Feelings Of Stigma Research Articles

No Pyro, No Party: Social factors, deliberate choices, and shared fan culture determine the use of illegal fireworks in a soccer stadium

Lighting illegal fireworks inside soccer stadiums is a worldwide and persistent problem. Despite rules and regulations as well as rigorous enforcement, the use of illegal fireworks in football stadium is increasing rather than decreasing. Little is yet known about the causes and predictors of this behavior, preventing the development of effective interventions or communication strategies. We therefore conducted a qualitative study, using semistructured interviews with both supporters of a large Dutch soccer club who participated in lighting fireworks, and with professionals who dealt with illegal fireworks in daily practice. Semi-structures interviews were based on hooliganism literature as well as the COM-B model. We concluded that hooliganism and lighting illegal are distinctly different phenomena, although they share some underlying constructs. From a behavioral perspective, using the COM-B model as a framework, reflective motivation was identified as the strongest facilitator of lighting fireworks, which appeared to be an important part of supporter life and shared culture. Quick interventions that target automatic behavior, such as nudges, will probably thus not be successful in changing this behavior. Supporters suggest compromise between supporters and professionals as preferred future direction. Reported feelings of stigmatization by and feeling unappreciated by professionals, could interfere with successful implementation of this direction. Professionals however contradict negative to have judgements of supporters. Building a bridge between supporters and professionals should be a first step towards a solution.

Emerging lessons from the commissioning and delivery of a gambling treatment service

ObjectivesGambling is a public health concern, given the multiplicity of harms for individuals, families and communities. This article reports on the commissioning and delivery of a problem gambling treatment service in a metropolitan area in England, where the concentration of problem gambling is often higher than the national average. Study designThis is a cross-sectional study, using purposively sampled ‘experts’ and stakeholders involved in the conception and set-up of the service. MethodsIndividual semistructured interviews were used to ascertain the depth of information required to fully appreciate the nuances and complexities of the service. Eight participants took part in the interviews, with an additional respondent providing written comments in relation to the interview schedule as a workaround to accommodate the organisational impacts of COVID-19. ResultsThe article identifies several factors contributing to the successful delivery of the service. Well-managed collaborative provision with expertise from across sectors is critical, but this needs to be balanced against the challenges faced by bridging cultural variances in practice and language. Adopting evidence-based models of delivery was central to practice, and moreover, geographical location is a key consideration to encourage access for those facing gambling problems and discourage feelings of stigma. ConclusionsThis article offers a unique contribution to understanding more about the provision of gambling treatment services. This is crucial, given that a greater number of people face challenges as a consequence of gambling harms, and such services should be seen part of forming a coherent public health response.

Multifamily Therapy for Adolescents With School Refusal: Perspectives of the Adolescents and Their Parents.

Introduction: School refusal is an important public health concern in adolescent psychiatry increasing over the past several years (5% of child and adolescent psychiatry consultations in France). Multifamily therapy has developed over 30 years. Its efficacy is validated in adult, child and adolescent psychiatry, including for children at risk of school exclusion. In this study, we aimed to explore the adolescents and their parent's experience of a multifamily therapy treatment of school refusal with a qualitative method.Materials and Methods: This qualitative study is based on an Interpretative Phenomenological Analysis approach. We conducted 15 semi-structured interviews, participants were adolescents (n = 6) and their parents (n = 9) who experienced multifamily therapy in an adolescent department in Paris. Data analysis was performed independently by two researchers.Results: For the six families, school was a source of suffering, system paralysis and social exclusion. Families reported painful emotions and separation anxiety. For teenagers, multifamily therapy increased self-confidence and allowed group experience. For parents, it gave support and relieved from feelings of stigmatization and guilt. Parents became more aware of their adolescent's suffering and their insight. They all considered that multifamily therapy improved intra-family communication and expression of emotion. Participants highlighted the benefits of intergenerational interactions, activities, group and guidance from therapists.Discussion: Multifamily therapy uses therapeutic tools from both family therapy (joining, resonance, family competence, and metacommunication) and group therapy (use of media, identity device, and mirror reactions). Parents expect school solutions from multifamily therapy and question how psychiatric treatment can deal with school, school refusal being therefore understood as a social functioning disorder.

Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

BackgroundIn China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young women have limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing its uptake among adolescents and young women in Guangzhou, China.MethodsA cross-sectional study was performed from 1st March 2020 to 30th September 2020 using an anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services.ResultsThe magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized.ConclusionsThe study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged subgroups of women in the study setting.

Media Commercials Conveying Awareness Regarding Prevention of Head and Neck Cancer by Focusing on Stigmatized Perspective of Disease: Right or Wrong?

Cancer in the head and neck region is among the most common cancer around the world, the incidence of which keep increasing in past years. Treatment of disease is usually done by the surgical excision which often leads to some degree of facial disfigurements which cause mutilation in patients. Mutilation imparts the feeling of stigma in patients, and patients usually tend to hide facial disfigurements using additional clothing. As a prevention strategy, awareness regarding the disease conveys to the mass population via media commercials. Media commercials which highlight the adverse outcomes of cancer are found to target the stigmatized perspective of disease. On the brighter side, more stigmatized is the patient image in the commercials, more motivation it will create in masses to avoid risk factors like tobacco, smoking and alcohol. But on the darker side, stigmatized commercials create a social environment in which people tend to maintain social distance to cancer patients, and patients have to bear social disapproval by society for their whole life. It reduces the self-esteem and quality of life of patients which affects their overall survival. In the present article, we review the status of stigma in head and neck cancer patients, tools that are available for assessment of stigma, and effects of the stigmatized media commercials on the patient's self-esteem. The present article represents the accurate picture of the problem and highlights the policies which could be employed to balance the paradox of stigmatized media commercials and a healthy social environment for cancer patients.

Screening for chlamydia and/or gonorrhea in primary health care: systematic reviews on effectiveness and patient preferences

BackgroundWe conducted systematic reviews on the benefits and harms of screening compared with no screening or alternative screening approaches for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in non-pregnant sexually active individuals, and on the relative importance patients’ place on the relevant outcomes. Findings will inform recommendations by the Canadian Task Force on Preventive Health Care.MethodsWe searched five databases (to January 24, 2020), trial registries, conference proceedings, and reference lists for English and French literature published since 1996. Screening, study selection, and risk of bias assessments were independently undertaken by two reviewers, with consensus for final decisions. Data extraction was conducted by one reviewer and checked by another for accuracy and completeness. Meta-analysis was conducted where appropriate. We used the GRADE approach to rate the certainty of the evidence. The Task Force and content experts provided input on determining thresholds for important effect sizes and on interpretation of findings.ResultsOf 41 included studies, 17 and 11 reported on benefits and harms of screening, respectively, and 14 reported on patient preferences. Universal screening for CT in general populations 16 to 29 years of age, using population-based or opportunistic approaches achieving low screening rates, may make little-to-no difference for a female’s risk of pelvic inflammatory disease (PID) (2 RCTs, n=141,362; 0.3 more in 1000 [7.6 fewer to 11 more]) or ectopic pregnancy (1 RCT, n=15,459; 0.20 more per 1000 [2.2 fewer to 3.9 more]). It may also not make a difference for CT transmission (3 RCTs, n=41,709; 3 fewer per 1000 [11.5 fewer to 6.9 more]). However, benefits may be achieved for reducing PID if screening rates are increased (2 trials, n=30,652; 5.7 fewer per 1000 [10.8 fewer to 1.1 more]), and for reducing CT and NG transmission when intensely screening high-prevalence female populations (2 trials, n=6127; 34.3 fewer per 1000 [4 to 58 fewer]; NNS 29 [17 to 250]). Evidence on infertility in females from CT screening and on transmission of NG in males and both sexes from screening for CT and NG is very uncertain. No evidence was found for cervicitis, chronic pelvic pain, or infertility in males from CT screening, or on any clinical outcomes from NG screening. Undergoing screening, or having a diagnosis of CT, may cause a small-to-moderate number of people to experience some degree of harm, mainly due to feelings of stigmatization and anxiety about future infertility risk. The number of individuals affected in the entire screening-eligible population is likely smaller. Screening may make little-to-no difference for general anxiety, self-esteem, or relationship break-up. Evidence on transmission from studies comparing home versus clinic screening is very uncertain. Four studies on patient preferences found that although utility values for the different consequences of CT and NG infections are probably quite similar, when considering the duration of the health state experiences, infertility and chronic pelvic pain are probably valued much more than PID, ectopic pregnancy, and cervicitis. How patients weigh the potential benefits versus harms of screening is very uncertain (1 survey, 10 qualitative studies); risks to reproductive health and transmission appear to be more important than the (often transient) psychosocial harms.DiscussionMost of the evidence on screening for CT and/or NG offers low or very low certainty about the benefits and harms. Indirectness from use of comparison groups receiving some screening, incomplete outcome ascertainment, and use of outreach settings was a major contributor to uncertainty. Patient preferences indicate that the potential benefits from screening appear to outweigh the possible harms. Direct evidence about which screening strategies and intervals to use, which age to start and stop screening, and whether screening males in addition to females is necessary to prevent clinical outcomes is scarce, and further research in these areas would be informative. Apart from the evidence in this review, information on factors related to equity, acceptability, implementation, cost/resources, and feasibility will support recommendations made by the Task Force.Systematic review registrationInternational Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018100733.

