Poverty, Substance Use, and Stigma in Four Organizations

四个组织中的贫困、药物滥用和耻辱

• 批准号: 6681800
• 负责人: Daniel P. Dohan
• 金额: $ 15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-15 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6681800
• 关键词: attitude; behavior test; behavioral /social science research tag; belief; clinical research; ethnic group; experience; health care policy; health care quality; health care service evaluation; health care service organization; health services research tag; human subject; interview; low socioeconomic status; medically underserved population; outcomes research; patient care personnel relations; psychosocial separation; socioeconomics; substance abuse related disorder

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)：贫困或与酒精或药物使用有关的问题的个人在寻求医疗保健时可能会遭遇负面的社会耻辱。与贫困或药物使用问题有关的耻辱可能会给受影响的个人带来负面后果，包括延误或避免必要的医疗护理，加剧可治疗的疾病，增加疼痛和痛苦，以及更高的医疗费用。更好地了解医疗保健组织如何产生和/或改善与贫困和药物使用问题相关的污名，可能会导致采取积极的干预措施，减少对这些弱势群体的污名。 这个探索性和发展性项目的目标是检查不同的医疗组织如何形成贫穷或有药物使用问题的患者的污名经历。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如何受到医疗保健组织中的污名过程的影响。这项研究通过确定影响污名化的医疗保健组织的特征，提出了指导未来研究的理论命题。 具体目标是：1)使用四个医疗保健组织的人种学研究来描述护理人员的行为如何产生和/或改善与贫困和药物使用问题有关的污名；2)使用对患者的采访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药物使用问题有关的污名的战略；以及3)确定在产生和/或改善与贫困和药物使用问题有关的污名方面突出的医疗组织的特征。