Stigma Scores Research Articles

Stigma towards people with mental conditions in healthcare workers: an Italian cross-sectional study

Abstract Background Stigma towards people with mental disorders (MD) in healthcare workers (HCWs) can negatively influence the quality of care provided and hinder patients from accessing healthcare. The aim of this study was to analyze stigma and its determinants among physicians and nurses in Italy, as a basis for future strategies to reduce its extent. Methods A cross-sectional study was conducted from April to September 2023. A sample of 1053 physicians and nurses working in Italy answered an online 52-item questionnaire. Variables explored demographic data, work context, burnout symptoms, and personal or family history of MD. The Opening Minds Scale for Health Care Providers (OMS-HC) was used to assess the level of stigma (score from 20 to 100, higher scores represent higher levels). Descriptive analysis and multivariable linear regression were performed. Results Females were 69.5% and median age was 48 years (IQR=37-58). Physicians were 60.5%. A total of 20% of the sample worked in psychiatric settings. Burnout symptoms were reported by 23.5%. Results showed a median OMS-HC score of 49 (IQR=43-54). Positive associations with stigmatizing attitudes were found for being a nurse (p = 0.020) and being in burnout (p = 0.017), while working in a psychiatric setting (p < 0.001) and having personal or family history of MD (p < 0.001) had negative associations. Conclusions This research unveiled a notable amount of stigma among Italian HCWs towards individuals with MD. Since people with MD experience higher rates of disability and mortality, it has to be a public health priority to develop targeted strategies to reduce stigma in HCWs, as it discourages patients from accessing healthcare. Future interventions should be tailored for different professionals and dealing with HCWs burnout. Key messages • Future interventions should consider that healthcare workers in burnout and nurses tend to have more stigma toward patients with mental conditions. • Healthcare professionals working in psychiatric settings and having personal or family history of mental disorders showed lower stigma.

Stigma assessment scale for adolescent idiopathic scoliosis: A new tool for spine deformity stigma evaluation.

Stigma is the negative attitudes towards an illness or difference. The literature lacks detailed scales specifically addressing stigmatization in AIS. This study aimed to develop Adolescent Idiopathic Scoliosis Stigma Assessment Scale (AIS-SAS) to measure stigmatization in AIS patients. In creating the AIS-SAS, we developed items via literature review and expert input, confirmed content validity, and conducted a field test for construct validity and reliability. Our experts designed 38 items in three subscales: Scoliosis, Brace, and Surgery-related stigma. Exploratory factor analysis (EFA) and convergent validity were examined for construct validity. The convergent validity of AIS-SAS was assessed through its correlations with the Rosenberg Self-Esteem Scale (RSES), SRS-22, and Spinal Appearance Questionnaire (SAQ). Reliability was gauged via internal consistency and test-retest methods. Sixty-seven adolescents with AIS were included in the study. EFA results confirmed one-dimensionality for each subscale, with factor loadings from 0.51 to 0.96, leading to the removal of 8 items with loadings below 0.3 from the AIS-SAS. The final AIS-SAS has three subscales: scoliosis (18 items), brace (5 items), and surgery-related stigma (7 items). Regarding convergent validity, the scoliosis-related stigma scores significantly correlated with SRS-22 self-image (r= -0.413 p = 0.001) and SAQ-Appearance (r = 0.441 p = 0.002). The RSES-Total score shows a negative correlation with Scoliosis, Brace, and Surgery-related stigma scores: -0.500 (p < 0.001), -0.435 (p = 0.049), and -0.498 (p = 0.042), respectively. AIS-SAS subscales showed good reliability (Cronbach-α > 0.8 ICC > 0.8). AIS-SAS is the first valid and reliable high-quality scale assessing stigmatization from AIS, measuring scoliosis, brace, and surgery-related stigma via three subscales.

