Jefferson Headache Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
Department of Sociology, Institute of Health, Health Care Policy, and Aging Research, Rutgers University, The State University of New Jersey, New Brunswick, NJ, 08901, USA.
Curr Pain Headache Rep. 2021 Dec 6;25(11):75. doi: 10.1007/s11916-021-00982-z.
Migraine and other primary headache disorders do not receive adequate research funding, medical resources, or other forms of structural support relative to their prevalence and the disability they cause. In recent research, scholars have argued that stigma associated with headache disorders explains some of this discrepancy. This review will discuss (1) the factors contributing to stigma toward migraine and other primary headache disorders, (2) how structural and enacted stigma may perpetuate individual disability, (3) the impact of internalized stigma, and (4) interventions to mitigate stigma toward headache disorders with an emphasis on outcome monitoring. The review will also propose new areas of stigma research in need of further investigation.
Recent research shows that discrimination can exacerbate chronic pain. Stigma profoundly affects everything from the allocation of federal research funds and healthcare resources to individual patients' self-efficacy and ability to care for themselves. Understanding the stigma of migraine and learning how to develop effective interventions to mitigate this stigma will increase access to appropriate migraine care, improve healthcare providers' ability to care for their migraine patients, and help advocates reverse policies that discriminate against those with migraine. It is important to closely monitor outcomes of anti-stigma efforts for both positive and negative consequences and take note of outcomes and "lessons learned" from anti-stigma campaigns for other diseases.
综述目的:偏头痛和其他原发性头痛障碍相对于其流行程度和所导致的残疾而言,并未得到足够的研究资金、医疗资源或其他形式的结构性支持。在最近的研究中,学者们认为与头痛障碍相关的耻辱感解释了这种差异的部分原因。本综述将讨论:(1)导致偏头痛和其他原发性头痛障碍耻辱感的因素;(2)结构性和表现性耻辱感如何可能使个人残疾永久化;(3)内化耻辱感的影响;(4)减轻头痛障碍耻辱感的干预措施,重点是监测结果。该综述还将提出需要进一步研究的新的耻辱感研究领域。
最近的发现:最近的研究表明,歧视会加剧慢性疼痛。耻辱感深刻地影响着从联邦研究资金和医疗保健资源的分配到个体患者的自我效能感和自我护理能力等方方面面。了解偏头痛的耻辱感,并学习如何制定有效的干预措施来减轻这种耻辱感,将增加获得适当偏头痛护理的机会,提高医疗保健提供者照顾偏头痛患者的能力,并帮助倡导者扭转歧视偏头痛患者的政策。密切监测反耻辱感工作的结果,包括积极和消极的后果,并注意从其他疾病的反耻辱感运动中获得的结果和“经验教训”,这一点很重要。