Well-being and Perceived Stigma in Individuals With Rheumatoid Arthritis and Fibromyalgia: A Daily Diary Study.

The presence or absence of clearly defined symptoms and underlying pathophysiology may be a crucial variable related to variability in well-being and stigmatization in individuals with chronic pain (ICPs). In the context of pain, absence of clearly defined symptoms and pathophysiology deviates from the widely endorsed biomedical model and as such, may lead to stigmatization, which in turn could be related to ICPs' well-being. The present study compared physical, psychological, social well-being, and perceived stigmatization in individuals with clearly defined symptoms and underlying pathophysiology (rheumatoid arthritis, RA) and individuals with less well understood symptoms and pathophysiology (fibromyalgia, FM) using daily diaries. Furthermore, the association between daily perceived stigmatization and daily well-being was examined. Seventy-nine participants with FM, 86 participants with RA, and 33 participants with both diagnoses completed a diary for 14 consecutive days. Compared to individuals with RA, individuals with FM and individuals with both diagnoses reported worse daily well-being. After controlling for age, pain duration, and daily pain, differences between FM and RA remained significant for social well-being and completion of plans. Differences between RA and the dual diagnosis group remained significant for completion of plans, negative affect, and isolation. Furthermore, results suggested more stigmatization in individuals with FM than in individuals with RA. Individuals with both diagnoses reported equal stigmatization as individuals with FM, but more stigmatization than individuals with RA. Finally, increased levels of perceived stigma were associated with lower well-being. Findings highlight that the absence of clearly defined symptoms and pathophysiology could be contributing to greater feelings of stigmatization, which may be detrimental for ICPs' well-being.

Food Insecurity Experiences of Idaho Head Start Families

Using the social-ecological model, this basic interpretive qualitative study sought to examine the phenomenon of food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. A total of 11 interviews were conducted with parents who had children enrolled in five Idaho Head Start programs. The data were coded and analyzed and are reflective of how individual, interpersonal, community, and organizational levels factors are reflected in participants’ decisions to access available nutrition assistance programs. Participants reported feelings of stigma and shame and transportation concerns as individual barriers as well as the interpersonal barrier of a lack of support systems. Lack of awareness of resources, limited food choices, and the questionable quality of foods provided at pantries were noted among the community and organizational deterrents. The results of this study may be used to create interventions that promote food security among Head Start families.