Understanding depression, anxiety and stress in young people living with HIV in Ghana

Ghanaians with perinatally acquired human immunodeficiency virus (HIV) infection now live into adulthood. It is known that adolescents and young adults living with HIV have a high risk of mental health comorbidity. Despite increasing global attention on HIV–mental health interactions, the field remains understudied in Ghana, with an attendant lack of national integrated care solutions. This study aimed to measure the burden and explore the context of depression, anxiety and stress symptoms among young people living with HIV receiving care at a tertiary care hospital in Ghana. This was an explanatory sequential mixed-methods study. Depression, anxiety and stress symptoms were measured using the Depression, Anxiety and Stress Scale, and their associations with quality of life (QoL), socioeconomic status, internalised stigma, disease stage and HIV-related risk-taking behaviours were explored. After preliminary quantitative data analysis, semi-structured interviews were conducted for those who screened positive for depression and/or anxiety to explore their experience with this comorbidity. This study found a low prevalence of depression and anxiety symptoms, which were associated with higher stigma scores and lower QoL. We believe this low prevalence to be attributable to the effect of several psychosocial interventional programmes, which were previously piloted with the study cohort that have gradually normalised mental health discussions. Participants also showed marked resilience and knowledge about their condition. The results of this study present an opportunity to advocate and scale up effective locally adapted and strength-based solutions to address the mental illness–HIV syndemic in Ghanaian young people living with HIV.

Socio-demographic, psychosocial, and suicidal behavior correlates of stigma among people with physical disabilities in Northwest Ethiopia

BackgroundPeople with physical disability may experience stigma in various ways, including social avoidance, negative attitudes and discrimination. Stigma among people with physical disability can vary based on study participants’ socio-demographic, behavioral and psychosocial factors. Therefore, identifying the socio-demographic, behavioral and psychosocial correlates of stigma is important because the findings of the study can help inform future interventions aimed at reducing stigma among individuals with a physical disability.ObjectiveThis study aimed to assess the psychosocial, suicidal behavior, and socio-demographic correlates of stigma among people with physical disabilities in the University of Gondar communities, northwest Ethiopia.MethodData collection was conducted among 269 participants who had a physical disability within University of Gondar communities in Northwest Ethiopia. The participants, who included students and employees at the University completed the stigma scale for chronic illness (SSCI-8), which was used to measure stigma. The participants also completed four other questionnaires, including the perceived social support, the Kessler − 10, and the WHODAS. We used independent sample t-tests and ANOVA to examine group differences in stigma, while Pearson correlation analysis identified the correlates of stigma with other continuous variables.ResultThe overall mean stigma score among people with a physical disability was 14.68 with 95% CI (13.98, 15.38). About 90.71% of people with physical disability had stigma. Stigma varied along socio-demographic variables, including marital status (single) with a mean (SD) score of 15.17 ± 5.64, educational level (diploma and above) with a mean (SD) score of 14.99 ± 5.89, and occupational status with a mean (SD) score of 15.54 ± 5.79 (p < 0.001). In addition, stigma varied among participants with suicidal ideation with a mean (SD) score of 16.93 ± 7.43 and attempt (18.74 ± 8.41), levels of psychological distress (severe) with a mean (SD) score of 20.88 ± 6.94 (p < 0.001), low perceived social support with a mean (SD) score of 18.60 ± 7.54 (p < 0.001), and moderate/severe level of functional impairment with a mean (SD) score of 21.76 ± 7.34 (p < 0.001). Moreover, stigma was positively correlated with psychological distress (r = 0.42, p < 0.001) and WHO Disability Assessment Schedule (r = 0.5, p < 0.001). Conversely, it was negatively correlated with perceived social support (r=-0.31, p < 0.001).ConclusionOur findings indicate that stigma is prevalent among people with physical disabilities, with variations observed based on marital status, occupation, and education level. Additionally, stigma showed significant correlations with functional impairment, psychological distress, perceived social support, and health related quality of life. Therefore, addressing stigma, promoting social support and providing appropriate interventions can help improve the psychological well-being and quality of life of individuals with physical disabilities.

The correlation between stigma and treatment adherence, quality of life in patients with rheumatoid arthritis: A mixed-methods study.

