将健康污名和歧视框架应用于马拉维的精神病污名
Melissa A Stockton1, Jack Kramer2, Joshua Chienda3
1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PLOS mental health
|June 23, 2025
概括
对精神病患者的耻辱是马拉维的一个主要问题,影响了他们的健康和社会生活. 解决这个问题需要将基于证据的耻辱化减轻纳入护理计划.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 精神病症带有重大的全球耻辱,对个人和家庭产生负面影响.
- 关于撒哈拉以南非洲精神病患者所经历的特定耻辱的理解有限.
研究的目的:
- 探索撒哈拉以南非洲,特别是马拉维,精神病患者的耻辱的性质,驱动因素,表现和影响.
- 在现有的心理健康服务中,为制定有针对性的耻辱减轻策略提供信息.
主要方法:
- 使用基于构造主义认识论和形成性研究的半结构面试指南进行定性研究.
- 在马拉维的布兰泰尔进行了36次深入采访和2次焦点小组讨论.
- 参与了各种各样的利益相关者:有生活经验的人 (PWLE),护理人员,传统治疗师,医疗提供者,社区领导人和宗教领袖.
主要成果:
- 确定了关键的耻辱驱动因素:缺乏意识,偏见,刻板印象和恐惧.
- 耻辱表现为经历,预期,感知,内化和次要形式,包括侮辱,虐待,暴力,社会排斥和歧视.
- 负面结果包括护理质量受损,弹性降低,心理健康恶化,发病率增加,社会排斥和生活质量下降.
结论:
- 耻辱感是马拉维精神病患者普遍面临的挑战,严重影响了他们的健康和社会福祉.
- 投资基于证据的耻辱减少活动,并纳入精神病管理计划,是非常必要的.
- 与有实践经验的人建立伙伴关系对于有效的干预开发和实施至关重要.
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