1
|
Luo T, Xu S, Zhang K. Policies for recovery from drug use: Differences between public stigma and perceived stigma and associated factors. Drug Alcohol Rev 2024. [PMID: 38326226 DOI: 10.1111/dar.13818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Public stigma towards people who use drugs is widespread and places obstacles in way of their recovery. Previous studies have used different approaches to measure public stigma, resulting in a notable gap in the understanding of the relationship between it and its associated factors. Some studies measure public stigma by assessing stigma perceived by those who use drugs, while others investigate attitudes towards them among the general public. This study aimed to compare perceived and public stigma, and factors related to these two variables. METHODS The study comprised a cross-sectional survey in China of two samples: males who used drugs (N = 257) and the general public (N = 376). The survey assessed demographic variables, social distance, public stigma and perceived stigma of those who use drugs. The data were analysed using t-tests and linear regression. RESULTS Public stigma was significantly higher than perceived stigma. The findings indicated that gender, knowledge of drugs, family relationships with people who use drugs, attributions of drug use and social distance were significantly related to levels of public stigma. Among those who use drugs, perceived stigma was significantly correlated with age, marital status, duration of drug abstinence and social distance. DISCUSSION AND CONCLUSIONS Findings indicate that public stigma undermines the recovery of people who use drugs and highlight the importance of interaction between them and the social environment. The study also underscores the necessity of developing policies to enhance their integration into mainstream culture and provide access to social support and life activities.
Collapse
Affiliation(s)
- Tingyu Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shuping Xu
- Department of Social Work, East China University of Political Science & Law, Shanghai, China
| | - Kun Zhang
- Department of Social Work, East China University of Political Science & Law, Shanghai, China
| |
Collapse
|
2
|
Ghajarzadeh M, Fitzgerald KC, Mowry EM, Nourbakhsh B. Association between demographics, socioeconomics, and disease-related factors and the perception of stigma in people with MS. Mult Scler 2024; 30:238-246. [PMID: 38179970 DOI: 10.1177/13524585231223057] [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] [Indexed: 01/06/2024]
Abstract
BACKGROUND Stigma is prevalent among individuals with chronic diseases, such as multiple sclerosis (MS) and those with comorbid mental health disorders, but its associated factors are poorly understood. OBJECTIVE To investigate the prevalence and correlates of stigma in people living with MS. METHODS We analyzed data from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network, which collected patient information and outcomes during routine clinic visits. We used a multinomial logistic regression model to examine the cross-sectional association between stigma and demographic, socioeconomics, and MS-related factors. RESULTS We included 11,634 participants. The mean Neuro-QoL stigma T-score was 47.2 ± 8.6, and 17.7% of participants were classified as having moderate to severe stigma using established cutoffs. Multinomial logistic regression models suggest that higher disability levels, progressive form of the disease, shorter duration of the disease, and unemployment were associated with higher stigma while being male, married, undergoing treatment with high-efficacy disease-modifying therapies (DMTs), and being from European MS centers were associated with lower stigma perception. Disability levels, measured by Patient-Determined Disease Steps (PDDS), had the strongest independent association with stigma. CONCLUSION Stigma remains a relevant issue for people living with MS. Factors, such as physical and cognitive disability, DMT, and employment status may influence the severity of perceived stigma.
Collapse
Affiliation(s)
- Mahsa Ghajarzadeh
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathryn C Fitzgerald
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Ellen M Mowry
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Bardia Nourbakhsh
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
3
|
Albarraq RH, Alhujaili NA, Alshehri ZI, Alqarni AM, Bawareth RM. Anticipated Stigma among Patients with Multiple Sclerosis in Saudi Arabia. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:54-59. [PMID: 38362097 PMCID: PMC10866384 DOI: 10.4103/sjmms.sjmms_21_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/06/2023] [Accepted: 08/09/2023] [Indexed: 02/17/2024]
Abstract
Background Social stigma is a major problem among patients with multiple sclerosis (MS), which can affect their quality of life. There is limited research from Saudi Arabia on the anticipated stigma among patients with MS. Objectives To determine the levels of anticipated stigma and its predictors in patients with MS in Saudi Arabia. Methods This cross-sectional study included adult patients with MS across Saudi Arabia. Sociodemographic and medical information, including age, gender, marital status, educational level, duration of disease, number of MS episodes in the past 12 months, previous diagnosis of mental illness, and performing activities of daily living without assistance, were collected. Anticipated stigma was measured using an Arabic version of the Chronic Illness Anticipated Stigma Scale. Results A total of 222 patients with MS were included. Moderate to severe anticipated stigma was found among 70.4% of the patients. The highest anticipated stigma mean score was from work colleagues (2.96/5). Predictors of stigma were age (P = 0.049), gender (P = 0.016), marital status (P = 0.015), education level (P = 0.003), number of MS episodes in the previous year (P < 0.001), and previous diagnosis of a mental disorder (P = 0.001). Conclusions The findings of this study indicate the need for developing programs that reduce the anticipated stigma among patients with MS in Saudi Arabia.