To investigate the current status of stigma in patients with rheumatoid arthritis (RA), and its correlation with treatment adherence and quality of life. The convenience sample of 266 patients diagnosed with RA was surveyed at the rheumatology and immunology outpatient department of a tertiary hospital in Jiangsu Province from May 2022 to September 2022. In addition to this, 20 RA patients were purposively sampled for semi-structured in-depth interviews, and the data were analysed using content analysis methods. The total stigma's score of the 266 participants was (47.8 ± 10.8), which indicates a moderate level of stigma. The mean scores for alienation, stereotype endorsement, perceived discrimination, and social withdrawal were (2.2 ± 0.7), (2.4 ± 0.7), (2.9 ± 0.6), and (2.2 ± 0.6) respectively. A comparison of the average family monthly income, family roles, duration, disease activity, duration of morning stiffness, visual analogue scale score, C-reactive protein, erythrocyte sedimentation rate, and total stigma score revealed significant differences (p < 0.05). The total treatment adherence score was negatively correlated with the total stigma's score and scores in each dimension (p < 0.05). Similarly, the total psychological health score and total physical health score were negatively correlated with the total stigma score and scores in each dimension (p < 0.05). The qualitative study identified six themes: self-denial, discrimination, lack of disease-related knowledge, high medical costs, increased life burden and resistance to stigma. Stigma affects RA patients' treatment adherence and quality of life negatively. Healthcare workers are advised to develop comprehensive intervention programs that address the current status of stigma, with the aim of controlling disease progression, reducing disability rates, and improving the quality of life for RA patients.

Identifying and Describing Mental Health Stigma Among Agricultural Youth Directors: Does Stigma Influence Practices?

ABSTRACT Objectives This exploratory study aims to: 1) evaluate mental health stigma levels among agricultural youth directors, 2) examine the influence of professional characteristics on stigma, and 3) investigate the relationship between agricultural youth directors’ stigma levels and their self-efficacy. Methods An online survey was administered from March to May 2022 to 642 agricultural youth directors in Illinois who work with youth aged 1–19. Directors’ personal and perceived stigmas toward mental illness were measured using the Depression Stigma Scale. Directors’ self-efficacy (perceived level of knowledge and confidence) across 19 mental health topics was measured using a 3-point Likert scale. Analyses were conducted by generating descriptive statistics and performing Mann–Whitney U tests on the data. Results The median personal depression stigma score was 7.57 (SD = 8.02). Our analyses identified significantly higher personal depression stigma scores among men, FFA advisors, agricultural educators, and those lacking personal experience with mental illness. A lack of self-efficacy correlated significantly with increased personal stigma. Conclusions This study underscores the critical need for targeted educational interventions to reduce stigma among agricultural youth directors and enchance mental health literacy. Anti-stigma and mental health literacy initiatives are essential for fostering a supportive environment that encourages open discussions about mental health issues with youth within the agricultural community.

Intersectionality of HIV Stigma with Female Identity: An Investigation among Women Living with HIV/AIDS in Vietnam.

Women living with HIV/AIDS (WLHA) in Vietnam encounter challenges stemming from HIV-related stigma and gender disparities. This study delves into the intersectionality of HIV-related stigma and gender disparities as perceived by WLHA. A cross-sectional survey was conducted among 91 WLHA in Hanoi, Vietnam. Two sets of identically worded scales were used to measure awareness, agreement, and application of stigma towards people living with HIV/AIDS (PLHA) and WLHA. A larger difference between stigma scores towards WLHA and that of PLHA represents a higher level of female-specific stigma. Univariate analyses and multiple regressions were conducted to identify demographic and psycho-social factors associated with the gendered differences in stigma measures. Multiple linear regression showed that WLHA who were currently married were more likely to apply stigma concepts to themselves due to gender identity (adjusted beta coefficient (aBeta Coef) = 0.223). Psychological capital was negatively associated with awareness of stigma towards female identity (aBeta Coef = -0.261). A higher perceived norm in women's equity and power was associated with less self-application of female-specific stigma (aBeta Coef = -0.294). Our findings underscore the importance of addressing psychological well-being and promoting gender equity norms as essential components in the efforts to reduce female-specific HIV-related stigma in WLHA.

