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同伴支持干预对泰国结核病患者内化耻辱感的影响:一项重复测量设计。

The effect of the peer support intervention on internalized stigma among Thai patients with tuberculosis: A repeated measures design.

作者信息

Vibulchai Nisakorn, Dana Kamthorn, Sanchan Monruedee, Churari Charanya, Jadboonnak Bunjong, Sawangsri Wattana, Pothiporn Wansu Taweekanachote, Sutthicharoen Udomlak

机构信息

Boromarajonani College of Nursing, Nakhon Ratchasima, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, Thailand.

Srimahasarakham Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, Thailand.

出版信息

Belitung Nurs J. 2024 Aug 28;10(4):408-415. doi: 10.33546/bnj.3327. eCollection 2024.

Abstract

BACKGROUND

Internalized stigma among patients with tuberculosis (TB) significantly affects delayed diagnosis, increased disease transmission, and poor treatment outcomes. However, conclusive empirical evidence on psychosocial interventions to reduce internalized stigma among patients with TB in Thailand remains scarce.

OBJECTIVE

This study aimed to examine the impact of a peer support intervention on reducing internalized stigma among patients with TB in Thailand.

METHODS

A one-group within-subjects repeated-measure design was conducted in the Muang Maha Sarakham district, Thailand, from February 2023 to July 2023. The study included 26 participants who met specified criteria. Measurements were taken at baseline, three months, and six months following TB diagnosis and medication treatment. The peer support intervention comprised TB health education, psycho-educational sessions, self-management support, and home visits. The Internalized Stigma of Tuberculosis Scale Thai Version was used to measure internalized stigma. Statistical analyses included descriptive statistics and repeated measures ANOVA.

RESULTS

Mean scores of total internalized stigma and its sub-dimensions (alienation, stereotype endorsement, discrimination experience, social withdrawal, and stigma resistance) differed significantly across the three-time points ( <0.001, <0.001, <0.001, <0.001, <0.001, = 0.002, respectively). Furthermore, stigma resistance scores significantly increased from pre-intervention to three months ( = 0.005) and from pre-intervention to six months ( = 0.007). However, no significant increase was observed from three to six months ( = 0.079).

CONCLUSIONS

The study underlines the positive impact of peer support intervention in reducing internalized stigma among patients with TB in Thailand over time. The findings suggest that interventions focusing on peer support can potentially address internalized stigma, highlighting the importance of integrating these strategies into healthcare practices to enhance patient care and improve TB management outcomes.

摘要

背景

结核病患者的内化耻辱感严重影响诊断延迟、疾病传播增加以及治疗效果不佳。然而,关于泰国减少结核病患者内化耻辱感的心理社会干预措施的确凿实证证据仍然匮乏。

目的

本研究旨在探讨同伴支持干预对减少泰国结核病患者内化耻辱感的影响。

方法

2023年2月至2023年7月在泰国玛哈沙拉堪府直辖县采用单组被试内重复测量设计。该研究纳入了26名符合特定标准的参与者。在结核病诊断和药物治疗后的基线、三个月和六个月进行测量。同伴支持干预包括结核病健康教育、心理教育课程、自我管理支持和家访。使用泰国版结核病内化耻辱感量表来测量内化耻辱感。统计分析包括描述性统计和重复测量方差分析。

结果

内化耻辱感总分及其子维度(疏离感、刻板印象认同、歧视经历、社交退缩和耻辱感抵抗)的平均得分在三个时间点上存在显著差异(分别为<0.001、<0.001、<0.001、<0.001、<0.001、=0.002)。此外,耻辱感抵抗得分从干预前到三个月(=0.005)以及从干预前到六个月(=0.007)显著增加。然而,从三个月到六个月未观察到显著增加(=0.079)。

结论

该研究强调了同伴支持干预随着时间推移对减少泰国结核病患者内化耻辱感的积极影响。研究结果表明,侧重于同伴支持的干预措施有可能解决内化耻辱感问题,凸显了将这些策略纳入医疗保健实践以加强患者护理和改善结核病管理结果的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/736f/11350345/4254271e45f0/BNJ-10-4-408-g001.jpg

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