Poverty, Substance Use, and Stigma in Four Organizations

四个组织中的贫困、药物滥用和耻辱

基本信息

批准号：
6941393
负责人：
Daniel P. Dohan
金额：
$ 15.15万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-15 至 2007-08-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Individuals who are poor or who suffer from problems related to alcohol or drug use can encounter negative social stigma when seeking medical care. Stigma related to poverty or substance use problems may result in negative consequences for affected individuals including delay or avoidance of needed medical care, exacerbation of treatable conditions, increased pain and suffering, and higher healthcare costs. A better understanding how healthcare organizations generate and/or ameliorate stigma associated with poverty and substance use problems may lead to positive interventions to reduce stigmatization of these vulnerable populations. The objective of this exploratory and developmental project is to examine how different healthcare organizations shape the stigma experiences of patients who are poor or have substance use problems. Qualitative research methods will be used to document how patients manage stigma and examine how these management strategies are affected by stigma processes in healthcare organizations. This study develops theoretical propositions to guide future research by identifying characteristics of healthcare organizations that affect stigmatization. The specific aims are: 1) to use ethnographic research in four healthcare organizations to describe how the behaviors of care-providers generate and/or ameliorate stigma related to poverty and substance use problems, 2) to use interviews with patients to describe how their interactions at each study clinic affect their strategies for managing stigma related to poverty and substance use problems, and 3) to identify the characteristics of healthcare organizations that are salient in the generation and/or amelioration of stigma related to poverty and substance use problems.

描述（由申请人提供）：穷人或患有与酗酒或吸毒有关的问题的个人在寻求医疗护理时可能会遇到负面的社会耻辱。与贫困或药物滥用问题相关的耻辱可能会给受影响的个人带来负面后果，包括延迟或避免所需的医疗护理、可治疗病情的恶化、疼痛和痛苦的增加以及医疗费用的增加。更好地了解医疗保健组织如何产生和/或改善与贫困和药物使用问题相关的耻辱可能会导致积极的干预措施，以减少这些弱势群体的耻辱。这个探索性和发展性项目的目的是研究不同的医疗机构如何塑造贫困或有药物滥用问题的患者的耻辱经历。定性研究方法将用于记录患者如何管理耻辱感，并检查这些管理策略如何受到医疗机构中耻辱感过程的影响。本研究通过确定影响污名化的医疗保健组织的特征，提出了指导未来研究的理论命题。具体目标是：1) 在四个医疗保健组织中使用人种学研究来描述护理提供者的行为如何产生和/或改善与贫困和药物使用问题相关的耻辱，2) 通过对患者的访谈来描述他们的互动如何每个研究诊所影响其管理与贫困和药物使用问题相关的耻辱的策略，以及 3) 确定医疗保健组织的特征，这些特征在产生和/或改善与贫困和药物滥用问题相关的耻辱方面显着。物质使用问题。