Stigma of sickle cell disease among Indian tribal population: A multi-centric qualitative study.

Autor:	Bhat D; Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India., Babu BV; Division of Socio-Behavioural, Health Systems & Implementation Research, Indian Council of Medical Research, New Delhi, India. Electronic address: babubontha@gmail.com., Surti SB; Department of Community Medicine, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, India., Ranjit M; Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, India., Sarmah J; Department of Biotechnology, Bodoland University, Kokrajhar, India., Sridevi P; Department of Biotechnology, Central Tribal University of Andhra Pradesh, Vizianagaram, India., Sharma Y; Division of Socio-Behavioural, Health Systems & Implementation Research, Indian Council of Medical Research, New Delhi, India.
Jazyk:	angličtina
Zdroj:	Journal of the National Medical Association [J Natl Med Assoc] 2023 Dec; Vol. 115 (6), pp. 556-565. Date of Electronic Publication: 2023 Oct 14.
DOI:	10.1016/j.jnma.2023.09.006
Abstrakt:	Background: Sickle Cell Disease (SCD) is the most prevalent hemoglobinopathy, impacting around 5% of the global population. The Indian tribal population, which has been a key focus of the Indian SCD program, can experience health-related stigma due to the multidimensional impact of the disease. This preliminary qualitative inquiry delves into the lived experiences of individuals and synthesizes domains to identify the sources of stigma. Methodology: The study's framework for developing the stigma tool was rooted in Bronfenbrenner's Ecology of Human Development. The study was implemented in five tribal-dominated districts of India and involved in-depth interviews with sickle cell disease (SCD) patients and their caregivers to explore their stigmatizing experiences. Results: The analysis revealed four overarching themes and several subthemes explaining the type of stigma, its source, and factors contributing to stigmatization. First, the study focused on elements associated with perceived stigma, such as disclosure, self-isolation/refusal to participate, and self-judgment. The second theme pertained to the internalization of stigma. The third theme addressed experienced stigma concerning the disease's impact on day-to-day events, and the fourth theme explored the support system patients needed. The framework highlighted the varying degrees of stigmatizing components within different aspects of patients' ecology. Conclusion: Our study highlights the importance of addressing stigma at various levels. Policies, programs, and healthcare interventions must target stigma across these levels. Culturally adaptive tools for identifying stigma, implementing appropriate interventions, and improving healthcare participation are essential for enhancing the quality of life and reducing the disease burden. Competing Interests: Declaration of Competing Interest Authors declare that they have none to declare the conflicts of interest. (Copyright © 2023 National Medical Association. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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