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Wang H, Li N, Ye Y, Zhao N, Liu M, Xu M, Zhou Q. Development and Validation of the Healthcare-Seeking Intention Questionnaire in Patients with Diabetic High-Risk Foot. Patient Prefer Adherence 2024; 18:1873-1883. [PMID: 39286515 PMCID: PMC11404499 DOI: 10.2147/ppa.s479644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/29/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Timely screening and intervention can prevent the development of the diabetic foot. However, delayed visits to the clinic are common among diabetic foot patients. The study aimed to develop and validate a questionnaire to assess healthcare-seeking behavior among patients with diabetic high-risk foot. Methods The questionnaire of healthcare-seeking intention for patients with diabetic high-risk foot was developed in two phases: (1) Developing the questionnaire: 1) questionnaire items were formulated after literature review, group discussion and semi-qualitative interview; 2) a two-round modified Delphi method was to examine the content validity and the degree of consistency in questionnaire items; 3) conducting pre-survey to revise the questionnaire items. (2) Assessing the internal reliability and construct validity. Results The final questionnaire consisted of five main themes and 28 items with a five-point rating. Cronbach's alpha coefficients for the five dimensions were respectively 0.937 (relevant knowledge of diabetic foot), 0.669 (attitudes toward seeking care), 0.896 (social support for seeking care), 0.621 (efficacy in coping with foot symptoms), 0.871 (intention to seek care). The Scale-level Content Validity Index of the five parts was 1.00, 0.80, 1.00, 1.00, and 1.00, respectively. The Kaiser-Meyer-Olkin values for each dimension was greater than 0.7, and the p-value for Bartlett's test of sphericity was less than 0.05. Conclusion This questionnaire showed good validity, internal consistency, and reliability. It provided a potentially useful instrument to evaluate healthcare-seeking intention among patients with diabetic high-risk foot.
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Affiliation(s)
- Honglin Wang
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
- School of Health and Nursing, Guangzhou Huali College, Jiangmen, People's Republic of China
| | - Na Li
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Ying Ye
- Department of Nursing, First People's Hospital of Yunnan, Kunming, People's Republic of China
| | - Nan Zhao
- School of Nursing, Zhengzhou Shuqing Medical College, Zhengzhou, People's Republic of China
| | - Meizi Liu
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Min Xu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Qiuhong Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, People's Republic of China
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Ning X, Huang S, Hilario C, Yamanda J, Vahabi M, Poon ML, Yao Z, Fung KP, Cheng S, Gao J, Jia C, Li AT, Wong JP. Chinese university students' help-seeking behaviors when faced with mental health challenges. J Ment Health 2024; 33:386-393. [PMID: 38845178 DOI: 10.1080/09638237.2024.2361259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Mental illnesses and mental health challenges have become increasingly pervasive among Chinese university students. However, the utilization rate of mental health services is low among students. AIMS We aimed to explore Chinese university students' help-seeking behaviors to understand how they deal with mental health challenges and use the results to inform the development of effective mental health promotion initiatives. METHODS In this study, we conducted 13 focus group interviews with students in six universities in Jinan, China, including 91 (62%) female students and 56 (38%) male students. We drew on the Theory of Planned Behaviors to guide our thematic analysis to gain a contextual understanding of participants' accounts on help-seeking. RESULTS Our results have depicted the help-seeking patterns of Chinese university students and show that there are four major behaviors which are self-reliance, seeking support from peers and families, seeking professional support, and accessing virtual mental health care. CONCLUSION Results from this study can be used to inform the development of mental health literacy programming for students in universities that share similar contexts, and the study has also opened up a new space for using qualitative approaches to study mental health needs and access to care in diverse populations.
