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尼泊尔西部博卡拉市社区对麻风病患者的态度。

Community attitudes towards leprosy affected persons in Pokhara municipality of western Nepal.

作者信息

Adhikari B, Shrestha K, Kaehler N, Raut S, Chapman R S

机构信息

Nepal Community Health and Development Centre, Kathmandu, Nepal.

Kanchanaburi Polyclinic, Kanchanaburi, Thailand.

出版信息

J Nepal Health Res Counc. 2013 Sep;11(25):264-8.

Abstract

BACKGROUND

Stigma is a social process of interpretation of an attribute. Leprosy has been seen as the epitome of stigmatization. The psychosocial impact a person has to bear in a society after the diagnosis weighs heavier than the physical afflictions it causes, which does not get cured with the mere medical treatment. 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 community people living in ward 15, Pokhara municipality.

METHODS

Cross-sectional descriptive study among 281 community people above the age of 18 years was conducted. Two sets of questionnaire form with additional Explanatory Model Interview Catalogue (EMIC) for each individual were used.

RESULTS

Among 281 community people, the median score of perceived stigma was 12 while it ranged from 0-30. Ethnic groups, Brahmins, Dalits and minorities had highest perceived stigma score of 15 and above compared to the rest (p=0.001), community people living at the distance more than 2 km had highest perceived stigma score of 15 compared to those living closer to the hospital (p=0.019) and nuclear family had highest perceived stigma score of 15 compared to the joint family (p=0.014). People who lacked information on leprosy had higher score of perceived stigma compared to those who had information on leprosy (p=0.002).Similarly, those who perceived leprosy to be difficult to treat (p<0.001) and a severe disease (p<0.001) had highest score of perceived stigma.

CONCLUSIONS

Stigma in leprosy was found highly associated with the lack of information about leprosy and their perception in treatment and disease severity. Stigma reduction strategies should focus on health education, targeting to alleviate their perception about the disease with their active participation.

摘要

背景

污名化是对一种特质的社会性解读过程。麻风病一直被视为污名化的典型代表。诊断后,患者在社会中所承受的心理社会影响比疾病本身所带来的身体痛苦更为沉重,而单纯的医学治疗并不能消除这种影响。在麻风病患者和非患者中,有多种因素构成了对污名的认知。本研究的主要目的是确定博卡拉市第15病房社区居民的污名认知水平及其相关危险因素。

方法

对281名18岁以上的社区居民进行了横断面描述性研究。使用了两套问卷,并为每个人额外配备了解释性模型访谈目录(EMIC)。

结果

在281名社区居民中,污名认知的中位数为12分,范围在0至30分之间。婆罗门、达利特和少数族裔等族群的污名认知得分最高,为15分及以上,高于其他群体(p = 0.001);居住在距离医院2公里以上的社区居民的污名认知得分最高,为15分,高于居住在医院附近的居民(p = 0.019);核心家庭的污名认知得分最高,为15分,高于联合家庭(p = 0.014)。与了解麻风病信息的人相比,缺乏麻风病信息的人的污名认知得分更高(p = 0.002)。同样,那些认为麻风病难以治疗(p < 0.001)和是严重疾病(p < 0.001)的人,污名认知得分最高。

结论

发现麻风病的污名化与缺乏麻风病信息以及他们对治疗和疾病严重程度的认知高度相关。减少污名化的策略应侧重于健康教育,旨在通过他们的积极参与来减轻他们对疾病的认知。

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