Qualitative Study On The Status Of Stigma From The 14 Patients With Diabetes

Objective:This research carries out a qualitative study on the status of stigma in 14 patients with type 1 and type 2 diabetes in order to understand the status and origin of the stigma and how to treat such patients.The research will shed light on how to pay attention to psychological problems of diabetic patients,how to give specific health guidance to diabetic patients and how to improve the cognition degree of diabetes in society.Methods:The materials were collected from the type 1 and type 2 diabetes patients who were hospitalized in the Department of Endocrine and Metabolism at the First Hospital of Jilin University from January 2017 to October 2017.The study is carried out by using the phenomenological approach in qualitative study,target sampling,and interviewing the patients who met the inclusion criteria.In order to make the collected materials sufficient,14 patients were selected.The recording materials and notes were processed within 24 hours after the interview.The researcher herself repeatedly listened to the recording and converted it text without any modification of the subjects’ statements.Significant statements were extracted after careful reading,and the data was analyzed by using the Colaizzi analysis method.Finally,the themes are extracted.Results:It is easy to see from the interviews that either type 1 or type 2 diabetes patients have stigma.The common causal factors of the stigma include strict dietary,psychological resistance to insulin injection,fear of complications,inadequate social support,and public misunderstanding and stereotypes about diabetes.Since the self-treatment of diabetes is closely related to daily life,patients normally feel treated differently by normal people.Particularly,the special treatment from family,friends IV and other important sources of social support makes the patients feel that their own value cannot be reflected,thereby resulting in role disorder.The stigma of type 2 diabetes patients is mainly caused by the negative,stereotype understanding of diabetes such as alcoholism and overeating.The patients could normally feel ashamed for the correlation between the disease and bad lifestyle.The stigma of patients with type 1 diabetes mainly comes from body image disturbance and traditional misunderstanding of the disease.Based on the analysis of the interview contents,we extract themes from four aspects,namely inner feeling,experience,causes and treatment of the stigma.There are six themes about the inner feeling of the stigma,namely self-blame、sense of shame、anxiety、depression、low self-worth、being treated differently.There are two themes related to the experience of the stigma,namely employment discrimination and marriage discrimination.About the causes of the stigma,we summarize two themes,i.e.,external factors and the disease itself,and seven sub-themes,i.e.,family,friends,public media,medical staff,medical expenses,complications and insulin injections.There are three themes about the treatment of the stigma,including positive treatment,avoidance and rejection,and concealment.Conclusions:This study discovers that diabetes patients have the same sense of stigma as those with obesity,mental illness,epilepsy and so on.The stigma is mostly felt stigma or internalized stigma.The main causes of the stigma are negative stereotypes of the public about diabetes and the self-treatment of diabetes such as insulin injection and dietary.Other causes include the pressure of public opinion from media,insufficient social support and economic expenses.These make patients feel discriminated and separated,and develop negative emotions such as self-blame,shame,anxiety,depression,self-deprecation,etc.In view of the above problems,nursing staff should pay attention to the psychological state of diabetes patients and give appropriate psychological intervention on the basis of routine nursing.Diabetes is both a physical and a mental disease.Nursing staff should take psychological factors into account when making nursing plans for patients,and encourage patients to actively participate in the design of goals,contents and expected outcomes of the nursing program.Nursing staff should also communicate with patients in time,understand the factors that potentially affect their self-treatment such as patient’s education degree,financial position,and social support,figure out the sources of patients’ negative emotions,and give appropriate intervention.Nursing staff should be aware of the effects of self-management on diabetes patients in various aspects,encourage patients to react positively and establish healthy and positive personal images so as to lighten psychological burden and control negative emotions,finally reducing stigma.At the same time,many other efforts must be taken in the society to raise public awareness of diabetes,eliminate negative stereotypes,create a positive social atmosphere and finally help them treat the disease.