Background: Burn injuries are a significant global public health concern, particularly in low- and- middle-income countries like India. These patients often face economic hardships, vocational limitations, and social exclusion even before sustaining their injuries. The resulting disfigurement, disability, and scarring from burns lead to increased social stigma and discrimination, exacerbating mental health concerns among survivors. However, we could not find any existing research exploring this phenomenon in health facility settings. This study aims to investigate the presence and manifestations of stigma and discrimination experienced by burn patients in healthcare institutions in India.

Methods: A qualitative inquiry was conducted in Uttar Pradesh, India, between June and December 2023. A total of 18 face-to-face in-depth interviews were conducted with participants, including seven burn patients, eight healthcare providers, and three legal professionals who work for the welfare of burn survivors. Participants were selected through purposive sampling. The data was analysed in NVivo using thematic analysis.

Results: Three key themes were identified. The first theme, 'Health system factors contributing to stigma' highlights institutional barriers such as an overburdened health system, resource constraints, and the absence of guidelines. The second theme of 'Patient experiences of stigma in health facilities' delves into patient-provider interactions, instances of physical and mental abuse, and stigma intersectionality. Lastly, the third theme, 'Possible ways for promoting inclusivity and reducing stigma' discusses multistakeholder sensitization and policy reforms for discrimination-free care. In addition, we also use the Health Stigma and Discrimination framework to interpret stigma around burns, its outcome, and impact.

Conclusion: This study provides crucial insights into the multifaceted challenges of stigma and discrimination faced by burn patients within healthcare facilities. Our findings suggest an urgent need for reform within the health systems by developing policies and guidelines around discrimination-free healthcare--strengthening public-sector burn care, enhancing rehabilitation services, raising awareness of burns, and improving the social reintegration of survivors.

Keywords: Burns; Discrimination; Health facilities; Healthcare seeking; India; Stigma.

Copyright © 2025 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

背景： 烧伤是全球公共卫生的重要问题，特别是在印度这样的低收入和中等收入国家。这些患者在受伤之前就常常面临经济困难、职业限制和社会排斥的问题。烧伤导致的畸形、残疾和疤痕增加了社会歧视和污名化，加剧了幸存者的心理健康问题。然而，我们没有找到任何现有的研究探讨这一现象在医疗设施中的表现。本研究旨在调查印度医疗机构中烧伤患者所经历的污名和歧视的存在及其表现形式。

方法： 2023年6月至12月期间，在印度北方邦进行了一项定性调研。共进行了18次面对面深入访谈，受访者包括7名烧伤患者、8名医疗保健提供者和3名为烧伤幸存者福利工作的法律专业人士。参与者通过目的抽样法选择。使用NVivo软件对数据进行主题分析。

结果： 识别出三个关键主题。第一个主题是“促成污名的卫生系统因素”，强调制度障碍，如负担过重的医疗体系、资源限制和缺乏指导方针。第二个主题为“患者在医疗机构中的污名经历”，探讨了医患互动、身体和心理虐待事件及污名交叉现象。最后，第三个主题是“促进包容性和减少污名的可能性途径”，讨论了多利益相关方敏感化教育以及歧视零容忍的政策改革以提供无歧视医疗护理。此外，我们还使用卫生污名与歧视框架来解释围绕烧伤的污名及其结果和影响。

结论： 本研究提供了关于在医疗机构中遭受多重污名和歧视挑战的烧伤患者的重要见解。我们的发现表明，迫切需要通过制定无歧视医疗服务的相关政策和指导方针来改革卫生系统，加强公共部门烧伤护理、提升康复服务、提高对烧伤的认识，并改善幸存者的社会融入。

关键词： 烧伤；歧视；医疗机构；寻求医疗保健；印度；污名化。