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Affiliation(s)
- X Ning
- Department of Social Sciences, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - S Huang
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - C Hilario
- School of Nursing, The University of British Columbia, Vancouver, Canada
| | - J Yamanda
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - M Vahabi
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - M L Poon
- School of Social Work, York University, Toronto, Canada
| | - Z Yao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - K P Fung
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - S Cheng
- Department of Social Work, Shandong University, Jinan, China
| | - J Gao
- Department of Social Work, Shandong University, Jinan, China
| | - C Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - A T Li
- Regent Park Community Health Center, Toronto, Canada
| | - J P Wong
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
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Abdelmonaem YMM, Osman MA, Karim NAHA. Mental health stigma and internship nursing students' attitudes toward seeking professional psychological help: a cross-sectional study. BMC Nurs 2024; 23:275. [PMID: 38658957 PMCID: PMC11044461 DOI: 10.1186/s12912-024-01910-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Self-stigma and negative attitudes toward mental illness have been identified as significant barriers that hinder individuals from seeking psychological assistance, leading to adverse consequences in their lives. AIM This study aimed to assess mental health stigma and internship nursing students' attitudes toward seeking professional help. METHODS A cross-sectional design was conducted in the current study including a purposive sample of 228 participants of internship nursing students using a Socio-demographic data sheet, Self-Stigma of Seeking Help scale (SSOSH), and Attitude toward seeking professional psychological help scale (ATSPPH). The data acquisition period spanned from August to November 2022. RESULTS This study revealed significant insights into the attitudes of internship nursing students toward seeking professional psychological help. Gender emerged as a notable factor, with males exhibiting higher levels of self-stigma compared to females (mean = 2.872). Attitudes towards seeking professional help varied significantly based on age, gender, residence, and marital status. Specifically, participants aged 23 years, females, rural residents, and married individuals demonstrated the highest Mean scores reflecting attitudes that lean more positively towards seeking help. Furthermore, a significant negative correlation (r = -0.372, p < 0.01) was observed between self-stigma and attitudes toward seeking professional help. CONCLUSION This study concluded that more than three-fifths of internship nursing students hadn't stigma towards seeking professional psychological help while the vast majority had a positive attitude towards seeking professional psychological help. However, the majority of students reported that financial barriers, specifically the high cost of therapy, prevent them from seeking psychological help. This highlights the need for more affordable mental health services for this population.
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4
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Madsen J, Jobson L, Slewa-Younan S, Li H, King K. Mental health literacy among Arab men living in high-income Western countries: A systematic review and narrative synthesis. Soc Sci Med 2024; 346:116718. [PMID: 38489937 DOI: 10.1016/j.socscimed.2024.116718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
While interest in mental health literacy (MHL) is growing rapidly, cross-cultural research focusing on MHL is developing more slowly. This inaugural systematic review explored the recognition and beliefs about the causes of mental health disorders amongst Arab men living in high income Western countries (HIWC), their help-seeking beliefs, behaviors, and sources of help, as well as barriers and facilitators to help-seeking. Six electronic database searches were conducted using Medline, Embase, ProQuest Dissertations & Theses Global, PsycINFO, Scopus, and Web of Science. These searches yielded a total of 9,460 citations. After applying inclusion criteria through both database and manual hand searches, 46 studies were identified. The findings corresponded with four of the socioecological model's five factors: intrapersonal, interpersonal, societal, and institutional. Intrapersonal factors included attributing mental health illness to life and migration stressors, and religious reasons. Interpersonal and societal factors included men favoring informal help-seeking sources as stigma was a barrier to formal help-seeking. Institutional factors around the perceived cultural competence of healthcare professionals and access difficulties were obstacles to seeking formal help. The growth in Arab migration to HIWC highlights the need for culturally tailored care. Research is needed to understand the perspectives of healthcare providers working with Arab men in addition to how men's stigmatizing attitudes are an obstacle to formal help-seeking. Interventions should be designed to address the unique mental health needs of Arab men, recognizing that some explanatory beliefs may not align with current Western models of mental health. Moreover, efforts should be made to integrate men's informal sources of support into treatment planning.
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Affiliation(s)
- Julian Madsen
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Shameran Slewa-Younan
- Macarthur Clinical School, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 275, Australia.
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Kylie King
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
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Fekih-Romdhane F, Malaeb D, Hallit S, Obeid S. Does mindfulness moderate the association between impulsivity and well-being in Lebanese university students? INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1397-1409. [PMID: 37211811 DOI: 10.1080/09603123.2023.2212595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
Limited evidence showed that impulsivity is negatively related to life satisfaction and wellbeing; however, the mechanisms underlying this relationship remain unclear. We aimed through this work to investigate the relationship between impulsivity dimensions and well-being and to explore the moderator role of mindfulness on this relationship in a sample of Lebanese university students. This cross-sectional study was carried out among 363 university students recruited through convenience sampling through several universities in Lebanon's governorates. Higher mindfulness was significantly associated with better wellbeing in the models that considered urgency and sensation seeking as independent variables. A lack of premeditation and a lack of perseverance were both inversely associated with well-being. The interaction lack of perseverance by mindfulness was significantly associated with wellbeing; for students who were low in mindfulness, more lack of perseverance was significantly associated with a lower wellbeing. Our study suggested that mindfulness practice may offer a promising avenue for implementing strategies aiming at improving the well-being of students with high levels of impulsivity.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, Manouba City, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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6
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Fekih-Romdhane F, Boukadida Y, Abassi B, Chaibi LS, Conus P, Krebs MO, Thornicroft G, Cheour M, Jahrami HA. French validation of the barriers to access to care evaluation (BACE-3) scale. L'ENCEPHALE 2024:S0013-7006(24)00010-1. [PMID: 38311478 DOI: 10.1016/j.encep.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND The aim of this study was to develop and evaluate a French version of the Barriers to Access to Care Evaluation (BACE-3) scale that is tailored to the socio-cultural and language setting of the study. METHODS The translation of the BACE-3 into French and its validation were the two key components of this psychometric investigation. An online survey was created and circulated to French-speaking participants who volunteered to participate in the study. RESULTS For all translated questions, the reliability analysis key results (Cronbach's alpha and McDonald's Omega) were both>0.95, which is an excellent reliability value. The BACE-3 items were shown to be positively related to one another, implying excellent validity. Results of exploratory and confirmatory factor analyses showed that all stigma-related items were loaded under the same factor. CONCLUSIONS The BACE-3 has been validated in French, and its psychometric qualities have been thoroughly evaluated and found to be excellent.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia.
