Investigation on Stigma of Inpatients with Diabetic Foot Ulcer and Analysis of Related Factors

Investigation on Stigma of Inpatients with Diabetic Foot Ulcer and Analysis of Related Factors | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Investigation on Stigma of Inpatients with Diabetic Foot Ulcer and Analysis of Related Factors Ying Wang, Tianlan Li, Yanfei Ma, Rong Hu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9007703/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aims: To investigate stigma and its associated factors in hospitalized patients with diabetic foot ulcer (DFU), so as to provide theoretical and data support for psychological care of patients with diabetic foot ulcer. Methods: Patients with diabetic foot ulcer who were hospitalized in the Department of Orthopedics of xx hospital from October 2024 to August 2025 were selected as the research subjects. The status quo was investigated using general information questionnaire, Type 2 diabetes stigma rating scale (DSAD-2), generalized anxiety disorder self-rating scale (GAD-7), patient health questionnaire self-rating depression scale (PHQ-9), and social support rating scale (SSRS) and SPSS 25.0 software was used for data analysis. Results: A total of 180 inpatients with diabetic foot ulcer were investigated. The total stigma score was 52.98±7.14. Univariate analysis showed significant associations of stigma with gender, age, education, diabetes duration, anxiety, depression, and social support ( P <0.05). Stigma correlated negatively with social support and positively with anxiety and depression ( P <0.05)..Multiple linear stepwise regression analysis showed significant differences (R²=0.507, adjusted R²=0.495, F=42.192, P < 0.001) between gender, diabetes duration, anxiety and depression, and stigma. Conclusion: Stigma is common in hospitalized patients with diabetic foot ulcer, and it is more serious in some patients. Gender, duration of diabetes, anxiety and depression were the important factors affecting stigma. Personalized psychological interventions are recommended to promote recovery. Implications for the Profession and Patient Care: Training nurses to recognize stigma and psychological distress, alongside implementing tailored support and strengthening social support, can mitigate stigma and improve outcomes. Impact: This study provides empirical evidence on the psychological burden of stigma in DFU inpatients, directly informing clinical nursing practice and patient-centered care strategies. Patient or public contribution: Patients were involved as the study population. No patient or public contribution. Reporting Method: The study adhered to the STROBE checklist. Health sciences/Diseases Health sciences/Endocrinology Health sciences/Health care Health sciences/Medical research Biological sciences/Psychology Social science/Psychology diabetic foot ulcer Stigma Anxiety Depression social support 1 Introduction Globally, diabetes has become one of the chronic metabolic diseases that seriously threaten human health(Heald et al., 2020 ). According to the GBD 2021 study published in The Lancet in 2024, the number of diabetic patients in the world increased from 139 million in 1990 to 526 million in 2021. China is currently the country with the largest number of adult diabetic patients and the heaviest burden of diabetes in the world, with 117 million patients in 2021, accounting for 22% of the global diabetic population(C. Liu et al., 2025 ). According to the Diabetes Atlas of the International Diabetes Federation, 11th edition (2025), 589 million adults aged 20–79 years were estimated to have diabetes worldwide by 2024 (about 11.1% of the adult population, or one-ninth), and the figure is expected to rise to 853 million by 2050, with 15–25% of diabetic patients suffering from Diabetic foot ulcers, DFU)(Wang et al., 2021 ). DFU is one of the serious complications of diabetes, especially when the Wagner classification reaches grade 3 or higher, the condition becomes more severe and the treatment cycle is significantly prolonged(Chen, Sun, Gao, & Ran, 2023 ). Patients usually present with deep foot ulcers involving tendon and bone tissue, accompanied by the development of deep abscesses and osteomyelitis that can lead to local or even whole foot gangrene in severe cases, seriously threatening the life of the patient and limb function(McDermott, Fang, Boulton, Selvin, & Hicks, 2023 )(McDermott, et al., 2023 ). It is estimated that about 18. 6 million people are affected by diabetic foot ulcers each year(Armstrong, Tan, Boulton, & Bus, 2023 ). About 10% of patients diagnosed with DFU for the first time will die within 1 year, and about 20% of patients will be at risk of lower extremity amputation. The 5-year mortality rate in patients with DFU is 30%, while the mortality rate in patients with foot amputations is over 70%(Armstrong et al., 2020 ). Stigma refers to the inner shame of the diseased people due to social stereotypes, which may lead to their experience of discrimination, isolation, and self-discrimination and inferiority complex against themselves.(Dubreucq, Plasse, & Franck, 2021 ; Favre & Richard-Lepouriel, 2023 ). The concept of stigma was first proposed by the sociologist Goffman and was originally used to study people with mental disorders(Angermeyer & Schulze, 2001 ). With the deepening of social and medical research, the connotation of stigma has gradually expanded, which is widely used in the research of many diseases and has become an important framework to understand the social interaction and psychological reaction of patients(Cataldo, Slaughter, Jahan, Pongquan, & Hwang, 2011 ; N. F. Liu et al., 2017 ). The stigma of diabetes refer to that negative emotions of self-blame, shame, and rejection of diabetic who are labeled to differentiate themselves from others and even devalue them because they have the condition(N. F. Liu, et al., 2017). According to a recent large transnational survey, one fifth (19.2%) of people with diabetes report having experienced discrimination(Nicolucci et al., 2013 ). Patients with DFU often face a series of physiological and psychological difficulties. In outpatient treatment, patients with DFU often face the problems of poor treatment effect, increased wound exudate, and significant odor. during hospitalization, patients should not only cope with the repeated illness, wound odor, slow wound healing and other physiological discomfort, but also often bear the increased economic burden and uncertainty of future treatment effect(Kolaric, Svircevic, Bijuk, & Zupancic, 2022 ; Sen, 2023 ). Stigma not only leads to social isolation and reduced quality of life, but may also have an adverse effect on patients' self-esteem, self-efficacy, and clinical and functional outcomes. In addition, patients may encounter negative evaluation from society, public prejudice or even misunderstanding from relatives and friends during the treatment. These external pressures are likely to intensify their inner stigma, leading to inferiority complex, anxiety and other emotional distress(Akyirem, Ekpor, Namumbejja Abwoye, Batten, & Nelson, 2023 ). Stigma not only increases the psychological burden of patients, but may also affect their willingness to actively seek help and hinder treatment compliance, thus aggravating the disease and affecting the rehabilitation process(Guo et al., 2023 ). Therefore, the treatment of DFU not only focuses on limb salvage rate, but also focuses on improving the quality of life of patients, promoting physical and mental rehabilitation, and ultimately reducing the mortality and disability rate(Lipsky & Uckay, 2021 ). Although significant advances have been made in clinical treatments in recent years, the comprehensive treatment of DFU still faces many challenges. Among them, the mental health problems of patients have gradually become a difficult and hot topic to be solved. Therefore, exploring the current situation of stigma and its influencing factors in hospitalized patients with DFU not only has important theoretical significance, but also provides a practical direction for clinical intervention practice. The purpose of this study was to investigate the stigma status of hospitalized patients with DFU and analyze the related influencing factors, in order to provide a theoretical basis for clinical psychological care intervention, and provide scientific support for improving the psychological state of patients and promoting their comprehensive rehabilitation. 2 Methods 2.1 Research Design This study is a cross-sectional cross-sectional study. 