B59-06 Stigma Experiences, Psychosocial and Physical Health, and Self-Management in Chronic Obstructive Pulmonary Disease: Path Analysis

Rationale/Objectives

Stigma experiences may influence how individuals perceive their illness, manage their health, and ultimately affect their overall well-being. Chronic obstructive pulmonary disease (COPD) is often viewed as a disease primarily caused by smoking, which can contribute to stigmatization. People with COPD may experience an accelerated aging process that affects both their health and social roles. However, there is limited understanding of whether experiences of stigma are associated with poorer health behaviors for individuals with COPD. This study aimed to examine the relationship between stigma related to aging and that associated with COPD and self-management behaviors, and the mediating effect of psychosocial health on the relationship among individuals living with COPD.

Methods

A cross-sectional study using an online survey method was conducted. Participants who self-reported having COPD (N = 448; mean = 55.1±9.9 years) completed a series of questionnaires, including the Everyday Ageism Scale, the COPD-related Stigma Scale, the PROMIS Anxiety (SF-8a) and Depression (SF-8a), the Social Isolation Scale, the PROMIS Physical Function (SF-10), the COPD Assessment Test, the COPD Self-Efficacy Scale, and the Physical Activity Scale for the Elderly. Independent variables included ageism and COPD-related stigma, while dependent variables were physical activities, self-efficacy, and the impact of COPD on health and well-being. Mediators examined were social isolation, depression, and physical function. Path analysis was conducted using the lavaan package in R.

Results

The path model for mediation demonstrated a good fit for the combined outcomes of physical activities, self-efficacy, and the impact of COPD on health and well-being (X2(10)= 21.917, p= 0.016; RMSEA= 0.052, 90% CI [0.022-0.082]; CFI= 0.992; SRMR= 0.032; R2= 0.208, 0.381, and 0.475, respectively). COPD-related stigma has a direct effect on the three outcomes (β = 24.46, p= 0.002; β = 0.31, p< 0.001; β = 3.06, p< 0.001, respectively), while ageism does not show a direct effect. Both ageism and COPD-related stigma have indirect effects on the combined outcomes, being mediated by physical function abilities, and have indirect effects on self-efficacy and the impact of COPD on health and well-being, being mediated by depression. COPD-related stigma has indirect effects in physical activities and self-efficacy, being mediated by social isolation. Although the total indirect effect was significant (β= -13.52, SE = 3.65, p< 0.001), the total effect was not significant (β = 13.32, SE = 7.54, p = 0.077).

Conclusion

Findings enhance the understanding of direct and indirect effects of aging-related and COPD-related stigma experiences on self-management behaviors of individuals with COPD.

This abstract is funded by: None