| | - Youssef Boukadida
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Bouthaina Abassi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Leila Sarra Chaibi
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Laboratoire de physiopathologie des maladies psychiatriques, UMR_S1266 institut de psychiatrie et neurosciences de Paris, université Paris Descartes, Inserm, Paris, France; Institut de psychiatrie (CNRS GDR 3557), Paris, France; Service hospitalo universitaire, faculté de médecine Paris Descartes, centre hospitalier Sainte-Anne, université Paris Descartes, Paris, France
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Haitham A Jahrami
- Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Fekih-Romdhane F, Daher-Nashif S, Stambouli M, Alhuwailah A, Helmy M, Shuwiekh HAM, Mohamed Lemine CMF, Radwan E, Saquib J, Saquib N, Fawaz M, Zarrouq B, Naser AY, Obeid S, Saleh M, Haider S, Miloud L, Badrasawi M, Hamdan-Mansour A, Barbato M, Bakhiet A, Sayem N, Adawi S, Grein F, Loch AA, Cheour M, Hallit S. Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries. Int J Soc Psychiatry 2023; 69:1658-1669. [PMID: 37191228 DOI: 10.1177/00207640231174359] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship. METHOD A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N = 1029, Kuwait: N = 2182, Lebanon N = 781, Tunisia N = 2343; Total sample: N = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide. RESULTS Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide. CONCLUSION We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Psychiatry Ibn Omrane, The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunisia
| | - Suhad Daher-Nashif
- School of Medicine, Keele University, Staffordshire, UK
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Manel Stambouli
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Psychiatry Ibn Omrane, The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunisia
| | | | - Mai Helmy
- Psychology Department, College of Education, Sultan Qaboos University, Muscat, Oman
- Psychology Department, Faculty of Arts, Menoufia University, Egypt
| | | | | | - Eqbal Radwan
- Department of Biology, Faculty of Science, Islamic University of Gaza, Palestine
| | - Juliann Saquib
- Clinical Sciences Department, College of Medicine, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Nazmus Saquib
- Clinical Sciences Department, College of Medicine, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Mirna Fawaz
- Nursing Department, Faculty of Health Sciences, Beirut Arab University, Lebanon
| | - Btissame Zarrouq
- Faculty of Medicine and Pharmacy, Laboratory of Epidemiology and Research in Health Sciences, Fez, Morocco
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Maan Saleh
- Department of Psychiatry, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Sanad Haider
- Faculty of Medicine and Health Sciences, Behavioral Sciences Dep. A, Aden, Yemen
| | - Lahmer Miloud
- The National Centre of Research in Social and Cultural Anthropology, Oran, Algeria
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | | | - Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE
| | - Aisha Bakhiet
- Department of Psychiatry, University of Khartoum, Sudan
| | - Najat Sayem
- Psychology Department, Sanaa University, Yemen
| | - Samir Adawi
- Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Psychiatry Ibn Omrane, The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Fekih-Romdhane F, Daher-Nashif S, Stambouli M, Alhuwailah A, Helmy M, Shuwiekh HAM, Mohamed Lemine CMF, Radwan E, Saquib J, Saquib N, Fawaz M, Zarrouq B, Naser AY, Obeid S, Saleh M, Haider S, Miloud L, Badrasawi M, Hamdan-Mansour A, Barbato M, Motwakil Bakhiet A, Khalil NS, Adawi S, Grein F, Loch AA, Cheour M, Hallit S. Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries. BMC Public Health 2023; 23:1671. [PMID: 37649023 PMCID: PMC10469418 DOI: 10.1186/s12889-023-16622-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. METHOD The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). RESULTS Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. CONCLUSION Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia.
