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对罕见病患者所经历的污名的归纳定性内容分析。

An inductive qualitative content analysis of stigma experienced by people with rare diseases.

机构信息

Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA.

School of Psychological Science, Oregon State University, Corvallis, OR, USA.

出版信息

Psychol Health. 2022 Aug;37(8):948-963. doi: 10.1080/08870446.2021.1912344. Epub 2021 Apr 22.

Abstract

OBJECTIVE

There are more than 6,000 known rare diseases (RDs), which are often serious, chronic, and progressive conditions. Cumulatively, having a RD is actually common, impacting an estimated 300 million people worldwide. While the stigmatization of some specific RDs has been studied, examining stigma in a large sample of many RDs allows for a broader understanding of patterns.

DESIGN

We used inductive qualitative content analysis to analyze survey responses to an open-ended question about challenges of living with a RD among 384 people with 178 distinct RDs.

RESULTS

We identified eight codes which were organized under the following three themes: structurally enacted, interpersonally enacted, and felt stigma. People with RDs experience structurally enacted stigma in the forms of healthcare stigma, education/workplace stigma, and an overall lack of accessibility. They also face interpersonally enacted stigma, including insufficient social support, a lack of understanding from others, and capitalist norms of productivity and self-sufficiency. Additionally, they experience felt stigma related to shame and the pressure to pass as able-bodied.

CONCLUSION

Possible solutions to RD stigma include increased education about RDs for healthcare professionals, a societal shift towards prioritizing accessibility, strengthened legal protections for disabled people, and expanded disability justice-focused community organizing.

摘要

目的

已知的罕见病(RD)超过 6000 种,这些疾病通常严重、慢性且呈进行性发展。累积起来,全世界约有 3 亿人患有 RD,尽管一些特定 RD 的污名化已经得到研究,但在许多 RD 的大样本中检查污名可以更全面地了解模式。

设计

我们使用归纳定性内容分析,对 384 名患有 178 种不同 RD 的人对生活中面临的 RD 挑战的开放性问题的调查回答进行了分析。

结果

我们确定了 8 个代码,这些代码组织在以下三个主题下:结构性实施、人际间实施和感觉污名。RD 患者在医疗保健污名、教育/工作场所污名和整体缺乏可及性方面经历结构性实施的污名。他们还面临人际间实施的污名,包括社会支持不足、他人缺乏理解以及资本主义的生产力和自给自足规范。此外,他们还经历了与羞耻感和假装身体健全的压力相关的感觉污名。

结论

RD 污名的可能解决方案包括增加医疗保健专业人员对 RD 的教育、向无障碍性倾斜的社会转变、加强对残疾人的法律保护以及扩大以残疾正义为重点的社区组织。

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