Factors Affecting Perceived Stigma in Leprosy Affected Persons in Western Nepal

BackgroundThere are various factors which construct the perception of stigma in both leprosy affected persons and unaffected persons. The main purpose of this study was to determine the level of perceived stigma and the risk factors contributing to it among leprosy affected person attending the Green Pastures Hospital, Pokhara municipality of western Nepal.MethodsA cross-sectional study was conducted among 135 people affected by leprosy at Green Pastures Hospital and Rehabilitation Centre. Persons above the age of 18 were interviewed using a set of questionnaire form and Explanatory Model Interview Catalogue (EMIC). In addition, two sets of focused group discussions each containing 10 participants from the ward were conducted with the objectives of answering the frequently affected EMIC items.ResultsAmong 135 leprosy affected persons, the median score of perceived stigma was 10 while it ranged from 0–34. Higher perceived stigma score was found in illiterate persons (p = 0.008), participants whose incomes were self-described as inadequate (p = 0.014) and who had changed their occupation due to leprosy (p = 0.018). Patients who lacked information on leprosy (p = 0.025), knowledge about the causes (p = 0.02) and transmission of leprosy (p = 0.046) and those who had perception that leprosy is a severe disease (pConclusionThe factors associated with higher stigma were illiteracy, perceived economical inadequacy, change of occupation due to leprosy, lack of knowledge about leprosy, perception of leprosy as a severe disease and difficult to treat. Similarly, visible deformities and ulcers were associated with higher stigma. There is an urgent need of stigma reduction strategies focused on health education and health awareness programs in addition to the necessary rehabilitation support.

研究背景：麻风病（leprosy）患者与健康人群的污名感知均受多种因素影响。本研究旨在评估尼泊尔西部博卡拉市绿色牧场医院（Green Pastures Hospital）就诊的麻风病患者的感知污名程度及其相关危险因素。
研究方法：本研究于绿色牧场医院及康复中心纳入135名麻风病患者，开展横断面研究。对18岁以上的受试者采用问卷与解释性模型访谈目录（Explanatory Model Interview Catalogue, EMIC）进行访谈。此外，为解答EMIC中高频出现的条目相关问题，本研究开展了2组焦点小组讨论，每组各纳入10名来自社区的受试者。
研究结果：135名麻风病患者的感知污名评分中位数为10，评分范围为0~34。文盲群体（p=0.008）、自认为收入不足的受试者（p=0.014）以及因麻风病更换职业的受试者（p=0.018）的感知污名评分更高。缺乏麻风病相关知识（p=0.025）、不了解麻风病病因（p=0.02）及传播途径（p=0.046）的患者，以及认为麻风病为重症的受试者（p
研究结论：与感知污名程度升高相关的因素包括：文盲状态、自认为经济拮据、因麻风病更换职业、缺乏麻风病相关知识、认为麻风病为重症且难以治愈。此外，可见的畸形与溃疡也与更高的感知污名相关。亟需在提供必要康复支持的基础上，制定以健康教育与健康科普为核心的污名缓解策略。