Causes Of Stigma Research Articles

Assessment of patients’ perceptions towards the diagnosis of leprosy

Leprosy is a contagious, long-term infection, which manifests dermatological and neurological symptoms and signs, being considered an endemic, widespread disease, regarded as a serious health problem in Brazil. Early diagnosis of leprosy and its proper treatment prevents disease from progressing, avoiding physical disabilities, which are frequent as the infection evolves, and constitute a major cause of stigma, leading the patient to social isolation. This study aimed to verify the patient's perceptions regarding Hansen's disease diagnosis, seeking to contribute to the prevention of physical disabilities. It was carried out in Sinop in the State of Mato Grosso, being classified as a qualitative research approach. Patients diagnosed with leprosy, enrolled for annual treatment in Nacoes Basic Health Unity (Unidade de Saude Basica Nacoes), took part in the research. Data was collected using semi-structured interviews, and the results were analyzed in categories, these being, the implications on the patients’ self-esteem after diagnosis of leprosy; patients’ perceptions of treatment and changes in socioeconomic status after leprosy. It is worth noting that leprosy as a public health issue does not restrict to the immense amount of cases and its potential to cause physical disability, which interferes in the psychosocial context, should be taken into consideration. It is valid to point out that leprosy affects several aspects of the pacient’s life, including their physical, mental and social well-being, requiring a holistic and humane nursing care.

The Reciprocal Relationship between Suicidality and Stigma.

Although suicidality is frequently the cause of stigma, it is conversely true that stigma may be the cause of suicidality. The present paper focuses on the complex relationships that exist between suicidal behavior and stigmatizing attitudes. A narrative review of the topic will be presented on the basis of the relevant literature collected from an electronic search of PubMed, ISI Web of Knowledge, and Scopus databases, using stigma, public stigma, structural stigma, perceived stigma, self-stigma, suicide, attempted suicide, and suicidality as key words. A negative perception is frequently held of suicidal people, labeling them as weak and unable to cope with their problems, or selfish. Individuals who have attempted suicide are subject to similar processes of stigmatization and "social distancing"; insurance policies include an exclusion clause against death by suicide. Subjects with a direct personal experience of depression or suicide strongly endorse a feeling of self-stigma; those who have attempted suicide are often ashamed and embarrassed by their behavior and tend to hide the occurrence as much as possible. Similar processes are observed among family members of subjects who have committed suicide or made a suicide attempt, with a higher perceived stigma present in those bereaved by suicide. Perceived or internalized stigma produced by mental or physical disorders, or through belonging to a minority group, may represent a significant risk factor for suicide, being severely distressing, reducing self-esteem and acting as a barrier in help-seeking behaviors. With the aim of preventing suicide, greater efforts should be made to combat the persisting stigmatizing attitudes displayed toward mental disorders and suicide itself. Indeed, the role of stigma as a risk factor for suicide should further motivate and spur more concerted efforts to combat public stigma and support those suffering from perceived or internalized stigma. Experts and scientific societies should form an alliance with the media in an effort to promote a marked change in the societal perception of mental health issues and suicide. As stigma may result in severe consequences, specialist care and psychological interventions should be provided to populations submitted to stigma.

PERCEPTIONS OF STIGMA AND DISCRIMINATION IN HEALTH CARE SETTINGS TOWARDS SUB-SAHARAN AFRICAN MIGRANT WOMEN LIVING WITH HIV/AIDS IN BELGIUM: A QUALITATIVE STUDY.

Stigma and discrimination within health care settings remain a public health challenge across diverse cultural environments and may have deleterious effects on mental and physical health. This study explores the causes, forms and consequences of HIV-related stigma and discrimination among migrant sub-Saharan African women living with HIV in Belgium. A qualitative study was conducted with 44 HIV-positive sub-Saharan African migrant women between April 2013 and December 2014 in health care settings in Belgium. Data were analysed using thematic content analysis. Twenty-five of the women reported overt stigma and discrimination and fifteen reported witnessing behaviours that they perceived to be stigmatizing and discriminatory in health care settings. The themes that emerged as to the causes of stigma and discrimination were: public perceptions of migrants and HIV, fear of contamination and institutional policies on HIV management. Reported forms of stigma and discrimination included: delayed or denied care, excessive precautions, blame and humiliation. The consequences of stigma and discrimination were: emotional stress, inconsistent health-care-seeking behaviour and non-disclosure to non-HIV treating personnel. Stigma and discrimination in health care settings towards people with HIV, and more specifically towards HIV-positive sub-Saharan African migrant women, impedes sustainable preventive measures. Specialized education and training programmes for non-HIV health care providers require in-depth investigation.

