Effects of Perceived Stigma on Depressive Symptoms and Demoralization in Maintenance Hemodialysis Patients: Self-warmth and Self-coldness as Mediators

Patients with maintenance hemodialysis (MHD) experience stigma due to their dependence on machines and changes in appearance, which contributes to negative psychological outcomes. This study investigated the effect of perceived stigma on depressive symptoms and demoralization in MHD patients and explored the mediating roles of self-warmth and self-coldness.

This study included 301 MHD patients in a cross-sectional design. The participants completed self-reported measures of perceived stigma, self-warmth, self-coldness, depressive symptoms, and demoralization. Structural equation modeling was used to test the relationships among the main variables.

The results suggested that perceived stigma was directly and positively correlated with depressive symptoms and demoralization. Both relationships were mediated by self-warmth and self-coldness. Additionally, the mediating effect of self-coldness was significantly greater than self-warmth in both the depressive symptoms and demoralization models.

Perceived stigma was a risk factor for depressive symptoms and demoralization in MHD patients. Self-coldness played a more important mediating role than self-warmth in the relationship between perceived stigma and two negative psychological outcomes.