Investigation the effect of Acceptance and Commitment Therapy (ACT) training on stigma and family functioning in family members of patients with psychiatric disorders: a randomized controlled clinical trial

BackgroundRegarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness.MethodsThis randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23.ResultsA statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P < 0.05). The intervention group’s mean scores showed a rising trend, whereas the control group’s mean scores showed a declining trend. This was evident from within-group comparisons of the mean post-test and follow-up stigma scores. Repeated measures ANOVA indicated that the pattern of change in stigma for the intervention group was significant, in contrast to control group, suggesting a reduction in stigma (P < 0.001).ConclusionIn light of the findings presented in this study, ACT emerges as a promising intervention for mitigating stigma, and enhancing the family functioning of individuals afflicted with mental disorders. To improve the generalizability of the study results, comparable studies using this therapy method should be undertaken on family caregivers of patients with mental illnesses.Iranian Registry of Clinical TrialsIRCT registration number: IRCT20190917044802N10.Registration date14/9/2023.

Assessing stigma: Health and social worker regard towards working with people using illicit drugs in Athens, Greece

BackgroundAfter the 2008 Global Financial Crisis and resulting economic austerity, the rise in illicit drug use engendered an increased need for people who use drugs (PWUD) to access medical care, compounded by the COVID-19 pandemic. Research shows that perceptions of medical staff towards PWUD facilitate or act as a barrier to accessing health care. This study provides a better understanding of health and social work professionals’ perceptions by assessing stigma levels towards PWUD in Athens, Greece.MethodsThis is a mixed-method study. It calculates the stigma score for professionals (n = 60) and the stigma score associated with specific drugs based on the Medical Condition Regard Scale through a quantitative analysis of responses to a semi-structured online survey about attitudes of health and social work professionals towards PWUD. It draws on the qualitative analysis of 12 semi-structured interviews with 16 service managers, providers, and health services advocates working in the charity sector to determine whether perceptions of PWUD affect writing and implementing policy and protocols for services.ResultsStigma towards PWUD exists amongst health and social work professionals in Athens. Professionals who have worked with PWUD for longer periods of time, professionals who have had specific training on working with PWUD, and professionals who feel that they have the necessary training to work with PWUD all demonstrated a higher stigma score than those reporting the opposite. Cannabis and opioids were associated with lower stigma scores while shisha had the highest level of stigma associated with it. Finally, professional environments are not conducive to alleviating stigma as the lack of training specific to stigma, the lack of professional supervision, and worker burn-out are key barriers faced by professionals in their everyday practice.ConclusionsReducing and eliminating stigma towards PWUD among health and social workers requires immediate action. Measures to be taken include: introducing training programs focused on stigma towards PWUD to healthcare providers, social workers, lawyers, police, the media; increasing professional supervision on field work for health and social workers; introducing low barrier health care and specialist units. Peers and field-focused organisations should meaningfully participate in drug and alcohol policymaking, program development, and implementation.

Internalized stigma and its correlates in families of persons with mental illness in Qatar: a cross-sectional study

AbstractPersons with mental illness (PWMI) experience rejection, isolation, and discrimination in employment, education, and housing due to the prejudice associated with the illness. Families affiliated with PWMI often internalize the public’s prejudice towards mental illness. Such internalized stigma can further impact the health and quality of life of both PWMI and their families. This study aimed to examine the level and correlates of internalized stigma in family members of PWMI in Qatar. A cross-sectional study of 106 family members was conducted using the Family Internalized Stigma Mental Illness Scale. The mean stigma score was 2.04 suggesting a mild level of stigma overall. Being married was found to be a predictor of higher levels of internalized stigma, while having college education or higher predicted lower levels of stigma. The overall stigma scores among family members were not high, which may reflect the protective stance families take towards about their relatives with mental illness. Some sociodemographic attributes predicted trends in internalized stigma among our surveyed sample. Future research efforts in this area may help increase understanding of internalized stigma in this population to inform stigma reduction efforts.

Substance Use Stigma Among Clinical and Nonclinical Staff Who Provide Care for People With HIV in the Deep South: A Pilot Training Intervention.