Stigma against Tuberculosis Patients in Addis Ababa, Ethiopia.

BackgroundStigma attached to tuberculosis contributes to the limited effectiveness of current TB control approaches. However, there is a dearth of studies that explore the causes of stigma attached to tuberculosis and its effects on patients and tuberculosiscontrol programs in Ethiopia.MethodsAn institution-based qualitative study was conducted at St. Peter Tuberculosis Specialized Hospital in Addis Ababa, Ethiopia from July to August, 2015. Ten in-depth interviews and 6 key-informant interviews were carried out among tuberculosis patients and healthcare workers, respectively.The Open Code computer software package was used to analyze the data thematically.ResultsThe study revealed that fear of infection and inappropriate health education messages by media were the main causes of tuberculosis stigma. The patients experienced isolation within their family and community, separation, and financial crisis. The stigma attached to tuberculosis may contribute to delayed healthcare seeking, poor treatment adherence, and poor prognosis.ConclusionInterventions thatreduce the stigma attached to tuberculosis should target on areas, such as creating community awareness, patient counseling on problem-solving and emotional skills, preparing culturally sensitive and scientifically sound media messages, providing financial support for the patients, and enhancing the qualities of the healthcare workers, such as empathy, concern, respect for the patient and cultural sensitivity.

Understanding the Causes and Effects of Stigma and Discrimination in the Lives of HIV People Living with HIV/AIDS: Qualitative Study

Background: Globally HIV/AIDS is a disease of great public health importance, Nigeria has the second largest burden of the disease in the world and currently about 3.4% of the general population are HIV positive. Purpose of the study: The study aims to understand the causes of stigma and discrimination against people living with HIV/AIDS (PLWHA) and the effects of stigma and discrimination on the lives of PLWHA Methods: The study conducted using focused group discussions among people living with HIV/AIDS, who regularly attends ARV clinic, participants were selected based on the number of years of commencement of ARVs and those that have experienced one form of discrimination or the other. The interviews were transcribed verbatim and both manifest and latent content analysis was applied to analyze the texts. Findings: Following the analysis, two major themes emerged from the study: (1) Broken relationship and nondisclosure are consequences of stigma and discrimination, (2) Poor information strongly contributes to stigma and discrimination. These two themes were able to bring out the cause and effect of stigma and discrimination on the lives of PLWHA. Conclusion: Stigma and discrimination has contributed to broken relationship and promotes non-disclosure of HIV status to sexual partners, dissolution of families in Nigeria. Lack of proper information on the disease and poor education and information among the general public and especially health care workers (HCW) worsens stigma and discrimination.

ADHD stigma among college students.

The current study examined ADHD stigma within a college-enrolled young adult population, including the debate regarding the cause of stigma: label or behavior. In Phase 1, 135 college students rated stigma toward one of the four fictitious partners described as having either: the label of ADHD alone, the behaviors associated with ADHD alone, the label of ADHD and a set of behaviors associated with ADHD, or neither the label nor behaviors. In Phase 2, 48 college students rated stigma toward one of the two assigned fictitious partners described as having either: the label of ADHD and a set of behaviors associated with ADHD, or the label of Depression and a set of behaviors associated with Depression. It was hypothesized that the interaction between the label and the behaviors would cause the highest levels of ADHD stigma and that ADHD would elicit more stigma than Depression. In Phase 1, stigma was associated with the behaviors of ADHD, but not the label. In Phase 2, ADHD and Depression were found to be equally stigmatized. Implications, limitations, and future directions are discussed.

Concept: Using E-Learning Platforms in Economical and Entrepreneurial Development

