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埃塞俄比亚西南部公立卫生机构肺结核患者的感知污名:一项横断面研究。

Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study.

机构信息

Department of Psychiatry, Faculty of Public Health and Medical Sciences, Mettu University, Mettu, Ethiopia.

Department of Psychiatry, School of Health Sciences, Mada Walabu University, Shashemene campus, Shashemene, Ethiopia.

出版信息

PLoS One. 2020 Dec 8;15(12):e0243433. doi: 10.1371/journal.pone.0243433. eCollection 2020.

Abstract

OBJECTIVES

Although tuberculosis (TB) related stigma has a significant impact on the diagnosis, patient adherence with treatment, and recovery from the disease, there is limited evidence from Ethiopia regarding perceived stigma among patient with pulmonary tuberculosis (PTB).The purpose of this study was to assess perceived stigma and associated factors among patient with PTB on treatment in southwest Ethiopia.

METHODS

Institution-based cross-sectional study was conducted from April to May 2019 among 410 patient with PTB. Data were collected by using the perceived tuberculosis stigma scale. Epi data v3.1 and SPSSv23 were used for data entry and analysis. Multivariable logistic regression models were fitted to identify factors associated with perceived stigma. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs).

RESULT

Prevalence of perceived stigma among patient with Pulmonary tuberculosis was 57.1% (95% CI: 52.2, 61.7). Poor social support (AOR = 2.41; 95% CI: 1.06, 5.48), above a month duration of illness (AOR = 2.48; 95% CI: 1.33, 4.64), high perceived stress (AOR = 1.95; 95% CI:1.09, 3.49), current khat use (AOR = 1.88; 95% CI:1.05, 3.37), and presence of depression (AOR = 8.18; 95% CI:4.40, 15.22) were significantly associated with perceived stigma. Patient with HIV co-infection were 5.67 times (AOR = 5.67; 95% CI: 2.32, 13.87) more likely to have Perceived stigma than their counterparts.

CONCLUSION

TB related stigma was reported by more than half of the study participant. Stigma reduction measures are needed to lower TB related stigma perceived by the patient, the level of distress associated with it, and to promote the psychological wellbeing of patient with TB.

摘要

目的

尽管结核病(TB)相关的耻辱感对诊断、患者对治疗的依从性以及疾病的康复有重大影响,但在埃塞俄比亚,有关肺结核(PTB)患者感知耻辱感的证据有限。本研究旨在评估西南埃塞俄比亚接受治疗的肺结核患者的感知耻辱感及其相关因素。

方法

2019 年 4 月至 5 月,采用基于机构的横断面研究方法,对 410 名肺结核患者进行了研究。使用感知结核病耻辱量表收集数据。EpiData v3.1 和 SPSSv23 用于数据录入和分析。采用多变量逻辑回归模型来确定与感知耻辱感相关的因素。结果以调整后的优势比(AOR)及其 95%置信区间(CI)表示。

结果

肺结核患者感知耻辱感的患病率为 57.1%(95%CI:52.2,61.7)。社会支持差(AOR=2.41;95%CI:1.06,5.48)、患病时间超过一个月(AOR=2.48;95%CI:1.33,4.64)、感知压力高(AOR=1.95;95%CI:1.09,3.49)、当前使用恰特草(AOR=1.88;95%CI:1.05,3.37)和存在抑郁(AOR=8.18;95%CI:4.40,15.22)与感知耻辱感显著相关。与未合并 HIV 感染的患者相比,合并 HIV 感染的患者更有可能出现感知耻辱感(AOR=5.67;95%CI:2.32,13.87)。

结论

超过一半的研究参与者报告了与结核病相关的耻辱感。需要采取减少耻辱感的措施,降低患者感知到的与结核病相关的耻辱感、相关的痛苦程度,并促进结核病患者的心理健康。

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Knowledge and perceptions of tuberculosis among patients in a pastoralist community in Kenya: a qualitative study.
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Perceived stigma and depression in initially diagnosed pulmonary tuberculosis patients.
J Clin Nurs. 2017 Dec;26(23-24):4813-4821. doi: 10.1111/jocn.13837. Epub 2017 May 17.

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