Barbek Rieke, Makowski Anna Christin, von dem Knesebeck Olaf
Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Sociol. 2025 Feb 5;10:1528312. doi: 10.3389/fsoc.2025.1528312. eCollection 2025.
Fatigue is a frequent somatic symptom impacting health and well-being and lately receiving increased attention as a long-term consequence of COVID-19. Emerging evidence suggests that persons afflicted with fatigue symptoms are often stigmatized and discriminated because their symptoms are still poorly understood and not recognizable to others. Existing stigma research mainly focused on specific medical conditions and domains and overlooked intersectional discrimination - the negative amplification effect of intersecting social identities. The purpose of the current study is to examine perceived discrimination in fatigue across different medical conditions and domains, also considering intersectional discrimination.
Semi-structured telephone interviews were carried out with 19 patients with clinically significant fatigue, considering a variety of different social identities like gender, history of migration, and occupational status. The interviews were analyzed using a structured qualitative content approach with consensual coding.
The findings on perceived discrimination could be subsumed in eight practices: (nonverbal) communication, negative emotional reaction, medical treatment, leadership responsibility, structural barriers, diagnostic terminology, and scientific controversy. Participants reported overlapping experiences of perceived discrimination across several intertwined domains: medical setting, work, social, public, and at an overarching structural level. Thereby, especially discrimination in the medical setting and on structural level occurred with great impact on health care and social protection. By applying an intersectional approach, intersectional discrimination specific for certain stigmatized social identities, like female gender and low occupational status became apparent.
These findings need to be further researched and addressed in intervention strategies increasing resilience and public knowledge to reduce intersectional discrimination and health inequalities.
疲劳是一种常见的躯体症状，会影响健康和幸福感，最近作为新冠病毒病的长期后果受到了越来越多的关注。新出现的证据表明，有疲劳症状的人常常受到污名化和歧视，因为他们的症状仍未得到充分理解，其他人也无法识别。现有的污名研究主要集中在特定的医疗状况和领域，忽视了交叉歧视——即交叉社会身份的负面放大效应。本研究的目的是考察不同医疗状况和领域中对疲劳的感知歧视，同时考虑交叉歧视。
对19名有临床显著疲劳症状的患者进行了半结构化电话访谈，考虑了各种不同的社会身份，如性别、移民史和职业状况。访谈采用结构化定性内容分析法和共识编码进行分析。
关于感知歧视的发现可归纳为八种行为：（非语言）沟通、负面情绪反应、医疗治疗、领导责任、结构障碍、诊断术语和科学争议。参与者报告了在几个相互交织的领域中存在重叠的感知歧视经历：医疗环境、工作、社会、公众以及总体结构层面。因此，尤其是医疗环境和结构层面的歧视对医疗保健和社会保护产生了重大影响。通过采用交叉性方法，针对某些受污名化社会身份（如女性性别和低职业地位）的交叉歧视变得明显。
这些发现需要在干预策略中进一步研究和解决，以增强复原力和公众知识，减少交叉歧视和健康不平等。