2.2 Subjects Patients with DFU who were hospitalized in our hospital from October 2024 to August 2025 were selected as the research subjects. Inclusion criteria: ① Patients in line with the guidelines for the diagnosis and treatment of diabetic foot ulcer; ② Age ≥ 18 years old; ③ Patients with normal cognitive, understanding and communication abilities, and able to fill out the questionnaire on their own or with the help of the researcher. Exclusion criteria: ① patients combined with other severe physical or mental diseases; ② Patients who were unwilling to participate in the investigation. Removal criteria: ① Questionnaires with missing contents ≥ 20% were filled in. This study was approved by our Ethics Committee and with the informed consent of the participants. Calculation of sample size: The sample size was 10–20 times of the number of variables. There were 12 independent variables in this study. Considering the 20% invalid questionnaire, the calculation formula of sample size was: 12×(10–20)/80%=150–300. 2.3 Evaluation indicators General information questionnaire: In this study, based on evidence-based medicine and evidence-based nursing, and by comprehensively consulting the relevant literature both in China and abroad, we designed our own general information questionnaire, which specifically included the patient's hospitalization number, name, gender, age, educational level, marital status, duration of diabetes, duration of diabetic foot ulcer, and complications. Type 2 DIABETES Stigma Assessment Scale (DSAS-2): The scale was determined by Kato(Browne, Ventura, Mosely, & Speight, 2016 )R&D with a total of 19 items and three dimensions (differential treatment, blame and judgment, and self-shame). The items were scored with Likert 5-level scoring method, and were scored with 1–5 points in sequence from "very different meaning" to "very agree". The total score on the scale was the sum of the scores of each item. The higher the total score was, the stronger the individual's stigma was. The Cronbach's α coefficient of the scale was 0.879. Generalized anxiety disorder-7 (GAD-7)(M. Liu et al., 2023 ): There were seven items in the scale. The answers to the items were graded 0–3 points from "never" to "almost every day". The total score of the scale was the sum of the scores of each item. The higher the total score was, the more serious the individual anxiety was. The Cronbach's α coefficient for GAD-7 is 0.869. Patient Health Questionnaire-Self-Rating Depression Scale (PHQ-9) (Xu et al., 2023 ): There were nine items in the scale. The answers to the items were graded 0–3 points from "never" to "almost every day". The total score of the scale was the sum of the scores of each item. The higher the total score was, the more serious the individual depression was. The Cronbach's α coefficient for PHQ-9 is 0.895. Social Support Revalued Scale (SSRS)(Y. Wang et al., 2024 ): The scale had a total of 10 items and three dimensions (objective support, subjective support and utilization of support). The total score of the scale was the sum of the scores of each item. The higher the total score was, the higher the individual's social support was. The total Cronbach′s α coefficient was 0.920, which is widely used in China(Y. Wang, et al., 2024). 2.4 Survey methods Responsible nurses distributed questionnaires to patients on the day of admission and collected the questionnaires on site. Patients who were able to fill in the questionnaires themselves were required to fill in the questionnaires. Patients who could not fill in the questionnaires themselves were assisted by the responsible nurses. The place where the questionnaire was filled out was the fixed single room in our department. The environment was quiet and safe, and it was suitable for filling out the questionnaire. 2.5 quality control Members and data collection and processing personnel participating in the study were trained to ensure that they were familiar with the data entry requirements of the questionnaire. In the data entry stage, double entry is adopted to ensure the accuracy and authenticity of the data. 2.6 Data Analysis In this study, SPSS 25.0 was used for data analysis. For the measurement data of normal distribution, the mean standard deviation was used for statistical description. For the non-normal measurement data, the median and quartile were used for statistical description. The count data were described using frequency and constituent ratio and rate. T test, analysis of variance, and Pearson correlation analysis were selected for univariate analysis according to different types of data. The factors with statistical difference for single factor were finally included in the stepwise regression analysis to establish the model. 3 Results 3.1 Analysis of general data of hospitalized patients with DFU: A total of 191 questionnaires were collected in this study, and 180 valid questionnaires were collected, with the effective rate of 94.24%. Of the 180 subjects, 117(65%) were male and 63 (35%) were female, all aged between 40 and 79 years. The total stigma scores of the 180 hospitalized DF patients were (52.98 ± 7.14), the differential treatment dimension (15.04 ± 2.90), blame and critical dimension (19.38 ± 4.01) and self-stigma dimension (18.56 ± 4.48). The specific general data are shown in Table 1 . 3.2 univariate analysis of stigma of hospitalized patients with DFU The univariate analysis showed that there were statistical differences between gender, age, educational level, and duration of diabetes mellitus and stigma of hospitalized patients with DFU ( P < 0.05), as shown in Table 1 . 3.3 Correlation analysis between stigma, anxiety, depression and social support of hospitalized patients with DFU The Pearson correlation analysis showed that there was a negative correlation between social support and its various dimensions and stigma of hospitalized patients with DFU ( P < 0.05), and there was a positive correlation between anxiety, depression and stigma of hospitalized patients with DFU ( P < 0.05), as shown in Table 2 . 3.4 Stigma of hospitalized patients with DFU stepwise regression analysis The stigma of hospitalized patients with DFU was taken as the dependent variable, and the variables that were statistically significant in the univariate analysis ( P < 0.05) were introduced into the multiple linear stepwise regression model. At the same time, according to the requirements of independent variables for multivariate stepwise regression analysis, statistical analysis was performed after dummy variable assignment for multi-category independent variables. See Table 3 for the assignment of respective variables and settings of dummy variables. The stepwise regression analysis showed that there were significant differences in stigma between gender, diabetes duration, anxiety, depression and DFU inpatients (R 2 = 0.507, adjusted R 2 = 0.495, F = 42.192, P < 0.001), as shown in Table 4 . Table 1 General data of hospitalized patients with 1DFU and univariate analysis of stigma (n = 180) variable project Number (%) Stigma make a difference between Blame and judge Self-humiliation gender man 117(65%) 54.08 ± 7.57 15.31 ± 3.16 18.77 ± 4.32 19.00 ± 4.94 woman 63(35%) 49.43 ± 14.42 13.14 ± 3.67 18.57 ± 5.80 17.71 ± 7.18 t 2.388 4.138 0.238 1.269 P 0.019* <0.001*** 0.813 0.208 Age (years) 40–49 18(10%) 37.90 ± 6.64 10.50 ± 1.581 16.01 ± 3.16 11.40 ± 1.90 50–59 108(60%) 55.33 ± 7.48 16.25 ± 2.66 20.92 ± 3.72 18.17 ± 4.30 60–69 18(10%) 49.11 ± 2.74 14.22 ± 2.94 13.5 ± 3.65 21.39 ± 2.45 70–79 36(20%) 52.53 ± 3.54 13.01 ± 0.74 18.26 ± 1.71 21.26 ± 4.94 F 27.775 53.617 26.830 54.707 P <0.001*** <0.001*** <0.001*** <0.001*** marriage be unmarried 12(6.67%) 51.63 ± 7.15 16.42 ± 3.02 16.68 ± 5.97 18.53 ± 4.07 married 133(73.89%) 53.33 ± 7.51 15.3 ± 2.89 19.92 ± 3.74 18.11 ± 4.22 Divorced/widowed 35(19.44%) 52.52 ± 5.70 13.33 ± 2.07 19.03 ± 2.78 20.15 ± 5.32 F 0.550 9.160 3.273 2.036 P 0.578 <0.001*** 0.048 0.144 academic degree without 9(5%) 47.56 ± 1.87 12.89 ± 1.26 21 ± 1.225 13.67 ± 1.50 Primary and lower secondary 81(45%) 54.05 ± 8.16 15.48 ± 3.01 20.67 ± 4.12 17.90 ± 4.44 senior high school 72(40%) 52.03 ± 6.22 14.69 ± 2.95 17.87 ± 3.784 19.47 ± 4.41 University and above 18(10%) 56.22 ± 1.09 16.01 ± 1.21 18.02 ± 1.11 22.22 ± 1.09 F 3.525 3.067 7.795 8.024 P 0.016* 0.030* <0.001*** <0.001*** Diabetes Illness Years (years) 1–5 25(13.89%) 48.82 ± 2.03 14.24 ± 2.25 12.88 ± 2.17 21.71 ± 1.86 6–10 74(41.11%) 54.94 ± 8.77 16.04 ± 2.98 20.57 ± 4.12 18.33 ± 4.51 11–15 54(30%) 52.26 ± 6.38 14.15 ± 3.02 18.53 ± 2.40 19.58 ± 4.95 16–20 27(15%) 51.78 ± 3.23 14.63 ± 1.90 22.03 ± 1.59 15.15 ± 1.40 F 12.229 5.568 77.372 56.664 P <0.001*** 0.001** <0.001*** <0.001*** Diabetic foot ulcer disease Years (years) 5 9(5%) 51.56 ± 2.12 11.78 ± 0.97 16.11 ± 0.78 23.67 ± 1.58 F 1.382 37.199 92.083 78.694 P 0.264 <0.001*** <0.001*** <0.001*** complication no 36(20%) 53.02 ± 7.41 15.40 ± 2.96 20.34 ± 3.39 17.27 ± 4.09 be 144(80%) 52.88 ± 6.33 13.98 ± 2.42 16.58 ± 4.37 22.33 ± 3.30 t 0.105 2.849 5.814 -8.123 P 0.917 0.005* <0.001*** <0.001*** Note: * P < 0.05, ** P < 0.01, *** P < 0.001 Table 2 Analysis of anxiety, depression, social support, anxiety and the correlation of each dimension in hospitalized patients with 2DFU (n = 180) variable Stigma distinguish treat Blame and judge self shame objective support subjective support Utilization of support society support anxious depressed Stigma one make a difference between 0.720** one Blame and judge 