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Hernandez Fernandes RH, Carrara B, Andrade Vidigal BA, Barbosa Martins AL, Bobbili SJ, Arena Ventura CA. Stigma experienced by people with mental illness in South America: an integrative review. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: People with mental illness are highly stigmatized by populations around the world and are perceived to be a burden on society. As a result of stigma, many people with mental illness are discriminated against, which leads to limited life opportunities. Given that beliefs about mental illness can vary based on culture, religion, nationality and ethnicity, it is important to understand the different types of mental illness-related stigma experienced around the world. Materials and Methods: Whittemore and Knafl’s (2005) methodology for integrative reviews was used to analyze 18 studies about lived experiences of mental illness-related stigma in South America. Results: Findings suggest that certain types of stigma in South America are based on gender and social norms, such as the social position of men and women in society. This leads to discrimination, isolation and violence from family, intimate partners, friends, society and health professionals. Employment is also limited for South Americans with mental illness. Other consequences, such a self-stigma, also impact the lives of people with mental illness in many South American contexts. Discussion: Family, friendship and social relationships, including health professionals, can involve processes that lead to the stigma experienced by people with mental illness. Conclusion: This integrative review highlights how mental illness related-stigma impacts
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Psychometric properties of the attitudes scale of health care professionals’ toward people with a diagnosis of mental illness (EAPS-TM). CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01911-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Pons EV, Salvador‐Carulla L, Calcedo‐Barba A, Paz S, Messer T, Paccardi B, Zeller SL. The capacity of schizophrenia and bipolar disorder individuals to make autonomous decisions about pharmacological treatments for their illness in real life: A scoping review. Health Sci Rep 2020; 3:e179. [PMID: 32782974 PMCID: PMC7415958 DOI: 10.1002/hsr2.179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND AIM Having decision making capacity is central to the exercise of autonomy in mental health care. The objective of this scoping review is to summarize the evidence on the capacity of people with schizophrenia or bipolar disorder to make decisions about their treatment in real life to support medical practice. METHODS Systematic search of observational studies on the assessment of capacity of patients with schizophrenia, psychosis, or bipolar disorder to make healthcare and treatment-related decisions, conducted in any clinical setting published up to January 31, 2020 was performed. Free text searches and medical subject headings in English were combined in PubMed, Scopus, CINAHL, and PsycInfo. Publications were selected as per inclusion and exclusion criteria. The Newcastle-Ottawa Scale for observational studies was used to assess the quality of publications. RESULTS Thirty publications were reviewed. According to the Newcastle-Ottawa Scale criteria, the publications reviewed were good quality. Findings showed that more than 70% of schizophrenia and schizoaffective disorder outpatients understood treatment options at the point of making decisions about their illness and healthcare. Patients treated voluntarily had considerably better scores for decisional capacity than those treated involuntarily. The burden of psychiatric symptoms could compromise decisional capacity temporarily. Decision-making capacity improved over time from admission to discharge from hospital, and with treatment among psychiatry inpatients. Schizophrenia and bipolar disorder patients could be as competent as nonpsychiatric individuals in making decisions about their treatments in everyday life. CONCLUSIONS This scoping review provides a body of evidence for healthcare professionals in need of assessing the capacity of schizophrenia and bipolar disorder patients for autonomously decide about their treatments. Decisional capacity judgements should consider variations in capacity over time and be based on the type of decision to be made, the severity of symptoms, and the specific phase of the mental disorder.
