Peltzer Karl, Pengpid Supa
1ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; Department of Research Innovation and Development, University of Limpopo, Turfloop Campus, Sovenga, South Africa; HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
1ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; Department of Research Innovation and Development, University of Limpopo, Turfloop Campus, Sovenga, South Africa.
Nagoya J Med Sci. 2016 Dec;78(4):423-435. doi: 10.18999/nagjms.78.4.423.
The aim of this study was to explore the prevalence and relationship of anticipated chronic illness stigma among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam). A cross-sectional survey was conducted in 4,803 adult chronic disease patients (mean age 49.3 years; SD=16.5) recruited systematically from health facilities. Overall, the results indicate that 20.7% of patients reported that for any of the 12 stigma items, they anticipated they were likely or very likely to experience chronic disease stigma. A multivariate analysis of sociodemographics revealed the following were associated with anticipated chronic disease stigma: older versus younger age, OR (odds ratio) = 0.71; 95% Confidence Interval (CI) [0.58, 0.87]; higher versus lower education, OR = 2.23; 95% CI [1.81, 2.75]; origin from Myanmar or Vietnam, being single, divorced or widowed, rural residence, and health status (having three or more chronic conditions versus having one chronic condition), OR = 1.93; 95% CI [1.58, 2.35]; lower versus higher quality of life, OR = 0.73; 95% CI [0.63, 0.85]); health risk behavior (physical inactivity, poor diet, current smoking, and problem drinking) and low versus medium or high medication adherence (OR = 0.69; 95% CI [0.55,0.86]). This study demonstrated the possible consequences of anticipated stigma on the health and behavior of people living with chronic diseases, and several factors for chronic disease stigma were identified that can help guide interventions to reduce chronic illness stigma in this population.
本研究旨在探讨东南亚三个国家（柬埔寨、缅甸和越南）中被诊断患有多种慢性病的患者预期慢性病耻辱感的患病率及其关系。对从医疗机构系统招募的4803名成年慢性病患者（平均年龄49.3岁；标准差=16.5）进行了横断面调查。总体而言，结果表明，20.7%的患者报告称，对于12项耻辱感项目中的任何一项，他们预计自己很可能或非常可能经历慢性病耻辱感。对社会人口统计学的多变量分析显示，以下因素与预期慢性病耻辱感相关：年龄较大与年龄较小相比，比值比（OR）=0.71；95%置信区间（CI）[0.58, 0.87]；教育程度较高与较低相比，OR = 2.23；95% CI [1.81, 2.75]；来自缅甸或越南、单身、离异或丧偶、居住在农村以及健康状况（患有三种或更多慢性病与患有一种慢性病相比），OR = 1.93；95% CI [1.58, 2.35]；生活质量较低与较高相比，OR = 0.73；95% CI [0.63, 0.85]；健康风险行为（缺乏体育活动、饮食不良、当前吸烟和问题饮酒）以及药物依从性低与中等或高相比（OR = 0.69；95% CI [0.55,0.86]）。本研究证明了预期耻辱感对慢性病患者健康和行为可能产生的后果，并确定了几个导致慢性病耻辱感的因素，这些因素有助于指导干预措施以减少该人群中的慢性病耻辱感。
