Research progress on stigma among tuberculosis patients_West China Medical Journal

Authors：

LI Ling ,  QIU Yuxian , HUANG Fang , YANG Xiaoyi , LI Ruoting , LUO Liya , LAI Min , YAO Rong , LEI Limei , LI Yuanyuan

Tuberculosis Department, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610000, P. R. China;

Corresponding?author：

QIU Yuxian, Email: 710769649@qq.com

Keywords：

Tuberculosis; stigma; research progress; intervention strategy

DOI：

10.7507/1002-0179.202504095

Video：

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Tuberculosis poses a significant challenge to global public health, characterized by high incidence rates, high drug resistance rates, high mortality rates, and lengthy treatment cycles. Patients with tuberculosis often experience stigma, which can adversely affect their treatment adherence, psychological state, and quality of life. Despite numerous reported interventions both domestically and internationally, there remains a lack of systematic research on personalized intervention strategies tailored to diverse ethnic groups within China’s multicultural context. This article aims to review the domestic and international status of stigma among tuberculosis patients, assessment tools, influencing factors, and intervention strategies, with the goal of providing references for developing effective management strategies for stigma in multicultural tuberculosis patient populations.

1.	World Health Organization. Global tuberculosis report 2024. Geneva: World Health Organization, 2024.
2.	李丹妮, 趙琦, 徐飚. 1990—2019 年金磚五國結核病發病率變化及發病趨勢預測. 中華流行病學雜志, 2024, 45(8): 1066-1072.
3.	Stein R, Fastenau A, Aman H, et al. Understanding stigma: the experiences of people with drug-sensitive pulmonary tuberculosis in Rawalpindi, Pakistan. PLoS One, 2025, 20(6): e0324614.
4.	Goffman Erving. Stigma: notes on the management of spoiled identity. Touchstone: Am J Soc, 1963.
5.	Michael K, Chijioke-Akaniro O, George E. TB stigma in Nigeria: a health stigma and discrimination framework analysis. Arch Int Med Res, 2024, 7(3): 219-229.
6.	黃楹, 江琦, 蒙糧廣, 等. 結核病患者受歧視及產生病恥感的現狀及研究進展. 中國防癆雜志, 2019, 41(4): 452-456.
7.	Teo AKJ, Tan RKJ, Smyth C, et al. Characterizing and measuring tuberculosis stigma in the community: a mixed-methods study in Cambodia. Open Forum Infect. Dis, 2020, 7(10): ofaa422.
8.	Macalnas AD, Bangcola AA, Adiong SJ. Exploring social stigma and awareness towards tuberculosis in a municipality in Southern Philippines: a mixed-methods study. Malays J Nurs, 2023, 14(3): 94-101.
9.	Fuady A, Arifin B, Yunita F, et al. Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: a multi-site cross-sectional study. PLoS Glob Public Health, 2024, 4(1): e0002489.
