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2.
J Eur Acad Dermatol Venereol ; 33(11): 2029-2038, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31177601

RESUMO

Many patients with a visible chronic skin disease experience discrimination and stigmatization. This results in psychosocial impairments in addition to the burden of disease and emphasizes the urgency to implement effective stigma-reduction strategies. To synthesize what is known globally about effective interventions to reduce stigma associated with visible chronic skin diseases, a systematic review was conducted. Four electronic databases were searched until May 2018. Studies evaluating interventions to reduce stigmatization in patients with visible chronic skin diseases and applying at least one stigma-related outcome measure were included. Data were extracted on study design, country, study population, outcome measures and main findings. Results were subsequently synthesized in a narrative review. Critical Appraisal Skills Programme tools were used to assess study quality. Nineteen studies were included in the review. Study design was very heterogeneous and study quality rather poor. Thirteen studies addresses patients with leprosy in low- and middle-income countries, and one study each targeted patients with onychomycosis, leg ulcer, facial disfigurement, atopic dermatitis, vitiligo and alopecia. Evaluated interventions were mainly multi-faceted incorporating more than one type of intervention. While 10 studies focused on the reduction in self-stigma and 4 on the reduction in public stigma, another 5 studies aimed at reducing both. The present review revealed a lack of high-quality studies on effective approaches to reduce stigmatization of patients with visible chronic skin diseases. Development and evaluation of intervention formats to adequately address stigma is essential to promote patients' health and well-being.


Assuntos
Dermatopatias , Estereotipagem , Doença Crônica , Humanos , Dermatopatias/patologia
3.
Clin Dermatol ; 37(3): 175-181, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31178100

RESUMO

Mal de Meleda is an hereditary palmoplantar keratoderma named for the Mljet Island in Croatia. The lives of those affected by this disease represent a complex situation that encompasses members of a vulnerable group. They require enlightenment and should be approached with awareness, taking into account their overall psychophysical status and the environment of each patient. Those afflicted with Mal de Meleda not only have to deal with a difficult life due to their affliction, but they also must cope with the hardships of socialization while trying to realize a normal life within their island community. This is compounded by the frequent interviews and examinations of researchers interested in the various aspects of their illness. The subject of this contribution is not about the nature of this disease, rather about the traces it has left on the (sub)consciousness of the population. It is also concerned with exploring ways of how to access patients and understanding the depth of their vulnerability. We present some thoughts tied to the interpersonal experiences of researchers and patients afflicted with Mal de Meleda.


Assuntos
Ceratodermia Palmar e Plantar , Estereotipagem , Conscientização , Croácia , Ética , História do Século XVIII , História do Século XIX , História do Século XX , História Medieval , Humanos , Ceratodermia Palmar e Plantar/genética , Ceratodermia Palmar e Plantar/história , Ceratodermia Palmar e Plantar/patologia , Ceratodermia Palmar e Plantar/psicologia , Hanseníase , Distância Psicológica , Qualidade de Vida , Isolamento Social , Rede Social , Percepção Social , Populações Vulneráveis
4.
Int J Psychiatry Med ; 53(4): 317-338, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29807502

RESUMO

Objective To examine stigmatizing attitudes towards people with mental disorders among primary care professionals and to identify potential factors related to stigmatizing attitudes through a systematic review. Methods A systematic literature search was conducted in Medline, Lilacs, IBECS, Index Psicologia, CUMED, MedCarib, Sec. Est. Saúde SP, WHOLIS, Hanseníase, LIS-Localizador de Informação em Saúde, PAHO, CVSO-Regional, and Latindex, through the Virtual Health Library portal ( http://www.bireme.br website) through to June 2017. The articles included in the review were summarized through a narrative synthesis. Results After applying eligibility criteria, 11 articles, out of 19.109 references identified, were included in the review. Primary care physicians do present stigmatizing attitudes towards patients with mental disorders and show more negative attitudes towards patients with schizophrenia than towards those with depression. Older and more experience doctors have more stigmatizing attitudes towards people with mental illness compared with younger and less-experienced doctors. Health-care providers who endorse more stigmatizing attitudes towards mental illness were likely to be more pessimistic about the patient's adherence to treatment. Conclusions Stigmatizing attitudes towards people with mental disorders are common among physicians in primary care settings, particularly among older and more experienced doctors. Stigmatizing attitudes can act as an important barrier for patients to receive the treatment they need. The primary care physicians feel they need better preparation, training, and information to deal with and to treat mental illness, such as a user friendly and pragmatic classification system that addresses the high prevalence of mental disorders in primary care and community settings.


