尼泊尔勒利德布尔地区社区成员和卫生保健提供者对麻风病的感知污名：一项定性研究。
Perceived stigma of leprosy among community members and health care providers in Lalitpur district of Nepal: A qualitative study.
机构信息
Manmohan Memorial Institute of Health Sciences, Swayambhu, Kathmandu, Nepal.
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
出版信息
PLoS One. 2018 Dec 27;13(12):e0209676. doi: 10.1371/journal.pone.0209676. eCollection 2018.
BACKGROUND
Leprosy remains a major stigmatizing condition. Stigma is a dynamic process resulting from the interaction between physical attributes caused by leprosy and the existing stereotypes in a community. Leprosy has pervasive impacts on all areas of life including psychosocial burden to an individual, social interaction, marriage, and employment. These impacts vary and are largely dependent on a particular culture and community. The main objective of this study was to explore the perceived stigma of leprosy amongst community members and health care providers in Lalitpur district of Nepal.
METHODS
A total of six focused group discussions (FGDs) with 43 participants from a community living close to Anandaban Leprosy Hospital and ten semi structured interviews (SSIs) with health care providers were conducted between October and December 2016. An interview guide was used for the FGDs and SSIs. All qualitative data were transcribed and translated into English and were thematically analyzed using Atlas.ti software.
RESULTS
Visible deformities due to leprosy was one of the major contributing factors for stigma. Stigma was further exacerbated by an attitude to conceal the disease due to perceived fear of potential discrimination. While over the years, stigma was felt to be decreasing, various aspects of life were still affected by leprosy stigma including marriage, employment and social interaction. This was largely attributed to leprosy and its consequences, specifically the disability and deformity caused by leprosy.
CONCLUSION
Leprosy was still perceived to be feared and concealed because of potential discrimination, even within the community that was close to a long established leprosy hospital. Various aspects such as marriage, employment and social interaction were still affected by the stigma which was strongly associated with visible deformities. In addition to ongoing rehabilitation and stigma reduction programs, integrating strategies such as community engagement wherein community and leprosy affected person jointly take a role in stigma reduction programs can be helpful.
背景
麻风病仍然是一个主要的污名化疾病。污名是由麻风病引起的身体特征与社区中现有的刻板印象相互作用而产生的动态过程。麻风病对生活的各个方面都有广泛的影响，包括个人的心理社会负担、社会交往、婚姻和就业。这些影响因文化和社区的不同而不同。本研究的主要目的是探讨尼泊尔Lalitpur 区社区成员和卫生保健提供者对麻风病的感知污名。
方法
2016 年 10 月至 12 月期间，在靠近 Anandaban 麻风病医院的社区中进行了六次共 43 名参与者的焦点小组讨论（FGD）和 10 次与卫生保健提供者的半结构化访谈（SSI）。FGD 和 SSI 使用访谈指南进行。所有定性数据均被转录并翻译成英文，并使用 Atlas.ti 软件进行主题分析。
结果
麻风病引起的可见畸形是污名的主要原因之一。由于担心潜在的歧视，人们对隐瞒疾病的态度进一步加剧了污名。尽管多年来，污名感有所下降，但麻风病污名仍然影响着生活的各个方面，包括婚姻、就业和社会交往。这主要归因于麻风病及其后果，特别是麻风病引起的残疾和畸形。
结论
即使在靠近一家历史悠久的麻风病医院的社区中，由于潜在的歧视，麻风病仍然被认为是令人恐惧和隐瞒的疾病。婚姻、就业和社会交往等各个方面仍然受到污名的影响，这种污名与可见的畸形密切相关。除了正在进行的康复和减少污名的计划外，还可以整合社区参与等策略，使社区和麻风病患者共同参与减少污名的计划。
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