拉丁美洲和加勒比地区子宫内膜异位症女性的耻辱感、社会支持及其对生活质量和自尊的影响。

Stigma and social support and their impact on quality of life and self-esteem among women with endometriosis in Latin-America and the Caribbean.

作者信息

Matías-González Yatzmeli, Sánchez-Galarza Astrid, Rosario-Hernández Ernesto, Flores-Caldera Idhaliz, Rivera-Segarra Eliut

机构信息

School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.

Department of Basic Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.

出版信息

PLOS Glob Public Health. 2022 Dec 2;2(12):e0001329. doi: 10.1371/journal.pgph.0001329. eCollection 2022.

DOI:10.1371/journal.pgph.0001329

PMID:36962832

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10022163/

Abstract

Endometriosis is a complex disease affecting approximately 5-10% individuals worldwide. Prevalence rates in Latin-America and the Caribbean are largely unknown, with published data only from Puerto Rico and Chile. Pain associated with endometriosis negatively affects patients' health and quality of life. However, there is a need to better understand the role played by psychosocial variables such as stigma and social support in diverse cultural contexts. The purpose of this study was to examine the mediating role of endometriosis related stigma (endo-stigma) and the moderating role of social support on the endometriosis QoL and self-esteem among women with endometriosis from Latin America and the Caribbean. A cross-sectional design with online survey techniques was implemented. A total of 169 self-identified cisgender women with endometriosis from 14 Latin-American and Caribbean countries participated in the study. We used partial least squares structural equation modeling (PLS-SEM) to examine the study's hypotheses. Incapacitating pain was positively and significantly related to endometriosis QoL as measured by the EHP-5 (b = .266, p < .01). Endo-stigma was positively and significantly related to endometriosis QoL (b = .340, p< .01) and self-esteem (b = .297, p< .01). In addition, endo-stigma mediated the relationship between incapacitating pain and self-esteem (IE = .073, p = .018). Finally, social support moderated the relationship between stigma stress and endometriosis QoL (b = .060, p = .039). Findings suggest stigma could be one of the mechanisms through which the relationship between incapacitating pain and self-esteem among Latin American and Caribbean women with endometriosis could be partially explained. Furthermore, women who scored high in the need for social support and stigma stress also showed worst endometriosis QoL. These results point towards the need to develop tailored interventions targeting these factors in order to foster a better QoL and wellbeing for this population in the context of Latin America and the Caribbean.

摘要

子宫内膜异位症是一种复杂的疾病，全球约5%-10%的人受其影响。拉丁美洲和加勒比地区的患病率 largely unknown，仅有来自波多黎各和智利的已发表数据。与子宫内膜异位症相关的疼痛会对患者的健康和生活质量产生负面影响。然而，有必要更好地了解诸如耻辱感和社会支持等心理社会变量在不同文化背景中所起的作用。本研究的目的是探讨子宫内膜异位症相关耻辱感（内膜耻辱感）的中介作用以及社会支持对拉丁美洲和加勒比地区患有子宫内膜异位症女性的子宫内膜异位症生活质量和自尊的调节作用。采用在线调查技术实施了横断面设计。共有来自14个拉丁美洲和加勒比国家的169名自我认定为顺性别且患有子宫内膜异位症的女性参与了该研究。我们使用偏最小二乘结构方程模型（PLS-SEM）来检验研究假设。如通过EHP-5测量，致残性疼痛与子宫内膜异位症生活质量呈正相关且具有显著性（b = .266，p < .01）。内膜耻辱感与子宫内膜异位症生活质量呈正相关且具有显著性（b = .340，p < .01）以及与自尊呈正相关且具有显著性（b = .297，p < .01）。此外，内膜耻辱感介导了致残性疼痛与自尊之间的关系（间接效应 = .073，p = .018）。最后，社会支持调节了耻辱感压力与子宫内膜异位症生活质量之间的关系（b = .060，p = .039）。研究结果表明，耻辱感可能是部分解释拉丁美洲和加勒比地区患有子宫内膜异位症女性致残性疼痛与自尊之间关系的机制之一。此外，在社会支持需求和耻辱感压力方面得分高的女性也表现出最差的子宫内膜异位症生活质量。这些结果表明，有必要针对这些因素制定针对性的干预措施，以便在拉丁美洲和加勒比地区的背景下提高这一人群的生活质量和幸福感。