Substance use stigma is a barrier to care among people with HIV (PWH), which is exacerbated in the Deep U.S. South. Nurses and nonclinical staff serve a central role in strengthening and expanding care coordination in clinics that serve PWH. We sought to implement and evaluate a pilot training intervention that aimed to reduce substance use stigma among clinical and nonclinical staff who provide care for PWH in the Deep South. In total, 32 clinical and nonclinical staff from five clinics participated in the training, of whom 22% were nurses and 38% were linkage coordinators. We evaluated the association between the intervention and stigma by asking respondents about their agreement with varying levels of stigmatized statements both before and after the training. Overall, we observed a slight reduction in stigma scores. This training has promise as one low-burden approach to substance use stigma reduction in HIV care settings.

Assessment of Stigma among Caregivers of Armed Forces Professionals Suffering from Mental Illness

Abstract Background: Having a person with mental illness in the family invariably leads to stigmatic experiences to the family members. Perceived stigma in caregivers leads to social isolation, psychological distress, and suboptimal functioning. Additionally, perceived stigma among such caregivers is one of the barriers that prevent them from taking appropriate care of their dependents with mental illness. There has been little research in this field in the Indian armed forces population. Objective: The objective of this study was to assess the perceived stigma among caregivers of armed forces personnel suffering from mental illnesses. Methods: The calculated sample size was 139 but in our study period of time (December 1, 2019–February 28, 2020) we received the enough number of patients and we continued our study with 150 study subjects which is enough more than the 139. Hence, the total number of 150 caregivers visiting the psychiatry outpatient department of a tertiary care military hospital in North India along with their mentally ill dependents were included in the study after obtaining valid informed consent. The subjects were interviewed, their sociodemographic data were collected, and stigma scores were assessed on a 15-item Explanatory Model Interview Catalogue (EMIC) Stigma Scale. Results: Total stigma score ranged from 20 to 40 with a median of 31. Caregivers with lower level of education, lower income, rural residency, elder age, and diagnosis of psychosis/substance abuse in dependent were found to have higher scores of perceived stigma. Conclusions: Caregivers of patients with mental illnesses experience significant stigma which needs to be addressed so that they can provide optimum care to their mentally ill dependents. Limitation: As EMIC does not provide any standard cutoff for low or high stigma or to categorize persons as having stigma or not, it was difficult to compare results with other studies that used different tools to assess stigma.

Psychometric evaluation of the affiliate stigma scale for caregivers of people with mental illness in Uganda

BackgroundAffiliate stigma is common among caregivers of people with mental illness and impacts negatively on the caregivers’ quality of life and their ability to care for the patients. Although there is evidence of affiliate stigma in sub-Saharan Africa, the psychometric properties of commonly used tools are not available in the African context. The aim of this analysis was to evaluate the factor structure of the affiliate stigma scale among caregivers of people with mental illness in southwestern Uganda. Having a validated method to assess affiliate stigma in the Ugandan setting helps to appropriately evaluate affiliate stigma among caregivers of people with mental illnesses, which could inform the development of interventions to support such caregivers.MethodA total of 385 caregivers of people with mental illness attending outpatient psychiatry clinics in selected tertiary hospitals in southwestern Uganda were enrolled in the study. The affiliate stigma and depression were assessed using the affiliate stigma scale and the patient health questionnaire (PHQ-9) respectively. We conducted exploratory and confirmatory factor analysis to determine the factor structure, reliability and validity of the affiliate stigma scale. We also evaluated the convergent validity of the affiliate stigma scale by determining the correlation between affiliate stigma scale scores and the PHQ-9.ResultMore than half of participants were male (55.06%) and majority of caregivers were living in rural areas (80.26%). The sample size was adequate, as evidenced by the KMO of 0.91 and the inter-correlation was sufficient to conduct the factor analysis, according to the Bartlett test. Confirmatory factor analysis revealed four factors and all 22 items were retained as all of them had a factor loading > 0.4. The internal consistency of the total scale was excellent (alpha = 0.92). The affiliate stigma score correlated with depression which has been hypothesized to be associated with the stigma of mental illness.ConclusionThe study findings show the affiliate stigma scale as a valid measure of affiliate stigma among the caregivers of patients with mental illness in southwestern Uganda. Therefore, this scale provides an opportunity to mental health care providers to assess affiliate stigma and develop interventions aimed at prevention stigma among caregivers and improve outcomes among people with mental illness.