0.652** 0.508** one Self-humiliation 0.544** 0.046 -0.183* one Objective support -0.062 -0.157* 0.241** -0.211** one Subjective support -0.232** -0.204** 0.046 -0.280** 0.628** one Utilization of support -0.151 0.060 0.470** -0.699** 0.221** 0.195* one social support -0.216** -0.167* 0.245** -0.455** 0.799** 0.915** 0.489** one anxious 0.567** 0.419** 0.465** 0.217** -0.143 -0.197* -0.058 -0.192* one depressed 0.537** 0.422** 0.396** 0.229** -0.319** -0.184* -0.250** -0.296** 0.638** one Note: * P < 0.05, ** P < 0.01 Table 3 independent variable assignment table variable evaluation gender 1 = female; 2 = male age Brought in from original value academic degree 1 = none; 2 = Primary and Secondary; 3 = high school; 4 = University and above Duration of diabetes Brought in from original value social support Brought in from original value anxious Brought in from original value depressed Brought in from original value Table 4 Progressive regression analysis of the factors related to stigma in hospitalized patients with 4-D FU (n = 180) variable B SE β T value P value (constant) 38.371 1.754 21.872 <0.001 anxious 1.316 0.181 0.566 7.281 <0.001 gender 6.454 0.978 0.423 6.597 <0.001 Duration of diabetes -1.94 0.513 -0.239 -3.786 <0.001 depressed 0.503 0.15 0.246 3.358 0.001 Note: R 2 = 0.507, adjusted R 2 = 0.495, F = 42.192, P < 0.001 4 Discussion The results of this study showed that the overall score of stigma in hospitalized patients with diabetic foot ulcer was (52.98 ± 7.14), indicating that moderate or above stigma existed generally in this group, and some patients' stigma had reached a serious level. This finding was basically consistent with the conclusions of similar studies in China and abroad, but the overall score of stigma was slightly higher than that of simple type 2 diabetic patients(Speight et al., 2024 ), which is speculated to be related to additional pressure such as physical dysfunction, prolonged treatment cycle and increased medical expenses caused by diabetic foot ulcer as a serious complication of diabetes. The results of this study showed that there was a correlation between stigma and gender in hospitalized patients with DFU, and men showed a higher degree of stigma than women, which was partially different from the results of other studies. Studies have shown that women are 4.78 times more likely than men to have a sense of shame due to diabetes(N. F. Liu, et al., 2017). According to meta-regression, the stigma and psychological distress of patients with diabetes were not significantly gender-adjusted, according to a mata analysis(Emmer, Bosnjak, & Mata, 2020 ; Guo, et al., 2023). Such differences may be associated with a variety of factors. First, differences in cultural and social roles may play a key role in gender differences. In eastern culture, men are often expected to present a strong and unassailable image, so when faced with health problems, men may be more prone to stigma(Hirai et al., 2022 ). In addition, factors such as medical environment, family support and individual differences may play a role in the formation of gender differences. The role of gender in the stigma of hospitalized patients with DFU is complex, and in the future, large samples are needed to deeply study the interaction of various factors, in order to provide more accurate guidance for clinical intervention and treatment(Akyirem, et al., 2023 ). Second, this study found that there was a negative correlation between the stigma of hospitalized patients with DFU and the duration of diabetes. Specifically, with the increase in the number of years of diabetes mellitus, the stigma of hospitalized patients with DFU shows a declining trend, which is similar to the results of many studies, indicating that patients may be better able to cope with the psychological burden of the disease and reduce their stigma after years of illness(Basiri, Seidu, & Rudich, 2023 ). This negative correlation may be related to the patients gradually adapting to and accepting their own conditions during the disease experience. With the passage of time, patients may have a better understanding of how to effectively manage and respond to their own condition, and gradually build awareness and acceptance of their own situation.(M. Wang et al., 2024 ). This adaptive process may help to reduce stigma and allow patients to face the challenges of the disease more firmly. However, the negative correlation observed in this study does not necessarily mean that a longer duration of diabetes necessarily decreases stigma, as individual differences and other factors may lead to different outcomes. According to Ahmad(Ahmad, Abujbara, Jaddou, Younes, & Ajlouni, 2018 )According to the research, the incidence rate of anxiety in DF patients is 37.7%(Ahmad, et al., 2018 ). The results of this study showed that anxiety was a related factor of stigma in hospitalized patients with DFU. With the increase of anxiety score, the stigma of hospitalized patients with DFU tends to be stronger, which is consistent with the result of YUANYUAN Ding et al. Current research indicates that anxiety may have an adverse effect on wound healing(O'Donovan, Capobianco, Taylor-Bennett, & Wells, 2025 ). Therefore, a high level of anxiety among hospitalized patients with DFU may lead to an extended treatment cycle or exacerbation of disease progression, thereby increasing the level of stigma. In addition, the results of the study also showed that there was a positive correlation between stigma and depression in hospitalized patients with DFU(Jiang, Liu, Yu, Qian, & Chen, 2022 ). In the disease management process, patients may feel remorse and shame because of the differential treatment, alienation and incomprehension of family members or friends, or because of illness complications and other reasons that increase the financial burden on the family, resulting in negative emotions such as anxiety and depression. Such negative emotions further aggravate the psychological pressure of patients and form an internal stigma(Ying, Lv, Zhu, Zhang, & Fang, 2025 ). Faced with these mental health problems, medical staff can take appropriate interventions, such as mindfulness-based therapy, cognitive education, and health education, to alleviate the stigma of the patients. Such intervention is expected to promote the psychological rehabilitation of patients at the same time, improve their treatment participation and the overall quality of life. 5 Conclusion Stigma is common among hospitalized patients with DFU, and it is more serious in some patients. Gender, duration of diabetes, anxiety and depression were the important factors for the stigma of hospitalized patients with DFU. Medical staff should according to the patient's individual differences and the actual clinical situation, formulate personalized psychological intervention plan, promote the patient's physical and mental rehabilitation. This study was a cross-sectional survey and could not reflect the dynamic changes of stigma in hospitalized patients with DFU. Future studies should expand the sample size to further verify the results of this study, so as to promote the physical and psychological recovery of hospitalized patients with DFU, and improve their inpatient experience and satisfaction. Relevance to clinical practice : Clinically, results mandate integrating stigma and mental health screening into DFU management. Developing targeted interventions for high-risk groups (by gender, diabetes duration) and leveraging social support are crucial to address this neglected aspect of care and improve overall patient outcomes. Declarations Ethics statement The studies involving humans were approved by The Ethics Committee of Mianyang Central Hospital (S20230225). The studies were conducted in accordance with the local legislation and institutional requirements. Notes No conflict of interest in the submission of this manuscript is declared. Funding Statement The author(s) declare that financial support was received for the research and/or publication of this article. This project was supported by Project of Wound Disease by Sichuan Medical Association (Taige Project) (YXJKCB-2023-56). Author Contribution Ying Wang: Collection and organization of questionnaires; Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft. Tianlan Li: Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing. Yanfei Ma: Conceptualization, Data analysis and inspection, Writing – review & editing. Rong Hu: Funding acquisition, Resources, Writing – review & editing. Data Availability Data available on request due to privacy/ethical restrictions. References Ahmad, A., Abujbara, M., Jaddou, H., Younes, N. A. & Ajlouni, K. Anxiety and Depression Among Adult Patients With Diabetic Foot: Prevalence and Associated Factors. J. Clin. Med. Res. 10 (5), 411–418 (2018). 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Social support, family resilience and psychological resilience among maintenance hemodialysis patients: a longitudinal study. BMC Psychiatry . 