| | - Suhad Daher-Nashif
- School of Medicine, Keele University, Keele, Staffordshire, UK
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Manel Stambouli
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia
| | | | - Mai Helmy
- Psychology department, College of Education, Sultan Qaboos University, Muscat, Oman
- Psychology department, Faculty of Arts, Menoufia University, Menofia Governorate, Egypt
| | | | | | - Eqbal Radwan
- Department of Biology, Faculty of Science, Islamic University of Gaza, Gaza Strip, Palestine
| | - Juliann Saquib
- College of Medicine, Clinical Sciences Department, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Nazmus Saquib
- College of Medicine, Clinical Sciences Department, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Mirna Fawaz
- Nursing Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Btissame Zarrouq
- Faculty of Medicine and Pharmacy, Laboratory of Epidemiology and Research in Health Sciences, Fez, Morocco
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Maan Saleh
- Department of Psychiatry Khobar, Imam Abdulrahman Bin Faisal University, Dammam, KSA, Saudi Arabia
| | - Sanad Haider
- Faculty of Medicine and Health Sciences, Behavioral Sciences Dep. A, Aden, Yemen
| | - Lahmer Miloud
- The National Centre of Research in Social and Cultural Anthropology, Oran, Algeria
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | | | - Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE
| | | | | | - Samir Adawi
- College of Medicine and Health Sciences, Behavioural Medicine, Sultan Qaboos University, Muscat, Oman
| | | | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Faculdade de Medicina, Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR, Brazil
- Instituto Nacional de Biomarcadores Em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico E Tecnológico, Sao Paulo, Brazil
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, P.O. Box 446, Lebanon.
- Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Khatib HE, Alyafei A, Shaikh M. Understanding experiences of mental health help-seeking in Arab populations around the world: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:324. [PMID: 37161342 PMCID: PMC10170733 DOI: 10.1186/s12888-023-04827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in mental health service utilisation and access is well established. Mental illness is common among Arab populations globally, but most individuals display negative attitudes towards mental health and do not seek professional help. The aim of this systematic review was to determine 1) help-seeking behaviours 2) help-seeking attitudes and 3) help-seeking barriers and facilitators, related to mental health services among Arab adults. METHOD A pre-defined search strategy and eligibility criteria allowed for database searching using terms related to: mental health, Arabs, help-seeking, as well as experiences and behaviours. Seventy-four articles were included and analysed through narrative synthesis. Results were reported using the PRISMA guidelines. The review protocol was registered prospectively on PROSPERO (CRD42022319889). RESULTS Arabs across the world have negative attitudes towards formal help-seeking and are reluctant to seek help, despite the presence of psychological distress. There is little information on factors that influence help-seeking behaviours and rates of service use. Preference for informal help sources such as family and friends were expressed and considered more acceptable. Low mental health literacy, stigma, gender, age, education, religion, acculturation, and immigrant status were the most common factors influencing help-seeking attitudes. Barriers to help-seeking included stigma, privacy and confidentiality, trust, mental health literacy, language, logistics, and culture related barriers. Increasing societal and family awareness, external support and encouragement, shared culture between the client and therapist, quality of doctor patient relationship, and feelings of connectedness with the host country among refugees were mentioned facilitators. Mixed findings for the role of religion, and family and community, in relation to facilitating or hindering help-seeking were reported. CONCLUSIONS There is an increased likelihood and preference to seek informal sources of psychological support among Arabs. Contextual and cultural factors impeding help-seeking for Arabs are common across the world. Future research should address actual utilisation rates of services to better understand factors that influence help-seeking behaviours and facilitators to help-seeking. Increasing mental health literacy and developing anti stigma campaigns is necessary. Developing culturally informed interventions should inform future efforts to promote help-seeking among this population.
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Affiliation(s)
- Hania El Khatib
- Division of Psychiatry, University College London, London, UK
| | - Aisha Alyafei
- Division of Psychiatry, University College London, London, UK
| | - Madiha Shaikh
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- North East London NHS Foundation Trust, London, UK.
