. Moreover, those who possess a graduate diploma are more likely to encounter social disapproval, which may be attributed to the impaired self-esteem experienced by patients who have transitioned from a previously convenient lifestyle to a more challenging one [ 22 ] . This study found that social alienation was associated with stigma among in-patients with stroke, which could be explained by Pearson correlation analysis of stigma and social alienation. Due to the impact of the novel coronavirus, the hospital had allowed one to two caregivers to take care of the patients to prevent infections among patients [ 23 ] , which formed a great contrast between the hospital and the family atmosphere and reduced the social interaction of in-patients. In addition, patients had to endure the effects of stroke sequelae in this situation, which also increased the stigma of in-patients with stroke [ 24 ] . The results of multiple linear regression analysis showed that age, level of education, and social alienation had effects on the stigma of in-patients with stroke. Scholars had reported the influence of age on stigma, and the results of this study were consistent with the study of Li Chen et al. [ 9 ] , indicating that age was related to the stigma of in-patients with stroke. Medical professionals should pay attention to the emotions of young stroke in-patients and give them timely psychological guidance, which can reduce their stigma. However, in terms of the level of education, the results of this study were contrary to those of Zixiu Zheng et al. [ 21 ] . Remarkably, the study conducted by Zixiu Zheng et al. found that stroke in-patients with a graduate diploma had the highest stigma scores, which aligns with the findings of our research. It is recommended to conduct a comprehensive study involving many centers and a large sample size to investigate further the influence of education level on stigma in stroke patients. Currently, there is a lack of studies regarding the effect of social alienation on the stigma experienced by in-patients with stroke. The results of this study showed that social alienation was positively correlated with the level of stigma, which was same as Wenjuan Yan et al. [ 25 ] 's. Patients suddenly change from normal life to sequelae of stroke, hospitalization and sequelae of stroke limit their daily activities and then make them reluctant to participate in social activities, which leads to social alienation [ 26 ] . In addition, less social interaction among in-patients during therapy was more likely to increase the occurrence of stigma [ 27 ] . Our study has certain limitations. First, we chose a rehabilitation center in Beijing exclusively for our study, resulting in a limited sample representation. Furthermore, the study was conducted using a cross-sectional design, limiting its ability to capture the dynamic trend in stigma and social alienation experienced by the particular population under investigation. Future recommendations include doing longitudinal research to establish causal inference. Conclusions The study found that in-patients with stroke experience a moderate level of stigma, which is associated with factors such as age, education, and social isolation. Declarations Acknowledgements We would like to thank all the participants in this study. Authors’ Contributions The authors confirm contributions to the paper as follows: Study conception and design: XX; data collection and analysis: XX; drafted and revised the paper: XX. All authors reviewed the results and approved the final version of the paper. Funding This research is funded by the National Key Research and Development Program of China (Grant No.: 2023YFC3605203) and National Key Research and Development Program of China (Grant No.: 2022YFC3600300 and 2022YFC3600305). Data Availability The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate The ethics approval for this research study was obtained from China Rehabilitation Research Center (approval number: 2022-133-01) Ethics Committees. Informed consents were obtained from all participants prior to questionnaire investigation. The consent obtained from participants was verbal. Return of the questionnaire implied consent to participate. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Chohan S A, Venkatesh P K, How C H. Long-term complications of stroke and secondary prevention: an overview for primary care physicians. Singapore Med J. 2019; 60(12):616-620. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; 20(10):795-820. Lu Q, Deng C, Fu L, et al. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3837261","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267099092,"identity":"4dcc5d59-3247-4224-83b1-fbe9b50011f9","order_by":0,"name":"Yu Wu","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Yu","middleName":"","lastName":"Wu","suffix":""},{"id":267099093,"identity":"b5e68845-c8c7-4f8d-b601-75546ec1c705","order_by":1,"name":"Jian Liu","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Jian","middleName":"","lastName":"Liu","suffix":""},{"id":267099094,"identity":"72151893-41ae-43a7-b4cd-8e68800a34c2","order_by":2,"name":"Lovel Fornah","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Lovel","middleName":"","lastName":"Fornah","suffix":""},{"id":267099095,"identity":"8269e35f-5413-44dd-8a02-6f9cca593f8a","order_by":3,"name":"Jun Zhao","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jun","middleName":"","lastName":"Zhao","suffix":""},{"id":267099096,"identity":"f4e74062-5d1e-49f5-9ff6-84de2bd20f46","order_by":4,"name":"Shicai Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsklEQVRIiWNgGAWjYLCChAobOTb29gOkaDmTZszHcyaBBC2MLYcS50k4GBCn2uD84YcfHjYcSG+TYEhg+FGxjQgtN9KMJRJ33Mltk248wNhz5jZhLWY3eBgkEs88y22TOZDAzNhGjJbzZ5h/JLYdTmeTSDAgUsuBHDYJoJYE4rXY30gzswAGsmEbMJAPEuUXyf7Dj2/+qLCRl29vP/jgRwURWlDAARLVj4JRMApGwSjABQB/XUBhDqJKEQAAAABJRU5ErkJggg==","orcid":"","institution":"China Rehabilitation Research Center","correspondingAuthor":true,"prefix":"","firstName":"Shicai","middleName":"","lastName":"Wu","suffix":""}],"badges":[],"createdAt":"2024-01-05 12:44:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3837261/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3837261/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-25009-9","type":"published","date":"2025-10-23T16:17:01+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":94490750,"identity":"a52d44e1-8942-4cdc-b41b-245808759adc","added_by":"auto","created_at":"2025-10-27 17:14:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":867473,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3837261/v1/0dbb7ebc-122c-44ee-b551-c5ffcad4e7ff.