Culture, Gender, and Health Care Stigma in Parkinsonism

帕金森病中的文化、性别和医疗保健耻辱

• 批准号: 6684018
• 负责人: LINDA S TICKLE-DEGNEN
• 金额: $ 19.18万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 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 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6684018
• 关键词: Parkinson's disease; Taiwan; behavior test; behavioral /social science research tag; body movement; clinical research; culture; diagnosis quality /standard; face expression; gender difference; health care quality; health care service evaluation; health services research tag; human subject; impression; interview; neuropsychology; outcomes research; patient care personnel relations; patient care planning; perception; perceptual maskings; prejudice; psychosocial separation; social psychology; videotape /videodisc

DESCRIPTION (provided by applicant): The overall goal of the proposed research is to understand the stigmatizing role of the movement disorder of Parkinson's disease (PD) in health care practitioners' assessment of patient psychological traits, in the patient-practitioner relationship, and in the development of intervention recommendations. The first specific aim of the research is to elucidate the consequences of the operation of movement stereotypes on practitioner impressions of and conclusions about patients with PD. The second specific aim is to document the interaction of expressive masking (the diminishment of normal movement) with gender and culture on stigma outcomes. The third specific aim is to determine the degree to which practitioner expertise moderates the stigmatizing role of expressive masking on practitioner perceptions of and conclusions about patients. The fourth specific aim is to evaluate the clinical utility of the findings from the perspective of expert practitioners. Twelve Taiwanese patients (6 females and 6 males) and 12 American patients (6 females and 6 males) will be videotaped during a standardized health care interview in their respective homelands. Within each group of 6 patients (gender crossed with culture), there will be 3 patients with high expressive masking and 3 patients with normal expressive movement. Excerpts from the resulting 24 tapes will be shown to expert and novice health care practitioners in Taiwan and the U.S. who will assess patients' social and mental competence and potential for entering into a successful therapeutic relationship. In addition, the practitioners will make quality-of-life intervention recommendations. The results of the study will be presented to expert practitioners, in focus groups, who will evaluate the clinical utility of the findings and make recommendations for interventions to reduce practitioners' stigma responses. It is anticipated that PD with expressive masking will be more stigmatizing than PD without masking, especially as demonstrated in outcomes for novice compared to expert practitioners. It is also anticipated that negative outcomes of masking will be greater for female than male and American than Taiwanese patients because of different norms associated with movement expression in these groups.

描述（由申请人提供）：拟议研究的总体目标是了解帕金森病（PD）的运动障碍在卫生保健从业人员对患者心理特征的评估、医患关系以及干预建议的制定中的污名化作用。本研究的第一个具体目的是阐明运动刻板印象的操作对从业人员对PD患者的印象和结论的影响。第二个具体目标是记录表达性掩蔽（正常运动的减少）与性别和文化对耻辱结果的相互作用。第三个具体目标是确定在何种程度上，从业人员的专业知识缓和的表达掩蔽对从业人员的看法和结论对病人的污名化作用。第四个具体目标是从专家从业者的角度评估研究结果的临床效用。12名台湾患者（6女6男）和12名美国患者（6女6男）将在各自的家乡进行标准化的医疗保健访谈。每组6例患者（性别交叉培养）中有3例高表达掩蔽患者和3例正常表达运动患者。这24盘磁带的节选将播放给台湾和美国的专家和新手医疗保健从业人员，他们将评估患者的社会和心理能力以及进入成功治疗关系的潜力。此外，从业者将提出生活质量干预建议。研究结果将在焦点小组中提交给专家从业人员，他们将评估研究结果的临床效用，并提出干预措施建议，以减少从业人员的耻辱反应。预计具有表达性掩蔽的PD将比没有掩蔽的PD更容易被污名化，特别是在新手与专业从业者的结果对比中。我们也预期女性患者的负面结果会比男性更大，美国患者比台湾患者更大，因为这些群体中与运动表达相关的规范不同。