Purpose

Studies are increasingly showing that health related stigma is a barrier to employment, but it is not known how. The aim of this systematic review is to identify, appraise and analyse studies that have directly or indirectly addressed ways in which stigma affects sustainable employment and well-being at work of people with disabilities.

Methods

Using a multiphase screening process, this review is based on a comprehensive literature search (2000–2019) carried out in six electronic databases: Embase, Web of Science, Medline Ovid, Cochrane CENTRAL, PsycINFO and Google Scholar.

Results

7.263 publications were identified; 96 studies were found eligible to be included in the review. 72% of the studies were conducted in North America or Europe. Few studies directly assessed how stigma affects the employment of people with disabilities. Most studies highlighted that attitudes and behaviour of employers formed a barrier to employment, as well as anticipated stigma and self-stigma in people with health problems. However, the findings also showed that the attitudes and behaviour of co-workers, health care professionals, reintegration professionals, customers, and family and friends could act as a barrier to employment although these influences are under-researched. Although many similarities were seen in the relevant findings of studies about both physical and mental disabilities, several nuances were found.

Conclusion

Stigma hampers sustainable employment and well-being in multiple ways. Whereas the number of publications on this topic is rapidly increasing, the roles of health care professionals, reintegration professionals, co-workers, customers, and family and friends particularly warrant more attention.

中文翻译：

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与健康相关的污名化以何种方式影响可持续就业和工作幸福感？系统回顾

目的

越来越多的研究表明，与健康相关的耻辱感是就业的障碍，但尚不清楚其原因。本系统评价的目的是确定、评估和分析直接或间接解决污名影响残疾人可持续就业和工作福祉的方式的研究。

方法

本综述采用多阶段筛选过程，基于在六个电子数据库中进行的综合文献检索（2000-2019 年）：Embase、Web of Science、Medline Ovid、Cochrane CENTRAL、PsycINFO 和 Google Scholar。

结果

确定了 7.263 篇出版物；发现 96 项研究符合纳入审查的条件。72% 的研究是在北美或欧洲进行的。很少有研究直接评估污名化如何影响残疾人的就业。大多数研究强调，雇主的态度和行为构成了就业障碍，以及预期的对有健康问题的人的污名化和自我污名化。然而，调查结果还表明，同事、医疗保健专业人员、重返社会专业人员、客户以及家人和朋友的态度和行为可能成为就业障碍，尽管这些影响尚未得到充分研究。尽管在有关身体和精神残疾的研究的相关发现中发现了许多相似之处，但也发现了一些细微差别。

结论

污名化以多种方式阻碍可持续就业和福祉。尽管有关此主题的出版物数量正在迅速增加，但医疗保健专业人员、重返社会专业人员、同事、客户以及家人和朋友的作用尤其值得关注。