10.	劉曉莉, 雷麗梅, 郭周莉, 等. 結核病患者產生病恥感與領悟社會支持的相關性研究. 中國防癆雜志, 2020, 42(9): 1002-1008.
11.	陳丹萍, 吳麗萍. 肺結核患者病恥感狀況的調查與分析. 中國護理管理, 2016, 16(3): 303-306.
12.	Mohammedhussein M, Hajure M, Shifa JE, et al. Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: a cross-sectional study. PLoS One, 2020, 15(12): e0243433.
13.	姚蓉, 周艷, 雷麗梅, 等. 2189 例住院結核病患者病恥感現狀及影響因素分析. 四川醫學, 2024, 45(3): 239-244.
14.	Redwood L, Mitchell EMH, Nguyen TA, et al. Adaptation and validation of the van Rie tuberculosis stigma scale in Vietnam. Int J Infect Dis, 2022, 114: 97-104.
15.	茍玲, 張亞斌, 豆欣蔓. 結核病患者病恥感的測量及研究現狀. 重慶醫學, 2020, 49(5): 824-827, 832.
16.	楊婷婷, 龔言紅, 股曉旭, 等. 結核病相關病恥感量表的研制與評價. 公共衛生與預防醫學, 2016, 27(6): 46-48.
17.	Stanikzai MH, Rahimy N, Baray AH, et al. High stigma prevalence and associated factors among TB patients in Southern Afghanistan: a multi-center cross-sectional study. Indian J Tuberc, 2024, 71(Suppl 2): S203-S207.
18.	Sekandi JN, Quach T, Olum R, et al. Stigma and associated sex disparities among patients with tuberculosis in Uganda: a cross-sectional study. Res Sq, 2024: rs. 3. rs-3794900.
19.	趙君, 楊紅雨, 康雄. 肺結核患者病恥感影響因素及干預策略研究進展. 結核與肺部疾病雜志, 2024, 5(4): 364-369.
20.	Duko B, Bedaso A, Ayano G, et al. Perceived stigma and associated factors among patients with tuberculosis in Wolaita Sodo, Ethiopia: cross-sectional study. Tuberc Res Treat, 2019, 2019: 5917537.
21.	吳茜, 蔣宇, 金夢杰, 等. 321 例青年初治肺結核病患者社會疏離感現狀及影響因素研究. 護理學報, 2024, 31(4): 65-69.
22.	AlHamawi R, Khader Y, Abaza H, et al. Tuberculosis-related knowledge, practices, perceived stigma and discrimination among patients with tuberculosis: a cross-sectional study in Jordan. Infect Dis (Lond), 2024, 56(5): 359-375.
23.	Chen X, Du L, Wu R, et al. Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study. BMC Public Health, 2021, 21(1): 6.
24.	Adeoye BD, Michael TO, Agbana RD. Insights, beliefs, and myths surrounding tuberculosis among pulmonary patients with delayed healthcare access in a high-burden TB state in Nigeria - a qualitative inquiry. Front Sociol, 2024, 9: 1378586.
25.	Chang SH, Cataldo JK. A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. Int J Tuberc Lung Dis, 2014, 18(2): 168-173.
26.	Macdonald SHF, France NF, Hodgson I, et al. Piloting “from the inside out” - a toolkit addressing tuberculosis-related self-stigma. BMC Glob Public Health, 2024, 2(1): 31.
27.	余巧林, 雷麗梅, 古薪凝, 等. 正念減壓療法聯合心理干預在耐藥肺結核病患者中的應用. 心理月刊, 2023, 18(21): 167-169,173.
28.	賈彥梅. 賦能教育在肺結核病患者中的應用及對情緒障礙、心理韌性的影響. 中國健康心理學雜志, 2020, 28(1): 41-46.
29.	Vibulchai N, Dana K, Sanchan M, et al. The effect of the peer support intervention on internalized stigma among thai patients with tuberculosis: a repeated measures design. Belitung Nurs J, 2024, 10(4): 408-415.
30.	賈彥梅, 張慧芳. 團體心理治療對結核病患者病恥感、治療依從性及生活質量的影響. 中國健康心理學雜志, 2021, 29(6): 848-852.

