| Objective:To investigate the status of stigma and the influencing factors in chronic Hepatitis B Virus(HBV)infectors by combining qualitative and quantitative study,to understand the correlation among stigma,social support,general self-efficacy,to reduce the disease of chronic HBV infection stigma level and put forward effective intervention measures and provide theoretical basis for reference.Methods:1.Qualitative study:this study applied phenomenological approach.The study was conducted on 11 patients with chronic hepatitis B virus who were hospitalized in the Department of Gastroenterology of a Grade A hospital in Jinan,Shandong Province from April 2020 to July 2020.The interview outline was prepared,the data were collected by semi-structured in-depth interview,the interview data were encoded by Nvivo11.0 software,and the data were analyzed and integrated by Colaizzi’s seven-step method,so as to refine the themes and summarize the real experience of chronic hepatitis B virus infectors.2.Quantitative study:The method of questionnaire survey was adopted.The number of hospitalized patients decline because of the outbreak of Novel Coronavirus.To ensure the data reach the expected value,so on expanding our scope of collecting data.The subjects were extracted by convenience sampling,250 chronic hepatitis B virus infectors in four tertiary hospitals in Jinan,Shandong province and Shandong Province Public Health Clinical Center were hospitalized from March 2020 to November 2020.The questionnaire was divided into paper version and questionnaire star.The questionnaire included General Information Questionnaire,Discrimination Measurement Scale of Chronic Hepatitis B Virus Infectors,Social Support Rating Scale,General Self-Efficacy Scale.Data were input in pairs and IBM SPSS Statistics 25.0 software was used to analyze the data.In descriptive analysis,measurement data is expressed as(X±S),and count data is expressed as frequency and percentage Application of Single Factor Variance Analysis,Independent Samples Nonparametric Test analyze the differences in stigma of general information.In correlation analysis,if the data is normal distribution,then choose the Pearson correlation analysis,if the data does not obey normal distribution,then choose the Spearman rank correlation.Multiple linear regression analysis is used to analyze the impact on stigma of chronic hepatitis B virus infectors.Results:1.The qualitative interviews refined three major themes and twelve subthemes Theme One,stigma experience:(1)denial,(2)self-blame,helpless,(3)low self-worth,(4)fear,(5)employment discrimination,(6)The discrimination of marriage and love Theme Two,Sources of stigma:(1)relatives,friends and patients,(2)Medical staff,(3)the public.Theme Three,coping ways of stigma:(1)concealment,(2)avoiding social interaction,(3)positive response2.The total score of the stigma in chronic hepatitis B virus infectors was(68.72±16.55),and the average score of external discrimination was(2.83±0.77),negative self-evaluation was(2.97±0.89),perceived stigma was(2.97±0.89),confidentiality was(3.50±0.88),and secondary discrimination was(2.65±0.88)3.Chronic hepatitis B virus infectors’ social support total score was(41.11±7.97),and the scores of objective support,subjective support and utility of support scores were(9.11 ±2.68),(25.14±5.14)and(6.86±1.96).The total score of general self-efficacy in chronic hepatitis B virus infectors was(26.22±6.68)4.One-way ANOVA and independent sample nonparametric test results showed that the presence or absence of complications and perceived discrimination of hepatitis B status had significant influence on the stigma of chronic hepatitis B virus infectors(P<0.05)5.The results of correlation analysis showed that the total social support score,subjective support and the total stigma score,external discrimination,negative self-evaluation,perceived stigma,confidentiality,secondary discrimination scores were negatively correlated(P<0.05);Subjective support and the degree of use of support were negatively correlated with the total score of stigma,negative self-evaluation,perceived stigma,confidentiality and secondary discrimination(P<0.05),but not with external discrimination.General self-efficacy was negatively correlated with the total score of the stigma(P<0.05),and was negatively correlated with external discrimination,negative self-evaluation,perceived stigma,and secondary discrimination(P<0.05),but not with confidentiality.6.The results of multiple linear regression showed that occupation(P<0.05),marital status(P<0.05),presence or absence of complications(P<0.05),perceived discrimination of hepatitis B status(P<0.01),subjective support(P<0.05),utility of support(P<0.01),and general self-efficacy(P<0.05)were the major factors affecting stigma,which could explain 50.6%of stigma variation.Occupation,subjective support and utility of support in social support,general self-efficacy had a negative impact on stigma score,while marital status,presence or absence of complications,and perception of hepatitis B discrimination had a positive impact on stigma scoreConclusions:1.Qualitative study found that stigma comes largely from the perception of the public’s fixed impression on patients with chronic hepatitis B virus infection,and it is very important to improve the cognition of patients and the public on hepatitis B.2.Qualitative study also found that patients with chronic hepatitis B virus infection had heavy psychological burden in interpersonal communication after returning to social life,so they should be given psychological guidance in relevant aspects.3.There is widespread stigma in patients with chronic hepatitis B virus infection,especially in confidentiality,perceived stigma and negative self-evaluation.Clinical health care workers should pay more attention to the mental health of chronic hepatitis B virus infectors and reduce their stigma.4.Chronic hepatitis B virus infectors’ stigma would be affected by occupation,marital status,the presence of complications,and perceived discrimination of hepatitis B status. |
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