24 (1), 76 (2024). Wang, Y. et al. An update on potential biomarkers for diagnosing diabetic foot ulcer at early stage. Biomed. Pharmacother . 133 , 110991 (2021). Xu, L. et al. Validation of the Patient Health Questionnaire-9 for Suicide Screening in Transgender Women. Transgend Health . 8 (5), 450–456 (2023). Ying, Y., Lv, Y., Zhu, H., Zhang, Y. & Fang, X. The incidence of depression and its associated risk factors among diabetic foot ulcers patients: A meta-analysis and systematic review. J. Tissue Viability . 34 (4), 100964 (2025). Additional Declarations No competing interests reported. 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According to the GBD 2021 study published in The Lancet in 2024, the number of diabetic patients in the world increased from 139\u0026nbsp;million in 1990 to 526\u0026nbsp;million in 2021. China is currently the country with the largest number of adult diabetic patients and the heaviest burden of diabetes in the world, with 117\u0026nbsp;million patients in 2021, accounting for 22% of the global diabetic population(C. Liu et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). According to the Diabetes Atlas of the International Diabetes Federation, 11th edition (2025), 589\u0026nbsp;million adults aged 20\u0026ndash;79 years were estimated to have diabetes worldwide by 2024 (about 11.1% of the adult population, or one-ninth), and the figure is expected to rise to 853\u0026nbsp;million by 2050, with 15\u0026ndash;25% of diabetic patients suffering from Diabetic foot ulcers, DFU)(Wang et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDFU is one of the serious complications of diabetes, especially when the Wagner classification reaches grade 3 or higher, the condition becomes more severe and the treatment cycle is significantly prolonged(Chen, Sun, Gao, \u0026amp; Ran, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Patients usually present with deep foot ulcers involving tendon and bone tissue, accompanied by the development of deep abscesses and osteomyelitis that can lead to local or even whole foot gangrene in severe cases, seriously threatening the life of the patient and limb function(McDermott, Fang, Boulton, Selvin, \u0026amp; Hicks, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e)(McDermott, et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). It is estimated that about 18. 6\u0026nbsp;million people are affected by diabetic foot ulcers each year(Armstrong, Tan, Boulton, \u0026amp; Bus, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). About 10% of patients diagnosed with DFU for the first time will die within 1 year, and about 20% of patients will be at risk of lower extremity amputation. The 5-year mortality rate in patients with DFU is 30%, while the mortality rate in patients with foot amputations is over 70%(Armstrong et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStigma refers to the inner shame of the diseased people due to social stereotypes, which may lead to their experience of discrimination, isolation, and self-discrimination and inferiority complex against themselves.(Dubreucq, Plasse, \u0026amp; Franck, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Favre \u0026amp; Richard-Lepouriel, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The concept of stigma was first proposed by the sociologist Goffman and was originally used to study people with mental disorders(Angermeyer \u0026amp; Schulze, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). With the deepening of social and medical research, the connotation of stigma has gradually expanded, which is widely used in the research of many diseases and has become an important framework to understand the social interaction and psychological reaction of patients(Cataldo, Slaughter, Jahan, Pongquan, \u0026amp; Hwang, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; N. F. Liu et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The stigma of diabetes refer to that negative emotions of self-blame, shame, and rejection of diabetic who are labeled to differentiate themselves from others and even devalue them because they have the condition(N. F. Liu, et al., 2017). According to a recent large transnational survey, one fifth (19.2%) of people with diabetes report having experienced discrimination(Nicolucci et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePatients with DFU often face a series of physiological and psychological difficulties. In outpatient treatment, patients with DFU often face the problems of poor treatment effect, increased wound exudate, and significant odor. during hospitalization, patients should not only cope with the repeated illness, wound odor, slow wound healing and other physiological discomfort, but also often bear the increased economic burden and uncertainty of future treatment effect(Kolaric, Svircevic, Bijuk, \u0026amp; Zupancic, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Sen, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Stigma not only leads to social isolation and reduced quality of life, but may also have an adverse effect on patients' self-esteem, self-efficacy, and clinical and functional outcomes. In addition, patients may encounter negative evaluation from society, public prejudice or even misunderstanding from relatives and friends during the treatment. These external pressures are likely to intensify their inner stigma, leading to inferiority complex, anxiety and other emotional distress(Akyirem, Ekpor, Namumbejja Abwoye, Batten, \u0026amp; Nelson, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Stigma not only increases the psychological burden of patients, but may also affect their willingness to actively seek help and hinder treatment compliance, thus aggravating the disease and affecting the rehabilitation process(Guo et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Therefore, the treatment of DFU not only focuses on limb salvage rate, but also focuses on improving the quality of life of patients, promoting physical and mental rehabilitation, and ultimately reducing the mortality and disability rate(Lipsky \u0026amp; Uckay, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough significant advances have been made in clinical treatments in recent years, the comprehensive treatment of DFU still faces many challenges. Among them, the mental health problems of patients have gradually become a difficult and hot topic to be solved. Therefore, exploring the current situation of stigma and its influencing factors in hospitalized patients with DFU not only has important theoretical significance, but also provides a practical direction for clinical intervention practice. The purpose of this study was to investigate the stigma status of hospitalized patients with DFU and analyze the related influencing factors, in order to provide a theoretical basis for clinical psychological care intervention, and provide scientific support for improving the psychological state of patients and promoting their comprehensive rehabilitation.\u003c/p\u003e"},{"header":"2 Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Research Design\u003c/h2\u003e \u003cp\u003eThis study is a cross-sectional cross-sectional study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Subjects\u003c/h2\u003e \u003cp\u003ePatients with DFU who were hospitalized in our hospital from October 2024 to August 2025 were selected as the research subjects. Inclusion criteria: ① Patients in line with the guidelines for the diagnosis and treatment of diabetic foot ulcer; ② Age\u0026thinsp;\u0026ge;\u0026thinsp;18 years old; ③ Patients with normal cognitive, understanding and communication abilities, and able to fill out the questionnaire on their own or with the help of the researcher. Exclusion criteria: ① patients combined with other severe physical or mental diseases; ② Patients who were unwilling to participate in the investigation. Removal criteria: ① Questionnaires with missing contents\u0026thinsp;\u0026ge;\u0026thinsp;20% were filled in. This study was approved by our Ethics Committee and with the informed consent of the participants.\u003c/p\u003e \u003cp\u003eCalculation of sample size: The sample size was 10\u0026ndash;20 times of the number of variables. There were 12 independent variables in this study. Considering the 20% invalid questionnaire, the calculation formula of sample size was: 12\u0026times;(10\u0026ndash;20)/80%=150\u0026ndash;300.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Evaluation indicators\u003c/h2\u003e \u003cp\u003eGeneral information questionnaire: In this study, based on evidence-based medicine and evidence-based nursing, and by comprehensively consulting the relevant literature both in China and abroad, we designed our own general information questionnaire, which specifically included the patient's hospitalization number, name, gender, age, educational level, marital status, duration of diabetes, duration of diabetic foot ulcer, and complications.