{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T08:44:12Z","timestamp":1776069852469,"version":"3.50.1"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Nursing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study examined alexithymia, illness-related stigma, and self-esteem among patients with lymphedema to provide evidence for improving self-esteem, enhancing emotional expression, and reducing stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe levels of alexithymia, illness-related stigma, and self-esteem in patients with lymphedema; examine demographic differences; and test prespecified associations among these variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional, questionnaire-based study. A convenience sample of 195 patients with lymphedema receiving treatment at a tertiary oncology hospital in southern China completed questionnaires between October 2020 and February 2021. Instruments included the Toronto Alexithymia Scale, Social Impact Scale, and Rosenberg Self-Esteem Scale. Descriptive statistics summarized patient characteristics and scores. Group differences were tested with t-tests, analysis of variance, and rank-sum tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean alexithymia score was 56.53\u2009\u00b1\u20098.43, with externally oriented thinking highest and difficulty describing emotions lowest. Alexithymia differed by education, marital status, residence, income, and activity after onset (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">&lt;<\/jats:italic>\n                      \u2009.05). The mean stigma score was 60.36\u2009\u00b1\u200911.08, highest for social exclusion and lowest for internalized shame, differing by income, personality, and family relationships (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.05). The mean self-esteem score was 27.84\u2009\u00b1\u20094.07, differing by education, employment, residence, income, personality, activity, and family relationships (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\n                      <jats:italic toggle=\"yes\">&lt;<\/jats:italic>\n                      \u2009.05). Alexithymia correlated positively with stigma (r\u2009=\u2009.51,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01) and negatively with self-esteem (r\u2009=\u2009\u2212.65,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01). Stigma correlated negatively with self-esteem (r\u2009=\u2009\u2013.60,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Economic discrimination was the strongest correlate of stigma, and income and family relationships were key associated factors. Interventions targeting emotional expression and self-esteem may be relevant for psychosocial support in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23779608261442627","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:10:51Z","timestamp":1775823051000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation Between Alexithymia, Illness-Related Stigma, and Self-Esteem in Patients With Lymphedema: A Cross-Sectional Study"],"prefix":"10.1177","volume":"12","author":[{"given":"Qiaoling","family":"Zhong","sequence":"first","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8132-6064","authenticated-orcid":false,"given":"Yuezhou","family":"Guo","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghua","family":"Luo","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huizhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinlan","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Clinical Research Center for Cancer\uff0c Sun Yat-sen University Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001278"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742395319872796"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(94)90006-X"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2020-001682"},{"key":"e_1_3_3_6_1","first-page":"147","article-title":"Breast cancer awareness and prevention behavior among women of Delhi, India: Identifying barriers to early detection","volume":"10","author":"Dey S.","year":"2016","unstructured":"Dey S., Sharma S., Mishra A., Krishnan S., Govil J., Dhillon P. 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