Assuntos
Transtornos Mentais/psicologia , Médicos de Atenção Primária , Atenção Primária à Saúde , Estigma Social , Atitude do Pessoal de Saúde , Humanos , Determinação de Necessidades de Cuidados de Saúde , Médicos de Atenção Primária/ética , Médicos de Atenção Primária/psicologia , Médicos de Atenção Primária/normas , Atenção Primária à Saúde/ética , Atenção Primária à Saúde/normas , Estereotipagem
5.
Indian J Tuberc ; 64(4): 323-326, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28941857

RESUMO

BACKGROUND: For decades, tuberculosis and other communicable diseases like human immunodeficiency virus/acquired immune deficiency syndrome, leprosy, etc., have been associated with stigma and discrimination by the society; this can interfere with the lifestyle and disease management among these patients. OBJECTIVE: To assess the stigma experienced by tuberculosis patients and to find the factors associated with stigma. METHODS: A cross-sectional study was conducted among 209 sputum-positive and sputum-negative tuberculosis patients. Convenient sampling was used to identify the patients. A predesigned, pretested proforma from Explanatory Model Interview Catalogue developed by World Health Organization was used for data collection. RESULTS: The study revealed that out of 209 respondents, 51.2% of the respondents experienced some form of stigma. Majority of the patients have received only primary education and 71.3% of the respondents were males. Most of the patients were under category 1 of Directly Observed Treatment Short course. Age, education, and smear status of the patient were found to be associated with stigmatization (P<0.05), whereas factors like gender, income, occupation, family history, and marital status were found to be not significantly associated with stigmatization. CONCLUSION: Effective counseling measures are recommended for tuberculosis patients with advancing age and education which can help reduce stigmatization and thereby improve quality of life.


Assuntos
Estigma Social , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/psicologia , Adulto , Fatores Etários , Antituberculosos/uso terapêutico , Estudos Transversais , Terapia Diretamente Observada , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Participação Social , Escarro/microbiologia , Estereotipagem
6.
Clin Dermatol ; 34(1): 8-10, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26773617

RESUMO

One of the most important dermatologic diseases from the sociologic viewpoint has been leprosy. Those with leprosy were isolated, excluded from society, and stigmatized. Such a stigma indicates the strong feeling that a leprosy patient is shameful and should not be accepted by society. During the first millennium, leprosy was rapidly inscribed in the system of religious prohibitions-the disease was a punishment by God for wrongdoing, and the disease was associated with the lower spheres of the society. Social perception of leprosy gradually changed during the time of Crusades. The care for lepers became a Christian obligation, and celebrating Holy Masses as for the dead was forsaken. The sick were forced to stay at leprosaria, particularly from the 14th through the 19th centuries when fear of leprosy was at a high point. Admission to a leprosarium was mandatory not only for patients with leprosy but also even those suspected of having the disease.


Assuntos
Hanseníase , Estigma Social , Estereotipagem , História do Século XX , História Antiga , História Medieval , Humanos
7.
In. Grzybowski, Andrzej; Virmond, Marcos da Cunha Lopes. Clinics in Dermatology: Leprosy: 2. New York, Elsevier, 2016. p.8-10.
Não convencional em Inglês | SES-SP, HANSEN, SESSP-ILSLACERVO, SES-SP | ID: biblio-1096544

RESUMO

One of the most important dermatologic diseases from the sociologic viewpoint has been leprosy. Those with leprosy were isolated, excluded from society, and stigmatized. Such a stigma indicates the strong feeling that a leprosy patient is shameful and should not be accepted by society. During the first millennium, leprosy was rapidly inscribed in the system of religious prohibitions­the disease was a punishment by God for wrongdoing, and the disease was associated with the lower spheres of the society. Social perception of leprosy gradually changed during the time of Crusades. The care for lepers became a Christian obligation, and celebrating Holy Masses as for the dead was forsaken. The sick were forced to stay at leprosaria, particularly from the 14th through the 19th centuries when fear of leprosy was at a high point. Admission to a leprosarium was mandatory not only for patients with leprosy but also even those suspected of having the disease.