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of social alienation on stigma among in-patients with stroke: A cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to the Global epidemiological data, approximately 16.9\u0026nbsp;million people suffer a stroke each year, resulting in a global incidence rate of 258 per 100,000 individuals\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Stroke is the second-leading Level 3 cause of death after ischaemic heart disease worldside\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Stroke is one of the most common chronic and disabling neurological diseases in China\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, which contains two main subcategories: ischemic stroke (that is, cerebral infarction) and hemorrhagic stroke (that is, cerebral hemorrhage)\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAccording to research, more than half of individuals who have experienced a stroke will suffer from cognitive impairment, aphasia, dysphagia, hemiplegia, emotional instability, and other related conditions\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Consequently, this leads to a feeling of social disgrace among stroke patients.\u003c/p\u003e \u003cp\u003eStigma is a common phenomenon that most stroke survivors struggle with\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. Stigma is an established construct in the social sciences that describes the shame of patients doubting their values and creating stereotypes due to the original disease\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Stigma can adversely affect the rehabilitation among in-patients with stroke, which decreases motivation and functional improvement during rehabilitation in patients with stroke. Previous studies have shown that gender\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e, age\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e, level of education\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e, caregiver\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e, income\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e and other factors can affect stigma in patients with stroke.\u003c/p\u003e \u003cp\u003eIn addition, Lin Zhang et al.\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003efound that social alienation is related to stigma. Due to the potential influence of various reasons on the social behavior of patients, patients have the psychological and behavioral manifestation of automatic alienation and isolation, which is social alienation\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Social alienation not only alienates patients from family and friends, making it difficult for them to integrate into family and society, but also increases the risk of cognitive impairment and cardiovascular disease and aggravates the stigma of patients\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe social cognitive processing model, proposed by Lepore in 2001\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e, emphasizes that social constraints affect the social-psychological adjustment of patients by prolonging cognitive processing. According to the social cognitive processing model, when an individual has social constraints, cognitive processing is thwarted or delayed, maintaining disease-related distress and hindering adjustment\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Social constraints reflect the perception that one cannot share disease-related concerns with others. In this study, social alienation was used to assess social constraint, and stigma was used to assess social-psychological adjustment after cognitive processing. However, most of the current studies focus on the investigation of stigma among patients with stroke in the community. To our knowledge, no study has investigated the impact of social alienation on the stigma of in-patients with stroke. Thus, the purpose of this study is to explore the factors of demographic data and social alienation on stigma among in-patients with stroke.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Sample\u003c/h2\u003e \u003cp\u003eThis study utilized a cross-sectional design and adopted a convenient sampling technique. The study was conducted at a hospital for rehabilitation in Beijing, China, between July and December 2023. Before the investigation, patients were provided with information regarding the aim of the study and then signed a document indicating their informed consent. The hospital's Institutional Review Board, where the patients were receiving care (2022-133-01), approved this investigation.\u003c/p\u003e \u003cp\u003eThe inclusion criteria are as follows: (1) first clinical diagnosis of stroke[confirmed by head Computed Tomography (CT) or Magnetic Resonance Imaging (MRI)]; (2) onset of 1 to 6 months; (3) complete questionnaires. Patients were excluded from this study if they (1) did not finish the questions due to serious dysphasia or aphasia and (2) had cognitive impairment or mental illnesses.