School of Public Health, University of Haifa, Haifa, Israel.
Department of Psychology, Ariel University, Ariel, Israel.
J Clin Nurs. 2023 Apr;32(7-8):1103-1114. doi: 10.1111/jocn.16340. Epub 2022 Apr 29.
To explore the ways in which stigma is experienced, and what strategies are used to manage stigma among patients using medical cannabis to ease suffering from chronic pain.
Various jurisdictions have legalised medical cannabis in recent decades. Despite increasing prevalence and more liberal attitudes towards medical cannabis, it is possible that patients who use medical cannabis experience stigma.
A phenomenological qualitative study.
Fifteen patients living with chronic pain and licensed by the Israeli Ministry of Health to use medical cannabis to treat pain symptoms for at least 1 year participated in semi-structured interviews. Transcribed data were analysed using thematic analysis to identify themes related to stigma. The manuscript is in correspondence to SRQR EQUATOR checklist.
Expressions of stigma were more related to 'felt' than 'enacted' stigma. Stigma related to decisions to delay onset of medical cannabis treatment and the ways in which participants managed medical cannabis use during their everyday lives. Participants dissociated themselves from recreational cannabis users, by presenting themselves as responsible normative individuals and engaging in a form of normalisation known as 'normification', emphasising their own discrete and controlled medical cannabis use and cannabis' benefits.
Patients experienced 'felt' stigma which had consequences for their self-presentations and medical cannabis use. This suggests that medical cannabis is not normalised in Israel and interventions may be needed to handle stigma related to medical cannabis.
The findings emphasise the effects of 'felt' stigma on patients. Aiming to increase the effectiveness of medical cannabis treatment and reducing harms, we suggest that particular focus should be placed on managing stigma at the intrapersonal level. In addition, there may be a need to address stigma at the societal level including social interactions with friends, family and medical personnel.
探索在使用医用大麻缓解慢性疼痛患者中，经历污名化的方式，以及用于管理污名化的策略。
近几十年来，许多司法管辖区已经将医用大麻合法化。尽管对医用大麻的接受度越来越高，态度也越来越宽松，但使用医用大麻的患者可能仍然会经历污名化。
现象学定性研究。
15 名患有慢性疼痛且经以色列卫生部许可使用医用大麻治疗疼痛症状至少 1 年的患者参加了半结构化访谈。使用主题分析对转录数据进行分析，以确定与污名相关的主题。手稿符合 SRQR EQUATOR 清单。
污名的表达更多地与“感觉”污名而非“实施”污名有关。污名与延迟开始医用大麻治疗的决定以及参与者在日常生活中管理医用大麻使用的方式有关。参与者将自己与娱乐性大麻使用者区分开来，表现出自律、规范的正常人形象，并采用一种被称为“规范”的正常化方式，强调自己离散且受控的医用大麻使用和大麻的益处。
患者经历了“感觉”污名，这对他们的自我表现和医用大麻的使用产生了影响。这表明医用大麻在以色列尚未被正常化，可能需要采取干预措施来处理与医用大麻相关的污名化问题。
研究结果强调了“感觉”污名对患者的影响。为了提高医用大麻治疗的效果并减少危害，我们建议特别关注在个人层面上管理污名化问题。此外，可能需要在社会层面上解决污名化问题，包括与朋友、家人和医务人员的社会互动。
