The experience of SARS-related stigma at Amoy Gardens.
The experience of SARS-related stigma at Amoy Gardens.
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DOI：
10.1016/j.socscimed.2005.04.010
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发表时间：
2005-11
期刊：
影响因子：
--
通讯作者：
Kleinman A
中科院分区：
文献类型：
--
作者：
Lee S;Chan LY;Chau AM;Kwok KP;Kleinman A
严重急性呼吸系统综合症（SARS）具有使其特别容易受到污名化的特点。sars相关的病耻感，尽管在公共卫生和病耻感研究中很突出，但很少有研究。本研究采用问卷调查与个案研究相结合的方法，探讨淘大花园居民的主观污名。淘大花园是香港首个官方认可的SARS社区爆发地点。在为期3个月的疫情结束时，共有903名AG居民完成了来自两个焦点小组的自我报告问卷。对居住在AG SARS疫情中心E座的两名居民的案例研究补充了调查数据。研究结果表明，大多数居民受到耻辱的影响，在工作、人际关系、服务使用和学校教育等领域，耻辱以各种形式被回避、侮辱、边缘化和拒绝。病耻感也与心身痛苦有关。居民减少耻辱感的策略因性别、年龄、教育程度、职业以及与SARS感知风险因素的接近程度而异，如居住地、是否感染过SARS以及是否有曾感染过SARS的家庭成员。居民们把污名归咎于政府管理不善、神秘的SARS病毒的传染性和危言耸听的媒体报道。疫情爆发后，病耻感明显减少，但从未完全消失。这些发现证实并补充了关于病耻感的各种起源、相关关系和影响的现有知识。它们还强调了不一致的卫生政策反应的协同作用，以及媒体在迅速放大对一种不熟悉的疾病的污名化方面存在的沟通错误风险。虽然认识到控制非典型肺炎的公共卫生措施具有内在的污名化性质，但我们建议需要采取一致的跨部门办法，以尽量减少污名化，并对未来的疫情作出有效的卫生应对。
Severe Acute Respiratory Syndrome (SARS) possesses characteristics that render it particularly prone to stigmatization. SARS-related stigma, despite its salience for public health and stigma research, has had little examination. This study combines survey and case study methods to examine subjective stigma among residents of Amoy Gardens (AG), the first officially recognized site of community outbreak of SARS in Hong Kong. A total of 903 residents of AG completed a self-report questionnaire derived from two focus groups conducted toward the end of the 3-month outbreak. Case studies of two residents who lived in Block E, the heart of the SARS epidemic at AG, complement the survey data. Findings show that stigma affected most residents and took various forms of being shunned, insulted, marginalized, and rejected in the domains of work, interpersonal relationships, use of services and schooling. Stigma was also associated with psychosomatic distress. Residents’ strategies for diminishing stigma varied with gender, age, education, occupation, and proximity to perceived risk factors for SARS such as residential location, previous SARS infection and the presence of ex-SARS household members. Residents attributed stigma to government mismanagement, contagiousness of the mysterious SARS virus, and alarmist media reporting. Stigma clearly decreased, but never completely disappeared, after the outbreak. The findings confirm and add to existing knowledge on the varied origins, correlates, and impacts of stigma. They also highlight the synergistic roles of inconsistent health policy responses and risk miscommunication by the media in rapidly amplifying stigma toward an unfamiliar illness. While recognizing the intrinsically stigmatizing nature of public health measures to control SARS, we recommend that a consistent inter-sectoral approach is needed to minimize stigma and to make an effective health response to future outbreaks.
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