Stigma Management, Social Support, and quality of life: an exploratory study among people with Crohn's Disease

Crohn's disease (CD)-related stigma has been found to be a key challenge that people with CD face. CD-related stigma has been found to have a negative impact on the physical and psychological health and quality of life (QoL) of its targets. Studies have shown that people with concealable chronic illnesses employ various techniques to avoid stigmatization, referred to as "stigma management" strategies. To date, no studies have examined stigma management among people with CD. This study explored: (a) the use of stigma management strategies (secrecy, withdrawal, and preventive telling) and (b) whether social support mediates the relationship of stigma management strategies and QoL among people with CD. A convenience sample of 200 people with CD was drawn. Data were collected by online self-reported questionnaires. Findings show that many participants used preventive telling. Social support mediated the relationship between withdrawal and all four domains of QoL such that withdrawal hindered social support, which in turn, decreased QoL. Social support mediated the relationship between secrecy and preventive telling and one domain of QoL, such that preventive telling promoted social support, which in turn, enhanced QoL. Secrecy hampered social support, which in turn, decreased QoL. The findings suggest that rehabilitation and health care professionals should identify people with CD who use potentially destructive stigma management strategies. Interventions for such individuals should focus on sustaining and promoting social support and changing stigma management strategies.