Business failure is an intrinsic characteristic of entrepreneurship. Given its dimension and repercussions, we consider that entrepreneurial education, in particular entrepreneurial e-learning platforms should include a module on business failure covering in addition to the national legal framework and EU policies, the key barriers faced by and causes of business failure and other such elements. Thus, we propose to develop a platform based on open source software, such as Moodle in which modules based on SCORM and in-teractive teaching have been developed, with all the tools that are needed to simulate classic teaching.Keywords: Business failure, Bankruptcy, e-Learning Platforms, Moodle, Learning Objects1 IntroductionSMEs are the backbone of the European Union economy, according to the Annual report on small and medium-sized enterprises in the EU, 2011/12 [1] they account in 2012 for more than 98% of total enterprises active in the European Union. Moreover, SMEs contribute to almost 60% of gross added val-ue and ensure up to 67% of jobs. Considering the aforesaid and the Europe 2020 strategy for smart, sustainable and inclusive growth, entrepreneurship plays a key role. Thus, for achieving these, three areas of intervention have been considered in the Entrepreneurship 2020 Action Plan [2] as follows: extending entrepreneurial education and training; en-couraging business formation by providing a supportive business environment, promoting new business formation and fostering an en-trepreneurial culture.In this context and as a continuity of the Lis-bon Strategy, business failure, defined in this paper as bankruptcy or business closure, is considered to be a key aspect as it entails stigma of failure, which represents a barrier in creating a supportive entrepreneurial envi-ronment. Therefore, in order to encourage en-trepreneurship at EU level it is important to raise awareness that failure represents a learning opportunity for entrepreneurs. Bankruptcy is a burden on business owners, and alongside the legal and financial burden, hangs stigmatization by the business commu-nity and society in general. One cause of stigma is associating business failure with fraud [2].Offering a second chance to honest entrepre-neurs who have gone through bankruptcy, implies more efficient use of available re-sources, higher growth rates of business and a lower probability of failure due to their ex-perience as [9].These can be considered as resource, considering the Entrepreneurship 2020 Action Plan, and it is essential not to lose such a resource by not giving them a second chance to overcome stigma, while concentrating only on nurturing the new generation of entrepreneurs [2].Moreover, it is important to emphasize that despite the negative impact that business failure has at a social level [3], psychologi-cal level [4][5] and on the business envi-ronment [3], business failure is also linked to economic growth and to progress [6][7].Business failure is a natural event through which who do not have the ability to optimize the use of resources exit the market. An inefficient business provides certain warning signs, however it depends on the ability of management to perceive these signals and react in time to redress the business. Otherwise, it can lead to business failure and transfer of resources towards more productive activities. McKenzie & Lee [8] state that failure, as business closure, is both an output for unsuccessful enterprises and an input of economic success. Econom-ic growth and long-term progress are not possible without encouraging business growth and innovation.Taking into account the need to learn about entrepreneurship and business management including business failure, we propose the development of an e-learning module on business failure, while also considering the fact that the advantages of e-learning plat-forms outweigh their disadvantages. …

The barriers of stigma for service users: A critical realist viewpoint

Mental illness stigma presents significant barriers for service users to engage in meaningful civic participation, or to obtain or maintain work, subjecting them to systematic disadvantages in most facets of their lives. Evidence suggests that public attitudes towards mental health service users have not significantly improved over the past decades in spite of recent greater understanding about the causes of stigma. This article explores from a critical realist perspective, the central role of service users in challenging stigmatic attitudes to instigate a societal shift and bring parity of esteem between mental and physical health. The article articulates a salient recognition that service user experiences harnessed through the promotion of social contact with the wider community can help tackle stigma. A consideration of investing in the notions of co-production and the promotion of social capital is discussed in relation to the high cost of mental illnesses which not only are enumerated financially but also have higher personal and societal impact. The article concludes with a discussion regarding both the ethical and pragmatic importance of why service user involvement should not be tokenistic but rather service users have to be at the epicentre of any such a movement.

Geographic distribution of HIV stigma among women of childbearing age in rural Kenya

HIV stigma is considered to be a major driver of the HIV/AIDS pandemic, yet there is a limited understanding of its occurrence. We describe the geographic patterns of two forms of HIV stigma in a cross-sectional sample of women of childbearing age from western Kenya: internalized stigma (associated with shame) and externalized stigma (associated with blame). Geographic studies of HIV stigma provide a first step in generating hypotheses regarding potential community-level causes of stigma and may lead to more effective community-level interventions. Spatial regression using generalized additive models and point pattern analyses using K-functions were used to assess the spatial scale(s) at which each form of HIV stigma clusters, and to assess whether the spatial clustering of each stigma indicator was present after adjustment for individual-level characteristics. There was evidence that externalized stigma (blame) was geographically heterogeneous across the study area, even after controlling for individual-level factors (P=0.01). In contrast, there was less evidence (P=0.70) of spatial trend or clustering of internalized stigma (shame). Our results may point to differences in the underlying social processes motivating each form of HIV stigma. Externalized stigma may be driven more by cultural beliefs disseminated within communities, whereas internalized stigma may be the result of individual-level characteristics outside the domain of community influence. These data may inform community-level interventions to decrease HIV-related stigma, and thus impact the HIV epidemic.