Felt stigma and associated factors in children and adolescents with epilepsy: a multicenter cross-sectional study in China.

Epilepsy-related stigma is a global problem, yet there has been an inadequate focus on children and adolescents. The purpose of this study was to determine the status quo of stigma and its determinants among children and adolescents with epilepsy in China. A multicenter cross-sectional study was conducted across nine hospitals in eight cities within six provinces in China from 10 October 2023 to 15 June 2024. Participants included patients aged 8 to 18 years with epilepsy and their caregivers. Felt stigma was assessed with the Kilifi Stigma Scale for Epilepsy (KSSE). Social support and self-efficacy were collected through the Social Support Rating Scale (SSRS) and the Generalized Self-Efficacy Scale (GSES). The data were analyzed using t-tests, analysis of variance (ANOVA), Spearman correlation analysis, and multiple linear regression analysis. The study enrolled 281 children and adolescents, with a mean age of 12.25 years (SD = 2.56), including 46.6% females. A total of 35.6% participants had self-reported felt stigma. The mean KSSE score is 9.58 (SD = 7.11). Meanwhile, stigma scores correlated strongly with reduced social support (r = -0.55, p < 0.01) and self-efficacy (r = -0.43, p < 0.01). Place of residence (rural vs. non-rural), academic performance (average and above vs. fair or poor), region (western region vs. non-western region), duration of epilepsy (≤5 years vs. >5 years), drug-resistant epilepsy (yes vs. no), comorbidities (yes vs. no), social support and self-efficacy are major influencing factors among the complex factors influencing the felt stigma among children and adolescents. Medical staff should be more aware of stigma among children and adolescents with epilepsy, especially those who live in rural and western areas, have poor academic performance, have epilepsy duration of more than 5 years, have drug-resistant epilepsy, and have comorbidities, who are at higher risk of stigma. It is recommended that effective measures be taken to alleviate stigma by improving children and adolescents' self-efficacy and providing more social support for them and their families.

Mental health service use and shortages among a cohort of women living with HIV in Canada

BackgroundThe prevalence of mental health conditions among women with HIV in Canada ranges between 29.5% and 57.4%, highlighting the need for accessible mental health care. We aimed to (1) describe the availability and use of mental health services among women with HIV and (2) identify characteristics associated with reporting that shortages of these services presented a problem in their care.MethodsBaseline data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study were analysed. Self-reported availability and use of mental health services were examined using descriptive statistics. Participants indicated whether a lack of mental health support was a problem in their care. Logistic regression models were constructed to determine associations between sociodemographic, clinical, and psychosocial characteristics and reported problematic shortages.ResultsOf 1422 women, 26.7% (n = 380) used mental health services in the last year, which most accessed through their HIV clinic. Thirty-eight percent (n = 541) reported that a shortage of mental health support was a problem in their care. Among this subset, 22.1% (n = 119) used services at their HIV clinic, 26.5% (n = 143) reported available services but did not use them, and 51.4% (n = 277) either indicated that these services were unavailable, did not know if such services were available, or were unengaged in HIV care. Factors associated with reporting problematic shortages included rural residence [adjusted odds ratio (aOR): 1.69, 95% confidence interval (CI): 1.03–2.77], higher education level (aOR: 1.43, 95% CI: 1.02–2.02), and higher HIV stigma score (aOR: 1.03, 95% CI: 1.02–1.03). Conversely, African/Caribbean/Black identity (aOR: 0.37, 95% CI: 0.26–0.54), history of recreational drug use (aOR: 0.56, 95% CI: 0.39–0.81), and Quebec residence (aOR: 0.69, 95% CI: 0.50–0.96) were associated with lower odds of reporting service shortages.ConclusionOur findings highlight the HIV clinic as the primary location of mental health service use. However, existing services may not be sufficient to reach all patients or meet specific needs. Furthermore, the low uptake among those reporting a shortage suggests a lack of connection to services or patient knowledge about their availability. Characteristics associated with reporting shortages reflect geographic and socioeconomic disparities that must be accounted for in future service design.

