中青年糖尿病患者病耻感的质性研究
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摘要
目的深入了解中青年糖尿病患者的病耻感体验及其来源与应对方式,以期为制订针对性的干预措施提供参考依据。方法 2017年1-5月,采用目的抽样法,选择某三级甲等院内分泌科收治的15例中青年糖尿病患者为研究对象,采用现象学研究方法对其进行半结构式访谈,现场录音,借助NVivo 7.0软件,根据Colaizzi的7步分析法对资料进行分析,提炼主题。结果中青年糖尿病患者的病耻感体验可归纳为3个类属10个主题。类属一:病耻感体验,即悔恨与愧疚、对刻板印象的认可、自卑感、被歧视的经历、遭受异样的眼光;类属二:病耻感来源,即亲友和同事、医护人员、公众;类属三:病耻感的应对,即隐瞒、回避。结论糖尿病患者存在较强烈的病耻感,医护人员应为其提供相应的心理支持,指导其采取正确的应对方式;同时社会媒体及各界人士,应积极正确地宣传糖尿病的相关知识,并为糖尿病患者创造宽松的社会环境。
Objective To explore the experiences,sources and coping styles of stigma in young and middle-aged diabetic patients,and to provide a theoretical basis for planning specific interventions.MethodsBy purposive sampling method,15 diabetic patients were selected.The semi-structured interview outline was used for in-depth interview to collect the data,and the data were analyzed by phenomenological method.NVivo 7.0 software was used for analyzing the data.Results The experience of stigma in young and middle-aged diabetic patients could be classified into 3 categories and 10 themes.Category one was the experience of shame,which included regret and guilt,recognition of stereotypes,inferiority,experience of discrimination,and suffering from curious eyes.Category two was the source of stigma,which included relatives and friends,colleagues,medical staff and the public.Category three was coping style of stigma,which included concealing and evading.Conclusions Diabetic patients have a strong sense of stigma.Medical staffs should provide patients with psychological support and guide them to correctly deal with the stigma.Meanwhile,social media should actively publicize the correct diabetes knowledge and create a relaxed social environment for diabetic patients.
Objective To explore the experiences,sources and coping styles of stigma in young and middle-aged diabetic patients,and to provide a theoretical basis for planning specific interventions.MethodsBy purposive sampling method,15 diabetic patients were selected.The semi-structured interview outline was used for in-depth interview to collect the data,and the data were analyzed by phenomenological method.NVivo 7.0 software was used for analyzing the data.Results The experience of stigma in young and middle-aged diabetic patients could be classified into 3 categories and 10 themes.Category one was the experience of shame,which included regret and guilt,recognition of stereotypes,inferiority,experience of discrimination,and suffering from curious eyes.Category two was the source of stigma,which included relatives and friends,colleagues,medical staff and the public.Category three was coping style of stigma,which included concealing and evading.Conclusions Diabetic patients have a strong sense of stigma.Medical staffs should provide patients with psychological support and guide them to correctly deal with the stigma.Meanwhile,social media should actively publicize the correct diabetes knowledge and create a relaxed social environment for diabetic patients.
引文
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[2]XU Y,WANG L,HE J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948-959
[3]GREDIG D,BARTELSEN-RAEMY A.Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland:implications for healthcare providers.[J].Health Soc Care Community,2016,25(5):501-514.
[4]谷晓阳,甄橙,纪立农.走出孤岛:医患共同对抗糖尿病社会成见[J].中华糖尿病杂志,2016,24(3):193-197.
[5]GEARIGUATA L,WHITING D R HAMBLETON I,et al.Global estimates of diabetes prevalence for 2013and projections for 2035[J].Diabetes Res Clin Pr,2014,103(2):137-149.
[6]陈向明.质的研究方法与社会科学研究[M].北京:教育科学出版社,2000:67-69.
[7]NANCY B,SUMN K G.The practice of nursing research[M].3th Edition.W.B:Saundern Company,1998:542-547.
[8]葛华英,孙晓川.糖尿病患者神经病变对男性性功能影响的分析[J].中国性科学,2013,22(10):33-35.
[9]王英红,高琳.100例女性糖尿病患者性功能障碍的临床调查分析[J].中国性科学,2014,23(4):47-49.
[10]LINDSAY M,JAACKS,刘蔚.中国1型糖尿病的社会成见:请停止对这种可控慢性病患者的歧视[J].中华糖尿病杂志,2015,23(3):195-197.
[11]吴宇红.进一步完善《高校招生体检工作指导意见》[J].中国校医,2013,27(2):146-147.
[12]WESTBROOK M T,LEGGE V,PENNAY M.Attitudes towards disabilities in a multicultural society[J].Social Sci Med,1993,36(5):615-23.
[13]MAK W W,CHEUNG R Y.Self-stigma among concealable minorities in Hong Kong:conceptualization and unified measurement.[J].Am J Oorthopsychiat,2010,80(2):267-281.
[14]MAUCK A P.Managing care:the history of diabetes management in twentieth century America[J].PQDTGradworks,2010,15(10):75-76.