了解与结核病有关的耻辱:对患者、接触者和社会的影响--一项混合研究

K. Alselwi
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引用次数: 0

摘要

这项混合方法研究旨在探讨 62 名被诊断患有肺结核(TB)的参与者、57 名与患者有直接接触的参与者以及 61 名普通公众在肺结核相关耻辱感方面的经历。 本研究采用定性和定量研究方法来了解结核病问题。研究选取了具有代表性的样本,包括 62 名确诊为肺结核的参与者、57 名与患者有直接接触的参与者和 61 名普通公众。通过结构化问卷和深入访谈收集数据,并使用描述性统计和奇平方检验确定趋势和模式。 半数以上的肺结核患者表达了内化的污名化,包括自我污名化,他们感到羞愧,害怕别人会认为他们的疾病会传染或与众不同。在 62 名参与者中,共有 42 人(68%)表达了预期成见,包括害怕受到歧视、改变话题或避免公开讨论疾病。 6/62 人(10%)表达了既定成见和歧视,称他们缺乏医务人员的尊重。女性比男性更有可能表现出预期的耻辱感,觉得自己与众不同,害怕传染疾病(P 值),也更有可能避免谈论自己的疾病或改变话题(P 值)。性别与感觉受到医疗专业人员尊重之间没有明显联系(p 值 = 0.172)。接触者认为贫困会导致肺结核(17/57,30%);他们担心社区感染风险(45/57,79%)。大多数患者接触者对患者充满同情(36/57,63%),大多数接触者愿意与患者交往(47/57,82%)。男性接触者更有可能担心感染风险。对肺结核病人接触者的社会人口特征和对肺结核病人的鄙视的调查发现,教育水平、性别和经济地位与对肺结核病人的鄙视有很大关系。另一方面,男性比女性更容易预见到社区中的感染风险(P 值小于 0.001)。普通人害怕感染(44/61,72%),并认为贫困导致肺结核(17/61,28%)。大多数人同情病人(35/61,57%);他们愿意与病人交往(45/61,74%)。普通人的受教育程度与对感染的恐惧以及他们对肺结核病人是否应该患病的看法密切相关。与此相反,人们对肺结核病人的看法与性别和经济地位密切相关。根据所提供的数据,社会经济地位与对肺结核病人的鄙视之间可能存在联系;然而,要确定这种联系是否具有统计学意义,还需要进行更多的研究。总之,这项研究采用了全面而广泛的方法,为了解肺结核病人的污名化问题提供了宝贵的见解。这可能会对该领域的政策和实践产生影响。 研究结果表明,仍有必要开展一些计划,以尽量减少与肺结核有关的污名化,并促进公众对该疾病的了解,同时应教育医务工作者以尊重的态度对待病人。应努力教育公众了解结核病的病因,以减少与该疾病相关的耻辱感。必须制定旨在消除结核病耻辱感和支持结核病患者融入社会的治疗方法。
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Understanding tuberculosis-related stigma: Impacts on patients, contacts, and society – A mixed study
This mixed-methods study aimed to explore the experiences of 62 participants with tuberculosis (TB) diagnoses, 57 participants with direct contact with patients, and 61 participants from the general public, regarding TB-related stigma. This study used both qualitative and quantitative research methods to understand the issue of TB. A representative sample of 62 participants with TB diagnoses, 57 with direct patient contact, and 61 from the general public was selected. Data was collected through structured questionnaires and in-depth interviews, and trends and patterns were identified using descriptive statistics and the Chi-Squared test. Over half of TB patients expressed internalized stigma involving self-stigmatization by feeling ashamed, afraid that others would see them as contagious or different due to their illness. A total of 42 of 62 participants, or 68%, expressed anticipated stigma involving fear of discrimination and changing the topic of conversation or avoid discussing the disease openly. (6/62, 10%) expressed enacted stigma and discrimination reporting they lacked respect from medical staff. Females were more likely than males to show both anticipated stigma by feeling different and being afraid of transmitting the disease (p-value), and more likely to avoid talking about their disease or changing the subject (p-value). There was no significant association between gender and feeling respected by medical professionals (p-value = 0.172). Contacts believed poverty caused TB (17/57, 30%); they feared community infection risk (45/57, 79%). Most contacts with patients viewed patients with compassion (36/57, 63%), and most were willing to associate (47/57, 82%). Male contacts are more likely to fear infection risks. The investigation of sociodemographic characteristics and stigmatization of TB patients among contacts of TB patients found that education level, gender, and economic position were substantially linked with stigmatization towards TB patients. On the other hand, men were more likely than females to anticipate infection risks in the community (p-value < 0.001). Ordinary people feared infection (44/61, 72%) and thought poverty caused TB (17/61, 28%). Most saw the patients with compassion (35/61, 57%); they were willing to associate (45/61, 74%). Education level in the ordinary people was strongly connected with fear of infection and their opinions about whether TB patients deserve their disease. As opposed to this, perceptions of TB patients were strongly associated with gender and economic status. Based on the data supplied, there may be a link between socioeconomic status and stigmatization towards TB patients; however, more studies would be required to establish whether this association is statistically significant. Overall, the research employed a comprehensive and extensive methodology, offering valuable insights into the stigmatization of TB patients. This might influence policy and practice in the field. The results show that there is still a need for programs to minimize TB-related stigma and promote public knowledge of the illness, and medical workers should be educated to treat patients with respect. Efforts should be undertaken to educate the public about TB causes to lessen the stigma associated with the illness. It is vital to create treatments targeted at eliminating TB stigma and supporting TB patients’ social integration.
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