\u003c/p\u003e \u003cp\u003eType 2 DIABETES Stigma Assessment Scale (DSAS-2): The scale was determined by Kato(Browne, Ventura, Mosely, \u0026amp; Speight, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2016\u003c/span\u003e)R\u0026amp;D with a total of 19 items and three dimensions (differential treatment, blame and judgment, and self-shame). The items were scored with Likert 5-level scoring method, and were scored with 1\u0026ndash;5 points in sequence from \"very different meaning\" to \"very agree\". The total score on the scale was the sum of the scores of each item. The higher the total score was, the stronger the individual's stigma was. The Cronbach's α coefficient of the scale was 0.879.\u003c/p\u003e \u003cp\u003eGeneralized anxiety disorder-7 (GAD-7)(M. Liu et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e): There were seven items in the scale. The answers to the items were graded 0\u0026ndash;3 points from \"never\" to \"almost every day\". The total score of the scale was the sum of the scores of each item. The higher the total score was, the more serious the individual anxiety was. The Cronbach's α coefficient for GAD-7 is 0.869.\u003c/p\u003e \u003cp\u003ePatient Health Questionnaire-Self-Rating Depression Scale (PHQ-9) (Xu et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2023\u003c/span\u003e): There were nine items in the scale. The answers to the items were graded 0\u0026ndash;3 points from \"never\" to \"almost every day\". The total score of the scale was the sum of the scores of each item. The higher the total score was, the more serious the individual depression was. The Cronbach's α coefficient for PHQ-9 is 0.895.\u003c/p\u003e \u003cp\u003eSocial Support Revalued Scale (SSRS)(Y. Wang et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2024\u003c/span\u003e): The scale had a total of 10 items and three dimensions (objective support, subjective support and utilization of support). The total score of the scale was the sum of the scores of each item. The higher the total score was, the higher the individual's social support was. The total Cronbach\u0026prime;s α coefficient was 0.920, which is widely used in China(Y. Wang, et al., 2024).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Survey methods\u003c/h2\u003e \u003cp\u003eResponsible nurses distributed questionnaires to patients on the day of admission and collected the questionnaires on site. Patients who were able to fill in the questionnaires themselves were required to fill in the questionnaires. Patients who could not fill in the questionnaires themselves were assisted by the responsible nurses. The place where the questionnaire was filled out was the fixed single room in our department. The environment was quiet and safe, and it was suitable for filling out the questionnaire.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 quality control\u003c/h2\u003e \u003cp\u003eMembers and data collection and processing personnel participating in the study were trained to ensure that they were familiar with the data entry requirements of the questionnaire. In the data entry stage, double entry is adopted to ensure the accuracy and authenticity of the data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Data Analysis\u003c/h2\u003e \u003cp\u003eIn this study, SPSS 25.0 was used for data analysis. For the measurement data of normal distribution, the mean standard deviation was used for statistical description. For the non-normal measurement data, the median and quartile were used for statistical description. The count data were described using frequency and constituent ratio and rate. T test, analysis of variance, and Pearson correlation analysis were selected for univariate analysis according to different types of data. The factors with statistical difference for single factor were finally included in the stepwise regression analysis to establish the model.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cp\u003e3.1 Analysis of general data of hospitalized patients with DFU: A total of 191 questionnaires were collected in this study, and 180 valid questionnaires were collected, with the effective rate of 94.24%. Of the 180 subjects, 117(65%) were male and 63 (35%) were female, all aged between 40 and 79 years. The total stigma scores of the 180 hospitalized DF patients were (52.98\u0026thinsp;\u0026plusmn;\u0026thinsp;7.14), the differential treatment dimension (15.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.90), blame and critical dimension (19.38\u0026thinsp;\u0026plusmn;\u0026thinsp;4.01) and self-stigma dimension (18.56\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48). The specific general data are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e3.2 univariate analysis of stigma of hospitalized patients with DFU The univariate analysis showed that there were statistical differences between gender, age, educational level, and duration of diabetes mellitus and stigma of hospitalized patients with DFU (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e3.3 Correlation analysis between stigma, anxiety, depression and social support of hospitalized patients with DFU The Pearson correlation analysis showed that there was a negative correlation between social support and its various dimensions and stigma of hospitalized patients with DFU (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and there was a positive correlation between anxiety, depression and stigma of hospitalized patients with DFU (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e3.4 Stigma of hospitalized patients with DFU stepwise regression analysis The stigma of hospitalized patients with DFU was taken as the dependent variable, and the variables that were statistically significant in the univariate analysis (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) were introduced into the multiple linear stepwise regression model. At the same time, according to the requirements of independent variables for multivariate stepwise regression analysis, statistical analysis was performed after dummy variable assignment for multi-category independent variables. See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e for the assignment of respective variables and settings of dummy variables. The stepwise regression analysis showed that there were significant differences in stigma between gender, diabetes duration, anxiety, depression and DFU inpatients (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.507, adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.495, F\u0026thinsp;=\u0026thinsp;42.192, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\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\u003eGeneral data of hospitalized patients with 1DFU and univariate analysis of stigma (n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003evariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eproject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003emake a difference between\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBlame and judge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSelf-humiliation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003egender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e117(65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.08\u0026thinsp;\u0026plusmn;\u0026thinsp;7.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.77\u0026thinsp;\u0026plusmn;\u0026thinsp;4.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.94\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\u003ewoman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63(35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.43\u0026thinsp;\u0026plusmn;\u0026thinsp;14.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.57\u0026thinsp;\u0026plusmn;\u0026thinsp;5.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.71\u0026thinsp;\u0026plusmn;\u0026thinsp;7.18\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\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.238\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.269\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.019*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.813\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.90\u0026thinsp;\u0026plusmn;\u0026thinsp;6.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.50\u0026thinsp;\u0026plusmn;\u0026thinsp;1.581\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.40\u0026thinsp;\u0026plusmn;\u0026thinsp;1.90\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\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.33\u0026thinsp;\u0026plusmn;\u0026thinsp;7.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.92\u0026thinsp;\u0026plusmn;\u0026thinsp;3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.17\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30\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\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\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\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.53\u0026thinsp;\u0026plusmn;\u0026thinsp;3.