TY - JOUR
T1 - Stigmatization is common in patients with non-alcoholic fatty liver disease and correlates with quality of life
AU - Carol, Marta
AU - Pérez-Guasch, Martina
AU - Solà, Elsa
AU - Cervera, Marta
AU - Martínez, Sara
AU - Juanola, Adrià
AU - Ma, Ann T.
AU - Avitabile, Emma
AU - Napoleone, Laura
AU - Pose, Elisa
AU - Graupera, Isabel
AU - Honrubia, Maria
AU - Korenjak, Marko
AU - Torres, Ferran
AU - Ginès, Pere
AU - Fabrellas, Núria
N1 - Publisher Copyright:
© 2022 Carol et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/4/6
Y1 - 2022/4/6
N2 - Background and aims Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD. Methods One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation. Results Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables. Conclusions Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients.
AB - Background and aims Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD. Methods One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation. Results Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables. Conclusions Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients.
KW - BODY-WEIGHT
KW - CLDQ
KW - DISCRIMINATION
KW - HEALTH
KW - HEPATITIS-C
KW - Humans
KW - Liver Cirrhosis, Alcoholic/complications
KW - Liver Cirrhosis/complications
KW - MANAGEMENT
KW - Non-alcoholic Fatty Liver Disease/complications
KW - OBESITY
KW - PERCEIVED STIGMA
KW - QUESTIONNAIRE
KW - Quality of Life
KW - Stereotyping
UR - http://www.scopus.com/inward/record.url?scp=85127665984&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/541aa2e1-fe08-32a6-8c42-9fddeab64010/
U2 - 10.1371/journal.pone.0265153
DO - 10.1371/journal.pone.0265153
M3 - Article
C2 - 35385510
AN - SCOPUS:85127665984
SN - 1932-6203
VL - 17
JO - PloS one
JF - PloS one
IS - 4 April 2022
M1 - e0265153
ER -
