The Use of Person-Centered Language in Medical Research Journals Focusing on Psoriasis: Cross-sectional Analysis

Abstract

Background Person-centered language places a person’s identity before any disability or medical condition they may have. Using person-centered language reduces stigma and improves the patient-physician relationship, potentially optimizing health outcomes. Patients with psoriasis often feel stigmatized due to their chronic skin condition. Objective We seek to evaluate the use of person-centered language in psoriasis literature and to explore whether certain article characteristics were associated with non–person-centered language. Methods We performed a systematic search on PubMed for recently published articles in journals that regularly publish psoriasis studies. After article reduction procedures, randomization, and screening, we reached our target sample of 400 articles. The following non–person-centered language terms were extracted from each article: “Psoriasis Patient,” “Psoriasis subject,” “Affected with,” “Sufferer,” “Suffering from,” “Burdened with,” “Afflicted with,” and “Problems with.” Screening and data extraction occurred in a masked duplicate fashion. Results Of the 400 included articles, 272 (68%) were not adherent to person-centered language guidelines according to the American Medical Association Manual of Style. The most frequent non–person-centered language term was “Psoriasis Patient,” found in 174 (43.5%) articles. The stigmatizing language was associated with the type of article and funding status, with original investigations and funded studies having higher rates of stigmatizing language. Conclusions Articles about psoriasis commonly use non–person-centered language terms. It is important to shift away from using stigmatizing language about patients with psoriasis to avoid potential untoward influences. We recommend using “patients with psoriasis” or “patient living with psoriasis” to emphasize the importance of person-centered care.

Person-centred language and HIV research: a cross-sectional examination of stigmatising terminology in medical literature

“…In a study examining PCL in alcohol use disorder (AUD) research, Hartwell et al 17 found that nearly 80% of articles contained non-PCL terms. Similarly, in a study investigating PCL use in patients with psoriasis, Ottwell et al 18 found that 68% of articles were not PCL-adherent. The culmination of these findings suggests that the use of stigmatising language may persist throughout many fields of medicine.…”

“…With the help of PCL, we can help reduce stigma. As Ottwell et al state, and as we would like to reiterate, ‘non-PCL is most likely not malicious and is often a result of adherence to an unchanged status quo’ 18. While the use of non-PCL has been investigated in publications regarding topics such as AUD,17 dermatology18 and childhood obesity,29 it has yet to be examined among HIV research.…”

“…As Ottwell et al state, and as we would like to reiterate, ‘non-PCL is most likely not malicious and is often a result of adherence to an unchanged status quo’ 18. While the use of non-PCL has been investigated in publications regarding topics such as AUD,17 dermatology18 and childhood obesity,29 it has yet to be examined among HIV research. Our study of the use of non-PCL within HIV publications serves to fill this gap and increase awareness, a key component of translation of research into the medical community30 and clinical practice 31.…”

“…For instance, the Joint United Nations Programme on HIV/AIDS (UNAIDS) published the UNAIDS Terminology Guidelines in 2015 in order to bring awareness to the power of language as well as provide education on why certain terms are offensive and stigmatising to people living with HIV 16. Despite these initiatives and guidelines, non-PCL is still used frequently in medical research17 18 and among medical professionals 19 20…”

Use of person‐centred language among scientific research focused on childhood obesity

“…While both medical standards and social norms are moving away from stigmatizing language regarding individuals and their diagnosis, stigmatizing language still persists within medical literature including publications focused on alcohol use disorder, 29 psoriasis, 30 and amputations 31 With the integration of evidence‐based medicine into medical education and practice, we posit that the translation of medical literature is not only significant upstream mediator of stigma to clinical practice but also foundational to patient care 32 . However, the perpetuation of non‐PCL in obesity‐related literature has allowed for its continuation in medical practice.…”