Drug use among the Roma minority in Romania – a missing topic on the national health agenda

Issue/problem Drug use among the Roma minority in Romania, as well in other countries in the region, is a very sensitive subject. Although a well-known fact, its existence is nevertheless hard to be admitted by Roma leaders, as drug use represents an additional cause for stigma for the entire Roma community. Description of the problem Roma drug users face double stigma and discrimination due to their ethnicity and …

From badge of pride to cause of stigma: combatting mal del pinto in Mexico

Mal del pinto is a dermatological disease characterized by discoloured patches of skin on the face and body. It has been present in what is now the territory of Mexico from before the Spanish conquest up to recent times. Though early concerns for mal del pinto as a public health problem can be traced back to the late 19th century, no campaign to combat the disease was undertaken until the second half of the 20th. Thanks to the effectiveness of treatment with penicillin, the fight against this illness--which was once assumed as a symbol of pride--enjoyed a broader acceptance among the population that other health campaigns.

English

  HIV/AIDS continues to ravish society and yet legislators and health care practitioners overlook the impact the disease has on a social level. Advocating for mandatory HIV/AIDS testing as a means of curtailing stigma is a necessity. This paper proposes that mandatory HIV/AIDS testing be considered as a means of curtailing the spread of stigma. The paper discusses the causes of stigma, the ways in which stigma is spread and a solution as to how stigma can be abated through mandatory HIV/AIDS testing.   Key words: Stigmatisation, discrimination, mandatory HIV/AIDS testing.

A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement, conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as, transgender people. Context-specific (health care, community) interventions are needed to address various forms of stigma – enacted, perceived, internalised and layered – including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall, the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction.

Stigma and Violence: Isn't It Time to Connect the Dots?

Stigma against mentally ill persons is a major problem and has increased in incidence. Multiple studies have suggested that the perception of violent behavior by seriously mentally ill individuals is an important cause of stigma. It is also known that treating seriously mentally ill people decreases violent behavior. Therefore, the most effective way to decrease stigma is to make sure that patients receive adequate treatment.

Deinstitutionalization and attitudes toward mental illness in Jamaica: a qualitative study.

To consider whether or not deinstitutionalization and the integration of community mental health care with primary health care services have reduced stigma toward mental illness in Jamaica. A qualitative study of 20 focus groups, with a total of 159 participants grouped by shared sociodemographic traits. Results were analyzed using ATLAS.ti software. Participant narratives showed that stigma had transitioned from negative to positive, from avoidance and fear of violent behavior during the period of deinstitutionalization to feelings of compassion and kindness as community mental health services were integrated with Jamaica's primary health care system. The Bellevue Mental Hospital and homelessness were identified as major causes of stigma. Attitudes toward the mentally ill have improved and stigma has decreased since the increase of community involvement with the mentally ill. This reduction in stigma seems to be a result of the rigorous deinstitutionalization process and the development of a robust community mental health service in Jamaica.

The public’s stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations?

This study examined hypotheses that stigmatizing attitudes are increased by use of psychiatric labels, by conceptualization of symptoms as a medical illness and by belief in genetic causes. A survey of 3998 Australian adults asked questions about one of four vignettes: early schizophrenia, chronic schizophrenia, depression and depression with suicidal thoughts. Attitudes were measured by a social distance scale and a question about likely dangerousness. Social distance was unrelated to the hypothesized factors. For schizophrenia (but not depression), belief in dangerousness was predicted by medical illness conceptualizations and genetic causal attribution. However, more important factors were the behaviours in the vignette and the belief that they are because of weakness of character. Biomedical conceptualizations are not the major cause of stigma, rather it is the behaviour associated with mental illness and the belief that this is because of personal weakness.

