STIGMA IN THE LIVES OF ASTHMA PATIENTS: A REVIEW FROM THE LITERATURE

The main purpose of this review article is to synthesize the empirical literature on stigma and how stigma affects the lives of asthma patients. Limited search and strong evidence from the asthma management guidelines and news coverage conveying stigmatizing or destigmatizing messages are the provoking factors to write this review. The stigma associated with asthma is one of the important contributing factors for frequent patient anxieties, delayed diagnosis, denial and limited disclosure of being asthmatic, limited physical activity and avoidance of inhaler use in public. Pubmed (Medline), PsycInfo, Science Direct, Sage Pub and Wiley databases were used to review the work done to date on measuring stigma related to asthma by using the key terms of stigma and asthma combined with stigmatization/stigmatisation, questionnaire and scale. In addition, Google search engine was used to search the national and international guidelines, newspapers and related work done on stigma of asthma that was beyond the scope of publication by research databases. No time limit was used for the year of publication to address the issue of stigma thoroughly and deeply. In total 452 research articles were identified that addressed different dynamics of stigma by using the combination of a forementioned search keywords. Out of these 39 studies were included in this review addressing specifically the asthma related stigma. From these, four studies aimed to develop the questionnaire for the direct assessment of stigma in asthma patients. These instruments required rigorous validation and reliability assessment in the different population. The stigma of asthma has adverse consequences in the lives of asthma patients. Therefore, a vigorously validated and good reliable instrument is required to be developed to understand the dynamics and underlined causes of stigma of asthma in a comprehensive way. The instrument that can reflect and capture the phenomenon of stigma in asthma patients more accurately, may be served for more effective stigma reduction interventions and comparing stigma intensity in diverse populations and communities. Following the review, suggestions were made for future workplace anti-stigma interventions and evaluation for such intervention programs. Furthermore, stigma in the lives of asthma patients is the area for future research and actions for health care professionals and clinical researchers for better asthma management programs.