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非传染性疾病相关污名:混合方法系统评价。

Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review.

机构信息

Athena Institute, Faculty of Science, Vrije University Amsterdam, 1081 Amsterdam, The Netherlands.

Barcelona Institute for Global Health (ISGlobal), University of Barcelona, 08007 Barcelona, Spain.

出版信息

Int J Environ Res Public Health. 2020 Sep 12;17(18):6657. doi: 10.3390/ijerph17186657.

Abstract

This systematic review examines and consolidates existing evidence on stigma associated with the top four non-communicable diseases (NCDs)-cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes-and its impact on the lives of people affected. We conducted a systematic literature search in PubMed, PsycINFO, JSTOR, Science Direct, and Web of Science for original research in English that explored health-related stigma among people living with either of the four NCDs. A three-step integrative synthesis of data was conducted. Twenty-six articles (qualitative = 15; quantitative = 11) were selected, with most ( = 15) related to cancers, followed by diabetes ( = 7), chronic respiratory diseases ( = 3), and cardiovascular diseases ( = 1). Blame, shame, and fear were the main causes of stigma, the origin and nature of which differed according to the disease-specific features. The manifestations (enacted and felt stigma) and consequences (social, behavioral, psychological, and medical) of stigma across NCDs were similar. Inconsistencies existed in the conceptualization of stigma processes. To fill this gap, we developed an NCD-related stigma framework. People living with NCDs can experience stigma, which can negatively impact their health, management of their disease, and quality of life. The new framework can help in improving the understanding of the processes and experiences of stigma related to NCDs.

摘要

这篇系统综述考察并整合了与四大非传染性疾病(NCDs)——癌症、心血管疾病、慢性呼吸系统疾病和糖尿病——相关的污名及其对患者生活的影响的现有证据。我们在 PubMed、PsycINFO、JSTOR、Science Direct 和 Web of Science 中进行了系统的文献检索,以寻找探讨四大 NCDs 患者中与健康相关的污名问题的英文原创研究。我们采用三步综合数据综合方法。共选择了 26 篇文章(定性研究=15 篇;定量研究=11 篇),其中大部分(=15 篇)与癌症有关,其次是糖尿病(=7 篇)、慢性呼吸系统疾病(=3 篇)和心血管疾病(=1 篇)。污名的主要原因是指责、羞耻和恐惧,其起源和性质因疾病的特定特征而异。NCD 之间污名的表现(实施和感受到的污名)和后果(社会、行为、心理和医疗)相似。污名过程的概念化存在不一致。为了填补这一空白,我们开发了一个与 NCD 相关的污名框架。NCD 患者可能会经历污名,这可能会对他们的健康、疾病管理和生活质量产生负面影响。新框架有助于更好地理解与 NCD 相关的污名过程和体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f51/7559120/5636d7573c21/ijerph-17-06657-g001.jpg

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