Care and treatment needs of immunosuppressive therapy patients with warts and impact on everyday life: a qualitative study

Introduction Patients receiving immunosuppressive therapy have an increased risk of developing verrucae vulgaris (warts). They often suffer from dissemination of numerous warts, complicated by low treatment response and long-term treatment. How patients experience these challenges is not well characterized. The aim of this study was to explore how patients on immunosuppressive therapy experience everyday life with warts on the hands and feet, and their needs related to care and treatment. Methods The study took a phenomenological-hermeneutic approach. Semi-structured interviews were conducted with 10 adults. Data were analyzed using the thematic analysis described by Braun and Clark. Results Warts on the hands and feet impact everyday life and cause feelings of stigma and pain. Patients request treatment and hope to be cured although the prospects are poor. Self-treatment is experienced as a burden, because of the need for more specific information about and skills to treat the warts, and because individual patients’ resources are not considered. Patients experience a lack of care continuity. Conclusions Patients request a person-centred care and treatment approach, to establish a relationship with health care professionals. Establishing care continuity might reduce patients’ treatment-related insecurity.

Coping and Motivation for Change-An Interview Study of the Experience From Participation in an Educational Program for Patients With Medication-Overuse Headache.

Patient educational programs (PEP) are recommended as part of the treatment for medication-overuse headache (MOH), however, knowledge of patients’ experiences when participating is sparse. This study explored how patients experienced participating in a PEP focusing on empowering coping strategies and motivation for behavioral changes. Eight individual semistructured interviews were conducted among patients suffering from MOH who had attended a PEP intervention in a randomized controlled trial. The PEP involved techniques from Motivational Interviewing as its communicative approach. Data collection, analysis, and interpretation were performed within a phenomenological-hermeneutic framework. Results showed that patients found the educational program relevant regarding coping with headache. Participants shifted from focusing on medication to include other ways to manage headache. Experiences regarding ambivalent feelings for behavioral change and feelings of stigmatization were key issues. Participation in this PEP helped the participants cope with headache in new ways relevant to their everyday lives and challenges. The individualized approach enabled by Motivational Interviewing was experienced as useful by the participants, as it actively involved them in the treatment.

تصور مقترح من منظور الممارسة العامة للخدمة الاجتماعیة للتخفیف من حدة الضغوط الحیاتیة لأسر العائدین للإدمان

