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. 2003 Oct;18(10):835-44.
doi: 10.1046/j.1525-1497.2003.20826.x.

"They treated me like a leper". Stigmatization and the quality of life of patients with hepatitis C

Susan Zickmund  1 , Evelyn Y Ho, Masahiro Masuda, Laura Ippolito, Douglas R LaBrecque
Affiliations

"They treated me like a leper". Stigmatization and the quality of life of patients with hepatitis C

Susan Zickmund et al. J Gen Intern Med. 2003 Oct.

Abstract

Objective: Hepatitis C virus is the most prevalent chronic blood-borne infection in the United States, typically acquired through contaminated blood products or needle sharing. We hypothesized that patients with chronic hepatitis C infection experience stigmatization independent of mode of acquisition and that it negatively affects quality of life.

Design: Cross-sectional observation study.

Setting: Specialty clinic in a tertiary referral hospital.

Patients: Two hundred and ninety outpatients diagnosed with chronic hepatitis C infection and seen in a hepatology clinic. Thirty participants were excluded because of missing data.

Measurements and main results: Patients were asked to complete a demographic profile, a semistructured interview, the Sickness Impact Profile, and the Hospital Anxiety Depression Scale. A team of two blinded coders analyzed the interviews. A total of 147 of the 257 study patients experienced stigmatization that they attributed to the disease. Women were more likely to report perceived stigmatization than men (P <.05). Age, education, professional status, and mode of infection did not influence the likelihood of stigmatization. Stigmatization was associated with higher anxiety (P <.01) and depression (P <.01), worsened quality of life (P <.01), loss of control (P <.01), and difficulty coping (P <.01). Individuals who experienced stigmatization also mentioned problems in their health care (P <.01) and work environment (P <.01) as well as with family members (P <.01).

Conclusion: Stigmatization is a very common emotionally burdensome experience for patients with hepatitis C, which can erode social support. As it penetrates even into the health care environment, physicians and other care providers should be aware of the existence and impact of such negative stereotyping.

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Figures

FIGURE 1
FIGURE 1
Correlation between qualitative and quantitative data for anxiety and depression. Patients’ expressions of anxiety (a) and depression (b) coded qualitatively as none (□), moderate (▒), or severe (▪). Numeric score for anxiety or depression was obtained using the Hospital Anxiety Depression Scale (HAD). The coding of interview data reflects the severity of anxiety and depression as assessed by the HAD (P < .01).
FIGURE 2
FIGURE 2
Correlation between severity of stigmatization and the Hospital Anxiety Depression Scale (HAD) and Sickness Impact Profile (SIP). The mean HAD scores for anxiety (a) and depression (b) compared for patients who experienced none (□), mild (hatched bars), moderate (▒), or severe (▪) stigmatization. The HAD scores increased significantly with worsening experience of stigmatization for anxiety (P < .05) and depression (P < .01). The mean SIP scores for physical (c), psychosocial (d), and the total SIP score (e) compared for patients who experienced none (□), mild (□), moderate (▒), or severe (▪) stigmatization. While the psychosocial score differed significantly between the groups (P < .01), the physical and total scores were not statistically different dependent on the severity of experienced stigmatization (P > .1).
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References

    1. Alter MJ, Kruszon-Moran D, Nainan OV, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999;341:556–62. - PubMed
    1. Gebp KA, Jenckes MW, Chander G, et al. Management of Chronic Hepatitis C. Evidence Report/Technology Assessment no. 60. Rockville, MD: Agency for Healthcare Research and Quality; 2002. AHRQ Publication no. 02-E030.
    1. Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001;345:41–52. - PubMed
    1. Seeff LB. The natural history of chronic hepatitis C virus infection. Clin Liver Dis. 1997;1:587–602. - PubMed
    1. Wong JB, McQuillan GM, McHutchison JG, Poynard T. Estimating future hepatitis C morbidity, mortality, and costs in the United States. Am J Public Health. 2000;90:1562–9. - PMC - PubMed

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