Assuntos
Humanos , História Antiga , História Medieval , História do Século XX , Estigma Social , Hanseníase/história , Estereotipagem
8.
Rev. salud bosque ; 5(1): 67-80, 2015.
Artigo em Espanhol | LILACS | ID: lil-772925

RESUMO

Este artículo analiza la historia de la lepra o enfermedad de Hansen como un concepto reelaborado a lo largo de la historia por los discursos científicos, políticos, religiosos y por los saberes populares, puesto en relación al problema de la estigmatización. Buscamos realizar un análisis desde la teoría del estigma como un proceso social, que produce el aislamiento, la exclusión, discriminación y rechazo al enfermo y su familia, deteriorando la identidad de los mismos. Encontramos y analizamos cómo se produce en la interacción social la estigmatización, y a su vez, cómo los enfermos reelaboran su identidad, generando una serie de estrategias de afrontamiento y ocultamiento del estigma, estrategias de resistencia con las que reconstruyen su tejido social. Las categorías de análisis de la información fueron percepciones y creencias sobre la enfermedad, relaciones sociales y familiares, construcción de la imagen del enfermo y las metáforas de la enfermedad, actos de discriminación y rechazo, y actos de ocultamiento y afrontamiento del estigma. En este trabajo de carácter cualitativo, analítico y diacrónico, se utilizaron metodologías de investigación cualitativa, consistentes en entrevistas, observación etnográfica, trabajos de memoria y cartografía social, y revisión y análisis de fuentes primarias y secundarias, recolectando información de Colombia, específicamente los municipios de Agua de Dios, Cundinamarca y Contratación, Santander, considerando como marco temporal los siglos XX y XXI.


This article analyzes the history of leprosy or hansens disease as a concept that has been re elaborated throughout history by popular opinion and political, religious and scientific influence, all in relation with the problem of stigmatizing. Here we seek to make an analysis of the theory of stigma as social process that produces isolation, exclusion, discrimination and rejection of the sick and his family, reducing their own identity. We find and analyze how social interaction in stigmatization works, and how those with the disease recreate their identity, generating a series of coping strategies, ways of hiding the cause of stigma, and resilience strategy with which they rebuild their social network. The information was analyzed through the categories of perceptions and believes of the disease, social and family relations, self image construction of the sick and the metaphors of the disease, acts of discrimination and rejection, acts of hiding and confronting the stigma. In this work of analytic, qualitative and diachronic characteristics, we used qualitative investigation methodologies, consisting in interviews, ethnographic observation, social cartography and memory exercises, and reviews and analysis of primary and secondary sources. Information was collected from Colombia, specifically the towns of Agua de Dios, Cundinamarca and Contratacion, Santander, taking into account the XX and XXI century as the time frame.


Assuntos
Humanos , Doenças Transmissíveis/psicologia , Hospitais de Dermatologia Sanitária de Patologia Tropical , Hanseníase/psicologia , Discriminação Social , Estigma Social , Colômbia , Relações Interpessoais , Inquéritos e Questionários/normas , Estereotipagem
9.
Physis (Rio J.) ; 24(1): 89-104, Jan-Mar/2014.
Artigo em Português | LILACS | ID: lil-709881

