Anti-stigma advocacy for health professionals: a systematic review

Abstract

Background Many anti-stigma programs for healthcare workers already exist however there is less research on the effectiveness of training in skills for health professionals to counter stigma and its impacts on patients. Aims The objective of this study was to examine the theory base, content, delivery, and outcomes of interventions for healthcare professionals which aim to equip them with knowledge and skills to aid patients to mitigate stigma and discrimination and their health impacts. Methods Five electronic databases and grey literature were searched. Data were screened by two independent reviewers, conflicts were discussed. Quality appraisal was realized using the ICROMS tool. A narrative synthesis was carried out. Results The final number of studies was 41. In terms of theory base, there are three strands - responsibility as part of the professional role, correction of wrongful practices, and collaboration with local communities. Content focusses either on specific groups experiencing health-related stigma or health advocacy in general. Conclusions Findings suggest programs should link definitions of stigma to the role of the professional. They should be developed following a situational analysis and include people with lived experience. Training should use interactive delivery methods. Evaluation should include follow-up times that allow examination of behavioural change. PROSPERO, ID: CRD42020212527

Mental Health Related Stigma in Romania: Systematic Review and Narrative Synthesis

“…Although mental health professionals have better knowledge about mental illness compared to other health specialists, they are nevertheless predisposed to stigmatizing attitudes and discriminatory behaviour. However important the problem, empirical evidence is severely underrepresented thus, steps need to be taken to address stigma in mental health professionals in future research as they can play a signi cant role in anti-stigma advocacy [39][40][41]. Evaluation and evidence-based tailored intervention approaches should target mental health professionals as well as other healthcare specialists.…”

“…It is not yet clear how anti-stigma advocacy may be best included at the structural level in the education of mental health specialists and more evidence coming from mental health settings is needed in Romania. A recent systematic review [39] assessing the effectiveness of training in health advocacy and antistigma competency concluded that intervention in mental healthcare professionals should check a few important points: integrate advocacy in their professional roles; be developed based on a situational analysis; include people with experienced stigma and discrimination; and use behavioural outcomes. Research and educational elds should work together in the building and delivery of evidence-based actions to secure both educational and legal frameworks.…”

Patient-Physician Relationship in Irritable Bowel Syndrome: Review on Empathy and Stigma

“…It is observed that social stigma is bigger when illness is thought to be of behavioral or so-called mental cause [67,68]. People living with various chronic illnesses, but especially those associated with mental health may encounter stigmatization -social devaluation or discrediting due to their illness -in their social environment, workplace, or even health care system [69][70][71].…”