Investigating the Relationship Between Social Stigma and Treatment Adherence in Type 2 Diabetes Patients at Healthcare Centers in Northwest Iran

Abstract Background: The social stigma associated with type 2 diabetes is a significant global mental and social health issue that can hinder treatment adherence among patients. To address this concern, the present study aimed to examine the relationship between social stigma and treatment adherence levels in type 2 diabetes patients attending healthcare centers in northwest Iran. Methods: In this descriptive-correlation study, 432 patients with type 2 diabetes referred to Ardabil city health service centers were selected by simple random and multi-stage cluster method. The data collection tools included the personal-social profile form, type 2 diabetes stigma assessment scale (DSAS-2), and treatment adherence questionnaire. Data were analyzed using SPSS26 software with descriptive statistics, independent t-tests, analysis of variance, and logistic linear regression model. Results: The results indicated that the average score for the total social stigma of type 2 diabetes among the studied samples was 59.27 ± 15.52. A high level of perceived social stigma was observed in 55.6% of the patients. The average score for treatment adherence was 97.46 ± 28.79, with an adherence situation at an average level (59.7%). An inverse relationship was identified between the social stigma of diabetes and adherence to treatment (r = -0.29, p < 0.001). Additionally, there was a significant relationship between the average score of social stigma of diabetes and variables such as gender and marital status, as well as between the average score of treatment adherence and the gender of patients. The stepwise multiple linear regression model revealed that 15.1% of the variance in treatment adherence could be explained by age, duration of the disease, and social stigma of diabetes. Conclusion: Considering the significant inverse relationship between social stigma and treatment adherence, it is concluded that to enhance treatment adherence in patients with type 2 diabetes, necessary measures and interventions should be implemented to reduce social stigma. By addressing social stigma, health field decision-makers can consequently increase treatment adherence in these patients.