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探索污名对健康和幸福感的影响:从获得康复服务的有过亲身体验的母亲那里获得的见解。

Exploring the Impact of Stigma on Health and Wellbeing: Insights from Mothers with Lived Experience Accessing Recovery Services.

机构信息

Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE7 7XA, UK.

Department of Sociology, Faculty of Social Sciences and Health, Durham University, Durham DH1 3HN, UK.

出版信息

Int J Environ Res Public Health. 2024 Sep 6;21(9):1189. doi: 10.3390/ijerph21091189.

Abstract

Stigmatisation is the process by which an individual is devalued based on their attributes, characteristics, and/or behaviour, with this often leading to prejudice, social and health-related harms, active discrimination, and microaggressions. The aim of this paper is to show how social harms can occur and how stigma is damaging to the health and wellbeing of a person in recovery. To do so, we focus on the harms that arise from the internalisation of labels that mothers who use drugs encounter in a treatment and recovery setting whilst in active recovery, and how this stigmatisation can manifest negative self-beliefs. Qualitative data was used from two semi-structured focus groups involving females with lived experience of substance use ( = 13). A reflexive thematic analysis approach was used to analyse the interview transcripts, and three themes were identified: (1) the enduring nature of stigma; (2) gender disparity and the need for mothers- and women-only spaces; and (3) stigma as a barrier to services and wellbeing. Findings revealed the enduring nature of stigma amongst mothers who were in active recovery, with women feeling judged more harshly than men and experiencing pressure to live up to a "good mother" ideal whilst in recovery. This paper demonstrates that mothers in recovery are still stigmatised and, as a consequence, approach services with increased sensitivity, with stigma often resulting in disengagement or reluctance to access healthcare settings. We conclude that staff in health, social, and primary care settings need to develop a strong therapeutic alliance with mothers in recovery and promote anti-stigma approaches in their practice, in order to mitigate stigma and reduce harms to health and wellbeing.

摘要

污名化是指个体因其属性、特征和/或行为而被贬低的过程,这往往导致偏见、社会和健康相关的伤害、主动歧视和微侵犯。本文旨在展示社会伤害是如何产生的,以及污名化如何对康复者的健康和幸福造成损害。为此,我们关注的是在积极康复期间,使用毒品的母亲在治疗和康复环境中遇到标签内化所产生的伤害,以及这种污名化如何表现出消极的自我信念。定性数据来自两个半结构化的焦点小组,涉及有药物使用经历的女性(=13)。使用反思性主题分析方法对访谈记录进行了分析,确定了三个主题:(1)污名的持久性质;(2)性别差距和母亲/女性专用空间的必要性;(3)污名是服务和幸福感的障碍。研究结果表明,积极康复的母亲中仍然存在污名化现象,女性比男性受到更严厉的评判,并且在康复期间感受到了达到“好母亲”理想的压力。本文表明,康复中的母亲仍然受到污名化,因此在使用服务时会更加敏感,污名化往往导致她们不愿或不愿进入医疗保健场所。我们的结论是,卫生、社会和初级保健机构的工作人员需要与康复中的母亲建立强大的治疗联盟,并在实践中推广反污名化方法,以减轻污名化对健康和幸福感的影响。

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