College of Health and Human Sciences, Northern Illinois University, DeKalb, IL.
Case Western Reserve University School of Medicine and Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH.
Am J Geriatr Psychiatry. 2018 Mar;26(3):316-331. doi: 10.1016/j.jagp.2017.09.006. Epub 2017 Sep 12.
Stigma negatively affects individuals with cognitive impairment and dementia. This literature review examined the past decade (January 2004 to December 2015) of world-wide research on dementia-related stigma. Using standard systematic review methodology, original research reports were identified and assessed for inclusion based on defined criteria. Initial database searches yielded 516 articles. After removing duplicates and articles that did not fit inclusion criteria (419), 97 articles were reviewed, yielding a final total of 51 publications, mainly originating in the United States and Europe. Studies were assessed for date, geographic region, sample description, methodology, and key findings. Reports were evaluated on 1) how stigmatizing attitudes may present in various subgroups, including in racial or ethnic minorities; 2) stigma assessment tools; and 3) prospective or experimental approaches to assess or manage stigma. Stigma impedes help-seeking and treatment, and occurs broadly and world wide. Stigmatizing attitudes appear worse among those with limited disease knowledge, those with little contact with people with dementia, in men, in younger individuals, and in the context of ethnicity and culture. In some cases, healthcare providers may have stigmatizing attitudes. In research studies, there does not appear to be consensus on how to best evaluate stigma, and there are few evidence-based stigma reduction approaches. Given the projected increase in persons with dementia globally, there is a critical need for research that better identifies and measures stigma and tests new approaches that can reduce stigmatizing attitudes.
污名化会对认知障碍和痴呆症患者产生负面影响。本文献回顾了过去十年（2004 年 1 月至 2015 年 12 月）全球范围内与痴呆症相关的污名化研究。使用标准的系统评价方法，根据既定标准确定并评估了原始研究报告的纳入情况。最初的数据库搜索产生了 516 篇文章。在去除重复项和不符合纳入标准的文章（419 篇）后，对 97 篇文章进行了审查，最终共有 51 篇文章，主要来自美国和欧洲。对这些研究的日期、地理区域、样本描述、方法和主要发现进行了评估。报告评估了以下几个方面：1）在各种亚组中，包括少数族裔或少数民族，可能存在哪些污名化态度；2）污名评估工具；3）评估或管理污名的前瞻性或实验方法。污名化会阻碍寻求帮助和治疗，并且广泛存在于世界各地。在疾病知识有限、与痴呆症患者接触较少、男性、年轻人以及在种族和文化背景下，污名化态度似乎更为严重。在某些情况下，医疗保健提供者可能持有污名化态度。在研究中，似乎没有关于如何最好地评估污名的共识，也很少有基于证据的减少污名化的方法。鉴于全球痴呆症患者人数预计将增加，因此迫切需要开展研究，以更好地识别和衡量污名，并测试可以减少污名化态度的新方法。
