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癫痫患者家庭的耻辱感经历与认知:对家庭内部及外部与癫痫相关沟通的影响

The stigma experiences and perceptions of families living with epilepsy: Implications for epilepsy-related communication within and external to the family unit.

作者信息

Benson Ailbhe, O'Toole Stephanie, Lambert Veronica, Gallagher Pamela, Shahwan Amre, Austin Joan K

机构信息

School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.

School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.

出版信息

Patient Educ Couns. 2016 Sep;99(9):1473-81. doi: 10.1016/j.pec.2016.06.009. Epub 2016 Jul 1.

Abstract

OBJECTIVE

This paper presents the stigma experiences of children with epilepsy (CWE) and their parents and outlines the relationship between CWE's and parents' stigma perceptions, demographic and seizure variables, and epilepsy-related communication within and external to the family.

METHODS

A mixed-method design was employed. In phase one, 33 CWE and 40 parents participated in qualitative interviews. In phase two, 47 CWE and 72 parents completed a cross-sectional survey.

RESULTS

CWE and their parents experience felt and enacted stigma via social exclusion, activity restriction, teasing/bullying, internalised negative feelings to epilepsy, concealment of epilepsy and parental stigma-coaching. Higher CWE and parent stigma perceptions were significantly correlated with greater epilepsy concealment from others outside the family and greater negative affect around epilepsy-related communication within the home.

CONCLUSION

As CWE and their parents grapple with epilepsy-related stigma they may inadvertently contribute to the silence encircling epilepsy through diagnosis concealment, stigma-coaching and/or by engaging in limited family dialogue about epilepsy.

PRACTICE IMPLICATIONS

Healthcare professionals need to be cognisant of broaching the sensitive topic of epilepsy-related stigma during their engagements with families living with epilepsy. Assisting families to appropriately engage in dialogue surrounding epilepsy is likely to improve the psychosocial wellbeing of CWE and their parents.

摘要

目的

本文介绍了癫痫患儿(CWE)及其父母的耻辱经历,并概述了CWE与父母的耻辱认知、人口统计学和癫痫发作变量以及家庭内外与癫痫相关的沟通之间的关系。

方法

采用混合方法设计。在第一阶段,33名CWE和40名父母参与了定性访谈。在第二阶段,47名CWE和72名父母完成了一项横断面调查。

结果

CWE及其父母通过社会排斥、活动限制、取笑/欺凌、对癫痫的内化负面情绪、隐瞒癫痫以及父母的耻辱指导来感受和表现耻辱。CWE和父母较高的耻辱认知与对家庭外其他人隐瞒癫痫以及在家中与癫痫相关的沟通中更大的负面影响显著相关。

结论

由于CWE及其父母应对与癫痫相关的耻辱,他们可能会通过隐瞒诊断、耻辱指导和/或通过进行有限的关于癫痫的家庭对话,无意中促成围绕癫痫的沉默。

实践意义

医疗保健专业人员在与癫痫患者家庭接触时,需要意识到提及与癫痫相关的耻辱这一敏感话题。帮助家庭适当地参与围绕癫痫的对话可能会改善CWE及其父母的心理社会福祉。

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