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Huang S, Xiao M, Hu Y, Tang G, Chen Z, Zhang L, Fu B, Lei J. Attitudes toward seeking professional psychological help among Chinese pregnant women: A cross-sectional study. J Affect Disord 2023; 322:163-172. [PMID: 36400148 DOI: 10.1016/j.jad.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND There exists a gap between the high prevalence of mental health problems and negative attitudes toward seeking professional psychological help among Chinese pregnant women. This study aimed to investigate the attitudes and factors toward seeking professional psychological help among Chinese pregnant women to provide some suggestions for improving pregnant women's psychological help-seeking behaviors. METHODS A total of 1024 pregnant women were recruited. The Chinese version of the Attitude Toward Seeking Professional Psychological Help Scale (ATSPPH) was used to assess the attitudes toward professional psychological help-seeking. Demographic and socio-psychological factors were collected by self-developed questionnaire, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Patient Health Questionnaire-9 Scale. RESULTS 1006 pregnant women were included in the final analysis. Only 3.7 % of participants chose professionals as their first choice for psychological help-seeking. The attitudes toward seeking professional psychological help were relatively positive, with the highest score of stigma tolerance among four subscales in ATSPPH. Education level, perceived social support, and positive coping style had a positive predictive effect on the four subscales of ATSPPH. Women with prenatal depressive symptoms had a lower score in the subscales of recognition of need for psychotherapeutic help and confidence in mental health practitioner; women with higher scores of negative coping style had a lower score in the subscales of stigma tolerance and interpersonal openness. History of professional psychological help-seeking behaviors was only associated with the subscale of recognition of need for psychotherapeutic help; Maternal age was only associated with the subscale of interpersonal openness. CONCLUSION The attitudes toward seeking professional psychological help were relatively positive among Chinese pregnant women, and stigma tolerance was the significant barrier to professional psychological help-seeking. More attention should be paid to those women with older age, negative coping style, and women with prenatal depressive symptoms.
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Affiliation(s)
- Sasa Huang
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Meili Xiao
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Ying Hu
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Guanxiu Tang
- Department of Geriatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Zhihong Chen
- Pediatric Intensive Care Unit, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Lijuan Zhang
- Department of Emergency Pediatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Bing Fu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China.
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11
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Mlouki I, Naimi A, Sioud I, Bouanene I, El Mhamdi S. Adverse childhood experiences and sleep disorders among Tunisian adolescents: The mediating role of internet addiction. CHILD ABUSE & NEGLECT 2023; 136:106028. [PMID: 36652900 DOI: 10.1016/j.chiabu.2023.106028] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a prevalent health problem worldwide. Different side effects have been linked to this issue such as sleep disorders. This matter is well known. However, its influencing mechanisms are not well investigated in literature. OBJECTIVE To investigate the mediating role of internet addiction in the relation between adverse childhood experiences (ACEs) and sleep disorders among a population of high-school students in the region of Gafsa (Tunisia). PARTICIPANTS AND SETTING We performed a cross-sectional study, in February 2020, including adolescents registered in all secondary schools of Gafsa city. METHODS Sleep disorders were evaluated via the Pittsburgh Sleep Quality Index, internet addiction via the Internet Addiction Test and adverse childhood experiences via the Adverse Childhood Experiences-International Questionnaire. RESULTS A total of 414 students were enrolled in our study with a mean age of 17.18 ± 1.5 years. Exposure to intra-familial violence was more reported than social adversities with 99.1 % and 84 % respectively. Males showed higher rates of internet addiction (82.9 % vs 78.3 %, p < 0.001). Sleep disorders were reported in 94 % of students, predominantly among females (95.4 % vs 91 %, p < 0.001). Our results revealed that ACEs predict sleep disturbances through internet addiction (% mediation =18.3 %, p = 0.005). More particularly, an important mediation effect of internet addiction on the relationship between ACEs and sleep disorders was found among females (% mediation =30 %). CONCLUSION Internet addiction was found to be a mediating factor in the relation between ACEs and sleep disturbances among Gafsa high school students.
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Affiliation(s)
- Imen Mlouki
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia; Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia; Research Laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia.
| | - Arij Naimi
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia
| | - Imen Sioud
- Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia
| | - Ines Bouanene
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia
| | - Sana El Mhamdi
- Preventive and Community Medicine, Faculty of Medicine of Monastir, University of Monastir, 5000, Tunisia; Department of Preventive and Community Medicine, Taher Sfar University Hospital, Mahdia 5100, Tunisia; Research Laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
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12
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Fekih-Romdhane F, Farah N, Malaeb D, Cheour M, Obeid S, Hallit S. Validation of the Arabic Version of the Community Assessment of Psychic Experiences (CAPE-42) in a Large Sample of Young Adults from the General Population. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01011-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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13
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Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals. Soc Psychiatry Psychiatr Epidemiol 2022; 58:641-656. [PMID: 36583767 DOI: 10.1007/s00127-022-02403-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking. METHODS We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public. RESULTS More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants. CONCLUSION Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations.