Electro-Convulsive Therapy (ECT): an Egyptian perspective

The world celebrated 68 years of electroconvulsive therapy (ECT) recently. Whilst ECT has stood the test of time for nearly six decades. stigma remains one of the main issues that needs to be addressed. ECT is a technically advanced and effective treatment that is often misunderstood and maligned not only by the lay public but by psychiatrists as well. One of the main causes of stigma is the nomenclature which needs to be changed since shock and convulsion are absent when giving modified ECT.Based on the evidence derived from randomized controlled trials and extensive clinical experience for nearly 70 years, ECT is presently the most effective treatment for certain psychiatric disorders. The most transient memory disturbance is a moderate price for what can be achieved, as the benefit to risk ratio of ECT is usually favorable.The economic aspects of ECT use in Egypt, as well as the problem of ECT training, are discussed in this paper.The ethical aspects of ECT are reviewed as well as the discrepancies between developed and developing countries in its application, which needs to be addressed from a transcultural perspective. Keywords: Electroconvulsive Therapy, Developing Countries, Stigma, Transcultural aspects > South African Psychiatry Review Vol. 10 (1) 2007: pp 22-24

The efficacies of affected-limb care with penicillin, diethylcarbamazine, the combination of both drugs or antibiotic ointment, in the prevention of acute adenolymphangitis during bancroftian filariasis

Repeated attacks of adenolymphangitis (ADL) contribute significantly to the progression of chronic lymphoedema in lymphatic filariasis. They are a cause of stigma and, since they may prevent work and require treatment for which payment must be made, of economic loss. The aim of the present study was to improve the treatment of ADL attacks, which is currently mostly empirical. In a double-blind, placebo-controlled, clinical study, 150 subjects who had each suffered at least two ADL attacks in the preceding year were enrolled and randomly allocated to a programme of self-care of the affected limb (after an intensive training programme) and one of five treatments for 12 months. The subjects were supplied with tablets and ointment so that they could take oral penicillin (800 mg/day), oral diethylcarbamazine (DEC; 1 mg/kg.day) or both of these drugs (at the same doses), or apply framycetin ointment to the affected limb, or just take placebo tablets and apply placebo (zinc-oxide) ointment. Placebo tablets and placebo ointment were used so that neither the subjects nor those assessing the responses to treatment were aware of the treatment arm to which each subject had been assigned. The subjects were requested to continue with the affected-limb care after they had stopped taking the tablets and applying the cream, and were followed-up for 24 months from the first treatment.Overall, the mean incidence of ADL attacks decreased from 2.7 episodes/person-year in the pre-treatment year to just 0.38 episode/person-year during the treatment year (P< 0.01). The greatest reduction in incidence was seen in the 58 subjects who received penicillin (with or without DEC). Even in the placebo group, however, the incidence of ADL in the treatment year was significantly lower than that seen in the pre-treatment year, indicating that affected-limb care on its own helps to prevent some attacks. In all groups except the placebo, the incidence of ADL attacks in the year post-treatment exceeded that seen in the treatment year, indicating that chemoprophylaxis needs to be continued for more than a year if such attacks are to be prevented. In most (84%) of the attacks recorded, titres of anti-streptococcal antibodies were seen to be elevated (compared with those recorded during convalescence),indicating that streptococci have a role in the aetiology of ADL. It is recommended that a combination of penicillin prophylaxis and affected-limb care be incorporated into filariasis-control programmes, to decrease morbidity.

Stigma and social housing estates: Beyond pathological explanations

This paper aims to contribute to our understanding of the causes of stigma as it afflicts severely disadvantaged housing estates. It begins with a review of the literature on stigma and housing estates, identifying a lack of research and analysis of the causes of stigma specifically, yet a subtle adherence to pathological explanations. The remainder of the paper discusses evidence from a research project on stigmatised estates in the UK, identifying and counterpoising various perspectives on the causes of stigma. It concludes by offering an alternative framework for understanding the phenomenon of stigmatised estates which moves beyond pathological explanations to focus on the roles and contributions of external actors and influences.

Rural children's attitudes to people with HIV/AIDS in Mali: the causes of stigma

Qualitative research among young people and other community members in rural Mali elicited knowledge and attitudes with regard to HIV/AIDS. Findings indicated that rumours concerning methods of infection are likely to increase the stigmatization of those with the disease. The most frequently stated mode of transmission involved urinating in a place where someone with AIDS had already urinated. Shared clothes, food and water were seen as sources of infection. Both children and teachers recommended that people with AIDS be isolated. Even talking to them would lead to a risk of infection. Discriminatory views were likely to have been reinforced by parents and community elders who possessed the same misinformation. The notion that AIDS results from sexual encounters between young women and dogs belonging to white people in Côte d'Ivoire was also widespread. These discourses may reflect perceived xenophobia and risk to migrants associated with current tensions between the two countries, together with misgivings about Western sexual liberalism. A holistic educational programme is proposed to address not simply HIV/AIDS, but the social context in which infection occurs, with view to combating stigma and discrimination associated with not just HIV but also with migration in this setting.