ملخص الدراسة يعتبر الإدمان من المشکلات المجتمعية الخطيرة التي تؤثر على بناء المجتمع باعتبار أنها ظاهرة مرضية وتتضح خطورة هذه المشکله في أثر سلوک المدمنين على الأوضاع الإجتماعية والإقتصادية والقانونية والدينية والصحية في المجتمع الذي يعيشون فيه. وعلى الرغم من أن الخطة الوطنية لمواجهة مشکلة المخدرات في مصر أولت اهتماما واضحا بمحور الوقاية والعلاج والتأهيل في تطهير المجتمع من مشکلة الإدمان. وعلى الرغم من ذلک فإن هناک نسبة کبيرةمن المدمنين المتعافين عادوا الى الإدمان مرة أخرى. وهذا أثر بشکل کبير على أسر العائدين للإدمان وتسبب في العديد من المشکلات الإجتماعية والإقتصادية التي تؤثر على کل أفراد الأسرة.. هذا المشکلات تحولت الى ضغوط حياتية تؤثر على کل أفراد الأسرة. وهدفت الدراسة الى التعرف على الضغوط الحياتية التي تواجة أسر العائدين للإدمان ووضع تصور مقترح للتخفيف من حدتها. وقد طبقت الدراسة عن المستفيدين والمترددين من أسر العائدين للإدمان بنادي الدفاع الاجتماعي بالمحلة الکبرى بمحافظة الغربية وعددهم 78 بالإضافة الى أساتذة الجامعات والخبراء في مجال الدفاع الإجتماعي بصفة عامة والإدمان بصفة خاصة. وقد توصلت الدراسة الى أن معاناة الأسرة من الفقر والحرمان والنقد المجتمعي للمدمن وعدم انتظام المدمن في خطط علاجية متکاملة وانخراط المتعافي في نشاطات منحرفة لشغل وقت فراغه من العوامل التي تؤدي الى العودة للإدمان. إما الضغوط الحياتية التي تواجه أسر العائدين للإدمان تمثلت في ضعف قدرة الأسرة على تأدية الواجبات اليومية بشکل مناسب والشعور بالوصمة داخل الأسرة وضعف قدرة الأسر على مواجهة النفقات الکبيرة. بالإضافة الى الضغوط الاقتصادية الکبيرة. ABSTRACT Addiction is considered one of the serious societal problems that affect the building of society as it is a pathological phenomenon. The seriousness of this problem is evident in the effect of addicts' behavior on the social, economic, legal, religious and health conditions in the society in which they live. And despite the fact that the national plan to confront the drug problem in Egypt paid clear attention to the axis of prevention, treatment and rehabilitation in purifying society from the problem of addiction. In spite of that, a large percentage of recovering addicts have returned to addiction again. This greatly affected the families of the returnees of addiction and caused many social and economic problems that affect all family members .. These problems have turned into life pressures that affect all family members. The study aimed to identify the life pressures facing the families of returnees of addiction and to develop a proposed vision to alleviate their severity. The study was applied on the 78 beneficiaries and reluctant families of the returnees to addiction to the Social Defense Club in Mahalla al-Kubra in the Western Governorate, in addition to university professors and experts in the field of social defense in general and addiction in particular. The study found that the family's suffering from poverty, deprivation, societal criticism of the addict, the addict’s lack of regularity in integrated treatment plans, and the recovery’s involvement in deviant activities to occupy his spare time are among the factors that lead to a return to addiction. Either the life pressures facing the families of the returnees from addiction represented in the family's weak ability to perform daily duties appropriately, the feeling of stigma within the family and the weakness of families' ability to face large expenditures. In addition to the great economic pressure

Improving public stigma, sociocultural beliefs, and social identity for people with epilepsy in the Aseer region of Saudi Arabia.

Differences in the sociocultural practice and biases against people with epilepsy (PWE) largely contribute to the development of stigmatization. In this study, we evaluated factors that impact stigma for PWE involved in evolution and maintenance to report changes in the public awareness and cultural practices. We performed a cross-sectional study in which data were collected from a self-administered electronic survey composed of 33 items targeting the population in the Aseer region. Feedback response was obtained from 937 respondents. Of these, 921 participants (98.3%) had heard or read about the disorder previously. Approximately 84.8% believed that epilepsy was one of the brain disorders. 95.8% disagreed that epilepsy was due to a contagious disease. However, 40.1% of the responders were convinced that it was the result of a spiritual reason. Still, more than 9% believed treating PWE should be approached spiritually. About 75% felt that epilepsy could be the results of a test delievered by God. In addition to the clinical impact from seizures in PWE, it carries a social label and public stigma that influences one's social prognosis. Raising awareness through campaigns would improve the knowledge and practices of the population and hence provide a healthier environment for PWE, alleviating feelings of stigma, and improving their quality of life.

Feeling of stigmatization and satisfaction with life among Arabic psoriatic patients