Factors associated with nursing students' mental health-related stigma: A multisite cross-sectional study

BackgroundMental health-related stigma remains a complex and pervasive issue globally. It not only inhibits individuals from seeking help but also influences the quality of healthcare they receive. Despite extensive research on mental health-related stigma, there is still limited understanding of factors influencing mental health-related stigma among nursing students. ObjectivesThis study aimed to assess the level of mental health-related stigma among Chinese nursing students and investigate possible associated factors. MethodsData were collected from the 2023 Psychology and Behavior Investigation of Chinese Residents (PBICR) survey. A total of 967 nursing students were included in the study. Multivariate stepwise linear regression analysis was conducted to examine the influencing factors of mental health stigma. ResultsThe mean mental health-related stigma score among nursing students was 15.31 ± 5.23 (range = 0–27). Perceived stress (β = 0.14, P = 0.001), self-efficacy (β = 0.22, P < 0.001), academic stage (β = 0.17, P < 0.001), depression (β = 0.15, P < 0.001), and adverse life events (β = 0.06, P = 0.044) were significantly associated with mental health-related stigma among nursing students (R2 = 0.147, adjusted R2 = 0.143, F = 33.214, P < 0.001). ConclusionsNursing students in China exhibit a moderate level of mental health-related stigma, suggesting room for improvement. Perceived stress, self-efficacy, academic stage, depression, and adverse life events emerged as significant influencing factors for mental health-related stigma. These findings provide valuable insights for developing interventions to reduce mental health-related stigma among nursing students, ultimately enhancing their well-being and preparing them for becoming competent healthcare professionals in the future.

Stigma and depression among obese infertile women: a cross-sectional study

BackgroundObesity causes infertility through various pathways, including disruption of ovarian follicular development, qualitative and quantitative development of the oocyte, fertilization, embryo development, and implantation. In traditional societies such as Türkiye, having children is a determinant of social status. Stigma is defined as a negative sense of social difference from others. Depression is a common health problem in infertile women due to the stressful nature of treatment procedures, fear of treatment failure, and the patient’s inability to become pregnant. In this cross-sectional study, the sample consisted of 161 infertile women from an infertility outpatient clinic of a university hospital in Eastern Turkey.ResultsIt was determined that depression scores had a strong positive correlation with stigma scores. In the multiple regression analysis performed to evaluate the effects of five independent variables determined to have an effect on depression scores, it was seen that the independent variables explained depression levels by 80%.ConclusionThe findings of this study suggest that stigma and depression are significant factors affecting the psychosocial and emotional well-being of obese women experiencing infertility. These results underscore the potential need for more comprehensive psychosocial support and assessment for women experiencing infertility related to obesity. Obese patients should be informed about the importance of pre-pregnancy weight reduction and should be encouraged to lose weight before the treatment to reduce the poor obstetrical outcomes due to obesity. Additionally, evidence-based guidelines should be prepared for assisted reproductive techniques for fertility treatment in obese infertile women.

Knowledge and Attitudes of Undergraduate University Students in Oman With Regard to People Living With HIV.