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14
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Fekih-Romdhane F, Smaoui O, Jahrami H, Cheour M. Attitudes and beliefs of Tunisian High-School teachers about schizophrenia: The impact of vignette gender. Int J Soc Psychiatry 2022; 68:1737-1747. [PMID: 34903062 DOI: 10.1177/00207640211057726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Teachers have a crucial active role in provision of mental health services to students and fighting against mental health stigma in schools, hence their attitudes and beliefs toward mental illness should be assessed. METHOD We carried-out a cross-sectional study with a non-probabilistic sample of 304 higher secondary school teachers. We used a structured questionnaire in which a vignette describing an individual with schizophrenia was presented, and was followed by a series of stigma-related questions. RESULTS A substantial proportion of teachers endorsed stressful life events (79.6%) as a cause of schizophrenia, elicited feelings of discomfort (41.4%) and incomprehension (41.1%) with the person displaying symptoms of schizophrenia, and agreed that the person's condition will deteriorate even more (45.4%). Teachers perceived that the person described in the vignette is dependent on others, lacks will, is different from others and is unpredictable in 65.1%, 59.2%, 55.6%, and 49.7% of cases, respectively. In addition, 38.5% and 34.2% of teachers recommended turning to traditional healers and to a Sheikh or an imam of a mosque, respectively. Regarding gender effects, females with schizophrenia were regarded as more likely to be unable to make her own decisions and to be dependent on others than males, and were less likely to be recommended for seeking help from a family physician or to consult a psychiatric hospital than males. CONCLUSION In the light of our findings, raising awareness of teachers of the impact of mental health issues on students should be prioritized in high schools in Tunisia.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.,Department of Psychiatry "Ibn Omrane," The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Manouba, Tunisia
| | - Olfa Smaoui
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Haitham Jahrami
- Ministry of Health, Manama, Kingdom of Bahrain.,College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.,Department of Psychiatry "Ibn Omrane," The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Manouba, Tunisia
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15
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Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. MEDICAL EDUCATION ONLINE 2022; 27:2093427. [PMID: 35747998 PMCID: PMC9245981 DOI: 10.1080/10872981.2022.2093427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Depression is common worldwide, and stigmatizing attitudes toward depression have proved to be one of the major barriers to seeking professional help. The purpose of this study was to evaluate the level of personal depression stigma and identify its predictive factors among medical students in Hainan, China, as well as explore the gender difference. A total of 2,186 medical students were recruited using stratified random cluster sampling and interviewed by structured anonymous questionnaires. Personal stigma was measured by the standardized Depression Stigma Scale (DSS). Multivariate linear regression models were used to identify predictors of stigma, and the interactions between gender and each predictor were included to test its gender difference. The mean score on DSS Scale was 13.71 ± 5.35, with males significantly higher than females (14.85 vs 12.99, P < 0.0001). Compared to females, males were more likely to agree with 'I would not vote for a class cadre if I knew they had been depressed' and 'I would not make friends with him if I knew he had been depressed'. Multivariate linear regression analysis revealed that males' personal stigma was predicted by being only child (ß = 1.01, P = 0.0083), moderate-to-severe depression (ß = 1.12, P = 0.0302), and lower self-rated academic core competitiveness (Competitive: ß = 1.29, P = 0.0088, Not at all/Somewhat competitive: ß = 1.04, P = 0.0381), while females' personal stigma was only associated with moderate-to-severe depression (ß = 1.75, P < 0.0001). Significant interactions were found between gender and self-rated academic core competitiveness. Stigmatizing attitudes toward depression were prevalent among Chinese medical students, especially male students. Gender differences were found in the predictors of stigma. Effective measures must be taken to reduce the stigma of mental health among Chinese medical students.
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Affiliation(s)
- Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Yawen Feng
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Jiaxin Luo
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Yinuo Zhang
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Qin Yang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, P. R. China
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16
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The factors and outcomes of stigma toward mental disorders among medical and nursing students: a cross-sectional study. BMC Psychiatry 2022; 22:357. [PMID: 35614424 PMCID: PMC9131538 DOI: 10.1186/s12888-022-03996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/10/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Medical and nursing students' attitudes toward mental disorders have a large impact on their working intentions in mental health settings and patients' health outcomes. However, there are few studies about the stigma toward mental disorders among medical and nursing students in China. METHODS In this cross-sectional study, a total of 838 medical and nursing students completed questionnaires on their sociodemographic characteristics and familiarity with people diagnosed with mental disorders as well as the Community Attitudes toward Mental Illness Scale (CAMI). The stigma was compared between medical students and nursing students by ANOVA. A multiple logistic regression model was built to explore the relationships among sociodemographic characteristics, familiarity with mental disorders and stigma. RESULTS The total mean score of the CAMI was 137.61 (SD = 15.63). The score for authoritarianism (M = 33.33, SD = 3.62) was the lowest score of the four subscales. Medical students showed more positive attitudes toward mental disorders than nursing students. However, after controlling the co-variables, the difference disappeared. Stigma was significantly associated with students' education, area of residence, marital status, economic status, history of mental disorders and familiarity with mental disorders. CONCLUSIONS Medical and nursing students show a negative attitude toward mental illness to a certain degree, especially regarding the view that people with mental disorders are inferior. Higher education level, residence in urban areas, single marital status, better economic status, and better familiarity with mental disorders may be related to less stigma among medical and nursing students.