BackgroundSatisfaction and stigmatization are experienced differently in different cultural contests, especially, in patients with dermatological diseases affecting visible body parts. Reports in Arabic countries remain rare and very appealing in a multicultural population. AimsTo evaluate feeling of stigmatization and satisfaction with life in Arabic patients with psoriasis and identify predictors of feeling of stigmatization and satisfaction with life. MethodsIn a cross-sectional study design, Arabic patients with psoriasis completed the 6-item stigmatization scale and the satisfaction with life scale. Univariate and forward stepwise multivariate linear regression analyses were used to identify predictors of feeling of stigmatization and satisfaction with life. Covariates included patients' demographics (age, gender and education level), disease-related factors (disease severity, visibility, duration, and impact on quality of life) and patient-related factors (illness acceptance and dermatology self-care education level). ResultsIn total, 199 Arabic psoriatic patients were included in the study. Despite feeling highly stigmatized by their skin disease [mean (95% Confidence Intervals (CI)) of 7.0 (6.3–7.7)], psoriasis patients were generally positive about their overall satisfaction with life (mean (95% CI) of 21.0 (20.0–22.3). Impaired quality of life was the strongest predictor of both higher feeling of stigmatization (β-coefficient 0.39, 95% CI 0.30, 0.47) and less satisfaction with life (−0.36, 95% CI −0.53, −0.20). Higher levels of dermatology self-care education significantly predicted a lower feeling of stigmatization (−0.09, 95% CI −0.16, −0.01). Older patients (0.18, 95% CI 0.05, 0.30) and those with higher illness acceptance levels (0.14, 95% CI 0.03, 0.24) were more satisfied with life. ConclusionsA level of stigmatization was detected in most psoriatic patients including the satisfied ones. Patients with more impaired quality of life experienced higher level of stigmatization and less satisfaction with life. These findings further enforce the multidisciplinary approach in psoriatic patients and highlight the unmet need to include psychologist in the therapeutic algorithm.

"Moving from one environment to another, it doesn't automatically change everything". Exploring the transnational experience of Asian-born gay and bisexual men who have sex with men newly arrived in Australia.

Asian-born gay, bisexual and other men who have sex with men (gbMSM) who are newly arrived in Australia are at a higher risk of acquiring HIV than Australian-born gbMSM. We used a social constructionist framework to explore HIV knowledge and prevention strategies used by newly-arrived Asian-born gbMSM. Twenty four Asian-born gbMSM, aged 20-34 years, attending Melbourne Sexual Health Centre, who arrived in Australia in the preceding five years, participated in semi-structured, face-to-face interviews. Interviews were recorded, transcribed verbatim and analysed thematically. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from exposure to sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not forthcoming with their sexual identity due to internalised feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps. Fear of discrimination and judgement about their sexual identity can have a significant impact on Asian-born gbMSM living in Australia, particularly in terms of social connectedness. Additionally, HIV-related stigma can contribute to anxieties around HIV testing. Our data highlights the potential discrimination Asian-born gbMSM face in Australia, which has implications for social connectedness, particularly with regard to LGBTQI communities and HIV testing practices. Future studies should determine effective strategies to reduce sexual identity and HIV-related stigma in newly-arrived Asian-born gbMSM.

Evaluation of naloxone furnishing community pharmacies in San Francisco

ObjectivesIn 2017, the Centers for Disease Control and Prevention reported more than 47,600 deaths as a result of opioid overdose in the United States. In an effort to reduce these deaths, California passed legislation providing pharmacists with the ability to furnish naloxone without a prescription. Our study examined pharmacies in San Francisco that furnished naloxone and provided guidance for pharmacies seeking to develop similar programs. The study aims were to (1) identify the legal, structural, social-environmental, and financial components of a pharmacy model that allows for successful naloxone distribution, (2) evaluate the attitudes and beliefs of pharmacy staff members toward patients receiving or requesting naloxone, and (3) assess relationships between these attitudes and beliefs and naloxone furnishing at the pharmacy. MethodsThis cross-sectional study used a series of semistructured interviews of pharmacy staff in San Francisco conducted April-October 2019. Through a thematic, inductive analysis of collected data, emerging themes were mapped to the primary study aims. ResultsWe interviewed 14 pharmacists and pharmacy technicians at 4 community pharmacies. We identified 4 factors for success in implementing a naloxone furnishing protocol: administrative-led efforts, pharmacist-led efforts, increasing pharmacist engagement, and increasing patient engagement. The respondents also discussed the approaches they used to overcome previously identified barriers: cost, time, expectations of unwanted clientele, and patients’ feelings of stigma. ConclusionPharmacists’ approaches to implementing naloxone furnishing had common features across locations, suggesting many of these strategies could be replicated in other community pharmacies.

