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Poverty, Substance Use, and Stigma in Four Organizations

四个组织中的贫困、药物滥用和耻辱

基本信息

批准号：
6941393
负责人：
Daniel P. Dohan
金额：
$ 15.15万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-15 至 2007-08-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Individuals who are poor or who suffer from problems related to alcohol or drug use can encounter negative social stigma when seeking medical care. Stigma related to poverty or substance use problems may result in negative consequences for affected individuals including delay or avoidance of needed medical care, exacerbation of treatable conditions, increased pain and suffering, and higher healthcare costs. A better understanding how healthcare organizations generate and/or ameliorate stigma associated with poverty and substance use problems may lead to positive interventions to reduce stigmatization of these vulnerable populations. The objective of this exploratory and developmental project is to examine how different healthcare organizations shape the stigma experiences of patients who are poor or have substance use problems. Qualitative research methods will be used to document how patients manage stigma and examine how these management strategies are affected by stigma processes in healthcare organizations. This study develops theoretical propositions to guide future research by identifying characteristics of healthcare organizations that affect stigmatization. The specific aims are: 1) to use ethnographic research in four healthcare organizations to describe how the behaviors of care-providers generate and/or ameliorate stigma related to poverty and substance use problems, 2) to use interviews with patients to describe how their interactions at each study clinic affect their strategies for managing stigma related to poverty and substance use problems, and 3) to identify the characteristics of healthcare organizations that are salient in the generation and/or amelioration of stigma related to poverty and substance use problems.

描述（由申请人提供）：贫困或患有与酒精或药物使用相关问题的个人在寻求医疗护理时可能会遇到负面的社会耻辱。与贫困或药物使用问题相关的污名可能会对受影响的个人造成负面影响，包括延迟或避免所需的医疗护理，加剧可治疗的疾病，增加疼痛和痛苦，以及更高的医疗费用。更好地了解医疗机构如何产生和/或改善与贫困和药物使用问题相关的污名化，可能会导致积极的干预措施，以减少这些弱势群体的污名化。这个探索性和发展性项目的目的是研究不同的医疗机构如何塑造贫困或有物质使用问题的患者的耻辱体验。定性研究方法将被用来记录患者如何管理污名，并检查这些管理策略是如何影响污名过程中的医疗机构。本研究通过识别影响污名化的医疗机构特征，提出了指导未来研究的理论主张。具体目标是：1）在四个医疗机构中使用人种志研究来描述护理提供者的行为如何产生和/或改善与贫困和物质使用问题相关的污名，2）使用与患者的访谈来描述他们在每个研究诊所的互动如何影响他们管理与贫困和物质使用问题相关的污名的策略，以及3）确定医疗机构的特征，这些特征在产生和/或改善与贫困和药物使用问题相关的污名方面是突出的。