The mediating effect of self-acceptance on the relationship between illness stigma and social isolation in young and middle-aged male hemodialysis patients (自我接纳在中青年男性血液透析患者病耻感与社会疏离感间的中介效应)

Objective This study aims to explore the mediating effect of self-acceptance on the relationship between illness stigma and social isolation in young and middle-aged male hemodialysis patients. Methods A total of 213 young and middle-aged male hemodialysis patients receiving treatment at a tertiary hospital from April to September 2024 were selected using the convenience sampling method. The participants were assessed using the General Isolation Scale, the Stigma Scale, and the Self-Acceptance Scale. A mediation model was constructed to analyze the relationships among the variables. Results There were statistically significant differences in total social isolation scores based on education level, monthly family income, occupation, and dialysis duration (P < 0. 05). The mean stigma score was (62. 78±14. 16), the self-acceptance score was (35. 31±8. 80), and the social isolation score was (39. 18±8. 93). Stigma was negatively correlated with self-acceptance (r=-0. 218, P＜0. 01) and positively correlated with social isolation (r=0. 285, P＜0. 01), while self-acceptance was negatively correlated with social isolation (r=-0. 295, P＜0. 01). Self-acceptance partially mediated the relationship between stigma and social isolation, accounting for 32. 06% of the total effect. Conclusion Both stigma and social isolation were moderate to high in young and middle-aged male hemodialysis patients. Stigma can affect social isolation directly or indirectly through self-acceptance. Healthcare professionals should implement interventions to enhance self-acceptance in young and middle-aged male patients to reduce their social isolation. (目的 探讨自我接纳在中青年男性血液透析患者病耻感与社会疏离感间的中介效应。方法 采用便利抽样法选取2024年4月—2024年9月医院收治的行血液透析治疗的中青年男性患者213例为研究对象, 采用一般疏离感量表(GAS)评价患者的社会疏离感受, 采用社会影响量表(SIS) 评价患者的病耻感, 采用自我接纳量表(SAQ)评价患者的自我接纳程度, 构建中介模型。结果 不同文化程度、家庭月收入、职业、透析年限与中青年男性血液透析患者社会疏离总分比较, 差异有统计学意义(P＜0. 05)。患者病耻感得分为(62. 78±14. 16)分; 自我接纳得分为(35. 31±8. 80)分; 社会疏离得分为(39. 18±8. 93)分; 病耻感与自我接纳呈负相关(r=-0. 218, P＜0. 01)、与社会疏离呈正相关(r=0. 285, P＜0. 01), 社会疏离与自我接纳呈负相关(r=-0. 295, P＜0. 01); 自我接纳在病耻感与社会疏离之间具有部分中介作用, 中介效应占总效应比为32. 06%。结论 中青年男性血液透析患者病耻感和社会疏离均为中上等水平, 病耻感可直接或通过自我接纳间接作用于社会疏离感, 医护人员应采取干预措施提高中青年男性患者自我接纳水平, 减少其社会疏离。)