\u003c/p\u003e \u003cp\u003eAccording to the sample size calculation method of the cross-sectional study, the sample size was decided to be ten times the maximum number of questionnaire items\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. Considering the maximum number of questionnaire items (The items on the Stroke Stigma Scale were 16) and the invalid response rate of 20%, the sample size of this study was 192. A total of 220 in-patients with stroke were recruited.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eDemographic information\u003c/h2\u003e \u003cp\u003eThe patients were collected for demographic information based on previous studies, including gender, body mass index, age, level of education, marital status, primary caregiver, and average monthly family income.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eSocial alienation\u003c/h2\u003e \u003cp\u003eSocial alienation was measured by the Generalized Social Alienation Scale, developed by Jessor R \u0026amp; Jessor S and translated by Shuang Wu et al\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. The Generalized Social Alienation Scale was divided into four dimensions: social isolation (5 items), powerlessness (4 items), self-alienation (3 items), and meaninglessness (3 items). Each item is answered on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree), with a higher score indicating a higher level of social alienation. The Generalized Social Alienation Scale has been validated in older adults and confirmed good reliability (Cronbach\u0026rsquo;s α coefficient was 0.77).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eStigma\u003c/h2\u003e \u003cp\u003eThe Stroke Stigma Scale, developed by Minfang Zhu et al.\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e, was used to assess stigma. The Stroke Stigma Scale contains four dimensions: self-perception (5 items), somatic impairment (4 items), discrimination experience (4 items), and social interaction (3 items). It consists of 16 items with scoring using a Likert 5-point scale, each rated from 1 (never) to 5 (always), with a higher score indicating more severe stigma. The Stroke Stigma Scale has been verified with good reliability, with Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.916.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eSPSS version 21.0 was used for data analysis. Descriptive statistics for variables regarding demographics were performed for the in-patients with stroke. The mean and standard deviation for continuous data were calculated, whereas frequencies and percentages were utilized for categorical variables. The t-test or analysis of variance (ANOVA) was applied to data where the distributions met parametric assumptions, while the Mann-Whitney U test was used for data where the distributions did not. Pearson correlation analysis was used to explore the correlation between stigma and social alienation. Multiple linear regression analysis was used to evaluate the impact of the diverse factors on stigma. The results were considered statistically significant when \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the characteristics of patients and their different distribution of stigma. A total of 198 patients with stroke completed the survey and were included in the study. The mean age of patients was 61.48\u0026plusmn;12.17. Of the 198 patients, 143(72.2%) were male, and 55(27.8%) were female. Level of education among them included primary school or lower(17.7%), junior high school(13.1%), senior high school or technical secondary school(30.3%), undergraduate or junior college(29.8%), and graduate(9.1%). Stigma was distributed differently according to age and level of education(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe characteristics of participants and results of one-way ANOVA and \u003cem\u003et\u003c/em\u003e-test (N\u0026thinsp;=\u0026thinsp;198)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003cp\u003e(Mean\u0026plusmn;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143(72.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.65\u0026plusmn;4.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.554\u003csup\u003e1)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55(27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e46.60\u0026plusmn;4.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBody mass index\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e44.00\u0026plusmn;2.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.254\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.5\u0026thinsp;~\u0026thinsp;23.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108(54.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.47\u0026plusmn;4.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u0026thinsp;~\u0026thinsp;27.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71(35.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e46.94\u0026plusmn;4.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15(7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e49.40\u0026plusmn;4.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75(37.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e50.55\u0026plusmn;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43.345\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026thinsp;~\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70(35.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e46.57\u0026plusmn;3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u0026thinsp;~\u0026thinsp;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46(23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e43.89\u0026plusmn;3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e43.86\u0026plusmn;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary school or lower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35(17.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e43.26\u0026plusmn;3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27.993\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e44.38\u0026plusmn;2.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSenior high school or technical secondary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60(30.