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.26\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.26\u0026thinsp;\u0026plusmn;\u0026thinsp;4.94\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\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.775\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.617\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26.830\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e54.707\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emarriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebe unmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(6.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.63\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.68\u0026thinsp;\u0026plusmn;\u0026thinsp;5.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.07\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=\"left\" colname=\"c3\"\u003e \u003cp\u003e133(73.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.33\u0026thinsp;\u0026plusmn;\u0026thinsp;7.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.92\u0026thinsp;\u0026plusmn;\u0026thinsp;3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.11\u0026thinsp;\u0026plusmn;\u0026thinsp;4.22\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\u003eDivorced/widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(19.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.52\u0026thinsp;\u0026plusmn;\u0026thinsp;5.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.33\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.15\u0026thinsp;\u0026plusmn;\u0026thinsp;5.32\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\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.036\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eacademic degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ewithout\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.56\u0026thinsp;\u0026plusmn;\u0026thinsp;1.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.89\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13.67\u0026thinsp;\u0026plusmn;\u0026thinsp;1.50\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\u003ePrimary and lower secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81(45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.05\u0026thinsp;\u0026plusmn;\u0026thinsp;8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.67\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.90\u0026thinsp;\u0026plusmn;\u0026thinsp;4.44\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\u003esenior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.03\u0026thinsp;\u0026plusmn;\u0026thinsp;6.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.784\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.47\u0026thinsp;\u0026plusmn;\u0026thinsp;4.41\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\u003eUniversity and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.01\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\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\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.024\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.016*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.030*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes Illness\u003c/p\u003e \u003cp\u003eYears (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(13.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.82\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.88\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.86\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\u003e6\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74(41.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.94\u0026thinsp;\u0026plusmn;\u0026thinsp;8.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.57\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.33\u0026thinsp;\u0026plusmn;\u0026thinsp;4.51\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\u003e11\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.26\u0026thinsp;\u0026plusmn;\u0026thinsp;6.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.15\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.58\u0026thinsp;\u0026plusmn;\u0026thinsp;4.95\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\u003e16\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.63\u0026thinsp;\u0026plusmn;\u0026thinsp;1.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15.15\u0026thinsp;\u0026plusmn;\u0026thinsp;1.40\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\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e77.372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e56.664\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetic foot ulcer disease\u003c/p\u003e \u003cp\u003eYears (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144(80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.07\u0026thinsp;\u0026plusmn;\u0026thinsp;7.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.97\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.92\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53\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\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.03\u0026thinsp;\u0026plusmn;\u0026thinsp;4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.28\u0026thinsp;\u0026plusmn;\u0026thinsp;2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15.34\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\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\u003e\u0026gt;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.67\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58\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\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.382\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e92.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e78.694\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecomplication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.02\u0026thinsp;\u0026plusmn;\u0026thinsp;7.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.34\u0026thinsp;\u0026plusmn;\u0026thinsp;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.27\u0026thinsp;\u0026plusmn;\u0026thinsp;4.09\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\u003ebe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144(80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.88\u0026thinsp;\u0026plusmn;\u0026thinsp;6.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.58\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30\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\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.814\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-8.123\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\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote: * \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, ** \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, *** \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \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\u003eAnalysis of anxiety, depression, social support, anxiety and the correlation of each dimension in hospitalized patients with 2DFU (n\u0026thinsp;=\u0026thinsp;180)\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=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003evariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003edistinguish\u003c/p\u003e \u003cp\u003etreat\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBlame and judge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eself\u003c/p\u003e \u003cp\u003eshame\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eobjective\u003c/p\u003e \u003cp\u003esupport\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003esubjective\u003c/p\u003e \u003cp\u003esupport\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUtilization of support\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003esociety\u003c/p\u003e \u003cp\u003esupport\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eanxious\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003edepressed\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStigma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eone\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\u003emake a difference between\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.720**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eone\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\u003eBlame and judge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.652**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.508**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eone\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-humiliation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.544**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.183*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eone\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\u003eObjective