Achieving real equality in health and social care: IENE9 project, a work in progress for LGBT+ people

Abstract Background Issues with professional conduct and discrimination against Lesbian, Gay, Bisexual, Transgender (LGBT+) people in health and social care, continue to exist in most EU countries and worldwide. Objectives The project IENE9 titled: “Developing a culturally competent and compassionate LGBT+ curriculum in health and social care education” aims to enable teacher/trainers of theory and practice to enhance their skills regarding LGBT+ issues and develop teaching tools to support the inclusion of LGBT+ issues within health and social care curricula. The newly culturally competent and compassionate LGBT+ curriculum will be delivered though a Massive Open Online Course (MOOC) which is aimed at health and social care workers, professionals and learners across Europe and worldwide. Results We have identified educational policies and guidelines at institutions teaching in health and social care, taken into account for developing the learning/teaching resources. The MOOC will be an innovative training model based on the Papadopoulos (2014) model for “Culturally Competent Compassion”. The module provides a logical and easy to follow structure based on its four constructs 'Culturally Aware and Compassionate Learning', 'Culturally Knowledgeable and Compassionate Learning', 'Culturally Sensitive and Compassionate Learning', 'Culturally Competent and Compassionate Learning'. Conclusions Specific training may result in better knowledge and skills of the health and social care workforce, which helps to reduce inequalities and communication with LGBT+ people, as well as diminishing the feelings of stigma or discrimination experienced. Key messages More information about the IENE 9 project at http://iene-lgbt.com. The partners organization will support local partners, education and training providers, LGBT+ care organizations to do learning using our platform and our created MOOC, to set up new training.

The Sense of Stigmatization in Patients with Plaque Psoriasis

Background: Psoriasis is a systemic inflammatory disease capable of creating stigmatization in the form of social exclusion and decrement of psychological conditions. Aim: The aim of the study was to determine the level of stigmatization in patients with plaque psoriasis. Methods: The study included 166 patients with plaque psoriasis (55.6% women and 44.3% men) with Psoriasis Area and Severity Index scores ≤10. The age of the study patients ranged between 18 and 72 years (arithmetic mean = 37.4; median = 38; standard deviation [SD] = 11.0). The mean age at the diagnosis of psoriasis was 21.5 years (median = 20; SD = 9.1) and disease duration varied from 2 to 59 years (arithmetic mean = 15.8; median = 15; SD = 11.3). The study patients completed the Polish version of the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire and a survey developed by the authors of this study, containing questions about the participants’ sociodemographic characteristics (sex, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis). Results: The mean score for the 6-item Stigmatization Scale for the whole study group was 7.6 out of 18 points (median = 7; SD = 3.8; minimum = 0; maximum = 17). The average score for the 33-item Stigma Feelings Questionnaire in our series was 84.5 out of 165 points (median = 88; SD = 20.9; minimum = 30; maximum = 136). A statistically significant sex-related difference was observed in the 6-item Stigmatization Scale scores, with higher stigmatization levels found in men than in women (p = 0.0082). Moreover, significantly higher levels of stigmatization were observed in countryside dwellers (p = 0.0311) and unmarried persons (p = 0.0321). Patients with a longer history of the disease (≥15 years) scored significantly higher on the 6-item Stigmatization Scale (p = 0.0217) than those in whom psoriasis lasted less long, and presented with higher, at the threshold of statistical significance, scores for the 33-item Feelings of Stigmatization Questionnaire. Conclusions: Stigmatization awareness should be promoted among physicians and psoriatic patients to improve psoriasis management.

Perceptions of genetic risk, testing, and counseling among individuals with eating disorders.

