Social distancing, community stigma, and implications for psychological distress in the aftermath of Ebola virus disease.
Social distancing, community stigma, and implications for psychological distress in the aftermath of Ebola virus disease.
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DOI：
10.1371/journal.pone.0276790
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
2013-2016年埃博拉病毒病（EVD）疫情导致的感染和死亡人数超过了该病毒40年历史上所有疫情的总和。这项研究探讨了EVD感染的经历以及社交距离等预防措施如何与重新融入社区的人的耻辱和社会排斥经历联系起来。在EVD高发区进行了关键线人访谈（n = 42）和焦点小组讨论（n = 27），并代表地理和种族多样性（n = 228名参与者）。最终样本由成人（52%）和儿童（48%）组成，他们是EVD感染者（46%）和受影响者（42%）以及社区领导人（12%）。数据使用主题内容分析告知的扎根理论方法进行编码，并使用NVivo进行分析。评价者间可靠性较高，Cohen的κ = 0.80或更高。与会者描述了EVD相关压力的两个主要来源：由于社交距离和隔离等其他预防措施而与社区隔离，以及与感染或受影响状态相关的耻辱。与会者将社会孤立和污名化的经历与严重的痛苦和被排斥的感觉联系起来。这些经历在儿童中尤为明显。支助来源包括随着时间的推移重新融入社区，以及正式的社区努力提供教育和制定保护细则。这项研究发现，社交距离和EVD相关的耻辱是参与者痛苦的主要来源。这些结果表明，由于感染而被隔离，以及感染者及其家人的持久耻辱，需要协调一致的反应，以防止和减轻额外的心理伤害。这种应对措施应包括与社区领导人密切接触，以消除错误信息，促进重返社区。
The 2013–2016 Ebola virus disease (EVD) epidemic resulted in more infections and deaths than all prior outbreaks in the 40-year history of this virus combined. This study examines how experiences of EVD infection, and preventive measures such as social distancing, were linked to experiences of stigma and social exclusion among those reintegrating into their communities. Key informant interviews (n = 42) and focus group discussions (n = 27) were conducted in districts with a high prevalence of EVD and representing geographical and ethnic diversity (n = 228 participants). The final sample was composed of adults (52%) and children (48%) who were EVD-infected (46%) and -affected (42%) individuals, and community leaders (12%). Data were coded using a Grounded Theory approach informed by Thematic Content Analysis, and analyzed using NVivo. Interrater reliability was high, with Cohen’s κ = 0.80 or higher. Participants described two main sources of EVD-related stress: isolation from the community because of social distancing and other prevention measures such as quarantine, and stigma related to infected or affected status. Participants linked experiences of social isolation and stigma to significant distress and feelings of ostracization. These experiences were particularly pronounced among children. Sources of support included community reintegration over time, and formal community efforts to provide education and establish protection bylaws. This study found that social distancing and EVD-related stigma were each prominent sources of distress among participants. These results suggest that isolation because of infection, and the enduring stigmatization of infected individuals and their families, demand coordinated responses to prevent and mitigate additional psychosocial harm. Such responses should include close engagement with community leaders to combat misinformation and promote community reintegration.
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