support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.157*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.241**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.211**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eone\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\u003eSubjective support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.232**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.204**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.280**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.628**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eone\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\u003eUtilization of support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.470**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.699**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.221**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.195*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eone\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\u003esocial support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.216**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.167*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.245**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.455**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.799**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.915**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.489**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eone\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\u003eanxious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.567**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.419**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.465**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.217**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.197*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.058\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.192*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eone\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\u003edepressed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.537**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.422**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.396**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.229**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.319**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.184*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.250**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.296**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.638**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"11\"\u003eNote: * \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\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\u003eindependent variable assignment table\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\u003evariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eevaluation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003egender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;female; 2\u0026thinsp;=\u0026thinsp;male\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=\"left\" colname=\"c2\"\u003e \u003cp\u003eBrought in from original value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eacademic degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;none; 2\u0026thinsp;=\u0026thinsp;Primary and Secondary; 3\u0026thinsp;=\u0026thinsp;high school; 4\u0026thinsp;=\u0026thinsp;University and above\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBrought in from original value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esocial support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBrought in from original value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eanxious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBrought in from original value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edepressed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBrought in from 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=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProgressive regression analysis of the factors related to stigma in hospitalized patients with 4-D FU (n\u0026thinsp;=\u0026thinsp;180)\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\u003evariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eT value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP value\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(constant)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.754\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.872\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eanxious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.566\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003egender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-3.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edepressed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.507, adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.495, F\u0026thinsp;=\u0026thinsp;42.192, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThe results of this study showed that the overall score of stigma in hospitalized patients with diabetic foot ulcer was (52.98\u0026thinsp;\u0026plusmn;\u0026thinsp;7.14), indicating that moderate or above stigma existed generally in this group, and some patients' stigma had reached a serious level. This finding was basically consistent with the conclusions of similar studies in China and abroad, but the overall score of stigma was slightly higher than that of simple type 2 diabetic patients(Speight et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), which is speculated to be related to additional pressure such as physical dysfunction, prolonged treatment cycle and increased medical expenses caused by diabetic foot ulcer as a serious complication of diabetes.\u003c/p\u003e \u003cp\u003eThe results of this study showed that there was a correlation between stigma and gender in hospitalized patients with DFU, and men showed a higher degree of stigma than women, which was partially different from the results of other studies. Studies have shown that women are 4.78 times more likely than men to have a sense of shame due to diabetes(N. F. Liu, et al., 2017). According to meta-regression, the stigma and psychological distress of patients with diabetes were not significantly gender-adjusted, according to a mata analysis(Emmer, Bosnjak, \u0026amp; Mata, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Guo, et al., 2023). Such differences may be associated with a variety of factors. First, differences in cultural and social roles may play a key role in gender differences. In eastern culture, men are often expected to present a strong and unassailable image, so when faced with health problems, men may be more prone to stigma(Hirai et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In addition, factors such as medical environment, family support and individual differences may play a role in the formation of gender differences. The role of gender in the stigma of hospitalized patients with DFU is complex, and in the future, large samples are needed to deeply study the interaction of various factors, in order to provide more accurate guidance for clinical intervention and treatment(Akyirem, et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSecond, this study found that there was a negative correlation between the stigma of hospitalized patients with DFU and the duration of diabetes. Specifically, with the increase in the number of years of diabetes mellitus, the stigma of hospitalized patients with DFU shows a declining trend, which is similar to the results of many studies, indicating that patients may be better able to cope with the psychological burden of the disease and reduce their stigma after years of illness(Basiri, Seidu, \u0026amp; Rudich, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This negative correlation may be related to the patients gradually adapting to and accepting their own conditions during the disease experience. With the passage of time, patients may have a better understanding of how to effectively manage and respond to their own condition, and gradually build awareness and acceptance of their own situation.(M. Wang et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This adaptive process may help to reduce stigma and allow patients to face the challenges of the disease more firmly. However, the negative correlation observed in this study does not necessarily mean that a longer duration of diabetes necessarily decreases stigma, as individual differences and other factors may lead to different outcomes.