Same clinic, different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care

Salamat Samantha; Hegarty Peter; Patton Robert

摘要

Abstract > Stigma experienced by drug users by their healthcare professionals can be a barrier to treatment engagement, which in turn affects mortality and morbidity rates. Attribution theory suggests that stigma will be greatest whenever drug use is attributed to factors within personal control. Here, clients ( n ?=?76) and healthcare professionals ( n ?=?62) identified features that characterize good and bad clinical interactions, and responded to a vignette about a drug user who attributed his use to personal control or situational factors. Healthcare professionals completed the vignette and drug users gave their best guess of how healthcare professionals would react to this vignette. Clients and professionals held overlapping prototypes of clinical interactions. Clients overestimated both how negative healthcare professionals’ reactions would be, and the extent to which healthcare professionals’ reactions would accord with attribution theory. Despite healthcare professionals’ believing they are acting in nonstigmatizing ways, they may engender stigma in clinical situations more than they realize. Discrepancies between professionals’ hypothetical responses and clients’ anticipation of these responses are discussed in terms of the influence of self‐stigma and societal understandings of drug use and control. Attribution theory only offers a limited explanation for these discrepancies, because professionals’ beliefs about drug users are complex. Implications for theories of stigma and engagement with services are discussed, and the importance of clients’ anticipation of stigma is highlighted as a primary target for addressing treatment disengagement. Anti‐stigma campaigns may also benefit from changing their focus from individuals’ attributions to holistically addressing discrepa </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><abstract type =“main”xml：id =“jasp12602-abs-abs-0001”xml：lang =“en”> <title type =“main”>摘要</ title> >吸毒者由他们的医疗保健所经历的耻辱专业人士可以成为治疗订婚的障碍，这反过来影响死亡率和发病率。归因理论表明，每当药物使用归因于个人控制中的因素时，耻辱将是最大的。这里，客户（ n </ i>？=？76）和医疗保健专业人员（ n </ i>？=？62）鉴定了表征良好和不良临床互动的特征，并回应了一个小插图归因于他的个人控制或情境因素的药物用户。医疗保健专业人员完成了小插图，吸毒者能够猜测医疗保健专业人员如何对此小插图做出反应的最佳猜测。客户和专业人士保持临床互动的重叠原型。客户高估了负面医疗专业人士的反应以及医疗保健专业人员反应的程度如何符合归因理论。尽管医疗保健专业人员的信念相信他们以不稳定的方式行事，但它们可能比他们实现的临床情况更多地参加耻辱。专业人士的假设反应与客户对这些答复的差异是在自我耻辱和对药物使用和控制的社会理解的影响方面讨论的。归因理论仅对这些差异提供有限的解释，因为专业人员对吸毒者的信念是复杂的。讨论了对耻辱理论和与服务的参与的影响，客户预期耻辱的重要性被突出称作为解决治疗脱离的主要目标。反耻辱运动也可能受益于将他们的重点改变为全能的归属于全面解决 STOMEAA </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" >著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-33620/'>《Journal of applied social psychology》</a> <b style="margin: 0 2px;">|</b><span>2019年第8期</span><b style="margin: 0 2px;">|</b><span>共12页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Salamat Samantha&option=202" target="_blank" rel="nofollow">Salamat Samantha;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Hegarty Peter&option=202" target="_blank" rel="nofollow">Hegarty Peter;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Patton Robert&option=202" target="_blank" rel="nofollow">Patton Robert;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> <p>School of PsychologyUniversity of SurreyGuildford UK;</p> <p>School of PsychologyUniversity of SurreyGuildford UK;</p> <p>School of PsychologyUniversity of SurreyGuildford UK;</p> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li > <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span>B849:C91; </span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> </p> </li> </ul> </div> </div> <div class="literature cardcommon"> <div class="similarity "> <h3 class="all_title" id="enpatent66">相似文献</h3> <div class="similaritytab clearfix"> <ul> <li class="active" >外文文献</li> <li >中文文献</li> <li >专利</li> </ul> </div> <div class="similarity_details"> <ul > <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/journal-foreign-detail/0704025357831.html">Same clinic, different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care</a> <b>[J]</b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Salamat Samantha&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Salamat Samantha,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Hegarty Peter&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Hegarty Peter,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Patton Robert&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Patton Robert </a> <a href="/journal-foreign-33620/" target="_blank" rel="nofollow" class="tuijian_authcolor">Journal of applied social psychology .</a> <span>2019</span><span>,第8期</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：相同的诊所，不同的概念：吸毒者和医疗保健专业人士对耻辱如何影响临床护理的看法</span> </p> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/journal-foreign-detail/0704024792182.html">Stigma and discrimination in individuals with severe and persistent mental illness in an assertive community treatment team: Perceptions of families and healthcare professionals</a> <b>[J]</b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=OReilly Claire L.&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">OReilly Claire L.,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Paul Diane&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">Paul Diane,</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=McCahon Rebecca&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">McCahon Rebecca,</a> <a href="/journal-foreign-30704/" target="_blank" rel="nofollow" class="tuijian_authcolor">The International journal of social psychiatry .</a> <span>2019</span><span>,第7a8期</span> </span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：在自信社区治疗团队中具有严重和持续的精神疾病的个体中耻辱和歧视：对家庭和医疗保健专业人员的看法</span> </p> </li> <li> <div> <b>3. </b><a class="enjiyixqcontent" href="/academic-journal-foreign_detail_thesis/0204121142169.html">Pharmacological effects and safety monitoring of anabolic androgenic steroid use: differing perceptions between users and healthcare professionals</a> <b>[J]</b> . <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Stephanie A. 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