Heijnders Miriam, Van Der Meij Suzanne
Royal Tropical Institute (KIT), DEV/Health, Amsterdam, The Netherlands.
Psychol Health Med. 2006 Aug;11(3):353-63. doi: 10.1080/13548500600595327.
In many health conditions, people are severely affected by health-related stigma and discrimination. A literature review was conducted to identify stigma-reduction strategies and interventions in the field of HIV/AIDS, mental illness, leprosy, TB and epilepsy. The review identified several levels at which interventions and strategies are being implemented. These are the intrapersonal, interpersonal, organizational/institutional, community and governmental/structural level. Although a lot of work has been carried out on stigma and stigma reduction, far less work has been done on assessing the effectiveness of stigma-reduction strategies. The effective strategies identified mainly concentrated on the individual and the community level. In order to reduce health-related stigma and discrimination significantly, single-level and single-target group approaches are not enough. What is required is a patient-centred approach, which starts with interventions targeting the intrapersonal level, to empower affected persons to assist in the development and implementation of stigma-reduction programmes at other levels.
在许多健康状况下,人们受到与健康相关的耻辱感和歧视的严重影响。开展了一项文献综述,以确定在艾滋病毒/艾滋病、精神疾病、麻风病、结核病和癫痫领域减少耻辱感的策略和干预措施。该综述确定了正在实施干预措施和策略的几个层面。这些层面包括个人层面、人际层面、组织/机构层面、社区层面和政府/结构层面。尽管在耻辱感和减少耻辱感方面已经开展了大量工作,但在评估减少耻辱感策略的有效性方面所做的工作要少得多。所确定的有效策略主要集中在个人和社区层面。为了显著减少与健康相关的耻辱感和歧视,单一层面和单一目标群体的方法是不够的。需要的是以患者为中心的方法,这种方法从针对个人层面的干预措施开始,使受影响者有能力协助在其他层面制定和实施减少耻辱感方案。