"They treated me like a leper" - Stigmatization and the quality of life of patients with hepatitis C
"They treated me like a leper" - Stigmatization and the quality of life of patients with hepatitis C
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DOI：
10.1046/j.1525-1497.2003.20826.x
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发表时间：
2003-10-01
影响因子：
5.7
通讯作者：
LaBrecque, DR
中科院分区：
文献类型：
--
作者：
Zickmund, S;Ho, EY;LaBrecque, DR
目的：丙型肝炎病毒是美国最流行的慢性血液传播感染，通常通过受污染的血液制品或共用针头获得。我们假设，慢性丙型肝炎感染的患者经历的耻辱独立的收购模式，它会对生活质量产生负面影响。设计：横断面观察study.SETTING：专科门诊在三级转诊hospital.PAITIES：290例门诊诊断为慢性丙型肝炎感染，并在肝病门诊。30名参与者被排除在外，因为缺失data.MEASUREMENTS和主要结果：患者被要求完成人口统计学资料，半结构化的采访，疾病的影响配置文件，和医院焦虑抑郁量表。一个由两名盲态编码员组成的团队分析了这些采访。在257名研究患者中，共有147名患者经历了他们归因于这种疾病的耻辱。女性比男性更容易报告感知到的污名化（P < .05）。年龄、教育、职业地位和感染方式并不影响污名化的可能性。污名化与较高的焦虑（P < .01）和抑郁（P < .01）、生活质量恶化（P < .01）、失控（P < .01）和应对困难（P < .01）相关。经历过污名化的个体也提到了他们的医疗保健（P < .01）和工作环境（P < .01）以及家庭成员（P < .01）的问题。结论：污名化是丙型肝炎患者非常常见的情感负担，这会侵蚀社会支持。由于它甚至渗透到卫生保健环境中，医生和其他保健提供者应该意识到这种负面陈规定型观念的存在和影响。
OBJECTIVE: Hepatitis C virus is the most prevalent chronic blood-borne infection in the United States, typically acquired through contaminated blood products or needle sharing. We hypothesized that patients with chronic hepatitis C infection experience stigmatization independent of mode of acquisition and that it negatively affects quality of life.DESIGN: Cross-sectional observation study.SETTING: Specialty clinic in a tertiary referral hospital.PATIENTS: Two hundred and ninety outpatients diagnosed with chronic hepatitis C infection and seen in a hepatology clinic. Thirty participants were excluded because of missing data.MEASUREMENTS AND MAIN RESULTS: Patients were asked to complete a demographic profile, a semistructured interview, the Sickness Impact Profile, and the Hospital Anxiety Depression Scale. A team of two blinded coders analyzed the interviews. A total of 147 of the 257 study patients experienced stigmatization that they attributed to the disease. Women were more likely to report perceived stigmatization than men (P < .05). Age, education, professional status, and mode of infection did not influence the likelihood of stigmatization. Stigmatization was associated with higher anxiety (P < .01) and depression (P < .01), worsened quality of life (P < .01), loss of control (P < .01), and difficulty coping (P < .01). Individuals who experienced stigmatization also mentioned problems in their health care (P < .01) and work environment (P < .01) as well as with family members (P < .01).CONCLUSION: Stigmatization is a very common emotionally burdensome experience for patients with hepatitis C, which can erode social support. As it penetrates even into the health care environment, physicians and other care providers should be aware of the existence and impact of such negative stereotyping.