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探索帕金森病患者所经历的耻辱感:一项系统综述。

Exploring the stigma experienced by people affected by Parkinson's disease: a systematic review.

作者信息

Crooks Sophie, Mitchell Gary, Wynne Lisa, Carter Gillian

机构信息

School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.

Parkinson's Ireland, Dublin, Ireland.

出版信息

BMC Public Health. 2025 Jan 3;25(1):25. doi: 10.1186/s12889-024-21236-8.

Abstract

BACKGROUND

Stigma significantly impacts individuals with Parkinson's disease (PD) and their caregivers, exacerbating social isolation, psychological distress, and reducing quality of life (QoL). Although considerable research has been conducted on PD's clinical aspects, the social and emotional challenges, like stigma, remain underexplored. Addressing stigma is crucial for enhancing well-being, fostering inclusivity and improving access to care and support. The review aims to fill this knowledge gap by synthesising existing literature on PD stigma, examining its effects on individuals and families affected, and identifying areas where interventions could reduce stigma's impact.

METHODS

This systematic review was conducted following Joanna Briggs Institute guidance. Studies were identified through searches in six databases, relevant websites, and reference lists. Covidence was used for duplicate removal, screening, and data extraction. Thematic analysis identified key themes from qualitative data, while narrative synthesis integrated findings from qualitative and quantitative studies. The review protocol was registered on PROSPERO (CRD42023399343).

RESULTS

This review included 22 studies published between 2002 and 2024, using both qualitative and quantitative methodologies. Five key themes emerged. The first highlighted stereotypes in PD, such as misconceptions about symptoms, age stereotyping, and supernatural beliefs. The second explored drivers and facilitators of stigma, identifying factors like duration since diagnosis, disease severity, lack of public education, and media representation. The third theme revealed stigma's impact on mental health and well-being, exacerbating feelings of shame, embarrassment, and social isolation. The fourth, responses and consequences of stigma, detailed strategies employed by individuals with PD to manage stigma, including seeking social support and adopting coping mechanisms. The fifth theme, beyond stigma, explored positive aspects of living with PD, highlighting resilience, positive interactions, and advocacy efforts.

CONCLUSION

This systematic review underscores the significant impact of stigma on individuals with PD and their caregivers, manifesting as social isolation, diminished QoL, and psychological distress. Key drivers include public misconceptions, cultural biases, and limited awareness and addressing these challenges requires targeted interventions. Recommendations include education to dispel myths, public awareness campaigns and advocacy efforts to reduce stigma, enhance support, and improve QoL.

摘要

背景

污名化对帕金森病(PD)患者及其照料者产生重大影响,加剧了社会隔离、心理困扰,并降低了生活质量(QoL)。尽管针对PD的临床方面已开展了大量研究,但诸如污名化等社会和情感挑战仍未得到充分探索。应对污名化对于增进福祉、促进包容性以及改善获得护理和支持的机会至关重要。本综述旨在通过综合现有关于PD污名化的文献、研究其对受影响的个人和家庭的影响以及确定干预措施可减少污名化影响的领域来填补这一知识空白。

方法

本系统综述遵循乔安娜·布里格斯研究所的指南进行。通过在六个数据库、相关网站和参考文献列表中进行检索来识别研究。使用Covidence进行重复文献去除、筛选和数据提取。主题分析从定性数据中确定关键主题,而叙述性综合则整合了定性和定量研究的结果。该综述方案已在PROSPERO(CRD42023399343)上注册。

结果

本综述纳入了2002年至2024年间发表的22项研究,采用了定性和定量方法。出现了五个关键主题。第一个主题强调了PD中的刻板印象,例如对症状的误解、年龄刻板印象和超自然信仰。第二个主题探讨了污名化的驱动因素和促进因素,确定了诸如诊断后的时长、疾病严重程度、缺乏公众教育和媒体报道等因素。第三个主题揭示了污名化对心理健康和福祉的影响,加剧了羞耻感、尴尬感和社会隔离感。第四个主题,污名化的应对措施和后果,详细阐述了PD患者用于应对污名化的策略,包括寻求社会支持和采用应对机制。第五个主题,超越污名化,探讨了与PD共存的积极方面,强调了恢复力、积极互动和宣传努力。

结论

本系统综述强调了污名化对PD患者及其照料者的重大影响,表现为社会隔离、生活质量下降和心理困扰。关键驱动因素包括公众误解、文化偏见以及认识有限,应对这些挑战需要有针对性的干预措施。建议包括开展教育以消除误解、开展公众意识运动和宣传努力以减少污名化、加强支持并改善生活质量。

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