RESUMO

Os comprometimentos físicos ocasionados pela hanseníase são pactuados nas ações do Plano Nacional de Controle da Hanseníase e são considerados um grave problema de saúde pública. Como forma de prevenir o avanço de incapacidades, o Ministério da Saúde propõe ações educativas em autocuidado. No entanto, apesar da enfática importância da realização do autocuidado, observa-se a não aderência dos pacientes ao programa, que pode ser justificada, dentre outros motivos, pela desestruturação de sua imagem corporal e pelo estigma advindo das representações sociais do corpo "leproso". Sendo assim, acredita-se na importância de ampliar o discurso tecnicista nas ações educativas em autocuidado, considerando a imagem corporal como aspecto importante nas estratégias de tratamento da doença. Objetiva-se conhecer a imagem corporal de pessoas que tiveram hanseníase e que desenvolveram incapacidades físicas. Para tanto, aplicou-se o teste psicológico Desenho da Figura Humana (DFH), com ênfase na análise interpretativa das mãos e dos pés, locais mais afetados pela hanseníase, em cinco mulheres cadastradas e em acompanhamento no Programa de Autocuidado em Hanseníase de um Ambulatório Regional de Especialidades de um município do Vale do Paraíba Paulista. O teste foi realizado no período de março a dezembro de 2009. Os resultados revelaram a não inclusão ou a desfiguração de mãos e pés. Existe uma falta de integração dessas regiões à consciência, acarretando desestruturação da imagem corporal, que pode decorrer tanto da perda de sensibilidade cutânea como da deformidade advindas da doença. Infere-se que essa desestruturação da imagem corporal dificulta a aderência ao autocuidado e a sociabilização dessas pessoas, aumentando o estigma da hanseníase...


Physical impairment caused by leprosy are agreed in the National Plan for Leprosy Control and are considered a serious public health problem. In order to prevent the advance of disabilities, the Ministry of Health proposes educational actions in self-care. However, despite the emphatic importance of performing self-care, we observe non-adherence of patients to the program, which may be explained, among other reasons, by the destruction of their body image and the stigma arising from the social representations of the "leprous" body. Thus, we believe in the importance of increasing the technicist discourse in educational actions in self-care, considering body image as an important aspect in the treatment strategies of the disease. We aim to meet the body image of people who had leprosy and developed disabilities. For this, we applied the psychological test Human Figure Drawing (HFD), with emphasis on interpretive bnalysis of the hands and feet, the most affected by leprosy, in five women registered and monitored by the Self-Care Program in Leprosy, in a Regional Outpatient Clinic in the district of Vale do Paraíba Paulista. The test was conducted from March to December 2009. Results revealed the inclusion or disfigurement of hands and feet. There is a lack of integration between these regions and awareness, causing disruption of body image, which may result from both loss of cutaneous sensibility and the resulting deformity disease. It is inferred that this disruption of body image hinders adherence to self-care and socialization of these people, increasing the stigma of leprosy...


Assuntos
Humanos , Autocuidado/psicologia , Hanseníase/psicologia , Imagem Corporal/psicologia , Isolamento Social , Estereotipagem , Brasil/etnologia , Saúde Pública
10.
J Biosoc Sci ; 46(6): 717-32, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24524379

RESUMO

Summary This study examined the association of gender-based attitudes, HIV misconceptions and community feelings for marginalized groups with stigmatizing responses towards people with HIV/AIDS in Mumbai, India. Participants included 546 men and women sampled in hospital settings during 2007-2008. Structured measures were used to assess avoidance intentions and denial of rights of people with HIV/AIDS. Mean age of participants was 32 years; 42% had less than 10 years of education. Higher HIV transmission misconceptions (ß=0.47; p<0.001), more traditional gender attitudes (ß=0.11; p<0.01) and more negative feelings towards HIV-positive people (ß=0.23; p<0.001) were related to higher avoidance intentions. Endorsement of denial of rights was also significantly associated with higher transmission misconceptions (ß=0.20; p<0.001), more traditional gender attitudes (ß=0.33; p<0.001) and greater negative feelings towards HIV-positive people (ß=0.12; p<0.05), as well as with a lower education level (ß=-0.10; p<0.05). The feelings respondents had towards people with HIV/AIDS were more strongly correlated with their feelings towards those with other diseases (tuberculosis, leprosy) than with feelings they had towards those associated with 'immoral' behaviour (e.g. sex workers). Eliminating HIV transmission misconceptions and addressing traditional gender attitudes are critical for reducing HIV stigma in Indian society.


