尼泊尔西部麻风病影响者感知污名的影响因素。
Factors affecting perceived stigma in leprosy affected persons in western Nepal.
机构信息
TB/HIV Department, Medecins Sans Frontieres Holland, Nasir Hospital, Nasir, South Sudan; College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; Rissa Legesenter, Rissa, Norway.
出版信息
PLoS Negl Trop Dis. 2014 Jun 5;8(6):e2940. doi: 10.1371/journal.pntd.0002940. eCollection 2014 Jun.
BACKGROUND
There are various factors which construct the perception of stigma in both leprosy affected persons and unaffected persons. The main purpose of this study was to determine the level of perceived stigma and the risk factors contributing to it among leprosy affected person attending the Green Pastures Hospital, Pokhara municipality of western Nepal.
METHODS
A cross-sectional study was conducted among 135 people affected by leprosy at Green Pastures Hospital and Rehabilitation Centre. Persons above the age of 18 were interviewed using a set of questionnaire form and Explanatory Model Interview Catalogue (EMIC). In addition, two sets of focused group discussions each containing 10 participants from the ward were conducted with the objectives of answering the frequently affected EMIC items.
RESULTS
Among 135 leprosy affected persons, the median score of perceived stigma was 10 while it ranged from 0-34. Higher perceived stigma score was found in illiterate persons (p=0.008), participants whose incomes were self-described as inadequate (p=0.014) and who had changed their occupation due to leprosy (p=0.018). Patients who lacked information on leprosy (p=0.025), knowledge about the causes (p=0.02) and transmission of leprosy (p=0.046) and those who had perception that leprosy is a severe disease (p<0.001) and is difficult to treat (p<0.001) had higher perceived stigma score. Participants with disfigurement or deformities (p=0.014), ulcers (p=0.022) and odorous ulcers (p=0.043) had higher perceived stigma score.
CONCLUSION
The factors associated with higher stigma were illiteracy, perceived economical inadequacy, change of occupation due to leprosy, lack of knowledge about leprosy, perception of leprosy as a severe disease and difficult to treat. Similarly, visible deformities and ulcers were associated with higher stigma. There is an urgent need of stigma reduction strategies focused on health education and health awareness programs in addition to the necessary rehabilitation support.
背景
在麻风病患者和未受影响者中，有各种因素构成了污名的感知。本研究的主要目的是确定在尼泊尔西部博克拉市绿草地医院就诊的麻风病患者中，感知污名的程度以及导致污名的危险因素。
方法
对绿草地医院和康复中心的 135 名麻风病患者进行了横断面研究。对年龄在 18 岁以上的患者使用一套问卷表和解释性模型访谈目录（EMIC）进行访谈。此外，还进行了两组各有 10 名病房参与者参加的焦点小组讨论，目的是回答经常受到影响的 EMIC 项目。
结果
在 135 名麻风病患者中，感知污名的中位数评分为 10，范围为 0-34。文化程度较低的人（p=0.008）、收入自我描述不足的人（p=0.014）和因麻风病而改变职业的人（p=0.018）感知污名评分较高。缺乏麻风病信息的患者（p=0.025）、对麻风病病因（p=0.02）和传播方式（p=0.046）的了解、认为麻风病是一种严重疾病（p<0.001）且难以治疗（p<0.001）的患者感知污名评分较高。有畸形或残疾（p=0.014）、溃疡（p=0.022）和恶臭溃疡（p=0.043）的患者感知污名评分较高。
结论
与较高污名相关的因素包括文盲、经济上的贫困、因麻风病而改变职业、缺乏对麻风病的了解、认为麻风病是一种严重疾病和难以治疗。同样，可见的畸形和溃疡与较高的污名有关。迫切需要制定以健康教育和健康意识计划为重点的减少污名的策略，除了必要的康复支持外。
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