Self-stigma of Patients with Type 1 Diabetes and Their Coping Strategies

[Background] The purpose of this study was to examine the stigma and coping strategies of patients with type 1 diabetes. [Methods] Data were collected from 24 adult patients with type 1 diabetes via in-depth semi-structured interviews that took place in clinic waiting rooms. Qualitative and descriptive data analysis was conducted to identify stigma and coping strategies of patients with type 1 diabetes. [Results] Stigma of patients with type 1 diabetes consisted of four categories: (i) “hatred of insulin” due to a treatment-oriented lifestyle after the onset of the disease, (ii) “imperfect body” due to systemic changes caused by the disease, (iii) “social outcast” as a diabetes patient who used to be healthy, and (iv) “poor me,” a negative self-image due to the responses and attitudes of others. Regarding the coping strategies for reducing stigma, the following four categories were derived from the analysis: (i) In a stable disease stage, patients coped with stigma by “hiding their disease” or (ii) “pretending to be healthy” by avoiding self-care behaviors in public. When they told others about their disease, they (iii) “gradually spoke out to those around them about their illnesses.” (iv) When they could not do either (i) or (ii), they resorted to “limiting their social life” or limiting interactions with others. [Conclusion] Patients with type 1 diabetes changed their coping strategies for reducing stigma as the disease progressed because stigma was tied to their disease. Physical, psychological, social, and spiritual coping strategies are required to reduce stigma, and the strategies are interrelated. It is important for nurses to assesspatients from various viewpoints, including the viewpoint of stigma.