Assuntos
Atitude , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Marginalização Social , Estereotipagem , População Urbana , Adulto , Coleta de Dados , Emoções , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Índia , Masculino , Fatores Sexuais , Estigma Social
11.
Compr Psychiatry ; 55(1): 221-31, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24060237

RESUMO

The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item questionnaire measuring self-stigma among persons with psychiatric disorders. It was developed with substantial consumer input and has been widely used, but its psychometric qualities have not been comprehensively evaluated across multiple versions. Here we review the 55 known versions, and provide the 47 available versions, including: Arabic, Armenian, Bengali, Bulgarian, Chinese (Mainland, Taiwan, Hong Kong), Croatian, Dutch, English (USA, South Africa), Estonian, Farsi, Finnish, French, German, Greek, Hebrew, Hindi, Japanese, Khmer, Korean, Lithuanian, Lugandan, Maltese, Polish, Portuguese (Portugal, Brazil), Romanian, Russian, Samoan, Slovenian, Spanish (Spain), Swahili, Swedish, Tongan, Turkish, Urdu, and Yoruba, and qualitative English and Swahili versions, as well as versions for depression, schizophrenia, substance abuse, eating disorders, epilepsy, inflammatory bowel disease, leprosy, smoking, parents and caregivers of people with mental illness, and ethnicity. The various versions show reliability and validity across a wide range of languages, cultures, and writing systems. The most commonly reported findings of studies using the ISMI are that internalized stigma correlates with higher depression, lower self esteem, and higher symptom severity. Initial studies of ways to reduce internalized stigma are promising and warrant further investigation.


Assuntos
Cultura , Transtornos Mentais/psicologia , Autoimagem , Estigma Social , Estereotipagem , Comparação Transcultural , Humanos
12.
BMC Public Health ; 13: 298, 2013 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-23556435

RESUMO

BACKGROUND: Health-related stigma adds to the physical and economic burdens experienced by people suffering from neglected tropical diseases (NTDs). Previous research into the NTD podoconiosis showed significant stigma towards those with the disease, yet no formal instrument exists by which to assess stigma or interventions to reduce stigma. We aimed to develop, pilot and validate scales to measure the extent of stigma towards podoconiosis among patients and in podoconiosis-endemic communities. METHODS: Indicators of stigma were drawn from existing qualitative podoconiosis research and a literature review on measuring leprosy stigma. These were then formulated into items for questioning and evaluated through a Delphi process in which irrelevant items were discounted. The final items formed four scales measuring two distinct forms of stigma (felt stigma and enacted stigma) for those with podoconiosis and those without the disease. The scales were formatted as two questionnaires, one for podoconiosis patients and one for unaffected community members. 150 podoconiosis patients and 500 unaffected community members from Wolaita zone, Southern Ethiopia were selected through multistage random sampling to complete the questionnaires which were interview-administered. The scales were evaluated through reliability assessment, content and construct validity analysis of the items, factor analysis and internal consistency analysis. RESULTS: All scales had Cronbach's alpha over 0.7, indicating good consistency. The content and construct validity of the scales were satisfactory with modest correlation between items. There was significant correlation between the felt and enacted stigma scales among patients (Spearman's r = 0.892; p < 0.001) and within the community (Spearman's r = 0.794; p < 0.001). CONCLUSION: We report the development and testing of the first standardised measures of podoconiosis stigma. Although further research is needed to validate the scales in other contexts, we anticipate they will be useful in situational analysis and in designing, monitoring and evaluating interventions. The scales will enable an evidence-based approach to mitigating stigma which will enable implementation of more effective disease control and help break the cycle of poverty and NTDs.


Assuntos
Elefantíase/psicologia , Estereotipagem , Etiópia , Humanos , Projetos Piloto , Psicometria , Reprodutibilidade dos Testes
13.
J Soc Psychol ; 153(2): 212-28, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23484348

RESUMO

An evolutionary approach to stigmatization suggests that disease-avoidance processes contribute to some instances of social exclusion. Disease-avoidance processes are over-inclusive, targeting even non-threatening individuals who display cues of substandard health. We investigated whether such cues motivate avoidance of physical contact in particular. In Studies 1 and 2, targets with disease (e.g., leprosy) or atypical morphologies (e.g., amputated leg, obesity) were found to arouse differentially heightened discomfort with physical (versus nonphysical) contact, whereas a criminal target (stigmatized for disease-irrelevant reasons) was found to arouse elevated discomfort for both types of contact. Study 3 used a between-subjects design that eliminated the influence of extraneous factors. A diseased target was found to arouse differentially heightened discomfort with physical (versus nonphysical) contact, and to do so more strongly than any other type of target.