Collapse
Affiliation(s)
| | - Naseem Abdulmohi Alhujaili
- Department of Medicine, Division of Psychiatry, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | | |
Collapse
|
4
|
Taher TMJ, Ahmed HA, Abutiheen AA, Alfadhul SA, Ghazi HF. Stigma perception and determinants among patients with type 2 diabetes mellitus in Iraq. J Egypt Public Health Assoc 2023; 98:20. [PMID: 38017311 PMCID: PMC10684431 DOI: 10.1186/s42506-023-00145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND AND PURPOSE Diabetes mellitus (DM) is a leading cause of death worldwide. Stigma is a sign of social disgrace occurring within public relations, and it is linked with many health conditions including diabetes. Stigma could worsen the disease course, reduce treatment adherence, and affect the quality of life of diabetic patients. The objective of this study was to assess the magnitude of diabetic stigma among patients with type 2 DM. METHODS In this analytic cross-sectional study, data collection was performed from June 1, 2022, until November 1, 2022, et al.-Najaf City, Iraq. A consecutive sample of 429 patients with type 2 DM was interviewed using the Arabic version of the type 2 Diabetes Stigma Assessment Scale (DSAS-2), which is a validated tool. The total diabetic stigma score, treated differently score, self-stigma score, and blame and judgment score were estimated. RESULTS The mean age of the sample was 56.6 years, and males represented 61.8% of them. The total diabetic stigma score mean was 51.72. The question regarding people's judgment of food choices showed the highest rate (53%) among patients. Problematic stigma appeared in 24.71% of DM patients. Lower educational level, being divorced or widow, age above 50 years, being unemployed or housewife, and lower income showed significantly higher diabetic stigma scores. CONCLUSION One-quarter of type 2 DM patients showed problematic stigma. The mean diabetic stigma score was significantly higher among patients with lower education, divorced or widow status, older age, unemployment or housewife category, and low-income status.
Collapse
Affiliation(s)
- Taqi M J Taher
- Family and Community Medicine Department, College of Medicine, Wasit University, Wasit, Iraq
| | - Hussein A Ahmed
- Family and Community Medicine Department, Faculty of Medicine, University of Kufa, Kufa, Iraq
| | - Ali A Abutiheen
- Family and Community Medicine Department, College of Medicine, University of Kerbala, Kerbala, Iraq
| | - Shaymaa A Alfadhul
- Family and Community Medicine Department, Faculty of Medicine, University of Kufa, Kufa, Iraq
| | | |
Collapse
|
5
|
Foster J, Pettinicchio D, Maroto M, Holmes A, Lukk M. Trading Blame: Drawing Boundaries around the Righteous, Deserving and Vulnerable in Times of Crisis. SOCIOLOGY 2023; 57:1040-1059. [PMID: 37810547 PMCID: PMC10555531 DOI: 10.1177/00380385221137181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Symbolic boundaries shape how we see and understand both ourselves and those around us. Amid periods of crisis, these boundaries can appear more salient, sharpening distinctions between 'us' and 'them' and reinforcing inequalities in the social landscape. Based on 50 in-depth interviews about pandemic experiences among Canadians with disabilities and chronic health conditions, we examine how this community distinguishes between the 'deserving' and 'undeserving', and how emotions related to blame and resentment inform the boundaries they draw. We find that people with disabilities and chronic health conditions drew boundaries based on unequal health statuses and vulnerabilities and between those who are and are not legitimately entitled to government aid. Underlying these dimensions are a familiar set of moral tropes that respondents use to assert their own superiority and to inveigh their frustrations. Together, they play an important role in solidifying boundaries between groups, complicating public perceptions of policy responses to crisis.
Collapse
|
6
|
Mei Y, Yang X, Gui J, Li Y, Zhang X, Wang Y, Chen W, Chen M, Liu C, Zhang L. The relationship between psychological resilience and depression among the diabetes patients under the background of "dynamic zero COVID-19": the mediating role of stigma and the moderating role of medication burden. Front Public Health 2023; 11:1124570. [PMID: 37680269 PMCID: PMC10481163 DOI: 10.3389/fpubh.2023.1124570] [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: 12/15/2022] [Accepted: 08/11/2023] [Indexed: 09/09/2023] Open
Abstract
Objective Depression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China's dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden. Method From June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis. Results (1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of "psychological resilience → stigma → depression." Conclusion Under the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.
Collapse
Affiliation(s)
- Yujin Mei
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Xue Yang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - JiaoFeng Gui
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - YuQing Li
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - XiaoYun Zhang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Ying Wang
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Wenyue Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Mingjia Chen
- School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| | - Changjun Liu
- School of Marxism, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Higher Education Park, Wuhu City, Anhui Province, China
| |
Collapse
|
7
|
Mei Y, Yang X, Liu C, Li Y, Gui J, Zhang L. The impact of psychological resilience on chronic patients' depression during the dynamic Zero-COVID policy: the mediating role of stigma and the moderating role of sleep quality. BMC Psychol 2023; 11:213. [PMID: 37480116 PMCID: PMC10362636 DOI: 10.1186/s40359-023-01248-6] [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: 09/10/2022] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVE Chronic patients are experiencing depression caused by themselves or the surrounding environment, how to cope with the change of mentality and adjust the psychological stress response, especially under the background of the current dynamic Zero-COVID policy in China, is a problem worth further discussion. The researchers constructed a mediating regulation model to test the influence of psychological resilience on depression of chronic patients during dynamic Zero-COVID, as well as the mediating role of stigma and the moderating role of sleep. METHOD From October 2021 to February 2022, this study used a multi-stage sampling method and random number table method to collect data in the Shang Cheng District of Hangzhou City, Zhejiang Province. Firstly, the Second Affiliated Hospital of the Zhejiang University School of Medicine, a third-class hospital was randomly selected from the Shang Cheng District. Secondly, three departments were strategically selected from this hospital: endocrinology, dermatology, and traditional Chinese medicine. Thirdly, survey points were set up in each department, and chronic patients were strategically selected for questionnaire surveys. Finally, a face-to-face survey was conducted on 398 chronic patients who met the criteria for inclusion. In addition, chronic medical illness burden was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G), psychological resilience was measured by the Conner-Davidson Resilience Scale (CD-RISC), stigma was measured by the Stigma Scale for Chronic Illness (SSCI), sleep was measured by the Pittsburgh Sleep Quality Index(PSQI) and depression was estimated by the Patient Health Questionaire-9(PHQ-9). SPSS (version 25.0) and PROCESS (version 4.0) were used for correlation analysis, mediation analysis, and mediated moderation analysis. RESULTS Psychological resilience was negatively correlated with depression, stigma, and sleep. Depression was positively correlated with stigma and sleep. Stigma and sleep were positively correlated; Stigma played a mediating role in the relationship between psychological resilience and depression; Sleep moderated the first half of the pathway "psychological resilience [Formula: see text] stigma [Formula: see text] depression". CONCLUSION Psychological resilience affected depression directly and indirectly through stigma. At the same time, sleep played a moderating role between psychological resilience and depression. The correlation between psychological resilience and stigma was stronger when levels of sleep levels were higher.
