麻风相关污名的文化机制:在尼泊尔远西部使用最重要的框架进行性别分析。

IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE
Marlies J Visser, Eliza A Kc, Yoslien Sopamena, Pirt B Bist, Sita Bist, Madhusudan Subedi, Nand Lal Banstola, Sarju S Rai, Lawrence H Yang, Dadun, Ruth M H Peters
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引用次数: 0

摘要

在尼泊尔,与麻风有关的污名对社会经济和健康结果产生不利影响。在病耻感(减少)研究中,病耻感的文化塑造往往被忽视。因此,本研究旨在(i)确定日常生活中对男性和女性“最重要”的文化能力;扩展和证实与麻风有关的污名的观点和经验;(iii)探讨“最重要的”(WMM)如何在尼泊尔远西部加强或保护人们免受与麻风有关的污名。在WMM框架的指导下,我们对总共80名麻风病患者、家庭成员和卫生保健工作者进行了38次访谈和8次焦点小组讨论,进行了定向内容分析。WMM包括关键的个人和家庭能力,以个人和家庭荣誉和声望(ijjat)为中心。耻辱感根植于麻风病的文化信仰,认为麻风病是因果报应或神的惩罚,导致apahelana(不尊重或无视)和社会排斥,表明人格丧失。这阻碍了在家庭和社区环境中实现WMM,这可能对自信和(心理)健康产生负面影响,加剧了耻辱。该研究支持WMM对麻风病的适用性,并发现家庭的支持和参与与治疗一起可以减轻与麻风病有关的一些强有力的耻辱方面。鉴于本研究中发现的双重作用,应利用家庭支持来减少耻辱感,使家庭能够促进麻风病患者的WMM。本研究通过探索历史上与根深蒂固的误解、恐惧和排斥做法相关的传染病,推进了WMM和耻辱的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cultural Mechanisms of Leprosy-Related Stigma: A Gendered Analysis Using the What Matters Most Framework in Far-Western Nepal.

Leprosy-related stigma in Nepal adversely affects socioeconomic and health outcomes. The cultural shaping of stigma is often overlooked in stigma (reduction) research. Therefore, this study aimed to (i) identify cultural capabilities in daily life that "matter most" for men and women; (ii) extend and corroborate perspectives and experiences of leprosy-related stigma; and (iii) explore how "what matters most" (WMM) intensifies or protects against leprosy-related stigma in Far-Western Nepal. We performed a directed content analysis of 38 interviews and 8 focus group discussions with a total of 80 men and women affected by leprosy, family members, and healthcare workers-directed by the WMM framework. WMM included key personal and family capabilities, centered around personal and family honor and prestige (ijjat). Stigma was rooted in cultural beliefs of leprosy as karma or divine punishment leading to apahelana (disrespect or disregard) and social exclusion, indicating a loss of personhood. This hinders attainment of WMM in both family and community settings which can negatively affect self-confidence and (mental) health, exacerbating stigma. The study supports the applicability of WMM to leprosy and found that family support and involvement alongside treatment could mitigate some powerful aspects of stigma attached to leprosy. Given its dual role found in this study, family support should be leveraged for stigma reduction efforts enabling families to facilitate WMM for persons affected by leprosy. This study advances the work on WMM and stigma by exploring an infectious condition historically associated with deeply rooted misconceptions, fear, and exclusionary practices.

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来源期刊
CiteScore
6.80
自引率
6.20%
发文量
109
期刊介绍: QUALITATIVE HEALTH RESEARCH is an international, interdisciplinary, refereed journal for the enhancement of health care and to further the development and understanding of qualitative research methods in health care settings. We welcome manuscripts in the following areas: the description and analysis of the illness experience, health and health-seeking behaviors, the experiences of caregivers, the sociocultural organization of health care, health care policy, and related topics. We also seek critical reviews and commentaries addressing conceptual, theoretical, methodological, and ethical issues pertaining to qualitative enquiry.
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