Stigma management, social support, and quality of life among adults with Crohnʼs disease and ulcerative colitis in Saudi Arabia: A cross-sectional study
Fahad M. AlzahraniABSTRACT
Background:
Inflammatory bowel disease (IBD), including Crohnʼs disease (CD) and ulcerative colitis (UC), carries substantial physical and psychosocial burdens. Illness-related stigma may adversely affect quality of life (QoL), while perceived social support may be associated with these relationships. However, evidence from Saudi Arabia remains limited. This study examined the associations among stigma management strategies, perceived social support, and QoL among adults with IBD in Saudi Arabia.
Methods:
A cross-sectional study was conducted among 103 adults with a self-reported gastroenterologist diagnosis of CD or UC. Participants were recruited using convenience and snowball sampling through online patient support groups, healthcare networks, and WhatsApp groups. Data were collected using an adapted Stigma Management Strategies Scale, the Multidimensional Scale of Perceived Social Support, and the WHOQOL-BREF. Group comparisons and bootstrap analyses of indirect associations were performed.
Results:
Education/advocacy was the most frequently reported stigma management strategy, whereas withdrawal was the least common. Family was the highest perceived source of social support. Bootstrap analyses identified significant indirect associations involving perceived social support between secrecy, withdrawal, and poorer QoL, whereas education/advocacy showed positive indirect associations with QoL. Preventive telling showed no significant indirect associations. Participants with UC reported significantly higher social relationships and overall QoL scores than those with CD.
Conclusion:
Adaptive stigma management strategies and greater perceived social support were associated with better QoL among adults with IBD in Saudi Arabia, whereas concealment-based strategies were associated with poorer QoL. Longitudinal studies incorporating disease activity and other clinical factors are needed to confirm these findings.