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Strategies to reduce stigma related to visible chronic skin diseases A systematic review.

Abstract

Many patients with a visible chronic skin disease experience discrimination and stigmatisation. This results in psychosocial impairments in addition to the burden of disease and emphasises the urgency to implement effective stigma-reduction strategies. To synthesis what is known globally about effective interventions to reduce stigma associated with visible chronic skin diseases, a systematic review was conducted. Four electronic databases were searched until May 2018. Studies evaluating interventions to reduce stigmatisation in patients with visible chronic skin diseases and applying at least one stigma-related outcome measure were included. Data was extracted on study design, country, study population, outcome measures, and main findings. Results were subsequently synthesised in a narrative review. CASP critical appraisal tools were used to assess study quality. Nineteen studies were included in the review. Study design was very heterogeneous and study quality rather poor. Thirteen studies addresses patients with leprosy in low- and middle income countries and one study each targeted patients with onychomycosis, leg ulcer, facial disfigurement, atopic dermatitis, vitiligo, and alopecia. Evaluated interventions were mainly multi-faceted incorporating more than one type of intervention. While 10 studies focused on the reduction of self-stigma and 4 on the reduction of public stigma, another 5 studies aimed at reducing both. The present review revealed a lack of high quality studies on effective approaches to reduce stigmatisation of patients with visible chronic skin diseases. Development and evaluation of intervention formats to adequately address stigma is essential to promote patients' health and well-being. This article is protected by copyright. All rights reserved.

More information

Type
Journal Article
Author
Topp J
Andrees V
Weinberger N
Schäfer I
Sommer R
Mrowietz U
Luck-Sikorski C
Augustin M