Holzemer William L, Uys Leana, Makoae Lucy, Stewart Anita, Phetlhu René, Dlamini Priscilla S, Greeff Minrie, Kohi Thecla W, Chirwa Maureen, Cuca Yvette, Naidoo Joanne
University of California, San Francisco, California, USA.
J Adv Nurs. 2007 Jun;58(6):541-51. doi: 10.1111/j.1365-2648.2007.04244.x. Epub 2007 May 1.
This paper is a report on the development of a conceptual model delineating contexts and processes of HIV/AIDS stigma as reported by persons living with HIV/AIDS and nurses from African countries. It is part of a larger study to increase understanding of HIV/AIDS stigma.
Researchers have defined stigma, explored determinants and outcomes of stigma and attempted to measure its multiple dimensions. This literature is difficult to synthesize, and often does not distinguish adequately between experiences of stigma and its causes and outcomes.
Forty-three focus groups were held with persons living with HIV/AIDS and nurses in five African countries in 2004. Focus group recordings were transcribed and coded. The data were organized into a conceptual model of HIV/AIDS stigma.
Two components were identified in the data: contextual factors--environment, healthcare system, agents--that influence and affect stigma and the stigma process itself. The stigma process included four dimensions: triggers of stigma, stigmatizing behaviours, types of stigma and the outcomes of stigma.
A conceptual model is presented that delineates the dynamic nature of stigma as reported by study participants. The model may be used to identify areas appropriate for the design and testing of stigma reduction interventions that have a goal of reducing the burden of HIV/AIDS stigma.
本文报告了一个概念模型的构建情况,该模型描绘了来自非洲国家的艾滋病病毒/艾滋病感染者及护士所报告的艾滋病病毒/艾滋病污名化的背景和过程。它是一项旨在增进对艾滋病病毒/艾滋病污名化理解的更大规模研究的一部分。
研究人员已对污名进行了定义,探究了污名的决定因素和后果,并试图衡量其多个维度。这些文献难以综合,且常常没有充分区分污名经历及其成因和后果。
2004年在五个非洲国家对艾滋病病毒/艾滋病感染者和护士进行了43次焦点小组访谈。对焦点小组访谈的录音进行了转录和编码。数据被整理成一个艾滋病病毒/艾滋病污名化的概念模型。
数据中确定了两个组成部分:情境因素——环境、医疗保健系统、相关人员——这些因素影响并导致污名以及污名化过程本身。污名化过程包括四个维度:污名的触发因素、污名化行为、污名类型和污名的后果。
提出了一个概念模型,该模型描绘了研究参与者所报告的污名的动态性质。该模型可用于确定适合设计和测试旨在减轻艾滋病病毒/艾滋病污名负担的减少污名化干预措施的领域。