Forsyth Colin J
Department of Anthropology University of South Florida 4202 E. Fowler Avenue, SOC 107 Tampa, FL, United States of America.
PLoS Negl Trop Dis. 2017 Jan 18;11(1):e0005251. doi: 10.1371/journal.pntd.0005251. eCollection 2017 Jan.
Chagas disease (CD) profoundly affects the social and emotional dimensions of patients' lives, and disproportionately impacts poor, marginalized populations in Latin America. Biomedical treatment for CD fails to reach up to 99% of the people affected, and in any case seldom addresses the emotional health or socioeconomic conditions of patients. This study examines patient strategies for coping with CD in the department of Santa Cruz, Bolivia.
In this ethnographic study, semistructured interviews took place from March-June 2013 with 63 patients who had previously tested positive for CD. During the fieldwork period, participant observation was conducted and patient family members, providers, community members, and public health officials were consulted.
Patients often experienced emotional distress when diagnosed with CD, yet were generally unable to find biomedical treatment. Respondents stressed the need to avoid powerful emotions which would worsen the impact of CD symptoms. To manage CD, patients embraced a calm state of mind, described in Spanish as tranquilidad, which partially empowered them to return to a normal existence.
In the perceived absence of biomedical treatment options, patients seek their own means of coping with CD diagnosis. Rather than fatalism or resignation, patients' emphasis on maintaining calm and not worrying about CD represents a pragmatic strategy for restoring a sense of normalcy and control to their lives. Programs focused on treatment of CD should remain mindful of the emotional and social impact of the disease on patients.
恰加斯病（CD）深刻影响着患者生活的社会和情感层面，对拉丁美洲贫困、边缘化人群的影响尤为严重。针对恰加斯病的生物医学治疗未能惠及多达99%的患者，而且在任何情况下都很少关注患者的心理健康或社会经济状况。本研究考察了玻利维亚圣克鲁斯省患者应对恰加斯病的策略。
在这项人种志研究中，于2013年3月至6月对63名此前恰加斯病检测呈阳性的患者进行了半结构化访谈。在实地考察期间，进行了参与观察，并咨询了患者家属、医疗服务提供者、社区成员和公共卫生官员。
患者在被诊断出患有恰加斯病时常常经历情绪困扰，但通常无法获得生物医学治疗。受访者强调需要避免强烈情绪，因为这会加重恰加斯病症状的影响。为了应对恰加斯病，患者秉持一种平静的心态，用西班牙语来说就是“tranquilidad”，这在一定程度上使他们能够回归正常生活。
在认为缺乏生物医学治疗选择的情况下，患者寻求自己应对恰加斯病诊断的方法。患者强调保持冷静且不担心恰加斯病，这并非宿命论或听天由命，而是一种务实策略，旨在恢复生活的正常感和掌控感。专注于恰加斯病治疗的项目应始终关注该疾病对患者的情感和社会影响。