Eating disorders develop as a result of genetic and environmental factors. Given that they are multifactorial conditions with a genetic component, they fall within the scope of practice for genetic counseling, but people with these conditions are rarely referred. The purpose of this study was to explore the perceptions of causes of eating disorders, recurrence risk, and interest in genetic counseling and testing among individuals with eating disorders. An online survey comprising both multiple choice and free form text questions, vignettes about genetic counseling, and the ED100K (validated eating disorder diagnostic questionnaire) was shared via support organizations and prominent bloggers in the eating disorders community to recruit individuals with a personal history of an eating disorder from November 2018 to February 2019. In total, 107 participants completed the survey. They perceived that both experiences and genetics were important factors in the development of their eating disorder. All responding participants overestimated the risk for recurrence of eating disorders in children, often by a large margin, and a notable minority reported that their experience with an eating disorder had a negative influence on their childbearing decisions. After imagined experience of genetic counseling, participants reported significantly decreased feelings of stigma, shame, and guilt. Most participants expressed interest in genetic counseling; fewer were interested in genetic testing. Genetic counseling may benefit individuals with eating disorders by providing accurate recurrence risk information and reducing feelings of guilt, stigma, and shame, which may in turn encourage earlier support seeking and recovery.

Personal recovery and depression, taking existential and social aspects into account: A struggle with institutional structures, loneliness and identity.

Although depression is one of the most studied mental illness phenomena, the studies attempt to understand depression as different phases, turning points and transitions, but depression has an existential and social resonance. There is progress to be made in seeking to understand how people experience, cope and process, living with depression. There is a need of supplementary and alternative approaches that goes beyond medicine and traditional treatment of psychiatric disabilities. The aim of this study was to explore perceptions and challenging issues related to living with depression, allowing the researchers to get a deeper understanding of existential and social aspects. A phenomenological-hermeneutic study design was applied, based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through observations and semi-structured interviews. Several of the interviewees were lonely at home as well as at the hospital. This caused experiences of sheer isolation with feelings of sadness enhancing desperation concerning what to do with themselves. This could even cause physical feelings of pain. In different ways, the interviewees expressed how being with other people filled their lives with relationships and closeness. Health care professionals were focused on applying structure into the users' everyday life, shadowing the person's individuality, strengths and resources. The prioritizations between users and healthcare professionals were not always in concordance. The interviewees experienced recurrent situations where their authority and individuality were ignored or felt non-existent. Existential and social aspects are vital in regard to understanding people living with depression. However, personal recovery can be diminished by controlling structures and lack of a caring guidance, creating feelings of stigmatization missing out on autonomy, causing inner doubts. A recommendation is that we challenge institutional structures and accelerate education developing the healthcare professionals' empathic competences and ability to make wise judgments, empowering the users' autonomy.

Understanding domains that influence perceived stigma in individuals with Huntington disease.

Persons with Huntington's disease experience stigma because of their gene status. Whereas perceived stigma has been found to impact quality of life, it is unknown how different health domains (i.e., physical, emotional, cognitive, and social) are associated with feelings of stigma. In addition, stigma research has been limited by the use of cross-sectional analyses. The current study seeks to explore which domains are associated with stigma in a longitudinal assessment of persons with Huntington's disease. Research Method/Design: The current analysis used data from the HDQLIFE study, which included 479 participants at baseline, 315 participants at 12 months, and 277 participants at 24 months. A multilevel model (time nested within person) was used to examine the effect of physical, emotional, cognitive, and social health on perceived stigma (Neuro-QoL Stigma) while controlling for demographic factors. Findings indicate that physical, emotional, and cognitive health were associated with perceived stigma, whereas social health and demographic factors were not. Within-subject, time-varying predictors accounted for 20.2% of the variance in stigma. Our findings suggest that perceived stigma is influenced by physical, emotional, and cognitive health, which may be treated with physical therapy, emotional counseling, and cognitive rehabilitation. Application of these therapies may relieve the burden of perceived stigma; however, more research is needed in this area. (PsycInfo Database Record (c) 2020 APA, all rights reserved).