Stigma Experiences in People with Chronic Obstructive Pulmonary Disease: An Integrative Review

Int J Chron Obstruct Pulmon Dis. 2021 Jun 4:16:1647-1659. doi: 10.2147/COPD.S306874. eCollection 2021.

Abstract

Background: People with chronic obstructive pulmonary disease (COPD) are stigmatized by smoking history. Although little is known about COPD-related stigma, it can adversely affect self-management and quality of life.

Objective: To synthesize relevant scientific literature exploring stigma experiences and their impacts on people with COPD.

Methods: CINAHL/PsycINFO/PubMed/Scopus were searched for relevant studies. Findings were organized using Major et al's conceptual model.

Results: Fifteen studies documented COPD-related stigma processes: enacted, felt, internalized, and anticipated. Moderating factors included visibility, origin, and illness perception. Individual-level stigma responses included emotional distress, limited social interactions, and negative effects on medication adherence and help-seeking. Social/community-level stigma experiences included healthcare provider and employer behaviors. Smoking is interwoven throughout all domains of stigma processes and responses to stigma.

Conclusion: Substantial evidence documents processes, moderating factors, and individual and social/community responses to the complex phenomenon of COPD-related stigma; however, prevalence of COPD-related stigma and its health effects are unclear.

Keywords: COPD; chronic obstructive pulmonary disease; integrative review; shame; smoking; stigma.

Publication types

  • Review

MeSH terms

  • Humans
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Quality of Life
  • Self-Management*
  • Social Stigma