Stigma and discrimination in healthcare: Challenges faced by burn patients in India

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2025-06-02 DOI:10.1016/j.burns.2025.107566

Pratishtha Singh , Jagnoor Jagnoor , Mohammed Fahud Khurram , Brijesh Mishra , Vikash Ranjan Keshri

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引用次数: 0

Abstract

Background

Burn injuries are a significant global public health concern, particularly in low- and- middle-income countries like India. These patients often face economic hardships, vocational limitations, and social exclusion even before sustaining their injuries. The resulting disfigurement, disability, and scarring from burns lead to increased social stigma and discrimination, exacerbating mental health concerns among survivors. However, we could not find any existing research exploring this phenomenon in health facility settings. This study aims to investigate the presence and manifestations of stigma and discrimination experienced by burn patients in healthcare institutions in India.

Methods

A qualitative inquiry was conducted in Uttar Pradesh, India, between June and December 2023. A total of 18 face-to-face in-depth interviews were conducted with participants, including seven burn patients, eight healthcare providers, and three legal professionals who work for the welfare of burn survivors. Participants were selected through purposive sampling. The data was analysed in NVivo using thematic analysis.

Results

Three key themes were identified. The first theme, ‘Health system factors contributing to stigma’ highlights institutional barriers such as an overburdened health system, resource constraints, and the absence of guidelines. The second theme of ‘Patient experiences of stigma in health facilities’ delves into patient-provider interactions, instances of physical and mental abuse, and stigma intersectionality. Lastly, the third theme, ‘Possible ways for promoting inclusivity and reducing stigma’ discusses multistakeholder sensitization and policy reforms for discrimination-free care. In addition, we also use the Health Stigma and Discrimination framework to interpret stigma around burns, its outcome, and impact.

Conclusion

This study provides crucial insights into the multifaceted challenges of stigma and discrimination faced by burn patients within healthcare facilities. Our findings suggest an urgent need for reform within the health systems by developing policies and guidelines around discrimination-free healthcare--strengthening public-sector burn care, enhancing rehabilitation services, raising awareness of burns, and improving the social reintegration of survivors.

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医疗保健中的耻辱和歧视：印度烧伤患者面临的挑战

烧伤是一个重大的全球公共卫生问题，特别是在印度等低收入和中等收入国家。这些病人甚至在受伤之前就面临经济困难、职业限制和社会排斥。烧伤造成的毁容、残疾和疤痕导致社会污名和歧视增加，加剧了幸存者的心理健康问题。然而，我们没有发现任何现有的研究在卫生设施环境中探索这一现象。本研究旨在调查在印度的医疗机构烧伤患者所经历的耻辱和歧视的存在和表现。方法于2023年6月至12月在印度北方邦进行定性调查。共有18次面对面的深入访谈，参与者包括7名烧伤患者、8名医疗保健提供者和3名为烧伤幸存者福利工作的法律专业人士。参与者通过有目的的抽样选择。数据在NVivo中使用专题分析进行分析。结果确定了三个关键主题。第一个主题“卫生系统因素导致污名化”强调了体制障碍，如卫生系统负担过重、资源限制和缺乏指导方针。第二个主题“患者在卫生机构中的耻辱经历”深入探讨了患者与提供者的互动、身体和精神虐待的实例以及耻辱的交叉性。最后，第三个主题“促进包容性和减少耻辱感的可能途径”讨论了多方利益相关者的敏感性和无歧视护理的政策改革。此外，我们还使用健康耻辱和歧视框架来解释烧伤的耻辱，其结果和影响。结论：本研究为医疗机构烧伤患者所面临的耻辱和歧视的多方面挑战提供了重要见解。我们的研究结果表明，迫切需要通过制定有关无歧视医疗保健的政策和指导方针来改革卫生系统，加强公共部门的烧伤护理，加强康复服务，提高对烧伤的认识，并改善幸存者的社会融入。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.