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Affiliation(s)
- Enric Vincens Pons
- Department of PsychiatryParc Sanitari Sant Joan de Déu, Sant Boi de LlobregatBarcelonaSpain
| | - Luis Salvador‐Carulla
- Centre for Mental Health ResearchResearch School of Population Health, College of Health and Medicine, Australian National UniversityCanberraAustralia
| | - Alfredo Calcedo‐Barba
- Department of Psychiatry, Hospital Gregorio MarañónMedical School at the Universidad Complutense de MadridMadridSpain
| | | | - Thomas Messer
- Department of PsychiatryDanuviusklinikPfaffenhofenGermany
| | - Bruno Paccardi
- Psychiatric UnitSanta Chiara University Hospital, University of PisaPisaItaly
| | - Scott L. Zeller
- Department of PsychiatryUniversity of CaliforniaCaliforniaUSA
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Abstract
Individuals with schizophrenia die, on average, 20 years before their peers, with 'natural causes' accounting for 80% of premature deaths. The aim of this narrative review is to address this phenomenon from the perspective of known factors that contribute to long life. The relevant literature from the last decade was searched in PubMed and Google Scholar databases. Four factors have been shown to be common to centarians, people who live to be a hundred: genes, life style behaviors that favor a healthy heart, social support, and a subjective purpose in life. The latter three factors are potentially modifiable but, in the context of schizophrenia, there are barriers to change, namely poverty, illness symptoms, stress, stigma, and side effects of antipsychotic medication. Barriers to change need to be addressed before substantial progress can be made in increasing the health and mortality risk of people with schizophrenia.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, 260 Heath St. West, Suite #605, Toronto, Ontario, M5P 3L6, Canada.
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Mascayano F, Tapia T, Schilling S, Alvarado R, Tapia E, Lips W, Yang LH. Stigma toward mental illness in Latin America and the Caribbean: a systematic review. BRAZILIAN JOURNAL OF PSYCHIATRY 2017; 38:73-85. [PMID: 27111703 PMCID: PMC7115468 DOI: 10.1590/1516-4446-2015-1652] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 05/06/2015] [Indexed: 12/30/2022]
Abstract
Objective: Stigma toward individuals with mental disorders has been studied extensively. In the case of Latin America and the Caribbean, the past decade has been marked by a significant increase in information on stigma toward mental illness, but these findings have yet to be applied to mental health services in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries. Methods: A systematic search of scientific papers was conducted in the PubMed, MEDLINE, EBSCO, SciELO, LILACS, Imbiomed, and Bireme databases. The search included articles published from 2002 to 2014. Results: Twenty-six studies from seven countries in Latin America and the Caribbean were evaluated and arranged into the following categories: public stigma, consumer stigma, family stigma, and multiple stigmas. Conclusion: We identified some results similar to those reported in high-income settings. However, some noteworthy findings concerning public and family stigma differed from those reported in Western European countries. Interventions designed to reduce mental illness-related stigma in this region may benefit from considering cultural dynamics exhibited by the Latino population.
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Affiliation(s)
| | - Thamara Tapia
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Sara Schilling
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Rubén Alvarado
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Eric Tapia
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Walter Lips
- Escuela de Psicología, Universidad de Valparaíso, Valparaiso, Chile
| | - Lawrence H Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
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Abstract
OBJECTIVE Recognizing that needs differ between men and women with schizophrenia and that they vary over time, this review attempts to categorize the needs that are relevant to younger and to older women. METHOD This is a selective literature review focusing on topic areas the two authors determined to be most germane to women with schizophrenia. Articles were selected on the basis of currency, comprehensiveness, and study design. Particular attention was paid to the voices of the women themselves. RESULTS There is considerable overlap between the needs of younger and older women with schizophrenia, but as a general rule, younger women require preventive strategies to stop the escalation of illness while older women require recovery interventions to regain lost hopes and abilities. CONCLUSIONS There is clinical utility in cataloguing the needs of younger and older women with schizophrenia and conceptualizing interventions according to gender and age rather than viewing needed services along purely diagnostic lines.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Rina Gupta
- North East London Foundation Trust, Goodmayes Hospital, Ilford, Essex, UK
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Moonen C, Lemiengre J, Gastmans C. Dealing With Existential Suffering of Patients With Severe Persistent Mental Illness: Experiences of Psychiatric Nurses in Flanders (Belgium). Arch Psychiatr Nurs 2016; 30:219-25. [PMID: 26992874 DOI: 10.1016/j.apnu.2015.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/07/2015] [Accepted: 10/13/2015] [Indexed: 11/27/2022]
Abstract
Residential psychiatric patients with severe persistent mental illness are often confronted with unbearable existential suffering. This qualitative study aims to describe how psychiatric nurses in Flanders (Belgium) deal with these patients. In view of the data we describe the nursing support for the existential suffering of these patients in terms of a process-related development. In this process of care four phases can be distinguished: meeting and knowing the patient, acknowledging the patient as an individual and as a sufferer, building a personal caring relationship based on a bond of trust and on respect for the patient as person, and a concluding phase. The personal caring relationship between nurse and patient is the fundamental element in the care practices. Next we describe the contextual framework inasmuch it can influence the caring process in a restricting or stimulating way.