Assuntos
Atitude Frente a Saúde , Doenças Transmissíveis/psicologia , Sinais (Psicologia) , Distância Psicológica , Estereotipagem , Adulto , Análise de Variância , Comportamento de Escolha , Feminino , Humanos , Masculino , Preconceito/psicologia , Desejabilidade Social , Reino Unido , Adulto Jovem
14.
Pak J Biol Sci ; 16(18): 927-32, 2013 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-24502149

RESUMO

This study aims to explore the life experiences of Iranian leprosy patients in health, family and economic dimensions. Mycobacterium leprae is responsible for leprosy, a type of chronic inflammatory disease that existed from ancient times, still hearing the name of leprosy creates an awful imagination of cutting the organ, blindness and isolation and it has still remained as a serious social problem. The patients are confronted with particular problems physically and mentally. The phenomenological tradition was used to gain knowledge of the leprosy patients lived experiences. Data analysis method was based on Colaizzi's approach. This is a qualitative research using purposeful sampling, interviewing the leprosy patients referring to a contagious diseases department of the Health Network of Nourabad Lorestan City. Data were collected by interviews those were analyzed in Colaizzi's Methods to extract the conceptual codes. Some concepts obtained from the analysis of data in the study such as physical, psychological, social, family, economic experiences, cultural beliefs of society, the context for tendency toward defect and disability and social stigma. These findings suggest that health care professionals should pay attention not only to leprosy patients to reduce their physical and psychological but also to the community and public culture to reduce the leprosy patients suffering from social stigma. The results of the present study can help us in a better understanding of all aspects of patients' lived experiences.


Assuntos
Relações Familiares , Nível de Saúde , Hanseníase/psicologia , Acontecimentos que Mudam a Vida , Saúde Mental , Fatores Socioeconômicos , Compreensão , Efeitos Psicossociais da Doença , Avaliação da Deficiência , Humanos , Entrevistas como Assunto , Irã (Geográfico)/epidemiologia , Hanseníase/economia , Hanseníase/epidemiologia , Pobreza , Preconceito , Opinião Pública , Pesquisa Qualitativa , Qualidade de Vida , Comportamento Social , Estereotipagem
15.
Hansen. int ; 38(1/2): 1-2, 2013.
Artigo em Português | LILACS, SES-SP, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: lil-789346
16.
Afr Health Sci ; 12(2): 231-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23056033

RESUMO

BACKGROUND: Stigma has been associated with chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, Mental illness and Epilepsy. Different forms of stigma have been identified: enacted stigma, perceived stigma, and self stigma. Stigma is increasingly regarded as a key driver of the HIV/AIDS epidemic and has a major impact on public health interventions. OBJECTIVES: The initiative was to provide activities in the clinic while patients waited to be seen by healthcare professionals. It was envisaged this would contribute to reduction of clinic based stigma felt by clients. METHODS: This was a repeated cross-sectional survey (October-November 2005 and March-April 2007) that was conducted at the Infectious Diseases Institute clinic (IDC) at Mulago, the national referral hospital in Uganda. We utilized quantitative (survey) and qualitative (key informants, focus group discussions) methods to collect the data. Data were collected on stigma before the creativity initiative intervention was implemented, and a second phase survey was conducted to assess effectiveness of the interventions. RESULTS: Clients who attended the IDC before the creativity intervention were about twice as likely to fear catching an infection as those who came after the intervention. The proportion that had fears to be seen by a friend or relative at the clinic decreased. Thus during the implementation of the Creativity intervention, HIV related stigma was reduced in this clinic setting. CONCLUSIONS: The creativity intervention helped to build self esteem and improved communication among those attending the clinic; there was observed ambiance at the clinic and clients became empowered, with creative, communication and networking skills. Improved knowledge and communication are key in addressing self stigma among HIV positive individuals.


