Self‐stigma among Korean patients with diabetes: A concept analysis

Aims and Objectives To conduct a concept analysis of self‐stigma among patients with diabetes and introduce an operational definition of self‐stigma. Background Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients’ self‐care and socialisation. Design A concept analysis was conducted using a three‐phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz‐Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). Methods During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in‐depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. Results In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self‐stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self‐esteem and self‐efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. Conclusions Self‐stigma among patients with diabetes is defined as a state in which patients develop negative self‐feelings as they deal with the disease. This can cause diminished self‐esteem and self‐efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. Relevance to Clinical Practice Based on this self‐stigma concept analysis, we clarified the attributes of diabetes self‐stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment.