The Relationship Between Stigma and Loneliness in Stroke Survivors: The Longitudinal Mediating Role of Social Participation

AIMS: The study aims to investigate the longitudinal relationship between stigma and loneliness in stroke survivors and examine the mediating role of social participation. DESIGN: A prospective longitudinal study. METHODS: Using a convenience sampling approach, 277 stroke survivors were recruited from two hospitals in the acute rehabilitation phase (Time 1) and followed up at 3 months post-stroke (Time 2) and 6 months post-stroke (Time 3). Stigma, social participation and loneliness were assessed using the Short Stigma Scale for Chronic Illness (SSCI-8), the Utrecht Rehabilitation Participation Evaluation (USER-P) and the UCLA Loneliness Scale, respectively. A cross-lagged panel model was employed to examine the longitudinal relationships among stigma, social participation and loneliness. RESULTS: After controlling for confounding factors, higher levels of stigma predicted greater loneliness in subsequent periods. Loneliness significantly predicted stigma. Social participation at Time 2 mediated the relationship between stigma at Time 1 and loneliness at Time 3. CONCLUSIONS: Our findings suggest that among stroke survivors, there exists a potential bidirectional relationship between stigma and loneliness, with social participation playing a partial longitudinal mediating role. IMPLICATIONS TO CLINICAL PRACTICE: The study suggests that clinical interventions should prioritise the identification and management of early illness stigma post-stroke, while promoting meaningful social participation to decrease loneliness. REPORTING METHOD: The reporting followed the STROBE guideline. PATIENT OR PUBLIC CONTRIBUTIONS: No patient or public contribution.