中国东北大连市与结核病相关的耻辱感及其决定因素：一项横断面研究。
Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study.
机构信息
School of Public Health, Dalian Medical University, 9 Western Section, Lvshun South Street, Lvshunkou District, Dalian, People's Republic of China, 116044.
出版信息
BMC Public Health. 2021 Jan 4;21(1):6. doi: 10.1186/s12889-020-10055-2.
BACKGROUND
The stigma of tuberculosis (TB) poses a significant challenge to TB control because it leads to delayed diagnosis and non-adherence. However, few studies on TB-related stigma have been completed in China. The aim of the current study was to explore the status of TB-related stigma and its associated predictive factors among TB patients in Dalian, Northeast China.
METHODS
An institution-based, cross-sectional survey was conducted among outpatients at Dalian Tuberculosis Hospital in Liaoning Province, Northeast China. Data were collected by using a questionnaire that measured TB-related stigma, treatment status, anxiety, social support, doctor-patient communication and so on. A multiple linear regression model was used to determine the predictors of TB-related stigma.
RESULTS
A total of 601 eligible participants were recruited. The mean score for TB-related stigma was 9.07, and the median score was 10. The average scores for anxiety, social support and doctor-patient communication were 4.03, 25.41 and 17.17, respectively. Multiple linear regression analysis revealed that patients who were female (β = 1.19, 95% CI: 0.38-2.01, P < 0.05), had self-assessed moderate or severe disease (β = 1.08, 95% CI: 0.12-2.03 and β = 1.36, 95% CI: 0.03-2.70, respectively, P < 0.05), and had anxiety (β = 0.38, 95% CI: 0.30-0.46, P < 0.001) were more likely to have a greater level of TB-related stigma than their counterparts. However, a significantly lower level of TB-related stigma was observed in patients with good social support (β = - 0.25, 95% CI: - 0.33--0.17, P < 0.001) and doctor-patient communication (β = - 0.14, 95% CI: - 0.29--0.00, P < 0.05).
CONCLUSIONS
This study showed that stigma among TB patients was high. Targeted attention should be paid to female patients and patients with moderate or severe disease in TB stigma-related interventions. Moreover, the important role of social support and doctor-patient communication in reducing TB-related stigma should also be emphasized.
背景
结核病（TB）污名化对结核病控制构成重大挑战，因为它导致诊断延误和不遵医嘱。然而，中国完成的结核病相关污名研究很少。本研究旨在探讨中国东北地区大连市结核病患者的结核病相关污名现状及其相关预测因素。
方法
采用基于机构的横断面调查，在辽宁省大连市结核病医院的门诊患者中进行。数据收集采用问卷的方式，测量结核病相关污名、治疗状况、焦虑、社会支持、医患沟通等。采用多元线性回归模型确定结核病相关污名的预测因素。
结果
共纳入 601 名合格参与者。结核病相关污名平均得分为 9.07，中位数得分为 10。焦虑、社会支持和医患沟通的平均得分分别为 4.03、25.41 和 17.17。多元线性回归分析显示，女性患者（β=1.19，95%CI：0.38-2.01，P<0.05）、自我评估为中度或重度疾病患者（β=1.08，95%CI：0.12-2.03 和β=1.36，95%CI：0.03-2.70，P<0.05）以及焦虑患者（β=0.38，95%CI：0.30-0.46，P<0.001）比对照组更有可能出现更高水平的结核病相关污名。然而，在社会支持良好的患者（β=-0.25，95%CI：-0.33--0.17，P<0.001）和医患沟通良好的患者（β=-0.14，95%CI：-0.29--0.00，P<0.05）中，结核病相关污名水平显著较低。
结论
本研究表明，结核病患者的污名程度较高。在结核病污名相关干预措施中，应特别关注女性患者和中重度疾病患者。此外，还应强调社会支持和医患沟通在减少结核病相关污名方面的重要作用。
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