Miller Megan M, Kissi Ama, Rumble Deanna D, Hirsh Adam T, Vervoort Tine, Crosby Lori E, Madan-Swain Avi, Lebensburger Jeffrey, Hood Anna M, Trost Zina
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, USA.
J Racial Ethn Health Disparities. 2024 Dec 9. doi: 10.1007/s40615-024-02247-y.
Despite the fact that perceptions of racialized discrimination, health-related stigma, and pain-related injustice have been associated with worse patient functioning, little is known about their unique relationships in Black youth living with sickle cell disease (SCD). In this study, we (1) examined the prevalence of perceptions of racialized discrimination, perceptions of health-related stigma, and pain-related injustice appraisals and (2) investigated how the aforementioned variables were uniquely related to functioning (i.e., functional disability, depressive, and anxiety symptoms) in Black youth living with SCD. The study sample included 30 non-Hispanic Black or African American youth living with SCD (17 male, 13 female youths). The average age of the sample was approximately 11.3 years (SD = 2.73). Zero-order correlations and hierarchical regressions were used to examine and compare the multivariate relationships between perceived racialized discrimination, perceived health-related stigma, and perceived pain-related injustice and outcome variables (functional disability, anxiety symptoms, and depressive symptoms). For functional disability, perceived racialized discrimination and perceived pain-related injustice were significant predictors in the final model (F(3,26) = 11.00, p < .01). For depressive symptoms, health-related stigma trended toward significance (p = .09) as a predictor in the final model (F(2,26) = 6.69, p < .01). For anxiety symptoms, perceived pain-related injustice was the only significant predictor in the final model (F(3,26) = 10.25, p < .001). Results suggest that the youth living with SCD experience and perceive racialized discrimination, health-related stigma, and injustice surrounding their pain experience and these factors are associated with worse outcomes.
尽管种族化歧视、与健康相关的耻辱感以及与疼痛相关的不公正感已被认为与患者功能较差有关，但对于患有镰状细胞病（SCD）的黑人青年中这些因素之间的独特关系，我们却知之甚少。在本研究中，我们（1）调查了种族化歧视感、与健康相关的耻辱感以及与疼痛相关的不公正感评估的发生率，（2）研究了上述变量如何与患有SCD的黑人青年的功能（即功能残疾、抑郁和焦虑症状）存在独特关联。研究样本包括30名患有SCD的非西班牙裔黑人或非裔美国青年（17名男性，13名女性青年）。样本的平均年龄约为11.3岁（标准差=2.73）。采用零阶相关和层次回归来检验和比较感知到的种族化歧视、感知到的与健康相关的耻辱感、感知到的与疼痛相关的不公正感与结果变量（功能残疾、焦虑症状和抑郁症状）之间的多变量关系。对于功能残疾，感知到的种族化歧视和感知到的与疼痛相关的不公正感是最终模型中的显著预测因素（F(3,26) = 11.00，p <.01）。对于抑郁症状，与健康相关的耻辱感在最终模型中作为预测因素有接近显著的趋势（p =.09）（F(2,26) = 6.69，p <.01）。对于焦虑症状，感知到的与疼痛相关的不公正感是最终模型中唯一的显著预测因素（F(3,26) = 10.25，p <.001）。结果表明，患有SCD的青年经历并感知到种族化歧视、与健康相关的耻辱感以及围绕其疼痛经历的不公正感，并且这些因素与更差的结果相关。
