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Stigma-related experiences in non-communicable respiratory diseases: A systematic review

机译:非传染性呼吸系统疾病与耻辱感相关的经验:系统评价

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摘要

The stigma of non-communicable respiratory diseases (NCRDs), whether perceived or otherwise, can be an important element of a patient’s experience of his/her illness and a contributing factor to poor psychosocial, treatment and clinical outcomes. This systematic review examines the evidence regarding the associations between stigma-related experiences and patient outcomes, comparing findings across a range of common NCRDs. Electronic databases and manual searches were conducted to identify original quantitative research published to December 2015. Articles focussing on adult patient samples diagnosed with asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, lung cancer or mesothelioma, and included a measurement of stigma-related experience (i.e. perceived stigma, shame, blame or guilt), were eligible for inclusion. Included articles were described for study characteristics, outcome scores, correlates between stigma-related experiences and patient outcomes and methodological rigor. Twenty-five articles were eligible for this review, with most (n = 20) related to lung cancer. No articles for cystic fibrosis were identified. Twenty unique scales were used, with low to moderate stigma-related experiences reported overall. The stigma-related experiences significantly correlated with all six patient-related domains explored (psychosocial, quality of life, behavioral, physical, treatment and work), which were investigated more widely in COPD and lung cancer samples. No studies adequately met all criteria for methodological rigor. The inter-connectedness of stigma-related experiences to other aspects of patient experiences highlight that an integrated approach is needed to address this important issue. Future studies should adopt more rigorous methodology, including streamlining measures, to provide robust evidence.
机译:非传染性呼吸道疾病(NCRD)的污名(无论是否已感知)可能是患者患病经历的重要因素,也是导致不良社会心理,治疗和临床结果的因素。这项系统的审查检查了有关耻辱相关经历与患者预后之间关联的证据,并比较了一系列常见NCRD的发现。进行了电子数据库和手动搜索,以识别出发表于2015年12月的原始定量研究。文章重点关注被诊断患有哮喘,慢性阻塞性肺疾病(COPD),囊性纤维化,肺癌或间皮瘤的成年患者样本,其中包括对柱头的测量相关经验(例如,被认为的污名,羞辱,责备或内)可以被纳入。包括文章的研究特点,结局评分,与柱头相关的经历与患者结局之间的相关性以及方法学上的严谨性进行了描述。有25篇文章符合此评价标准,其中大多数(n = 20)与肺癌有关。没有发现囊性纤维化的文章。使用了20种独特的量表,总体上报告了中低的与耻辱相关的经历。柱头相关的经历与所探究的所有六个患者相关领域(社会心理,生活质量,行为,身体,治疗和工作)均显着相关,在COPD和肺癌样本中对这些领域进行了更广泛的调查。没有任何研究能够充分满足所有方法学严格性标准。烙印相关经历与患者经历其他方面的相互联系突出表明,需要采用综合方法来解决这一重要问题。未来的研究应采用更严格的方法,包括简化措施,以提供有力的证据。

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