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Inicio Gastroenterología y Hepatología (English Edition) Social stigmatization in Turkish patients with chronic hepatitis B and C
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Vol. 44. Issue 5.
Pages 330-336 (May 2021)
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Vol. 44. Issue 5.
Pages 330-336 (May 2021)
Original article
DOI: 10.1016/j.gastre.2020.08.008
Social stigmatization in Turkish patients with chronic hepatitis B and C
Estigmatización social en pacientes turcos con hepatitis crónica B y C
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Ahmet Yozgata,
Corresponding author
a_yozgat@yahoo.com

Corresponding author.
, Guray Canb, Hatice Canc, Nergiz Ekmend, Taner Akyole, Benan Kasapogluf, Murat Kekillid
a Department of Gastroenterology, Ufuk University, Faculty of Medicine, Ankara, Turkey
b Department of Gastroenterology, Abant İzzet Baysal University, Faculty of Medicine, Bolu, Turkey
c Department of Nephrology, İnönü University, Faculty of Medicine, Malatya, Turkey
d Department of Gastroenterology, Gazi University, Faculty of Medicine, Ankara, Turkey
e Department of Gastroenterology, Liv Hospital, Samsun, Turkey
f Department of Gastroenterology, Lokman Hekim University, Faculty of Medicine, Ankara, Turkey
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Tables (5)
Table 1. Socio-demographic and clinical characteristics of the patients with chronic hepatitis B and C.
Table 2. The comparison of the stigma rates and scores in the chronic hepatitis B and C patients.
Table 3. The comparison of the stigma scores between same stages of both diseases, and among different stages of one disease in chronic hepatitis B and C.
Table 4. The comparison of the stigma rates between same stages of both diseases, and among different stages of one disease in chronic hepatitis B and C.
Table 5. Associated factors with stigmatization and subscales.
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Abstract
Background and aim

Viral hepatitis is the most important cause of chronic hepatitis worldwide. Stigmatization is defined as a feeling of rejection and isolation of patients by society due to illness. There are no studies on chronic viral hepatitis in the literature in English, which has its own religious and socio-cultural structure. In our study, we aimed to investigate the presence of social stigmatism and psychosocial effects on patients with different stages of chronic viral hepatitis B and C.

Methods

Forty-five patients with chronic hepatitis C and 114 patients with chronic hepatitis B were enrolled in the study. Berger's scale was used for stigmatization, composed of 40 four-point Likert items that have four subscales: personalized stigma, disclosure, negative self-image, and public attitude. Stigma score ranges between one and four. Stigma is accepted as present if the overall score is above two.

Results

Overall the mean stigma scores were 1.97±0.58 and 2.14±0.57 for chronic hepatitis B and C, respectively. There was stigma in 47.4% of the patients with chronic hepatitis B, and 60% of the patients with chronic hepatitis C. Being male was the risk factor on overall stigma, disclosure and public attitude in chronic hepatitis C. Living in an urban setting was the risk factor on negative self-image in chronic hepatitis C and on personalized stigma and disclosure in chronic hepatitis B.

Conclusions

To the best of our knowledge, this is the first study that provides qualitative information about chronic hepatitis-related stigma. Stigmatization is a major problem in Turkey and worldwide. We believe that increasing the knowledge of the patients and society by teaching about the transmission routes of the disease and focusing on vaccination studies will prevent stigmatization.

Keywords:
Stigmatization
Chronic hepatitis B
Chronic hepatitis C
Resumen
Antecedentes y objetivo

La hepatitis viral es la causa más importante de hepatitis crónica en todo el mundo. La estigmatización se define como un sentimiento de rechazo y aislamiento de los pacientes, por parte de la sociedad debido a su enfermedad. No hay estudios sobre la hepatitis viral crónica en la literatura inglesa, que tiene su propia estructura religiosa y sociocultural. En nuestro estudio, nos propusimos investigar la presencia del estigma social y los efectos psicosociales en los pacientes con diferentes fases de hepatitis viral crónica B y C.

Métodos

Se incluyó en el estudio a 45 pacientes con hepatitis crónica C y 114 pacientes con hepatitis crónica B. Se utilizó la escala de Berger para la estigmatización, compuesta por 40 ítems Likert de cuatro puntos, con cuatro subescalas cada uno: estigma personalizado, revelación, imagen negativa de sí mismo y actitud pública. La puntuación del estigma oscila entre uno y cuatro. El estigma se acepta como presente si la puntuación general es superior a dos.

Resultados

En general, la media de las puntuaciones de estigmatización fue de 1,97 ± 0,58 y 2,14 ± 0,57 para la hepatitis crónica B y C, respectivamente. El 47,4% de los pacientes con hepatitis crónica B y el 60% de los pacientes con hepatitis crónica C sufrieron estigmatización. El hecho de ser varón fue el factor de riesgo del estigma general, la revelación y la actitud pública en la hepatitis crónica C. Vivir en un entorno urbano fue el factor de riesgo de la imagen negativa de sí mismo en la hepatitis crónica C y el estigma personalizado y la revelación en la hepatitis crónica B.

Conclusiones

Hasta donde sabemos, este es el primer estudio que proporciona información cualitativa sobre el estigma relacionado con la hepatitis crónica. La estigmatización es un problema importante en Turquía y en todo el mundo. Creemos que se puede prevenir la estigmatización informando a los pacientes y a la sociedad sobre las vías de transmisión de la enfermedad y centrándonos en los estudios de vacunación.

Palabras clave:
Estigmatización
Hepatitis B crónica
Hepatitis C crónica

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