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Stigma in Cirrhotic Patients

A Qualitative Study

Shabanloei, Reza, MSc; Ebrahimi, Hossein, PhD; Ahmadi, Fazlollah, PhD; Mohammadi, Eesa, PhD; Dolatkhah, Roya, MD

doi: 10.1097/SGA.0000000000000189
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Stigma is one of the main problems of patients suffering from cirrhosis, and it causes many challenges for the patients and their treatment. The present study aimed to discover and define the perceived stigma by cirrhotic patients. This qualitative study was conducted through a content analysis approach. The participants were 15 patients suffering from cirrhosis. Data were collected via semistructured, in-depth interviews and analyzed on the basis of methods described by Granheme and Landman. During data analysis, stigma was categorized into four categories and 13 subcategories: external representation of social stigma (others' avoidance behaviors, inadmissible tag, discriminative behaviors of treatment personnel, blaming behaviors), internal representation of social stigma (social ostracism, social isolation, curiosity to perceive people's perceptions), external representation of self-stigma (fear of disclosure of illness, threatening situation, difficult emotional relationships), and internal representation of self-stigma (condemned to suffer, self-punishment, self-alienation). Experiencing stigma is common among cirrhotic patients and may affect patients' coping with the illness and treatment. Thus, it is specifically important that treatment personnel know patients' perception, provide comprehensive support for these patients, and plan to enhance public awareness about the disease recommended.

Reza Shabanloei, MSc, is PhD Candidate, Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, and School of Nursing and Midwifery, Tabriz University (Aras) of Medical Sciences, Tabriz, Iran.

Hossein Ebrahimi, PhD, is Associate Professor of Nursing Education, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

Fazlollah Ahmadi, PhD, is Professor of Nursing Education, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Eesa Mohammadi, PhD, is Associate Professor of Nursing Education, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Roya Dolatkhah, MD, is PhD Candidate, Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Correspondence to: Hossein Ebrahimi, PhD, Tabriz University of Medical Sciences, School of Nursing and Midwifery, West Shariati, Postal Code 5138947977, Tabriz, Iran (ebrahimih@tbzmed.ac.ir).

This study is a part of PhD thesis, and has been supported by Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, as a Research Proposal.

The authors declare no conflicts of interest.

Received April 28, 2014

Accepted July 04, 2014

© 2016 by the Society of Gastroenterology Nurses and Associates, Inc.