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e48.43\u0026plusmn;3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndergraduate or junior college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59(29.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e48.71\u0026plusmn;3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18(9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e51.61\u0026plusmn;4.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10(5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.20\u0026plusmn;4.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.514\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.599\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e184(92.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.32\u0026plusmn;4.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e49.50\u0026plusmn;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary caregiver\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63(31.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.71\u0026plusmn;4.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.426\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.735\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOffspring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11(5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e46.82\u0026plusmn;3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNursing assistant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101(51.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.09\u0026plusmn;3.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23(11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.83\u0026plusmn;4.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage monthly family income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;3000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14(7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.43\u0026plusmn;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.443\u003csup\u003e2)\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3001\u0026thinsp;~\u0026thinsp;5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23(11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e46.39\u0026plusmn;4.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5001\u0026thinsp;~\u0026thinsp;7000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82(41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.51\u0026plusmn;4.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79(39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e47.36\u0026plusmn;4.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e1)\u003cem\u003et;\u003c/em\u003e2)\u003cem\u003eF\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eAbbreviations:\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eStandard Deviation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of stigma and social alienation are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The score of stigma is 47.36\u0026plusmn;4.28, with the highest score being self-perception(15.27\u0026plusmn;1.59) and the lowest being discrimination experience(7.92\u0026plusmn;2.92). The score of social alienation is 34.37\u0026plusmn;5.33, with the highest score being powerlessness(9.75\u0026plusmn;2.74) and the lowest being self-alienation(6.51\u0026plusmn;1.61).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe total and dimension scores of stigma and social alienation (N\u0026thinsp;=\u0026thinsp;198)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eScore range\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStigma\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026thinsp;~\u0026thinsp;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-perception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026thinsp;~\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomatic impairment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscrimination experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026thinsp;~\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial alienation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u0026thinsp;~\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial isolation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePowerlessness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026thinsp;~\u0026thinsp;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-alienation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026thinsp;~\u0026thinsp;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeaninglessness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026thinsp;~\u0026thinsp;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAbbreviations: Standard Deviation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the results of correlation analyses between stigma and social alienation. The total score of stigma and four dimensions (self-perception, somatic impairment, discrimination experience and social interaction) were correlated both overall and with each dimension of social alienation(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Pearson\u0026rsquo;s correlation coefficient ranged from 0.162 to 0.874.