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Affiliation(s)
| | | | - Chris Gastmans
- Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
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Saldivia S, Torres-González F, Runte-Geidel A, Grandon P, Xavier M, Killaspy H, Ballester D, Antonioli C, Melipillan R, Galende E, Caldas JM, King M. Standardization of the MARISTÁN scale to measure needs in people with schizophrenia and related psychoses. Int J Soc Psychiatry 2014; 60:219-26. [PMID: 23576195 DOI: 10.1177/0020764013481544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Existing measures of needs in severe mental illness have been developed mainly from professionals' viewpoints and are Eurocentric. Our aim was to standardize a measure of the needs of people with schizophrenia across several cultures and based on users' own viewpoints. METHOD An instrument to measure needs, based on qualitative data on users', carers' and professionals' views, was tested in 164 people with schizophrenia or related psychoses in six countries. Participants underwent face-to-face interviews, one third of which were repeated 30 days later. Principal axis factoring and Promax rotation evaluated scale structure; Horn's parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability. RESULTS The instrument contained four factors: (1) health needs; (2) work and leisure needs; (3) existential needs; and (4) needs for support in daily living. Cronbach's α for internal consistency was 0.81, 0.81, 0.77 and 0.76 for factors 1-4 and 0.81 for the scale as a whole. Correlation between factors was of moderate range for the first three factors (0.41-0.50) and low for the fourth factor (0.14-0.29). Intra-class correlation coefficient for test-retest reliability was 0.74 (0.64-0.82) for the whole scale. Mean item score on needs for support in daily living was lower than for the other factors. CONCLUSIONS The MARISTÁN Scale of Needs evaluates needs from the patient perspective and it is a valid instrument to measure the needs of people with severe mental illness across cultures.
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Affiliation(s)
- Sandra Saldivia
- 1Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Chile
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End-of-life (care) perspectives and expectations of patients with schizophrenia. Arch Psychiatr Nurs 2013; 27:246-52. [PMID: 24070994 DOI: 10.1016/j.apnu.2013.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/23/2013] [Accepted: 05/05/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Schizophrenia is a disabling and life-shortening psychiatric disorder due to disease, medication, and lifestyle-related factors. It is therefore not unreasonable to assume that existential themes are important for these patients. METHODS Transcripts of 20 patients were coded and analyzed thematically, using a modified grounded theory approach in the exploration of perspectives and expectations of end-of-life (care). RESULTS No fear of death, skilled companionship and preserving quality of life were major themes in the interviews. CONCLUSION This study showed that patients, despite emotional flattening and cognitive deficits, find the possibility to discuss end-of-life topics reassuring and some even therapeutic.
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Schennach R, Musil R, Möller HJ, Riedel M. Functional outcomes in schizophrenia: employment status as a metric of treatment outcome. Curr Psychiatry Rep 2012; 14:229-36. [PMID: 22477360 DOI: 10.1007/s11920-012-0261-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The importance of an adequate and satisfying level of functioning for the course and outcome of schizophrenia has been increasingly emphasized by researchers in recent years. Employment status is a major component of the patient's functioning and is generally believed to be essential for well-being, satisfaction in life, and a better prognosis for schizophrenia illness. This article summarizes recent relevant publications concerning the employment status of schizophrenia patients and its influence on treatment outcome. Given the significant link between employment status and outcome in schizophrenia, different influencing factors of employment are discussed, as they mirror potential treatment targets. Finally, currently available treatment strategies for the improvement of employment status are outlined.
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Affiliation(s)
- Rebecca Schennach
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany.
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Current world literature. Curr Opin Psychiatry 2012; 25:155-62. [PMID: 22297717 DOI: 10.1097/yco.0b013e3283514a53] [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: 11/26/2022]
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