Revealing the Most Vulnerable Groups: Courtesy Stigma in Care-givers of Quebecers Autistic persons

Caregivers of individuals often face with \"courtesy stigma,\" a phenomenon that adversely affects their well-being. Understanding the repercussions of this stigma is crucial not only for caregivers' mental health, but also for the quality of care provided to autistic individuals. This study aimed to explore the experience of cour-tesy stigma among caregivers of autistic individuals in Quebec, examining its prevalence and impact to identify groups that are particularly susceptible to nega-tive outcomes. Methods This was a cross-sectional online survey employing quota sampling and garnered responses from 194 participants. Data were collected using a computer-assisted web interview (CAWI) platform. The impact of courtesy stigma was specifically measured in terms of care burden, mental health, and overall well-being of care-givers. Results The findings revealed that caregivers frequently experience social exclusion, isola-tion, and work-related challenges. Notably, caregivers' health was below average compared to Quebec's general population. The vulnerable groups included female caregivers, those aged 45 or older, financially strained households, caregivers of children requiring elevated levels of support, those who self-isolated due to their autistic dependents, and those who experienced stigmatization directed at them-selves or their children in the form of rejection. Interestingly, 60% of respondents reported that the caregiving burden was \"not at all\" to \"somewhat\" difficult, raising questions about factors that may mitigate caregiving challenges. Conclusion This study underscores the need for targeted public policies and interventions, par-ticularly for those at higher risk of experiencing the negative effects of courtesy stigma. By focusing on resources and support for these priority groups, we can better address the challenges faced by the families of autistic persons.

照料者（caregivers）往往会遭遇"礼貌性污名"（courtesy stigma）——一种对其福祉产生负面影响的现象。深入理解此类污名所带来的影响，不仅关乎照料者的心理健康，更直接影响自闭症个体（autistic individuals）所获得的照护质量。本研究旨在探究魁北克（Quebec）地区自闭症个体照料者所经历的礼貌性污名体验，通过考察其流行程度与影响，识别出特别容易遭受负面后果的群体。方法 本研究采用横断面线上调查设计，运用配额抽样法，共回收194名参与者的有效回复。数据通过计算机辅助网络访谈（computer-assisted web interview, CAWI）平台采集。本研究从照料者的照料负担、心理健康与整体福祉三个维度，专门测量了礼貌性污名所带来的影响。结果 研究发现，照料者常遭遇社会排斥、孤立及职场相关困境。值得注意的是，与魁北克普通人群相比，照料者的健康水平处于平均线以下。脆弱群体包括女性照料者、45岁及以上人群、经济拮据家庭、需要更高水平照护的儿童的照料者、因自闭症受抚养者而选择自我隔离的照料者，以及自身或其子女遭遇以拒绝为表现形式的污名化的照料者。有趣的是，60%的受访者表示其照料负担"完全不"至"略有"困难，这为探讨可能缓解照料挑战的相关因素提供了研究方向。结论 本研究强调了制定针对性公共政策与干预措施的必要性，尤其是针对那些更易遭受礼貌性污名负面影响的群体。通过为这些重点群体提供资源与支持，我们能够更好地应对自闭症患者家庭所面临的各类挑战。