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe results of Pearson correlation analysis between stigma and social alienation (N\u0026thinsp;=\u0026thinsp;198)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial alienation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSocial isolation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePower-\u003c/p\u003e \u003cp\u003elessness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSelf-alienation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMeaning-\u003c/p\u003e \u003cp\u003elessness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSelf-perception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSomatic impairment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eDiscrimination experience\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSocial interaction\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial alienation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial isolation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.874**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePowerlessness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.868**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.672**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-alienation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.763**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.607**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.593**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeaninglessness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.476**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;0.621**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.591**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.537**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.366**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.327**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.381**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.311**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;0.313**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-perception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.176*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.167*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.187**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.168*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;0.189**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.486**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomatic impairment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.172*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;0.255**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.162*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.187**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.325**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.345**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscrimination experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.373**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.392**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.392**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.299**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;0.406**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.787**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.149*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.358**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.320**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.339**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.372**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;0.317**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.391**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.170*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;0.198**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"11\"\u003e*\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05; **\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe multiple linear regression analysis was performed with stigma as the dependent variable, the variables with statistical differences in univariate analysis and social alienation as the independent variable. Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the assignment of independent variables. In this study, dummy variables were used for the level of education. The results of multiple linear regression analysis in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e show that age(\u003cem\u003eB\u003c/em\u003e=\u0026minus;2.105, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the level of education[Junior high school(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.545, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.040), senior high school or technical secondary school(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.480, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), Undergraduate or junior college(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.716, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and graduate(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;5.483, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)] and social alienation(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.158, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) of in-patients with stroke have an impact on stigma.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe assignment of independent variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAssignment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;\u0026lt;60\u0026rdquo;=1, \u0026ldquo;60\u0026thinsp;~\u0026thinsp;70\u0026rdquo; =2, \u0026ldquo;71\u0026thinsp;~\u0026thinsp;80\u0026rdquo;=3, \"\u0026gt;80\"=4.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDummy variable was set with \"Primary school or lower\" as reference\u003c/p\u003e \u003cp\u003eDummy variable X1: \u0026ldquo;Junior high school\u0026rdquo;=1. \u0026ldquo;Senior high school or technical secondary school\u0026rdquo;, \u0026ldquo;Undergraduate or Junior College\u0026rdquo;, and \u0026ldquo;Graduate\u0026rdquo;=0.\u003c/p\u003e \u003cp\u003eDummy variable X2: \u0026ldquo;Senior high school or technical secondary school\u0026rdquo;=1. \u0026ldquo;Junior high school\u0026rdquo;, \u0026ldquo;Undergraduate or Junior College\u0026rdquo;, and \u0026ldquo;Graduate\u0026rdquo;=0.\u003c/p\u003e \u003cp\u003eDummy variable X3: \u0026ldquo;Undergraduate or Junior College\u0026rdquo;=1. \u0026ldquo;Junior high school\u0026rdquo;, \u0026ldquo;Senior high school or technical secondary school\u0026rdquo;, and \u0026ldquo;Graduate\u0026rdquo;=0.