Engebretson Joan
(Judy Fred Professor), UTHealth School of Nursing, Houston, Texas.
J Am Assoc Nurse Pract. 2013 Oct;25(10):545-550. doi: 10.1111/1745-7599.12009. Epub 2013 Feb 27.
This article explores the social processes in stigmatization and the theoretical background on the impact in chronic illness.
Review of literature from social sciences and applications to health issues.
Understanding the social utility of stigmatization in preserving social cohesion and protecting the social order is an important function. However, this process can be harmful when applied to persons with chronic illness, such as HIV-AIDS, and psychiatric illness. These individuals often become shamed, ostracized, isolated, discredited, and socially and economically marginalized. Recent theoretical work on stigma has identified several issues and patient responses that may have implications in many other chronic conditions. Stigma is based on visible or nonvisible health conditions and can be both externally imposed or perceived in a process of self-stigma.
Understanding stigma can aid clinicians in providing supportive help for patients with chronic illness. Stigma has been well researched in a few chronic illnesses; however, future studies in other conditions are much needed. Recognizing the underlying social factors has potential use in health-promoting behaviors. Sensitivity to stigma allows health professionals to critically reflect on ways the healthcare environment may add to stigma for their patients.
本文探讨了污名化的社会过程以及慢性病影响方面的理论背景。
对社会科学文献及其在健康问题中的应用进行综述。
理解污名化在维护社会凝聚力和保护社会秩序方面的社会效用是一项重要功能。然而，当将此过程应用于患有慢性病（如艾滋病毒/艾滋病）和精神疾病的人时，可能会造成伤害。这些人常常会感到羞耻、被排斥、孤立、名誉受损，并在社会和经济上被边缘化。近期关于污名的理论研究已经确定了几个问题以及患者的反应，这些可能对许多其他慢性病有影响。污名基于可见或不可见的健康状况，既可能是外部强加的，也可能是在自我污名化过程中自我感知到的。
理解污名有助于临床医生为慢性病患者提供支持性帮助。污名在一些慢性病中已有充分研究；然而，非常需要对其他病症进行进一步研究。认识到潜在的社会因素在促进健康行为方面具有潜在作用。对污名保持敏感能使医疗专业人员批判性地思考医疗环境可能对患者造成污名化的方式。
