ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1552518
This article is part of the Research TopicIntegrating Health Psychology in Practice: Enhancing Well-being and Improving Health Outcomes Across Diverse ContextsView all 23 articles
Understanding perceived stigma and depression symptoms in maintenance hemodialysis patients: A network perspective
Provisionally accepted
- 1Henan Provincial People's Hospital, Zhengzhou, China
- 2Hangzhou Medical College, Hangzhou, Zhejiang Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objectives Patients undergoing maintenance hemodialysis (MHD) experience stigma due to their reliance on machines and changes in appearance, contributing to negative psychological outcomes.Depression symptoms can be considered a product of perceived stigma. However, the inter-relationships between perceived stigma and depression symptoms have not been examined using network analysis among MHD patients. The aim of this study was to model the perceived stigma and depression symptoms network structure, identify its core symptoms, analyze the internal connections between perceived stigma and depression symptoms, as well as identify bridge symptoms in the stigma-depression network.This study included 301 MHD patients in a cross-sectional design. The participants completed self-reported measures of perceived stigma and depressive symptoms. A cross-sectional network analysis was performed using the R language to model the network structure and identify core and bridge symptoms in the network.The core symptoms of perceived stigma from the network analysis were SIS5 "Feel others avoid me because of my illness" (Strength = 1.258, Betweenness = 32, Closeness = 0.00303), SIS13 "Feel others think I am to blame" (Strength = 1.142, Betweenness = 62, Closeness = 0.00298), and SIS11 "My job security has been affected" (Strength = 1.108, Betweenness = 72, Closeness = 0.00313). The core symptoms of depression were PHQ6 "Worthlessness" (Strength = 1.213, Betweenness = 13, Closeness = 0.00211), PHQ1 "Anhedonia" (Strength = 1.048, Betweenness = 20, Closeness = 0.0150), and PHQ2 "Sad mood" (Strength = 1.012, Betweenness = 8, Closeness = 0.0164). Regarding the combination network, results showed that SIS2 "Some people think I am less competent" (Bridge Strength = 0.917) and SIS11 "My job security has been affected" (Bridge Strength = 0.783) were the two most prominent bridge nodes.Conclusions This research reveals the core and bridge symptoms in different symptomatic profiles (such as perceived stigma, depression symptoms, and their combination networks), which can be targeted for treatment personalization and aid in diminishing depressive symptoms and perceived stigma among MHD patients.
Keywords: Perceived stigma, depressive symptoms, Maintenance hemodialysis, Network analysis, Core symptoms, Bridge symptoms
Received: 28 Dec 2024; Accepted: 14 Aug 2025.
Copyright: © 2025 Li, Yang, Liang, Cao and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yaoyao Yang, Henan Provincial People's Hospital, Zhengzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.