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17
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Li XY, Liu Q, Chen P, Ruan J, Gong X, Luo D, Zhou Y, Yin C, Wang XQ, Liu L, Yang BX. Predictors of Professional Help-Seeking Intention Toward Depression Among Community-Dwelling Populations: A Structural Equation Modeling Analysis. Front Psychiatry 2022; 13:801231. [PMID: 35280177 PMCID: PMC8907597 DOI: 10.3389/fpsyt.2022.801231] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background A low intention of professional help seeking hinders the effective treatment of depression. The factors are from the perspectives of the social, family, and individual; however, an understanding of how they interact to predict professional help-seeking intention (PHSI) is not clear. Objectives The objectives of the study was to investigate PHSI toward depression in a Chinese community-dwelling population and construct a predictive model of the PHSI to explore the various factors involved. Methods Stratified random sampling and Kish table methods were used to identify 2,000 community residents. Participants completed a series of questionnaires to measure general characteristics, PHSI, professional help-seeking attitude, depression stigma, depression knowledge, family function, and depression symptoms. Analyses included descriptive statistics and Pearson correlation analysis using SPSS 26.0 and a Structural Equation Model using Amos 22.0. Results The score of the PHSI was 14.92 ± 9.574. Professional help-seeking attitude (r = 0.291, p < 0.001) and depression knowledge (r = 0.077, p = 0.002) were positively related to PHSI, while a negative correlation was found between stigma (r = -0.149, p < 0.001) and PHSI. The model of the PHSI indicated a good fit with a CMIN/DF = 2.740 and RESEA = 0.032. The total effect of the influencing factors on the PHSI was listed in the following order: professional help-seeking attitude (0.676) > stigma (-0.143) > depression knowledge (0.088) > depression symptoms (-0.009) > family function (0.005). The total effect of depression knowledge on PHSI included a direct negative effect (Beta = -0.266, p < 0.001) and an indirect positive effect (0.354) through professional help-seeking attitude and stigma. Also, depression knowledge was negatively associated with stigma (Beta = -0.153, p < 0.001). Depression symptoms were negatively associated with family function (Beta = -0.282, p < 0.001), depression knowledge (Beta = -0.252, p < 0.001), and stigma (Beta = -0.102, p < 0.001), indicating that people with less severe depression symptoms had good family function, depression knowledge, and higher stigma. Family function contributed a positive effect on depression knowledge directly (Beta = 0.145, p < 0.001) and a totally positive effect (0.033) on stigma. Conclusion The PHSI toward depression is low among Chinese community residents. Professional help-seeking attitude, depression knowledge, and family functioning were facilitators of PHSI, and stigma and the severity of depression symptoms were barriers to PHSI. This study provides reference for the development of policies and guidelines to promote community residents to actively seek professional mental health help. Future policies can focus on multicollaboration among the government, mental health services, and families to increase the mental health resources, improve family functioning, enhance mental health literacy (MHL) of the public, and reduce depression stigma to ease the burden of this mental health issue.