\u003c/p\u003e \u003cp\u003eAccording to Ahmad(Ahmad, Abujbara, Jaddou, Younes, \u0026amp; Ajlouni, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2018\u003c/span\u003e)According to the research, the incidence rate of anxiety in DF patients is 37.7%(Ahmad, et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). The results of this study showed that anxiety was a related factor of stigma in hospitalized patients with DFU. With the increase of anxiety score, the stigma of hospitalized patients with DFU tends to be stronger, which is consistent with the result of YUANYUAN Ding et al. Current research indicates that anxiety may have an adverse effect on wound healing(O'Donovan, Capobianco, Taylor-Bennett, \u0026amp; Wells, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Therefore, a high level of anxiety among hospitalized patients with DFU may lead to an extended treatment cycle or exacerbation of disease progression, thereby increasing the level of stigma. In addition, the results of the study also showed that there was a positive correlation between stigma and depression in hospitalized patients with DFU(Jiang, Liu, Yu, Qian, \u0026amp; Chen, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the disease management process, patients may feel remorse and shame because of the differential treatment, alienation and incomprehension of family members or friends, or because of illness complications and other reasons that increase the financial burden on the family, resulting in negative emotions such as anxiety and depression. Such negative emotions further aggravate the psychological pressure of patients and form an internal stigma(Ying, Lv, Zhu, Zhang, \u0026amp; Fang, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Faced with these mental health problems, medical staff can take appropriate interventions, such as mindfulness-based therapy, cognitive education, and health education, to alleviate the stigma of the patients. Such intervention is expected to promote the psychological rehabilitation of patients at the same time, improve their treatment participation and the overall quality of life.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eStigma is common among hospitalized patients with DFU, and it is more serious in some patients. Gender, duration of diabetes, anxiety and depression were the important factors for the stigma of hospitalized patients with DFU. Medical staff should according to the patient's individual differences and the actual clinical situation, formulate personalized psychological intervention plan, promote the patient's physical and mental rehabilitation. This study was a cross-sectional survey and could not reflect the dynamic changes of stigma in hospitalized patients with DFU. Future studies should expand the sample size to further verify the results of this study, so as to promote the physical and psychological recovery of hospitalized patients with DFU, and improve their inpatient experience and satisfaction.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eRelevance to clinical practice\u003c/b\u003e: Clinically, results mandate integrating stigma and mental health screening into DFU management. Developing targeted interventions for high-risk groups (by gender, diabetes duration) and leveraging social support are crucial to address this neglected aspect of care and improve overall patient outcomes.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cb\u003eEthics statement\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe studies involving humans were approved by The Ethics Committee of Mianyang Central Hospital (S20230225). The studies were conducted in accordance with the local legislation and institutional requirements.\u003c/p\u003e\u003ch2\u003eNotes\u003c/h2\u003e \u003cp\u003eNo conflict of interest in the submission of this manuscript is declared.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding Statement\u003c/h2\u003e \u003cp\u003eThe author(s) declare that financial support was received for the research and/or publication of this article. This project was supported by Project of Wound Disease by Sichuan Medical Association (Taige Project) (YXJKCB-2023-56).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eYing Wang: Collection and organization of questionnaires; Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing \u0026ndash; original draft. Tianlan Li: Data curation, Formal analysis, Investigation, Methodology, Writing \u0026ndash; review \u0026amp; editing. Yanfei Ma: Conceptualization, Data analysis and inspection, Writing \u0026ndash; review \u0026amp; editing. Rong Hu: Funding acquisition, Resources, Writing \u0026ndash; review \u0026amp; editing.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData available on request due to privacy/ethical restrictions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAhmad, A., Abujbara, M., Jaddou, H., Younes, N. A. \u0026amp; Ajlouni, K. Anxiety and Depression Among Adult Patients With Diabetic Foot: Prevalence and Associated Factors. \u003cem\u003eJ. Clin. Med. Res.\u003c/em\u003e \u003cb\u003e10\u003c/b\u003e (5), 411\u0026ndash;418 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAkyirem, S., Ekpor, E., Namumbejja Abwoye, D., Batten, J. \u0026amp; Nelson, L. E. 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Tissue Viability\u003c/em\u003e. \u003cb\u003e34\u003c/b\u003e (4), 100964 (2025).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"diabetic foot ulcer, Stigma, Anxiety, Depression, social support","lastPublishedDoi":"10.21203/rs.3.rs-9007703/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9007703/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAims:\u003c/strong\u003e To investigate stigma and its associated factors in hospitalized patients with diabetic foot ulcer (DFU), so as to provide theoretical and data support for psychological care of patients with diabetic foot ulcer.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003ePatients with diabetic foot ulcer who were hospitalized in the Department of Orthopedics of xx hospital from October 2024 to August 2025 were selected as the research subjects. The status quo was investigated using general information questionnaire, Type 2 diabetes stigma rating scale (DSAD-2), generalized anxiety disorder self-rating scale (GAD-7), patient health questionnaire self-rating depression scale (PHQ-9), and social support rating scale (SSRS) and SPSS 25.0 software was used for data analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 180 inpatients with diabetic foot ulcer were investigated. The total stigma score was 52.98±7.14. Univariate analysis showed significant associations of stigma with gender, age, education, diabetes duration, anxiety, depression, and social support (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Stigma correlated negatively with social support and positively with anxiety and depression (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05)..Multiple linear stepwise regression analysis showed significant differences (R²=0.507, adjusted R²=0.495, F=42.192, \u003cem\u003eP\u003c/em\u003e\u0026lt; 0.001) between gender, diabetes duration, anxiety and depression, and stigma.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eStigma is common in hospitalized patients with diabetic foot ulcer, and it is more serious in some patients. Gender, duration of diabetes, anxiety and depression were the important factors affecting stigma. Personalized psychological interventions are recommended to promote recovery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplications for the Profession and Patient Care:\u003c/strong\u003e \u0026nbsp;Training nurses to recognize stigma and psychological distress, alongside implementing tailored support and strengthening social support, can mitigate stigma and improve outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImpact: \u003c/strong\u003eThis study provides empirical evidence on the psychological burden of stigma in DFU inpatients, directly informing clinical nursing practice and patient-centered care strategies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient or public contribution:\u003c/strong\u003e Patients were involved as the study population. No patient or public contribution.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReporting Method: \u003c/strong\u003eThe study adhered to the STROBE checklist.\u003c/p\u003e","manuscriptTitle":"Investigation on Stigma of Inpatients with Diabetic Foot Ulcer and Analysis of Related Factors","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-17 07:16:30","doi":"10.21203/rs.3.rs-9007703/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fbf10ac2-7078-4ef7-917b-099a8dd3b416","owner":[],"postedDate":"March 17th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":64602458,"name":"Health sciences/Diseases"},{"id":64602459,"name":"Health sciences/Endocrinology"},{"id":64602460,"name":"Health sciences/Health care"},{"id":64602461,"name":"Health sciences/Medical research"},{"id":64602462,"name":"Biological sciences/Psychology"},{"id":64602463,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2026-04-22T11:11:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-17 07:16:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9007703","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9007703","identity":"rs-9007703","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}