\u003c/p\u003e \u003cp\u003eDummy variable X4: \u0026ldquo;Graduate\u0026rdquo;=1. \u0026ldquo;Junior high school\u0026rdquo;, \u0026ldquo;Senior high school or technical secondary school\u0026rdquo;, and \u0026ldquo;Undergraduate or Junior College\u0026rdquo;=0.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial alienation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnter the original value.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe multivariate linear regression analysis for factors associated with stigma (N\u0026thinsp;=\u0026thinsp;198)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.562\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27.595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;2.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;7.967\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.545\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior high school or technical secondary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndergraduate or junior college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.716\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.768\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.892\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial alienation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.562, Adjusted \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.548, \u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;40.874, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eAbbreviations: B\u0026thinsp;=\u0026thinsp;Unstandardized regression coefficient; SE\u0026thinsp;=\u0026thinsp;Standard Error; Beta\u0026thinsp;=\u0026thinsp;Standardized regression coefficient.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe conducted a cross-sectional stigma survey of in-patients with stroke from demographic and social alienation. This study explored the effect of social alienation on stigma among in-patients with stroke and identified possible predictors. The most important finding was that stigma was associated with age and level of education. The level of stigma was moderate among in-patients with stroke. Significant correlations were found between stigma and social alienation. In-patients with sequelae of stroke who reported greater social alienation had a greater level of stigma.\u003c/p\u003e \u003cp\u003eIn this study, we found that the majority of in-patients with stroke had a moderate level of stigma, which was similar to the results of Fred Stephen Sarfo et al.\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e, which explored the stigma of consecutive stroke survivors in West Africa. The average score of stigma among these 198 patients was 47.36 \u0026plusmn; 4.28. The results of this study showed that the score of self-perception was the highest. In clinical health education, we should focus on introducing related knowledge of stroke so that in-patients have a correct cognition of their condition, which may reduce their level of stigma\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. In addition, the discrimination experience score in this study was found to be the lowest, aligning with the findings of Minfang Zhu et al.\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. This observation may be related to the infrequent discrimination among doctors, nurses, and patients in hospital settings. Further research is needed to explore the varying experiences of discrimination among stroke patients in diverse settings. Notably, we found that the stigma level in different demographics differed. Younger patients had elevated levels of stigma\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e, potentially attributable to their perception of experiencing stroke at an early age. Moreover, those who possess a graduate diploma are more likely to encounter social disapproval, which may be attributed to the impaired self-esteem experienced by patients who have transitioned from a previously convenient lifestyle to a more challenging one\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study found that social alienation was associated with stigma among in-patients with stroke, which could be explained by Pearson correlation analysis of stigma and social alienation. Due to the impact of the novel coronavirus, the hospital had allowed one to two caregivers to take care of the patients to prevent infections among patients\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, which formed a great contrast between the hospital and the family atmosphere and reduced the social interaction of in-patients. In addition, patients had to endure the effects of stroke sequelae in this situation, which also increased the stigma of in-patients with stroke\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe results of multiple linear regression analysis showed that age, level of education, and social alienation had effects on the stigma of in-patients with stroke. Scholars had reported the influence of age on stigma, and the results of this study were consistent with the study of Li Chen et al.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e, indicating that age was related to the stigma of in-patients with stroke. Medical professionals should pay attention to the emotions of young stroke in-patients and give them timely psychological guidance, which can reduce their stigma. However, in terms of the level of education, the results of this study were contrary to those of Zixiu Zheng et al.\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. Remarkably, the study conducted by Zixiu Zheng et al. found that stroke in-patients with a graduate diploma had the highest stigma scores, which aligns with the findings of our research. It is recommended to conduct a comprehensive study involving many centers and a large sample size to investigate further the influence of education level on stigma in stroke patients. Currently, there is a lack of studies regarding the effect of social alienation on the stigma experienced by in-patients with stroke. The results of this study showed that social alienation was positively correlated with the level of stigma, which was same as Wenjuan Yan et al.\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e's. Patients suddenly change from normal life to sequelae of stroke, hospitalization and sequelae of stroke limit their daily activities and then make them reluctant to participate in social activities, which leads to social alienation\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. In addition, less social interaction among in-patients during therapy was more likely to increase the occurrence of stigma\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur study has certain limitations. First, we chose a rehabilitation center in Beijing exclusively for our study, resulting in a limited sample representation. Furthermore, the study was conducted using a cross-sectional design, limiting its ability to capture the dynamic trend in stigma and social alienation experienced by the particular population under investigation. Future recommendations include doing longitudinal research to establish causal inference.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study found that in-patients with stroke experience a moderate level of stigma, which is associated with factors such as age, education, and social isolation.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all the participants in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors confirm contributions to the paper as follows: Study conception and design: XX; data collection and analysis: XX; drafted and revised the paper: XX. All authors reviewed the results and approved the final version of the paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research is funded by the National Key Research and Development Program of China (Grant No.: 2023YFC3605203) and National Key Research and Development Program of China (Grant No.:\u0026nbsp;2022YFC3600300 and\u0026nbsp;2022YFC3600305).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethics approval for this research study was obtained from China Rehabilitation Research Center (approval number: 2022-133-01) Ethics Committees. Informed consents were obtained from all participants prior to questionnaire investigation. The consent obtained from participants was verbal. Return of the questionnaire implied consent to participate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChohan S A, Venkatesh P K, How C H. Long-term complications of stroke and secondary prevention: an overview for primary care physicians. Singapore Med\u003cem\u003e \u003c/em\u003eJ. 2019; 60(12):616-620.\u003c/li\u003e\n\u003cli\u003eGlobal, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; 20(10):795-820.\u003c/li\u003e\n\u003cli\u003eLu Q, Deng C, Fu L, et al. Reliability and validity of a Chinese version of the Stigma Scale for Chronic Illness (SSCI) in patients with stroke. Top Stroke Rehabil. 2019; 26(4):312-317.\u003c/li\u003e\n\u003cli\u003eHayashi Y, Shimada T, Hattori N, et al. A prehospital diagnostic algorithm for strokes using machine learning: a prospective observational study. Sci Rep. 2021; 11(1):20519.\u003c/li\u003e\n\u003cli\u003eZheng X, Wang H, Bian X. Clinical Correlation Analysis of Complications in Elderly Patients with Sequelae of Stroke with Different Barthel Index in Tianjin Emergency Department. Biomed Res Int. 2021; 2021:6625440.\u003c/li\u003e\n\u003cli\u003eHu R, Wang X, Liu Z, et al. Stigma, depression, and post-traumatic growth among Chinese stroke survivors: A longitudinal study examining patterns and correlations. Top Stroke Rehabil. 2022; 29(1):16-29.\u003c/li\u003e\n\u003cli\u003eWu Y, Yan Z, Fornah L, et al. The mediation effect of social support between stigma and social alienation in patients with stroke. Front Public Health. 2023; 11:1290177.\u003c/li\u003e\n\u003cli\u003eLu Q, Wang D, Fu L, et al. The effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae: A cross-sectional study. \u003cem\u003eClin Rehabil\u003c/em\u003e 2022; 36(3):407-414.\u003c/li\u003e\n\u003cli\u003eLi C, Hu M, Yang T, et al. Correlates of stigma for poststroke patients: A meta-analysis. J Clin Nurs. 2023; 32(9-10):1952-1962.\u003c/li\u003e\n\u003cli\u003eZhu M, Zhou H, Zhang W, et al. Stigma experienced by Chinese patients with stroke during inpatient rehabilitation and its correlated factors: a cross-sectional study. Top Stroke Rehabil. 2019; 26(5):342-348.\u003c/li\u003e\n\u003cli\u003eZhang L, Li W, Liu B, et al. Self-esteem as mediator and moderator of the relationship between stigma perception and social alienation of Chinese adults with disability. Disabil Health J. 2014; 7(1):119-123.\u003c/li\u003e\n\u003cli\u003eZhao C C, Xu F. Study on the status quo and influencing factors of social alienation of stroke patients during rehabilitation. Nursing Research. 2022; 36(05):835-839.\u003c/li\u003e\n\u003cli\u003eValtorta N K, Kanaan M, Gilbody S, et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016; 102(13):1009-1016.\u003c/li\u003e\n\u003cli\u003eLepore S J. A social\u0026ndash;cognitive processing model of emotional adjustment to cancer. Washington, DC: American Psychological Association, 2001.\u003c/li\u003e\n\u003cli\u003eSoriano E C, Otto A K, LoSavio S T, et al. Fear of Cancer Recurrence and Inhibited Disclosure: Testing the Social-Cognitive Processing Model in Couples Coping With Breast Cancer. Ann Behav Med. 2021; 55(3):192-202.\u003c/li\u003e\n\u003cli\u003eYin Y R, Zhou H C, Liu M R, et al. Investigation on social isolation status of elderly patients with maintenance hemodialysis. Chinese Journal of Nursing. 2019; 58(07):822-829. \u003c/li\u003e\n\u003cli\u003eWu S, Li Y Z, Zhao X L, et al. Reliability and validity analysis of general alienation scale in elderly people. Journal of Chengdu Medical College. 2015; 10(06):751-754.