1. World Health Organization. Global tuberculosis report 2024. Geneva: World Health Organization, 2024.
2. 李丹妮, 趙琦, 徐飚. 1990—2019 年金磚五國結核病發病率變化及發病趨勢預測. 中華流行病學雜志, 2024, 45(8): 1066-1072.
3. Stein R, Fastenau A, Aman H, et al. Understanding stigma: the experiences of people with drug-sensitive pulmonary tuberculosis in Rawalpindi, Pakistan. PLoS One, 2025, 20(6): e0324614.
4. Goffman Erving. Stigma: notes on the management of spoiled identity. Touchstone: Am J Soc, 1963.
5. Michael K, Chijioke-Akaniro O, George E. TB stigma in Nigeria: a health stigma and discrimination framework analysis. Arch Int Med Res, 2024, 7(3): 219-229.
6. 黃楹, 江琦, 蒙糧廣, 等. 結核病患者受歧視及產生病恥感的現狀及研究進展. 中國防癆雜志, 2019, 41(4): 452-456.
7. Teo AKJ, Tan RKJ, Smyth C, et al. Characterizing and measuring tuberculosis stigma in the community: a mixed-methods study in Cambodia. Open Forum Infect. Dis, 2020, 7(10): ofaa422.
8. Macalnas AD, Bangcola AA, Adiong SJ. Exploring social stigma and awareness towards tuberculosis in a municipality in Southern Philippines: a mixed-methods study. Malays J Nurs, 2023, 14(3): 94-101.
9. Fuady A, Arifin B, Yunita F, et al. Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: a multi-site cross-sectional study. PLoS Glob Public Health, 2024, 4(1): e0002489.
10. 劉曉莉, 雷麗梅, 郭周莉, 等. 結核病患者產生病恥感與領悟社會支持的相關性研究. 中國防癆雜志, 2020, 42(9): 1002-1008.
11. 陳丹萍, 吳麗萍. 肺結核患者病恥感狀況的調查與分析. 中國護理管理, 2016, 16(3): 303-306.
12. Mohammedhussein M, Hajure M, Shifa JE, et al. Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: a cross-sectional study. PLoS One, 2020, 15(12): e0243433.
13. 姚蓉, 周艷, 雷麗梅, 等. 2189 例住院結核病患者病恥感現狀及影響因素分析. 四川醫學, 2024, 45(3): 239-244.
14. Redwood L, Mitchell EMH, Nguyen TA, et al. Adaptation and validation of the van Rie tuberculosis stigma scale in Vietnam. Int J Infect Dis, 2022, 114: 97-104.
15. 茍玲, 張亞斌, 豆欣蔓. 結核病患者病恥感的測量及研究現狀. 重慶醫學, 2020, 49(5): 824-827, 832.
16. 楊婷婷, 龔言紅, 股曉旭, 等. 結核病相關病恥感量表的研制與評價. 公共衛生與預防醫學, 2016, 27(6): 46-48.
17. Stanikzai MH, Rahimy N, Baray AH, et al. High stigma prevalence and associated factors among TB patients in Southern Afghanistan: a multi-center cross-sectional study. Indian J Tuberc, 2024, 71(Suppl 2): S203-S207.
18. Sekandi JN, Quach T, Olum R, et al. Stigma and associated sex disparities among patients with tuberculosis in Uganda: a cross-sectional study. Res Sq, 2024: rs. 3. rs-3794900.
19. 趙君, 楊紅雨, 康雄. 肺結核患者病恥感影響因素及干預策略研究進展. 結核與肺部疾病雜志, 2024, 5(4): 364-369.
20. Duko B, Bedaso A, Ayano G, et al. Perceived stigma and associated factors among patients with tuberculosis in Wolaita Sodo, Ethiopia: cross-sectional study. Tuberc Res Treat, 2019, 2019: 5917537.
21. 吳茜, 蔣宇, 金夢杰, 等. 321 例青年初治肺結核病患者社會疏離感現狀及影響因素研究. 護理學報, 2024, 31(4): 65-69.
22. AlHamawi R, Khader Y, Abaza H, et al. Tuberculosis-related knowledge, practices, perceived stigma and discrimination among patients with tuberculosis: a cross-sectional study in Jordan. Infect Dis (Lond), 2024, 56(5): 359-375.
23. Chen X, Du L, Wu R, et al. Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study. BMC Public Health, 2021, 21(1): 6.
24. Adeoye BD, Michael TO, Agbana RD. Insights, beliefs, and myths surrounding tuberculosis among pulmonary patients with delayed healthcare access in a high-burden TB state in Nigeria - a qualitative inquiry. Front Sociol, 2024, 9: 1378586.
25. Chang SH, Cataldo JK. A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. Int J Tuberc Lung Dis, 2014, 18(2): 168-173.
26. Macdonald SHF, France NF, Hodgson I, et al. Piloting “from the inside out” - a toolkit addressing tuberculosis-related self-stigma. BMC Glob Public Health, 2024, 2(1): 31.
27. 余巧林, 雷麗梅, 古薪凝, 等. 正念減壓療法聯合心理干預在耐藥肺結核病患者中的應用. 心理月刊, 2023, 18(21): 167-169,173.
28. 賈彥梅. 賦能教育在肺結核病患者中的應用及對情緒障礙、心理韌性的影響. 中國健康心理學雜志, 2020, 28(1): 41-46.
29. Vibulchai N, Dana K, Sanchan M, et al. The effect of the peer support intervention on internalized stigma among thai patients with tuberculosis: a repeated measures design. Belitung Nurs J, 2024, 10(4): 408-415.
30. 賈彥梅, 張慧芳. 團體心理治療對結核病患者病恥感、治療依從性及生活質量的影響. 中國健康心理學雜志, 2021, 29(6): 848-852.

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