Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMJ Open. 2023 Apr 24;13(4):e070635. doi: 10.1136/bmjopen-2022-070635.
Some studies indicate that persistent somatic symptoms (PSS) are more prevalent among individuals with a low socioeconomic status (SES) and a migration background. However, factors explaining social inequalities in PSS are largely unknown. It is expected that aggravating factors of PSS like illness perception, illness beliefs (health literacy, stigma), illness behaviour and health anxiety may play an important role for this explanation. The SOMA.SOC study will examine social inequalities (according to SES and migration) in factors contributing to symptom persistence in irritable bowel syndrome (IBS) and fatigue.
The project will collect both quantitative and qualitative data. Quantitative data will be gathered via a representative telephone survey in Germany (N=2400). A vignette design will be used depicting patients varying in sex, condition (IBS/fatigue), occupational status (low/high) and migration (yes/no). In the survey, we will assess public knowledge and beliefs (eg, health literacy), attitudes (stigma) and personal experiences with the condition (eg, somatic symptom burden). Complementary, longitudinal qualitative interviews will be conducted with patients (n=32 at three time points, resulting in N=96 interviews) who will also vary according to sex, condition, occupational status and migration. Patients will be recruited from primary care practices in Hamburg. The interviews will cover origin and development of the condition, coping and help-seeking as well as social interactions and perception of the disease by others (eg, perceived stigma). SOMA.SOC is part of the interdisciplinary SOMACROSS (Persistent SOMAtic Symptoms ACROSS Diseases) research unit.
The study protocol was approved by the Ethics Committee of the Hamburg Medical Association on 25 January 2021 (reference number: 2020-10194- BO-ff). Informed consent will be obtained from all participants. The main findings will be submitted for publication in peer-reviewed journals within 12 months of study completion.
一些研究表明，持续的躯体症状（PSS）在社会经济地位（SES）较低和移民背景的人群中更为普遍。然而，导致 PSS 社会不平等的因素在很大程度上尚不清楚。预计 PSS 的加重因素，如疾病感知、疾病信念（健康素养、污名化）、疾病行为和健康焦虑，可能对此解释起到重要作用。SOMA.SOC 研究将调查社会不平等（根据 SES 和移民）对肠易激综合征（IBS）和疲劳中持续性症状的影响因素。
该项目将收集定量和定性数据。定量数据将通过德国具有代表性的电话调查收集（N=2400）。采用描绘患者在性别、病情（IBS/疲劳）、职业状况（低/高）和移民状况（是/否）方面存在差异的病例设计。在调查中，我们将评估公众对疾病的知识和信念（如健康素养）、态度（污名化）和个人经历（如躯体症状负担）。此外，我们将对患者（32 名患者，分三个时间点，共 96 次访谈）进行纵向定性访谈，这些患者还将根据性别、病情、职业状况和移民状况进行分组。患者将从汉堡的初级保健诊所招募。访谈将涵盖病情的起源和发展、应对和寻求帮助以及社会互动和他人对疾病的看法（如感知到的污名化）。SOMA.SOC 是跨学科 SOMACROSS（持续性躯体症状跨疾病）研究单位的一部分。
该研究方案于 2021 年 1 月 25 日获得汉堡医学协会伦理委员会的批准（参考编号：2020-10194-BO-ff）。将获得所有参与者的知情同意。主要发现将在研究完成后 12 个月内提交给同行评议期刊发表。
