Doosti-Irani Mehri, Abdoli Samereh, Parvizy Soroor, Fatemi Naimeh Seyed
School of nursing and midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
College of Nursing, University of Tennessee, Knoxville, TN, United States.
Appl Nurs Res. 2017 Aug;36:115-121. doi: 10.1016/j.apnr.2017.06.008. Epub 2017 Jun 11.
The study aimed to overcome diabetes-related stigma in individuals living with type 1 Diabetes Mellitus (T1DM) in Iran. The study proposed that if individuals with T1DM and the community work together to develop and implement an anti-stigma program, diabetes-related stigma in individuals with T1DM can be reduced.
This study was conducted as a participatory action research study based on Kemmis and McTaggert's (2000) Model to design and implement an anti-stigma program for T1DM. Participants were selected among individuals with T1DM, their family members, health care providers, and residents without diabetes in Isfahan, Iran. Data collection was conducted using interviews, focus groups, emails, and text messages. Content analysis was used to analyze the data to develop anti-stigma interventions. Interventions were prioritized based on the Suitability, Feasibility and Flexibility (SFF) Matrix. Anti-stigma interventions were implemented in different levels in Isfahan, Iran, from 2011 to 2014. The effect of the program was evaluated based on interviews, feedback, and focus groups at the individual level. However, interventions were implemented in different levels including community, organization, family, and individual.
Participants with T1DM experienced significant empowerment during the project to overcome diabetes-related stigma. The three main themes indicating this feeling of empowerment are "from doubt to trust", "from shadow to light", and "from me to us".
Participatory action research can be an effective way to reduce diabetes-related stigma in individuals living with T1DM. It integrates the voices of the marginalized group reducing stigma and discrimination against diabetes.
本研究旨在消除伊朗1型糖尿病（T1DM）患者中与糖尿病相关的耻辱感。该研究提出，如果T1DM患者与社区共同努力制定并实施一项反耻辱计划，那么T1DM患者中与糖尿病相关的耻辱感将会降低。
本研究是一项基于凯米斯和麦克塔格特（2000年）模型开展的参与式行动研究，旨在为T1DM设计并实施一项反耻辱计划。研究对象从伊朗伊斯法罕的T1DM患者、他们的家庭成员、医疗服务提供者以及无糖尿病居民中选取。通过访谈、焦点小组、电子邮件和短信进行数据收集。采用内容分析法对数据进行分析，以制定反耻辱干预措施。根据适用性、可行性和灵活性（SFF）矩阵对干预措施进行优先级排序。2011年至2014年期间，在伊朗伊斯法罕的不同层面实施了反耻辱干预措施。该计划的效果基于个体层面的访谈、反馈和焦点小组进行评估。然而，干预措施在社区、组织、家庭和个体等不同层面实施。
T1DM患者在该项目中经历了显著的赋权，从而克服了与糖尿病相关的耻辱感。表明这种赋权感的三个主要主题是“从怀疑到信任”、“从阴影到光明”以及“从我到我们”。
参与式行动研究可能是减少T1DM患者中与糖尿病相关耻辱感的有效方法。它整合了边缘化群体的声音，减少了对糖尿病的耻辱感和歧视。
