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HomeLifestyleCommon Stigmatizing Language on Liver Transplant Websites

Common Stigmatizing Language on Liver Transplant Websites

Stigmatizing words like “alcoholic” and “alcoholism” are frequently used on liver transplant center websites, and this language can discourage patients from seeking treatment, according to a cross-sectional study.

A review of language on 114 liver transplant center websites in the U.S. showed that 88% of those who mentioned alcohol use disorder and related conditions used stigmatizing language, reported Wei Zhang, MD, PhD. , of Massachusetts General Hospital in Boston, and colleagues in a research letter in Open JAMA Network.

An additional review of 104 addiction psychiatry websites found that 46% of those describing alcohol use disorder used stigmatizing language. Zhang and her colleagues noted that organizations such as the National Institute on Drug Abuse recommend terms such as “person with alcohol use disorder” instead of “alcoholic” and “alcohol abuse” instead of “alcoholism.”

“Our findings underscore the need for hospitals to improve their communications by updating their language to align with non-stigmatizing, patient-first approaches, which we know from experience can lead to better health outcomes,” Zhang said in a statement.

In an email to MedPage todayZhang noted that “in my clinical practice, I have witnessed the profound impact that empathic, non-stigmatizing language has on improving patient engagement and treatment outcomes. The use of stigmatizing language can lead patients to become defensive and withhold crucial health information. fostering a feeling of distrust.”

This is especially true for patients with alcohol-associated liver disease, he added. Feeling judged by doctors can cause them to hide their condition and delay seeking help, often causing the illness to worsen before seeking treatment.

On the other hand, using patient-centered language promotes a sense of openness, Zhang said. “By adopting this way of communicating, we have seen patients become more honest about their alcohol use and why they do it. This honesty helps us take better care of them and guide them more easily through their treatment, including making important decisions, like if I need a liver transplant.”

In the study, two independent reviewers evaluated the websites of accredited liver transplant centers in the US and addiction psychiatry websites at the same institutions.

They found that of the 53 websites that specifically mentioned alcohol use disorder, 42 used only stigmatizing language compared to 11 that used only non-stigmatizing language. Of the 60 websites that discussed alcohol-related liver disease, 40 websites used only stigmatizing language versus 12 that used only non-stigmatizing language, and eight websites used both types of language.

Of the 47 websites that discussed alcohol-associated hepatitis, 45 used only stigmatizing language, while only one used non-stigmatizing language and one used mixed language, and for alcohol-associated cirrhosis (28 websites), 24 used “cirrhosis alcoholic.” while three systematically used non-stigmatizing language and one used mixed language.

In addition to the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism and the American Association for the Study of Liver Diseases (AASLD) recommend using less stigmatizing language, Zhang and colleagues noted.

According to the AASLD Practice Guidelines“Alcohol-associated liver disease (ALD) carries significant stigma in society. Providers increasingly recognize that patients and their families are seeking to reduce the stigma of ALD, and a shift from the term “alcoholic” to “alcohol-associated alcohol.” ‘will help; therefore, alcohol-associated liver disease, alcohol-associated steatohepatitis, and alcohol-associated cirrhosis are suggested, retaining the familiar abbreviations (ALD, ASH, and AC, respectively).”

Zhang said MedPage today that his group plans more research in this area. “Our research team is working on several projects to address the use of stigmatizing language in healthcare,” she said. “We are closely analyzing patients’ medical records to find and understand how stigmatizing language could affect treatment outcomes. This work is important in helping healthcare professionals improve the way they talk about patients and with they”.

Researchers are also examining how alcohol-related liver disease is discussed in scientific articles and the media, Zhang added. They want to explore how using negative language changes the way the public and doctors think about the disease and how this could affect patient care.

A major limitation of the study was the challenge of comprehensively defining stigmatizing language, the researchers noted. “Although we did not cover all of the stigmatizing language around alcohol-associated liver disease, our study shows more frequent use of terms such as alcoholic, alcoholism, and alcohol abuse on transplant websites compared to their psychiatry counterparts,” they explained. “These findings highlight the need for further research into the association of language with the perception and treatment of alcohol-associated liver disease.”

  • Jeff Minerd is a freelance medical and science writer based in Rochester, New York.


One author of the study was supported by the Dean’s Clinical Research Scholar program at the University of Texas Southwestern. No other financing was indicated.

The authors reported no conflicts of interest.

Main source

Open JAMA Network

Source reference: Mahle R, et al “Stigmatizing language for alcohol use disorder and liver disease on liver transplant center websites” JAMA Netw Open 2024; DOI: 10.1001/jamanetworkopen.2023.55320.

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