02410nas a2200409 4500000000100000008004100001653003000042653002300072653001200095653002300107653002800130653002100158653001100179653001100190653001700201653001000218653001100228653002800239653001600267653001400283653002500297653002000322653001700342653002100359653001700380653001900397100001300416700001800429700001400447700001300461700001200474245010300486300000900589490000700598520138100605022001401986 2009 d10aAdaptation, Psychological10aAttitude to Health10aCulture10aDominican Republic10aElephantiasis, Filarial10aEndemic Diseases10aFamily10aFemale10aFocus Groups10aGhana10aHumans10aInterpersonal Relations10aMiddle Aged10aPrejudice10aQualitative Research10aQuality of Life10aSelf Concept10aSocial Isolation10aStereotyping10aWomen's Health1 aPerson B1 aBartholomew K1 aGyapong M1 aAddiss D1 aBorne B00aHealth-related stigma among women with lymphatic filariasis from the Dominican Republic and Ghana. a30-80 v683 a
People fearful of being stigmatized by a health-related condition often do not embrace prevention behaviors or seek medical help. They may adhere poorly to treatment regimes for disease and abruptly terminate much needed treatment. Globally, 120 million--many poor women--suffer consequences of lymphatic filariasis that include stigmatizing lymphedema or elephantiasis of the leg. We investigated how women with lymphedema from two different cultures experience stigma and its consequences. Our qualitative data were collected from 56 Dominican women and 48 Ghanaian women with lymphedema. A lymphedema-related stigma framework was developed from constructs derived from the literature and emergent themes from the data. Women described a spectrum of enacted, perceived, and internalized stigma experiences, such as being criticized and isolated by the community, health providers, and even by friends and relatives; they were often denied access to education and meaningful work roles. Some antecedents, consequences, coping strategies, and outcomes of these experiences varied across cultures, with Dominican women faring somewhat better than Ghanaians. Poverty, poor access to health care resources, limited education, and diminished social support challenged the coping strategies of many women and exacerbated negative consequences of lymphedema-related stigma.
a0277-9536