Taft Tiffany H, Craven Meredith R, Adler Emerald P, Simons Madison, Nguyen Linda
Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Gastroenterology, Stanford University, Palo Alto, CA, USA.
Neurogastroenterol Motil. 2022 Apr;34(4):e14223. doi: 10.1111/nmo.14223. Epub 2021 Aug 1.
Stigmatization toward chronic digestive diseases is well documented. Patients perceive others hold negative stereotypes toward their disease and may internalize these beliefs as true. Because of this, stigmatization is associated with poor outcomes across disease-related and psychosocial domains. No study to date evaluates stigmatization toward patients living with gastroparesis (GP), a poorly understood disease affecting gastric motility. We aimed to gain deep understanding of stigma in patients living with gastroparesis.
Patients with GP were recruited from two university-based gastroenterology practices as well as patient advocacy support groups. Participants underwent a semi-structured qualitative interview about their experiences with stigma related to their GP diagnosis, which were audio-recorded and transcribed to text for analysis using a grounded theory approach. Major themes with representative quotations were documented.
Twenty-three patients participated. The majority were White, female, with idiopathic GP under the care of a gastroenterologist. All patients reported stigma related to GP. Seven major themes were found: stigma from healthcare providers, stigma within interpersonal relationships, GP as an invisible disease, blame, unsolicited suggestions on how to manage disease, disclosure, and stigma resistance.
This is the first study to describe stigma experiences in patients with GP. The results suggest patients experience considerable stigmatization toward their condition from multiple sources. Patients also demonstrated resistance to negative beliefs, which can serve as a protective factor for the negative effects of disease stigma. Clinicians should be aware of stigma in GP patients, including their own potential internal biases and behaviors.
对慢性消化系统疾病的污名化已有充分记录。患者认为他人对其疾病持有负面刻板印象,并可能将这些观念内化视为事实。因此,污名化与疾病相关和心理社会领域的不良后果有关。迄今为止,尚无研究评估对患有胃轻瘫(GP)患者的污名化情况,胃轻瘫是一种对胃动力影响了解甚少的疾病。我们旨在深入了解胃轻瘫患者的污名化情况。
从两家大学附属医院的胃肠病科以及患者支持团体中招募胃轻瘫患者。参与者接受了关于他们与胃轻瘫诊断相关的污名化经历的半结构化定性访谈,访谈进行了录音,并转录为文本,采用扎根理论方法进行分析。记录了带有代表性引语的主要主题。
23名患者参与。大多数是白人女性,患有特发性胃轻瘫,由胃肠病学家诊治。所有患者都报告了与胃轻瘫相关的污名化情况。发现了七个主要主题:来自医疗服务提供者的污名化、人际关系中的污名化、胃轻瘫是一种无形的疾病、指责、关于疾病管理的主动建议、披露以及污名抵抗。
这是第一项描述胃轻瘫患者污名化经历的研究。结果表明患者从多个来源对其病情经历了相当程度的污名化。患者也表现出对负面观念的抵抗,这可以作为疾病污名化负面影响的保护因素。临床医生应该意识到胃轻瘫患者中的污名化情况,包括他们自身潜在的内在偏见和行为。