Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2020 Sep 16

PMID 32932667

Citations 19

Authors

Sarju Sing Rai

Elena V Syurina

Ruth M H Peters

Annisa Ika Putri

Marjolein B M Zweekhorst

Affiliations

Soon will be listed here.

Abstract

This systematic review examines and consolidates existing evidence on stigma associated with the top four non-communicable diseases (NCDs)-cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes-and its impact on the lives of people affected. We conducted a systematic literature search in PubMed, PsycINFO, JSTOR, Science Direct, and Web of Science for original research in English that explored health-related stigma among people living with either of the four NCDs. A three-step integrative synthesis of data was conducted. Twenty-six articles (qualitative = 15; quantitative = 11) were selected, with most ( = 15) related to cancers, followed by diabetes ( = 7), chronic respiratory diseases ( = 3), and cardiovascular diseases ( = 1). Blame, shame, and fear were the main causes of stigma, the origin and nature of which differed according to the disease-specific features. The manifestations (enacted and felt stigma) and consequences (social, behavioral, psychological, and medical) of stigma across NCDs were similar. Inconsistencies existed in the conceptualization of stigma processes. To fill this gap, we developed an NCD-related stigma framework. People living with NCDs can experience stigma, which can negatively impact their health, management of their disease, and quality of life. The new framework can help in improving the understanding of the processes and experiences of stigma related to NCDs.

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References

Thornicroft G . Stigma and discrimination limit access to mental health care. Epidemiol Psichiatr Soc. 2008; 17(1):14-9. DOI: 10.1017/s1121189x00002621. View

Wood A, Barden S, Terk M, Cesaretti J . The influence of stigma on the quality of life for prostate cancer survivors. J Psychosoc Oncol. 2017; 35(4):451-467. DOI: 10.1080/07347332.2017.1307896. View

Engelgau M, Rosenhouse S, El-Saharty S, Mahal A . The economic effect of noncommunicable diseases on households and nations: a review of existing evidence. J Health Commun. 2011; 16 Suppl 2:75-81. DOI: 10.1080/10810730.2011.601394. View

Scambler G . Sociology, social structure and health-related stigma. Psychol Health Med. 2006; 11(3):288-95. DOI: 10.1080/13548500600595103. View

Browne J, Ventura A, Mosely K, Speight J . 'I'm not a druggie, I'm just a diabetic': a qualitative study of stigma from the perspective of adults with type 1 diabetes. BMJ Open. 2014; 4(7):e005625. PMC: 4120421. DOI: 10.1136/bmjopen-2014-005625. View

Holzemer W, Uys L . Managing AIDS stigma. SAHARA J. 2007; 1(3):165-74. DOI: 10.1080/17290376.2004.9724839. View

Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A . Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010; 376(9754):1785-97. DOI: 10.1016/S0140-6736(10)61353-0. View

Lee S, Lim L, Koh D . Stigma among workers attending a hospital specialist diabetes clinic. Occup Med (Lond). 2014; 65(1):67-71. DOI: 10.1093/occmed/kqu150. View

DuPont-Reyes M, Villatoro A, Phelan J, Painter K, Link B . Adolescent views of mental illness stigma: An intersectional lens. Am J Orthopsychiatry. 2019; 90(2):201-211. PMC: 7000296. DOI: 10.1037/ort0000425. View

10.

Thomas J, Harden A, Oakley A, Oliver S, Sutcliffe K, Rees R . Integrating qualitative research with trials in systematic reviews. BMJ. 2004; 328(7446):1010-2. PMC: 404509. DOI: 10.1136/bmj.328.7446.1010. View

11.

van Brakel W . Measuring health-related stigma--a literature review. Psychol Health Med. 2006; 11(3):307-34. DOI: 10.1080/13548500600595160. View

12.

Rao P . Study on differences and similarities in the concept and origin of leprosy stigma in relation to other health-related stigma. Indian J Lepr. 2011; 82(3):117-21. View

13.

Nishio I, Chujo M . Self-stigma of Patients with Type 1 Diabetes and Their Coping Strategies. Yonago Acta Med. 2017; 60(3):167-173. PMC: 5611471. View

14.

Kien V, Minh H, Ngoc N, Phuong T, Ngan T, Quam M . Inequalities in Household Catastrophic Health Expenditure and Impoverishment Associated With Noncommunicable Diseases in Chi Linh, Hai Duong, Vietnam. Asia Pac J Public Health. 2017; 29(5_suppl):35S-44S. DOI: 10.1177/1010539517712919. View

15.

Kemp C, Jarrett B, Kwon C, Song L, Jette N, Sapag J . Implementation science and stigma reduction interventions in low- and middle-income countries: a systematic review. BMC Med. 2019; 17(1):6. PMC: 6376798. DOI: 10.1186/s12916-018-1237-x. View

16.

Meacham E, Orem J, Nakigudde G, Zujewski J, Rao D . Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda. Psychooncology. 2016; 25(10):1206-1211. DOI: 10.1002/pon.4215. View

17.

Gausset Q, Mogensen H, Yameogo W, Berthe A, Konate B . The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso. Soc Sci Med. 2012; 74(7):1037-44. DOI: 10.1016/j.socscimed.2011.11.044. View

18.

Thornicroft G, Alem A, Dos Santos R, Barley E, Drake R, Gregorio G . WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry. 2010; 9(2):67-77. PMC: 2911080. DOI: 10.1002/j.2051-5545.2010.tb00276.x. View

19.

Kato A, Fujimaki Y, Fujimori S, Izumida Y, Suzuki R, Ueki K . A qualitative study on the impact of internalized stigma on type 2 diabetes self-management. Patient Educ Couns. 2016; 99(7):1233-1239. DOI: 10.1016/j.pec.2016.02.002. View

20.

Li L, Wu Z, Wu S, Zhaoc Y, Jia M, Yan Z . HIV-related stigma in health care settings: a survey of service providers in China. AIDS Patient Care STDS. 2007; 21(10):753-62. PMC: 2795451. DOI: 10.1089/apc.2006.0219. View