There is scarce literature from the region pertinent to university students' HIV-related knowledge, perception, attitudes, and behavior toward people living with HIV. Moreover, university students in Oman are remarkably uninformed about HIV, resulting in misconceptions and stigmatization among students. This research aimed to examine HIV-related knowledge and attitudes of undergraduate medical and non-medical university students toward people living with HIV in Oman. This was a qualitative cross-sectional study using convenience sampling to recruit participants from nine colleges at Sultan Qaboos University, Muscat, Oman. An online questionnaire composed of 17 Likert scale statements examining students' knowledge and nine Likert scale statements exploring students' attitudes was used. A knowledge score ≥ the mean was considered good knowledge, whereas a stigma score > the mean was regarded as stigmatization. A sample size of 376 students was computed using a Raosoft calculator (Raosoft, Inc., Seattle, Washington, United States) with a confidence level of 95% and a margin of error of 5%. Cronbach's alpha for the 26-item questionnaire was α = 0.716. Responses were collected and analyzed using IBM SPSS Statistics for Windows, Version 26, (Released 2019; IBM Corp., Armonk, New York, United States). The questionnaire and the study protocol were approved by the institution's medical research and ethics committee. A total of 678 undergraduate university students responded to the questionnaire including 450 (66.4%) and 228 (33.6%) female and male students, respectively. Medical students represented 20.8% of the responders. The mean knowledge score was 12.3 ± 1 signifying good knowledge in 72% of the students and the mean stigma score was 6.03 ± 3.51 indicating that 43.4% of the responders had a negative and stigmatizing attitude. Medical students had the highest mean knowledge score (14.2 ± 1.8) denoting good knowledge in 83.5% of the students. Additionally, medical students had the lowest mean stigma score (4.64 ± 3.32) implying that 29% of the surveyed medical students had negative attitudes toward people living with HIV. No significant association was found between students' academic performance or students' sex with mean knowledge scores. Contrarily, male sex was found to be significantly associated with lower mean stigma scores. No significant relationship between students' knowledge scores and stigma scores was observed. The findings of this study denote a substantial gap in HIV-related knowledge among university students, leading to undesirable attitudes toward people living with HIV. These findings call for an urgent need to escalate HIV awareness and educational programs tailored to university students in Oman.

Internalized Stigma and Quality of Life in Patients With Alcohol Use Disorder: A Cross-Sectional Study From Gujarat, India

Introduction: Substance use disorders (SUDs) contribute to one-fifth of all disability- adjusted life years caused by psychiatric illnesses. They have a high treatment gap. Stigma affects the lives of people with SUDs and is shown to impede the pursuit of valued life goals and recovery from addiction. We studied stigma and QOL in patients with Alcohol Use disorders (AUD). Methods: Participants between 18 and 65 years with a clinical diagnosis of AUD were included (inpatients and outpatients). Demographic and clinical data were recorded using a semistructured questionnaire. ISMIS &amp; WHOQOL-Bref questionnaires were used to assess internalized stigma and quality of life. Results: Of the 141 participants, 89(63.10%) patients had severe self-stigma, 31(22.10%) patients had moderate self-stigma, and 21(14.90) patients had mild self-stigma. In ISMIS, stigma due to alienation (3.22) was higher than social withdrawal, discrimination, stereotype, and stigma resistance. In the WHOQOL-Bref questionnaire, the mean score of social domain (9.45) was the lowest compared to the other domains of the quality of life scale. A significant association was found between the education and the duration of substance use with ISMI grades with people with up to 10th standard education (p-value - 0.002*), living in urban areas (p-value - 0.022*), and ten or more years of substance use (p-value - 0.00002). Conclusion: The various domains of quality of life generally negatively correlated with the internalized stigma score, suggesting that a greater degree of self-stigma is associated with poorer quality of life.

Cross-cultural reliability of Van Rie TB perceived Stigma Scale among TB survivors in North India

BackgroundAs India progresses towards TB elimination five years ahead of Sustainable Development Goals (SDG), Community-based perceptions of tuberculosis stigma become particularly relevant in the context of TB elimination efforts. This study aims to assess the cross-cultural reliability of ‘Community Perspectives Van Rie TB Stigma Scale’ which can been used for screening and rapid evaluation of prevalent stigma themes in community. MethodsA community based cross-sectional study was conducted in North India among 400 TB survivors to assess the cross-cultural reliability of ‘Community Perspective Van Rie TB stigma Scale’. Cronbach Alpha and McDonald's Omega were used for reliability analysis. ResultsCronbach ɑ value for the Van Rie TB Stigma Scale was 0.826 and McDonald's ω is 0.832 indicative of good reliability of the TB Stigma Scale. ConclusionThe study is one the first studies to assess the cross-cultural reliability of Community Perspective of Van Rie TB Stigma Score in India. The reliability analysis indicates that the ‘Community Perspectives Van Rie TB Stigma Scale’ can be used in the Indian settings for screening of TB associated stigma.