Collapse
Affiliation(s)
- Yujin Mei
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Xue Yang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Changjun Liu
- School of Marxism, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Yuqing Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Jiaofeng Gui
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, Anhui Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China.
| |
Collapse
|
8
|
Cerqueira A, Botelho Guedes F, Marques-Pinto A, Branco A, Galvão C, Sousa J, Goulao LF, Bronze MR, Viegas W, Gaspar T, Godeau E, de Matos MG. Chronic Conditions and School Participation of First-Year University Students-HOUSE ULisbon Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1397. [PMID: 36138706 PMCID: PMC9497637 DOI: 10.3390/children9091397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022]
Abstract
Students with chronic conditions (CC) tend to experience several barriers in terms of their school participation and performance. Therefore, the present study aims to explore the factors related to the time of diagnosis of CC (recent/non-recent), the barriers to participation and academic success (health condition, people's attitude towards CC and school physical environment), the physical and mental health (physical/psychological symptoms and concerns) and school-related variables (relationship with teachers and peers), regarding the school participation of first-year students with CC. This work is part of the HOUSE-Colégio F3 Project, University of Lisbon, which includes 1143 first-year university students from 17 Faculties and Institutes of the University of Lisbon. In this specific study, only the subsample of 207 students with CC was considered, 72.4% of which were female, aged between 18 and 54 years (M = 20.00; SD = 4.83). The results showed that students with a recent diagnosis of CC and students with school participation affected by the CC were those who presented more negative indicators regarding barriers to school participation, physical and mental health, and school-related variables. A greater impact of CC in terms of school participation was associated with having a recent diagnosis, with people's attitude towards CC and with the health condition as barriers, with more psychological symptoms and worse relationships with teachers and peers. This is a relevant message for the organization of health services for students with CC at the beginning of their university studies, especially since they are often displaced from home and managing their health conditions alone (in many cases, for the first time).
Collapse
Affiliation(s)
- Ana Cerqueira
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Faculty of Human Kinetics, University of Lisbon/FMH-UL, 1499-002 Lisbon, Portugal
| | - Fábio Botelho Guedes
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Faculty of Human Kinetics, University of Lisbon/FMH-UL, 1499-002 Lisbon, Portugal
| | - Alexandra Marques-Pinto
- Research Center for Psychological Science, Faculty of Psychology of the University of Lisbon, 1649-013 Lisbon, Portugal
| | - Amélia Branco
- GHES Research Center—Office of Economic and Social History, ISEG—Lisbon School of Economics & Management of the University of Lisbon, 1249-078 Lisbon, Portugal
| | - Cecília Galvão
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Institute of Education, University of Lisbon (IEUL), 1649-013 Lisbon, Portugal
| | - Joana Sousa
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Nutrition Laboratory, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Luis F. Goulao
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Unit, School of Agriculture, University of Lisbon (ISA/ULisbon), 1349-107 Lisbon, Portugal
| | - Maria Rosário Bronze
- Faculty of Pharmacy, University of Lisbon (FFULisbon), 1649-003 Lisbon, Portugal
- Institute of Experimental Biology and Technology (iBET), 2780-157 Lisbon, Portugal
| | - Wanda Viegas
- Linking Landscape, Environment, Agriculture and Food (LEAF) Research Unit, School of Agriculture, University of Lisbon (ISA/ULisbon), 1349-107 Lisbon, Portugal
| | - Tania Gaspar
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Digital Human-Environment Interaction Labs (HEI-LAB), Lusófona University of Humanities and Technologies, 1749-024 Lisbon, Portugal
| | - Emmanuelle Godeau
- French School of Public Health, EHESP, 35043 Rennes, France
- CERPOP—UMR 1295, Unite Mixte UMR INSERM—Université Toulouse III Paul Sabatier—Team SPHERE, 31000 Toulouse, France
| | - Margarida Gaspar de Matos
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- APPSYci, ISPA—University Institute, 1149-041 Lisbon, Portugal
| |
Collapse
|
9
|
Salih MH, Mekonnen H, Derseh L, Lindgren H, Erlandsson K. Anticipated stigma and associated factors among chronic illness patients in Amhara Region Referral Hospitals, Ethiopia: A multicenter cross-sectional study. PLoS One 2022; 17:e0273734. [PMID: 36107943 PMCID: PMC9477324 DOI: 10.1371/journal.pone.0273734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Anticipated stigma related to chronic illness patients undermines diagnosis, treatment, and successful health outcomes. The study aimed to assess the magnitude and factors associated with anticipated stigma among patients with chronic illness attending follow-up clinics in Amhara Region Referral Hospitals, Ethiopia. Methods A cross-sectional institution-based study was conducted in Amhara Region Referral Hospitals from 01 March to 15 April 2021. A simple random sampling technique was used to select the three Referral Hospitals in the region and study subjects. Data were collected using a pre-tested interview-based questionnaire. Data were entered and cleaned with Epi-Info version 6 and exported for analysis STATA version 14. Multiple linear regression was used to show the association between anticipated stigma and potential factors. Associations were measured using ß coefficients and were considered statistically significant if the p-value > 0.05. Results A total of 779 patients were included for analysis with a response rate of 97%. Their mean (Standard deviation) of anticipated stigma was estimated at 1.86 and 0.5, respectively. After running an assumption test for multiple linear regression; educational status, cigarette smoking, psychological distress, medication adherence, alcohol consumption, and social part of the quality of life were statically significantly associated with anticipated stigma. Conclusion and recommendation The result showed a high level of anticipated stigma reported among the participants. Emphasizing improving their social part of the quality of life, avoiding risky behaviors like alcohol consumption and cigarette smoking, access to health education for chronically ill patients, integrating mental health in all types of chronic disease, and developing strategies and protocols which will help to improve patient medication adherence to their prescribed medication will be crucial. This can provide a foundation for government andnon-governmental organizations, and researchers implementing evidence-based interventions and strategies on chronic care to address factors related to anticipated stigma.