\u003c/li\u003e\n\u003cli\u003eZhu M, Zhou H, Zhang W, et al. The Stroke Stigma Scale: a reliable and valid stigma measure in patients with stroke. Clin Rehabil. 2019; 33(11):1800-1809.\u003c/li\u003e\n\u003cli\u003eSarfo F S, Nichols M, Qanungo S, et al. Stroke-related stigma among West Africans: Patterns and predictors. J Neurol Sci. 2017; 375:270-274.\u003c/li\u003e\n\u003cli\u003eDeng C, Lu Q, Yang L, et al. Factors associated with stigma in community-dwelling stroke survivors in China: A cross-sectional study. J Neurol Sci. 2019; 407:116459.\u003c/li\u003e\n\u003cli\u003eZheng Z, Song R, Zhao Y, et al. An investigation of the level of stigma and the factors influencing it in the rehabilitation of young and middle-aged stroke patients-a cross-sectional study. BMC Neurol. 2023; 23(1):139.\u003c/li\u003e\n\u003cli\u003eFan W, Ma K K, Yang C X, et al. The mediating effect of stigma between self-perceived burden and loneliness in stroke patients. Front Psychiatry. 2023; 14:1219805.\u003c/li\u003e\n\u003cli\u003eDu R, Yang X L, Dong J, et al. Prevention and control strategy of novel coronavirus pneumonia in general ward of general hospital.\u003cem\u003e \u003c/em\u003eJournal of North China University of Science and Technology (Medical Edition).\u003cem\u003e \u003c/em\u003e2021; 23(01):68-72.\u003c/li\u003e\n\u003cli\u003eSingh A, Mattoo S K, Grover S. Stigma and its correlates in patients with schizophrenia attending a general hospital psychiatric unit. Indian J Psychiatry. 2016; 58(3):291-300.\u003c/li\u003e\n\u003cli\u003eYan W J, Li Z M, Yu M T, et al. A systematic evaluation of influencing factors of stigma in stroke patient. Journal of Nursing. 2012; 29(08):46-52.\u003c/li\u003e\n\u003cli\u003eZhao J, Gao Y, Li G M. Status and influencing factors of social alienation in patients with sequelae of ischemic stroke. South China Preventive Medicine. 2019; 48(07):854-856.\u003c/li\u003e\n\u003cli\u003eYang L H. Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singapore Med J.\u003cem\u003e \u003c/em\u003e2007; 48(11):977-985.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Stigma, Social alienation, Cross-sectional, Stroke","lastPublishedDoi":"10.21203/rs.3.rs-3837261/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3837261/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eBackgroud\u003c/b\u003e Stigma adversely affects the rehabilitation among in-patients with stroke, which decreases the motivation and functional improvement during rehabilitation in patients with stroke. The study aims to investigate the influencing factors of stigma.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e The study design is a cross-sectional survey. A total of 220 in-patients with stroke completed demographic information, 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.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e The findings indicate that there were moderate scores on stigma among in-patients with stroke. Age(\u003cem\u003eB\u003c/em\u003e=\u0026minus;2.105, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), level of education[Junior high school(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.545, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.040), senior high school or technical secondary school(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.480, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), Undergraduate or junior college(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.716, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and graduate(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;5.483, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)] and social alienation(\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.158, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were all significantly associated with stigma in patients with stroke.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusions\u003c/b\u003e To address stigma among in-patients with stroke, efforts should be directed towards reducing social alienation among younger patients and those with higher levels of education.\u003c/p\u003e","manuscriptTitle":"The effect of social alienation on stigma among in-patients with stroke: A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-16 12:30:10","doi":"10.21203/rs.3.rs-3837261/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-12-31T01:34:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-12-18T12:45:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180587170332839588641944006782516036976","date":"2024-12-09T12:00:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-18T14:27:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"173998392298504911234263897968180826140","date":"2024-06-06T16:36:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"340108925071351154228413804090558685418","date":"2024-05-27T10:58:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-15T07:15:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-03T06:22:25+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-01-15T04:45:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-15T04:41:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-01-05T12:43:08+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cdb3920c-c9c4-416b-b317-ec28efc58f50","owner":[],"postedDate":"January 16th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T16:27:02+00:00","versionOfRecord":{"articleIdentity":"rs-3837261","link":"https://doi.org/10.1186/s12889-025-25009-9","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-10-23 16:17:01","publishedOnDateReadable":"October 23rd, 2025"},"versionCreatedAt":"2024-01-16 12:30:10","video":"","vorDoi":"10.1186/s12889-025-25009-9","vorDoiUrl":"https://doi.org/10.1186/s12889-025-25009-9","workflowStages":[]},"version":"v1","identity":"rs-3837261","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3837261","identity":"rs-3837261","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}