TY - JOUR KW - Adaptation, Psychological KW - Attitude to Health KW - Culture KW - Dominican Republic KW - Elephantiasis, Filarial KW - Endemic Diseases KW - Family KW - Female KW - Focus Groups KW - Ghana KW - Humans KW - Interpersonal Relations KW - Middle Aged KW - Prejudice KW - Qualitative Research KW - Quality of Life KW - Self Concept KW - Social Isolation KW - Stereotyping KW - Women's Health AU - Person B AU - Bartholomew K AU - Gyapong M AU - Addiss D AU - Borne B AB -

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.

BT - Social science & medicine C1 -

http://www.ncbi.nlm.nih.gov/pubmed/18992982?dopt=Abstract

DO - 10.1016/j.socscimed.2008.09.040 IS - 1 J2 - Soc Sci Med LA - eng N2 -

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.

PY - 2009 SP - 30 EP - 8 T2 - Social science & medicine TI - Health-related stigma among women with lymphatic filariasis from the Dominican Republic and Ghana. VL - 68 SN - 0277-9536 ER -