Collapse
Affiliation(s)
- Mohammed Hassen Salih
- University of Gondar, College of Medicine and Health Sciences, School of Nursing, Gondar, Ethiopia
- * E-mail:
| | - Hussen Mekonnen
- Addis Ababa University, School of Nursing and Midwifery, College of Nursing and Midwifery, Addis Ababa, Ethiopia
| | - Lema Derseh
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Helena Lindgren
- Department of Women’s and Children’s Health, Karolinska Institute, Solna, Sweden
| | - Kerstin Erlandsson
- Department of Women and Children’s Health, Karolinska Institute, Karolinska Institutet, Solna and School of Health and Welfare, Dalarna University, Falun, Sweden
| |
Collapse
|
10
|
Anand T, Kandasamy A, Suman LN. Self-stigma, hope for future, and recovery: An exploratory study of men with early-onset substance use disorder. Ind Psychiatry J 2022; 31:299-305. [PMID: 36419702 PMCID: PMC9678179 DOI: 10.4103/ipj.ipj_52_21] [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: 03/04/2021] [Revised: 06/17/2021] [Accepted: 07/30/2021] [Indexed: 03/14/2023] Open
Abstract
CONTEXT The internalizing of experience of stigma among patients with substance use disorders (SUDs) can be debilitating to recovery. Individual factors such as self-regulation and abstinence self-efficacy can impact confidence in recovery and hope for future. AIMS The aim of the study was to explore relationship among self-stigma, self-regulation, self-efficacy, optimism, and confidence in recovery of patients with early-onset SUDs. SETTINGS AND DESIGN The study was carried out on a sample of 40 male patients with SUDs. The study had a single group exploratory design. MATERIALS AND METHODS The Self-Regulation Questionnaire, Drug Taking Confidence Questionnaire, Substance Abuse Self Stigma Scale, Revised Generalized Expectancy of Success (GES), and visual analog scale for craving were the measures used in the study. STATISTICAL ANALYSIS Pearson and spearman's correlation coefficient were used to test associations between the variables. Multiple regression models were drawn to examine predictors of generalized expectancy of success and confidence in recovery. RESULTS Self-regulation, generalized expectancy of success (optimism), and confidence in recovery were found to be significantly correlated with self-stigma dimensions. The multiple regression model revealed self-regulation and self-devaluation as significant predictors of optimism (GES), whereas abstinence self-efficacy and values disengagement dimension of self-stigma predicted patients' confidence in recovery. CONCLUSIONS Poor regulatory capacities along with internalized feelings of shame, guilt, and devaluation may lead to lower levels of optimism and poorer expectancies of success from future. Patient's self-efficacy in terms of abstaining from use behaviors and disengagement from pursuing life goals can lead to lower levels of confidence in recovery from SUDs and have implications for treatment seeking.
Collapse
Affiliation(s)
- Tanya Anand
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| |
Collapse
|
11
|
Propiedades psicométricas de la versión en español del Type 2 Diabetes Stigma Assessment Scale (DSAS 2) en población colombiana. BIOMÉDICA 2022; 42:41-54. [PMID: 35866729 PMCID: PMC9388199 DOI: 10.7705/biomedica.6128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Indexed: 11/21/2022]
Abstract
Introducción. El estigma se ha asociado negativamente al control metabólico y la calidad de vida de pacientes con diabetes de tipo 2. El cuestionario Diabetes Stigma Assesment Scale 2 (DSAS 2) fue diseñado para medir específicamente el estigma asociado en personas con este tipo de diabetes. Sin embargo, las propiedades psicométricas de su versión en español aún no han sido analizadas. Objetivo. Analizar la validez y confiabilidad de la versión en español del DSAS 2 en población colombiana. Materiales y métodos. Se solicitó a 501 pacientes con diabetes de tipo 2 en Barranquilla contestar la versión en español del DSAS 2, un cuestionario con indicadores sociodemográficos y clínicos, así como instrumentos de medición de la depresión, la autoeficacia y el estrés. Se hizo un análisis factorial (exploratorio y confirmatorio) para determinar la estructura interna del DSAS 2 en español y se usó el coeficiente alfa (α) para evaluar su confiabilidad. Además, se analizó la relación entre los puntajes del DSAS 2 y las otras variables estudiadas. Resultados. La estructura de tres factores (trato diferente-juicio, culpa y vergüenza) se ajustó adecuadamente a los datos (raíz del error cuadrático medio (RMSEA)=0,081, índice de ajuste comparativo (CIF)=0,959, índice de Tucker-Lewis (TLI)=0,95) y su confiabilidad fue buena (α=0,76). Se observaron correlaciones significativas del puntaje del DSAS 2 en español con la autoeficacia (rs=-0,37; p<0,001), el estrés (rs=0,24; p<0,001) y la presencia de síntomas depresivos (rs=0,1; p=0,021). Además, los puntajes de la escala mostraron variaciones asociadas a variables sociodemográficas y clínicas. Conclusiones. La versión en español presenta ciertas diferencias con la versión original del DSAS2, sin embargo, su validez y confiabilidad son suficientes y adecuadas para su uso en Colombia.
Collapse
|
12
|
Salih MH, Wettergren L, Lindgren H, Erlandsson K, Mekonen H, Derseh L. Translation and psychometric evaluation of chronic illness anticipated stigma scale (CIASS) among patients in Ethiopia. PLoS One 2022; 17:e0262744. [PMID: 35061829 PMCID: PMC8782391 DOI: 10.1371/journal.pone.0262744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background Stigma is common among patients with chronic illnesses. It affects the delivery of healthcare for not addressing the psychological components and may interfere with the patient’s attendance to necessary health care services. Therefore, a valid and reliable instrument to measure anticipated stigma related to chronic illness is vital to inform possible interventions. This study aimed to translate the Chronic Illness Anticipated Stigma Scale (CIASS) into the Amharic language and evaluate its psychometric properties in Ethiopia. Methods The CIASS was translated into Amharic language using standard procedures. The Amharic version was completed by 173 patients (response rate 96%) with chronic illness from three referral hospitals in the Amhara region. Internal consistency was examined through Cronbach’s alpha. Construct validity was evaluated by confirmatory factor analysis and convergent validity by using a Pearson correlation of P-value less than or equal to 0.05. Results The internal consistency was estimated at Cronbach alpha of 0.92. By using a structural equation model, and modification indices a model fitness testing was run and shows a root mean squared error of approximation 0.049 (90% CI, 0.012–0.075). The structural validity results in 78.8% of confirmatory factor analysis showed from the extraction of the three-dimension (components). Validity tests for convergent by using Pearson correlation positively correlated with common mental distress and negatively correlated with quality of life–BREF, and the construct validity shows a good valid tool to CIASS. Conclusion The Amharic language version of the chronic illness anticipated stigma scale shows a satisfactory level of reliability and validity on different psychometric measures of assessment. The tool may be useful for future researchers and patients with chronic illness in the Amharic-speaking population. Moreover, it will be used to see the psychological burden related to chronic illness and for comparison among international population groups.
Collapse
Affiliation(s)
- Mohammed Hassen Salih
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Lena Wettergren
- Department of Public Health and Caring Sciences, Uppsala University and Department of Women’s and Children’s Health, Karolinska Institute, Solna, Sweden
| | - Helena Lindgren
- Department of Women’s and Children’s Health, Karolinska Institute, Solna, Sweden
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University and Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institute, Solna, Sweden
| | - Hussen Mekonen
- School of Nursing and Midwifery, College of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lemma Derseh
- College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
13
|
Associations of perceived stigma, perceived environmental inaccessibility, and self-compassion among people with physical disability in Hong Kong. Disabil Health J 2022; 15:101274. [DOI: 10.1016/j.dhjo.2022.101274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/12/2021] [Accepted: 01/20/2022] [Indexed: 11/20/2022]
|
14
|
Pedrero V, Manzi J, Alonso LM. A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12657. [PMID: 34886383 PMCID: PMC8656822 DOI: 10.3390/ijerph182312657] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of stigma surrounding type 2 diabetes in the Colombian population and its relationships with sociodemographic, clinical, psychosocial variables and behaviors related to management of the disease (self-management behaviors). This cross-sectional study included 501 Colombian adults with type 2 diabetes. We estimated the relation between stigma and selected variables through linear regression models. Additionally, we analyzed the mediator role of psychosocial variables in the relationship between stigma and self-management behaviors through structural equation models. A total of 16.4% of patients showed concerning levels of stigma. The time elapsed since diagnosis (β = -0.23) and socioeconomic status (β = -0.13) were significant predictors of the level of stigma. Stigma was negatively correlated with self-efficacy (β = -0.36), self-esteem (β = -0.37), and relationship with health care provider (β = -0.46), and positively correlated with stress (β = 0.23). Self-efficacy, self-esteem, and the relationships with health care providers had a mediation role in the relationship between stigma and self-management behaviors. These variables would be part of the mechanisms through which the perception of stigma harms self-management behaviors. The stigma of type 2 diabetes is frequent in the Colombian population and negatively associated with important aspects of disease management.
Collapse
Affiliation(s)
- Victor Pedrero
- Nursing Faculty, Universidad Andrés Bello, Santiago 8370146, Chile
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Jorge Manzi
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Luz Marina Alonso
- Department of Public Health, Universidad del Norte, Barranquilla 081007, Colombia;
| |
Collapse
|
15
|
Cococcia S, Lenti MV, Mengoli C, Klersy C, Borrelli de Andreis F, Secco M, Ghorayeb J, Delliponti M, Corazza GR, Di Sabatino A. Validation of the Italian translation of the perceived stigma scale and resilience assessment in inflammatory bowel disease patients. World J Gastroenterol 2021; 27:6647-6658. [PMID: 34754158 PMCID: PMC8554395 DOI: 10.3748/wjg.v27.i39.6647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/21/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Stigmatization is the separation of an individual from a group due to aspects that make them different. Resilience may in turn influence the perception of stigma. Patients with inflammatory bowel disease (IBD) are susceptible to stigma, although data are very limited.
AIM To validate an Italian translation of the IBD perceived stigma scale (PSS) in relation to patients’ resilience.
METHODS Consecutive IBD outpatients were prospectively enrolled (December 2018-September 2019) in an Italian, tertiary referral, IBD center. Clinical and demographic data were collected. Stigma and resilience were evaluated through the IBD-PSS and the 25-item Connor-Davidson Resilience Scale, respectively. The International Quality of Life Assessment Project approach was followed to translate the IBD-PSS into Italian and to establish data quality. Higher scores represent greater perceived stigma and resilience. Multivariable analysis for factors associated with greater stigma was computed.
RESULTS Overall, 126 IBD patients (mean age 46.1 ± 16.9) were enrolled. The International Quality of Life Assessment criteria for acceptable psychometric properties of the scale were satisfied, with optimal data completeness. There was no ceiling effect, whilst floor effect was present (7.1%). The discriminant validity and the internal consistency reliability were good (Cronbach alpha = 0.87). The overall internal consistency was 95%, and the test-retest reliability was excellent 0.996. The median PSS score was 0.45 (0.20-0.85). Resilience negatively correlated with perceived stigma (Spearman’s correlation = -0.18, 95% confidence intervals: -0.42-0.08, P = 0.03).
CONCLUSION We herein validated the Italian translation of the PSS scale, also demonstrating that resilience negatively impacts perceived stigma.
Collapse
Affiliation(s)
- Sara Cococcia
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Marco Vincenzo Lenti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Caterina Mengoli
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Catherine Klersy
- Service of Biometry & Statistics, Foundation IRCCS Policlinico San Matteo, Pavia 27100, Lombardia, Italy
| | - Federica Borrelli de Andreis
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Matteo Secco
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Jihane Ghorayeb
- Psychology, Zayed University, Dubai 00000, United Arab Emirates
| | - Mariangela Delliponti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Gino Roberto Corazza
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia 27100, Lombardia, Italy
| |
Collapse
|
16
|
Brown RL, Ciciurkaite G. The "Own" and the "Wise" Revisited: Physical Disability, Stigma, and Mental Health among Couples. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:170-182. [PMID: 33719633 DOI: 10.1177/0022146521998343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Utilizing data from a cross-sectional community survey of 455 heterosexual couples in which at least one partner has a physical disability, we examine the associations between stigma and psychological distress for both partners. We also assess whether these associations are moderated by gender. Findings from an actor-partner interdependence model analysis reveal that personally experienced stigma and vicarious stigma experiences have additive effects on psychological distress, but only among women. We discuss how these findings extend a relational understanding of stigma and its effects and implications for research and practice.
Collapse
|
17
|
Ma GYK, Mak WWS. Perceptions of the International Symbol of Accessibility among nondisabled university students in Hong Kong. APPLIED ERGONOMICS 2021; 92:103314. [PMID: 33307383 DOI: 10.1016/j.apergo.2020.103314] [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: 03/17/2020] [Revised: 09/25/2020] [Accepted: 11/10/2020] [Indexed: 06/12/2023]
Abstract
The present experimental study involved 346 university students without self-reported disability and investigated the perceived symbolic meanings of the International Symbol of Accessibility (ISA) along with its associations with stereotypes toward wheelchair users and the perceived inclusiveness of the social climate. Participants were randomized into four groups with exposure to either the ISA, Motion-symbol, Universal-Design-symbol, or all-symbols. The results showed that different symbols were associated with different patterns of perceived symbolic meanings. Exposure to the Universal-Design-symbol, which emphasizes equality (but not the Motion-symbol, which emphasizes autonomy), was significantly and indirectly associated with relatively lower stereotypes toward wheelchair users (and perceived less inclusive social climate) through associating the Universal-Design-symbol with relatively lower perceived symbolic meanings of "Passive" and "Labeling" (and "Passive") compared to exposure to the ISA. Recommendations for a contextual-dependent replacement of symbol, the methodology of implicit association tests, and the usage of symbols of access in cartography were discussed.
Collapse
Affiliation(s)
- Gloria Y K Ma
- Diversity and Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.
| | - Winnie W S Mak
- Diversity and Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| |
Collapse
|
18
|
Namkung EH, Carr D. The Psychological Consequences of Disability over the Life Course: Assessing the Mediating Role of Perceived Interpersonal Discrimination. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2020; 61:190-207. [PMID: 32425066 PMCID: PMC7450392 DOI: 10.1177/0022146520921371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We examine whether perceived interpersonal discrimination mediates the association between disability and psychological well-being (depression, negative and positive affect) and how these processes differ across the life course. Data are from two waves (2004-2006; 2013-2014) of the Midlife in the United States (MIDUS; N = 2,503). Perceived discrimination accounts for 5% to 8% of the association between disability and the three mental health outcomes. Moderated mediation analyses reveal significant age differences; perceived discrimination is a stronger explanatory mechanism among midlife (ages 40-64) relative to older (age 65+) adults. Disability stigma takes a heightened psychological toll at midlife, a life stage when adults are expected to be able-bodied and interact with a diverse social network, which may be a source of interpersonal mistreatment. Among older adults, for whom impairment is expected and common, the psychological impact of disability may operate through other pathways. We discuss implications for research and practice.
Collapse
|
19
|
Kleinstäuber M, Wolf L, Jones ASK, Dalbeth N, Petrie KJ. Internalized and Anticipated Stigmatization in Patients With Gout. ACR Open Rheumatol 2020; 2:11-17. [PMID: 31943969 PMCID: PMC6957912 DOI: 10.1002/acr2.11095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 11/26/2022] Open
Abstract
Objective To investigate the relationship between stigma perception and demographic, clinical, and psychosocial variables. Methods A sample of 50 patients with gout and prescribed urate‐lowering medication (84% were males, mean serum urate 0.34 mmol/l) completed questionnaires on internalized and anticipated stigma, demographics, clinical gout‐related variables, and psychosocial variables (illness perceptions, illness‐related disability, illness‐related body satisfaction, intentional nonadherence). Serum urate level was obtained from the most recent blood test. Results In this sample, 26% experienced internalized stigma, 26% expected to be stigmatized by friends or family members, and 14% by health care workers. Univariate regression analyses showed that younger age, ethnicity other than New Zealand European, increased severity of gout pain, cognitive and emotional illness perceptions, greater illness‐related disability, and increased intentional nonadherence to urate‐lowering medication were associated with increased internalized and anticipated stigma. Younger age, emotional illness response, and intentional nonadherence were the only variables explaining incremental variance of the experience of anticipated stigma in a multivariate regression model. Conclusion Internalized and anticipated illness‐related stigma was reported by a subgroup of patients with gout. The experience of stigma is associated with younger age, a negative emotional illness response, and intentions to not adhere with a medical treatment.
Collapse
Affiliation(s)
- Maria Kleinstäuber
- University of Otago, Dunedin, New Zealand, and Philipps-University, Marburg, Germany
| | | | | | - Nicola Dalbeth
- Auckland District Health Board, Auckland, New Zealand and University of Auckland, Auckland, New Zealand
| | | |
Collapse
|
20
|
Namkung EH, Carr D. Perceived interpersonal and institutional discrimination among persons with disability in the U.S.: Do patterns differ by age? Soc Sci Med 2019; 239:112521. [PMID: 31518845 DOI: 10.1016/j.socscimed.2019.112521] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 08/05/2019] [Accepted: 08/24/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE One-third of U.S. adults have an activity-limiting health condition and this proportion increases with age. However, it is unclear whether functional limitation renders one vulnerable to institutional and interpersonal discrimination, and whether this vulnerability differs over the life course. Stigma theories suggest disability would be more discrediting to younger persons relative to older adults, as it violates cultural norms and expectations regarding able-bodied working-age adults. OBJECTIVE We evaluate whether U.S. adults with functional impairment report higher levels of perceived interpersonal mistreatment and institutional discrimination relative to persons without impairment, and whether these patterns differ across age groups. METHOD We use data from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), collected between 2004 and 2006 (n = 3931). We estimate OLS and logistic regression models to predict interpersonal and institutional discrimination, respectively. RESULTS Persons with impairment report more frequent encounters of disrespectful treatment, insults, and being treated as if they have a character flaw, and elevated odds of workplace- and service-related discrimination, net of sociodemographic, and physical and mental health characteristics. Effects are significantly larger among early (age 40-49) and late (age 50-64) midlife versus older (age 65+) adults. CONCLUSIONS We discuss implications for policy and practice, and underscore that stigmatization processes may further amplify health and socioeconomic disparities between those with versus without functional limitations.
Collapse
Affiliation(s)
- Eun Ha Namkung
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, USA.
| | - Deborah Carr
- Department of Sociology, Boston University, USA.
| |
Collapse
|
21
|
Zhu M, Zhou H, Zhang W, Deng Y, Wang X, Zhang X, Yang L, Li M, Bai X, Lin Z. Stigma experienced by Chinese patients with stroke during inpatient rehabilitation and its correlated factors: a cross-sectional study. Top Stroke Rehabil 2019; 26:342-348. [PMID: 31104577 DOI: 10.1080/10749357.2019.1605759] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Stroke-related stigma can have a negative effect on patients, and is associated with stereotyping, prejudice, and discrimination; however, the exact stigma experienced by patients remains ambiguous. Objectives: To evaluate the stigma experienced by patients with stroke, determine associated factors, and explore relationships between stigma and early rehabilitation. Methods: Overall, we examined 288 patients with stroke. Patient characteristics were determined through medical records and investigations, while stigma status (comprising total stigma, internalized stigma, and enacted stigma), depression level, functional independence, and functional outcome were also assessed. Demographic and clinical characteristics were evaluated through univariate analysis, and significant variables were further analyzed through linear regression. The relationships between stigma and early rehabilitation (depression, functional independence, and functional outcomes) were also analyzed. Results: The sample's total stigma, internalized stigma, and enacted stigma scores were 47.76 ± 18.00, 30.07 ± 12.25, and 17.69 ± 6.37, respectively. Employment status before stroke, caregivers, physical impairment, and number of impairments were all relevant to all types of stigma (P< .05). The regression analysis showed that caregivers and physical impairment are the two main predictors of total, internalized, and enacted stigma (P< .01). The correlation analysis revealed that stigma is associated with depression (r = 0.671 ~ 0.690, P< .001), functional independence (r = -0.562~-0.707, P< .001), and functional outcomes (r = 0.436 ~ 0.637, P< .001). Conclusions: Stigma was moderate, and internalized stigma may be more apparent; therefore, physicians should pay more attention to patients who report or show signs of experiencing stroke-related stigma.
Collapse
Affiliation(s)
- Minfang Zhu
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Hongzhen Zhou
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Weibin Zhang
- b Department of Pathology , Jiangmen Central Hospital , Jiangmen , Guangdong , China.,c Department of Pathology , School of Basic Medical Sciences, Southern Medical University , Guangzhou, Guangdong , China
| | - Yingying Deng
- d Department of Neurosurgery , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Xiaoyan Wang
- d Department of Neurosurgery , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Xiaomei Zhang
- e Department of Neurology , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Lei Yang
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Muling Li
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Xuejie Bai
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Zhenzhou Lin
- e Department of Neurology , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| |
Collapse
|
22
|
Moore KE, Milam KC, Folk JB, Tangney JP. Self-stigma among Criminal Offenders: Risk and Protective Factors. STIGMA AND HEALTH 2018; 3:241-252. [PMID: 30271876 DOI: 10.1037/sah0000092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Those involved in the criminal justice system are swiftly identified as "criminals." Receipt of this label may promote self-stigma, a process wherein criminal stereotypes are internalized and produce negative psychological and behavioral consequences. Research has yet to identify which types of offenders are at risk for, or in contrast, protected from, experiencing self-stigma. The current study examines whether risk and protective factors predict multiple components of the self-stigma process (i.e., perceived stigma, stereotype agreement, internalized stigma, anticipated stigma) in a sample of male jail inmates (N = 111). Results showed that mental health symptoms were a consistent risk factor across three of four self-stigma components, whereas antisocial characteristics were a risk factor for stereotype agreement and internalized stigma. Self-esteem was a protective factor for internalized and anticipated stigma. Implications for preventing self-stigma among offenders are discussed.
Collapse
|
23
|
Moloney ME, Brown RL, Ciciurkaite G, Foley SM. "Going the Extra Mile": Disclosure, Accommodation, and Stigma Management among Working Women with Disabilities. DEVIANT BEHAVIOR 2018; 40:942-956. [PMID: 31885409 PMCID: PMC6934373 DOI: 10.1080/01639625.2018.1445445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 11/14/2017] [Indexed: 06/10/2023]
Abstract
Although research has quantitatively evaluated the impacts of stigma on working women with disabilities (WWD), nuanced, qualitative accounts voiced by these women are rare. To address this literature gap, we conducted seven focus groups with forty-two WWD. We asked: "What are women's experiences of disability disclosure and accommodation in the workplace?" Findings reveal that WWD face intentional and unintentional structural discrimination and must weigh the pros and cons of disclosure and navigate devaluation threats in pursuing workplace accommodations. "Going the extra mile" emerged as a stigma management technique that was prevalent among women of higher social capital.
Collapse
|
24
|
Maugest L, McGovern EM, Mazalovic K, Doulazmi M, Apartis E, Anheim M, Bourdain F, Benchetrit E, Czernecki V, Broussolle E, Bonnet C, Falissard B, Jahanshahi M, Vidailhet M, Roze E. Health-Related Quality of Life Is Severely Affected in Primary Orthostatic Tremor. Front Neurol 2018; 8:747. [PMID: 29379467 PMCID: PMC5775514 DOI: 10.3389/fneur.2017.00747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022] Open
Abstract
Background Primary orthostatic tremor (POT) is a movement disorder characterized by unsteadiness upon standing still due to a tremor affecting the legs. It is a gradually progressive condition with limited treatment options. Impairments in health-related quality of life (HQoL) seem to far exceed the physical disability associated with the condition. Methods A multi-center, mixed-methodology study was undertaken to investigate 40 consecutive patients presenting with POT to four movement disorder centers in France. HQoL was investigated using eight quantitative scales and a qualitative study which employed semi-structured interviews. Qualitative data were analyzed with a combination of grounded-theory approach. Results Our results confirm that HQoL in POT is severely affected. Fear of falling was identified as the main predictor of HQoL. The qualitative arm of our study explored our initial results in greater depth and uncovered themes not identified by the quantitative approach. Conclusion Our results illustrate the huge potential of mixed methodology in identifying issues influencing HQoL in POT. Our work paves the way for enhanced patient care and improved HQoL in POT and is paradigmatic of this modern approach for investigating HQoL issues in chronic neurological disorders.
Collapse
Affiliation(s)
- Lucie Maugest
- Département de Neurologie, EA 4184, Hôpital universitaire de Dijon, Dijon, France
| | - Eavan M McGovern
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Katia Mazalovic
- Département de Médecine générale, Faculté de Médecine, Université de Bourgogne, Dijon, France
| | - Mohamed Doulazmi
- Sorbonne Universités, UPMC Univ Paris 06, UMR8256, INSERM, CNRS, Institut de Biologie Paris Seine, Adaptation Biologique et Vieillissement, Paris, France
| | - Emmanuelle Apartis
- Département de Neurophysiologie, Hôpital de Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathieu Anheim
- Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Illkirch-Graffenstaden, France.,Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Frédéric Bourdain
- Département de Neurologie, Centre médico-chirurgical Foch, Suresnes, France
| | - Eve Benchetrit
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Virginie Czernecki
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Broussolle
- Département de Neurologie, Service de Mouvements anormaux, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Université Lyon I, Faculté de Médecine Lyon Sud Charles Mérieux, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Lyon, France
| | - Cecilia Bonnet
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bruno Falissard
- CESP, Univ. Paris-Sud, Université Paris-Saclay, UVSQ, INSERM U1178, Paris, France
| | - Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom
| | - Marie Vidailhet
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC Université Paris, Paris, France
| | - Emmanuel Roze
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC Université Paris, Paris, France
| |
Collapse
|
25
|
Nishio I, Chujo M. Self-stigma of Patients with Type 1 Diabetes and Their Coping Strategies. Yonago Acta Med 2017; 60:167-173. [PMID: 28959127 PMCID: PMC5611471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The purpose of this study was to examine the stigma and coping strategies of patients with type 1 diabetes. METHODS Data were collected from 24 adult patients with type 1 diabetes via in-depth semi-structured interviews that took place in clinic waiting rooms. Qualitative and descriptive data analysis was conducted to identify stigma and coping strategies of patients with type 1 diabetes. RESULTS Stigma of patients with type 1 diabetes consisted of four categories: (i) "hatred of insulin" due to a treatment-oriented lifestyle after the onset of the disease, (ii) "imperfect body" due to systemic changes caused by the disease, (iii) "social outcast" as a diabetes patient who used to be healthy, and (iv) "poor me," a negative self-image due to the responses and attitudes of others. Regarding the coping strategies for reducing stigma, the following four categories were derived from the analysis: (i) In a stable disease stage, patients coped with stigma by "hiding their disease" or (ii) "pretending to be healthy" by avoiding self-care behaviors in public. When they told others about their disease, they (iii) "gradually spoke out to those around them about their illnesses." (iv) When they could not do either (i) or (ii), they resorted to "limiting their social life" or limiting interactions with others. CONCLUSION Patients with type 1 diabetes changed their coping strategies for reducing stigma as the disease progressed because stigma was tied to their disease. Physical, psychological, social, and spiritual coping strategies are required to reduce stigma, and the strategies are interrelated. It is important for nurses to assess patients from various viewpoints, including the viewpoint of stigma.
Collapse
Affiliation(s)
- Ikuko Nishio
- Faculty of Nursing, Soka University, Hachioji, Tokyo 192-8577, Japan
| | - Masami Chujo
- †Department of Adult and Elderly Nursing, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| |
Collapse
|
26
|
McCoy K, Higgins M, Zuñiga JA, Holstad MM. Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women. HIV/AIDS RESEARCH AND TREATMENT : OPEN JOURNAL 2015; 2015:S1-S8. [PMID: 27200416 PMCID: PMC4869875 DOI: 10.17140/hartoj-se-3-101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants <50 years old (n=90), age was significantly associated with viral load (rho=-.24, p=.02) and stigma was negatively associated with CD4% (r =-.26, p=.02). For the 30 participants >50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma.
Collapse
Affiliation(s)
- Katryna McCoy
- Assistant Professor, School of Nursing & Health Studies, University of Washington Bothell, Bothell, Washington, USA
| | - Melinda Higgins
- Associate Research Professor, Senior Biostatistician, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Julie Ann Zuñiga
- Assistant Professor, School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Marcia McDonnell Holstad
- Professor and Marcia Stanhope Professor in Public Health, Nell Hodgson Woodruff School of Nursing; Assistant Director for Clinical and Social Science Integration, Emory Center for AIDS Research, Emory University, Atlanta, Georgia, USA
| |
Collapse
|