Assuntos
Infecções por HIV/psicologia , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Rede Social , Estigma Social , Estereotipagem , Adulto , Instituições de Assistência Ambulatorial , Atitude do Pessoal de Saúde , Criatividade , Estudos Transversais , Feminino , Grupos Focais , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Encaminhamento e Consulta , Autoimagem , Distribuição por Sexo , Fatores Socioeconômicos , Uganda
17.
Indian J Lepr ; 84(3): 177-84, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23484332

RESUMO

Although leprosy has been declared as eliminated in India, treated patients with persisting disabilities still require care. With the shift from vertical to integrated services, questions remain about case detection and maintaining the quality of patient care. We conducted a qualitative study to clarify the perceived status of elimination, patient care and other aspects of leprosy control from the perspective of various stakeholders. We interviewed leprosy programme managers, Non-governmental organization directors, healthcare providers, patients and community leaders from Kanchipuram district, Tamil Nadu. Consensus endorsed the current approach to integration of leprosy in primary healthcare, but healthcare personnel acknowledged problems from shortage of medicines and failure to fill key positions. Patients were concerned about limited clinic hours, long waits and delayed treatment. Disabled patients indicated how they were troubled by stigmatization of their condition. Programme managers mentioned limited support for needed research and some emphasized the potential threat of emerging drug resistance. Although consensus supports an integrated approach for leprosy services in primary care, the relative priority of different aspects of leprosy control vary among stakeholders. Perspectivist approaches to methodologically sound operational research could guide planning for effective case detection and patient care during the post-elimination era.


Assuntos
Planejamento em Saúde Comunitária , Hanseníase/prevenção & controle , Hanseníase/terapia , Controle de Doenças Transmissíveis , Planejamento em Saúde Comunitária/organização & administração , Serviços de Saúde Comunitária , Cultura , Coleta de Dados , Pessoal de Saúde , Humanos , Índia/epidemiologia , Hansenostáticos/uso terapêutico , Hanseníase/epidemiologia , Serviços Preventivos de Saúde , Fatores Socioeconômicos , Estereotipagem
19.
Lepr Rev ; 82(2): 103-8, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21888135

RESUMO

Oft-cited as a deterrent to elimination of the disease, stigma is still a critical feature of the leprosy landscape leading to ostracism, loss of employment, loss of housing, ridicule and rejection from society. The reason for leprosy-stigma rests historically and culturally on the mythology about the disease's origin and transmission, and its aesthetic features such as the enigmatic physical disfigurement, and the distinctive ulcers consequent of untreated leprosy. While the literature on leprosy has been consistent in showing that stigma is a social complication of the condition worldwide, there is seldom recognition of processes of stigmatisation in broader contexts. Effective and sustainable interventions directed at curbing leprosy stigma and so improving its social course must, however, be informed by an appreciation of such contexts; particularly in the light of the goal to eliminate the disease worldwide. Examining stigma in the broader contexts of historical, social, economic, political contexts is the aim of this paper. The paper also has implications for broad ranging intervention efforts aimed at de-constructing leprosy-stigma in order to craft a more accommodating ambiance of acceptance, care and support for people affected by leprosy.


Assuntos
Hanseníase/psicologia , Estigma Social , Estereotipagem , Cultura , Humanos , Hanseníase/etnologia , Hanseníase/reabilitação , Meio Social , Isolamento Social
20.
Lepr Rev ; 82(2): 109-23, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21888136

RESUMO

Synoptic life history accounts and case studies of people with leprosy have tended to follow conventionalised narrative forms, with the onset of leprosy causing a violent rupture in otherwise positively construed life courses. Many of those I worked with in India, well-versed in relating their stories to donor agencies, were also aware of the power of such narratives to access funding. While case studies can be informative about the politics of representation, then, they often obscure as much as they reveal about the lives of those described within them, emphasising leprosy-related stigma at the expense of other forms or drivers of social exclusion. Drawing upon a series of interviews with a leprosy affected man I have known and worked with for 25 years, this paper demonstrates how more nuanced--and, from a policy perspective, more useful--accounts might be achieved through intensive biographical interviews carried out over time. In particular, analysis of such biographies, set against the wider backdrop of ethnographic research, allows for a more subtle reading of leprosy-related stigma, contextualised in relation to a range of intersecting socio-political, cultural and economic concerns.


Assuntos
Hanseníase/etnologia , Hanseníase/psicologia , Estigma Social , Estereotipagem , Antropologia Cultural , Biografias como Assunto , Cultura , Humanos , Índia , Masculino , Classe Social
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