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Affiliation(s)
- Xin Yi Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- School of Nursing, Wuhan University, Wuhan, China
| | - Pan Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Juan Ruan
- Wuhan Mental Health Center, Wuhan, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Luo
- School of Nursing, Wuhan University, Wuhan, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China
| | - Cong Yin
- Wuhan Mental Health Center, Wuhan, China
| | | | | | - Bing Xiang Yang
- School of Nursing, Wuhan University, Wuhan, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
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18
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Validating measures of stigma against those with mental illness among a community sample in Kilifi Kenya. Glob Ment Health (Camb) 2022; 9:241-248. [PMID: 36618740 PMCID: PMC9806973 DOI: 10.1017/gmh.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/11/2022] [Accepted: 04/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Stigma against persons with mental illness is a universal phenomenon, but culture influences the understanding of etiology of mental illness and utilization of health services. METHODS We validated Kiswahili versions of three measures of stigma which were originally developed in the United Kingdom: Community Attitudes Toward the Mentally Ill Scale (CAMI), Reported and Intended Behaviors Scale (RIBS) and Mental Health Awareness Knowledge Schedule (MAKS) and evaluated their psychometric properties using a community sample (N = 616) in Kilifi, Kenya. RESULTS Confirmatory factor analysis confirmed the one-factor solution for RIBS [root mean-squared error of approximation (RMSEA) < 0.01, comparative fit index (CFI) = 1.00, Tucker-Lewis index (TLI) = 1.01] and two-factor solution for MAKS (RMSEA = 0.04, CFI = 0.96, TLI = 0.95). A 23-item, three-factor model provided the best indices of goodness of fit for CAMI (RMSEA = 0.04, CFI = 0.90, TLI = 0.89). MAKS converged with both CAMI and RIBS. Internal consistency was good for the RIBS and acceptable for CAMI and MAKS. Test-retest reliabilities were excellent for RIBS and poor for CAMI and MAKS, but kappa scores for inter-rater agreement were relatively low for these scales. Results support validity of the original MAKS and RIBS scale and a modified CAMI scale and suggest that stigma is not an enduring trait in this population. The low kappa scores are consistent with first kappa paradox which is due to adjustment for agreements by chance in case of marginal prevalence values. CONCLUSIONS Kiswahili versions of the MAKS, RIBS and a modified version of the CAMI are valid for use in the study population. Stigma against people with mental illness may not be an enduring trait in this population.
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Ruiz JC, Fuentes-Durá I, López-Gilberte M, Dasí C, Pardo-García C, Fuentes-Durán MC, Pérez-González F, Salmeron L, Soldevila-Matías P, Vila-Francés J, Balanza-Martínez V. Public stigma profile toward mental disorders across different university degrees in the University of Valencia (Spain). Front Psychiatry 2022; 13:951894. [PMID: 36032229 PMCID: PMC9411748 DOI: 10.3389/fpsyt.2022.951894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A large proportion of studies carried out in recent years in different populations have shown that stigma toward mental disorders is highly prevalent. In the present study we conducted a comprehensive assessment of stigma to describe and compare stigma toward mental disorders in students enrolled in five different university degrees. METHODS Three hundred and twenty-five students from the University of Valencia (Spain), attending the second term of their first-degree courses in the faculties of medicine, psychology, teaching, economics, and data science participated in this cross-sectional study. Stigma was measured using: the Reported and Intended Behavior Scale (RIBS), the Scale of Community Attitudes toward Mental Illness (CAMI), the Attribution Questionnaire (AQ-27), and the Knowledge about Mental Illness test (KMI). RESULTS We found different patterns of stigma according to gender, the fact of knowing or living with a person with mental disorders and the university degree studied. Overall, women show fewer stigmatizing attitudes than men but similar stereotypes and prejudice toward people with mental disorders. However, the pattern of results across degrees is more complex. Overall, students of medicine, psychology and teaching showed fewer stigmatizing attitudes than students of economics and data science but differences between degrees were more subtle in stereotypes and prejudice toward people with mental disorders. CONCLUSION Our study suggests the existence of different profiles of stigma in relation to mental disorders in university students. These profiles varied in relation with the degree being studied, gender and already knowing or living with a person with mental disorders.
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Affiliation(s)
- Juan C Ruiz
- Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Faculty of Psychology, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | - Carmen Dasí
- Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | | | | | | | | | - Joan Vila-Francés
- Intelligent Data Analysis Laboratory (IDAL), University of Valencia, Valencia, Spain
| | - Vicent Balanza-Martínez
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
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20
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Time Waits for No One: Longitudinal Study on the Effects of an Anti-Stigma Seminar on the Psychology Student Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105441. [PMID: 34069628 PMCID: PMC8161382 DOI: 10.3390/ijerph18105441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022]
Abstract
The primary aim is to describe the changes in the knowledge of mental health conditions, the attitudes toward the mentally ill, and the intended behaviour towards people with mental illness among the entire student population of the third year of a degree course in Psychology. A total of 570 students attended a seminar on stigma towards mental illness and were invited to complete an online survey which collected data on sociodemographic characteristics and three validated questionnaires evaluating different aspects of stigma at three different time points (pre-intervention, post-intervention, and at one year follow up). A total of 253 students (44.39%) completed the questionnaires at t0, t1, and t2. The mean age of the sample was 23.7 (SD = ±5.89), and 86.96% (n = 220) were females. Between t0 and t1, a statistically significant improvement was observed for all three outcomes, while the intended behaviour outcome was no longer significant between t1 and t2 (Z = −0.70; p = 0.48). Females and who participated live at the seminar maintained a significant knowledge of mental illness and a better attitude toward community mental health care. The effects of the seminar focused on reducing stigma tended to diminish over time at one year follow-up, particular in relation to intended behaviour.
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