Health care providers and people with mental illness: An integrative review on anti-stigma interventions

Carrara, Bruna Sordi; Fernandes, Raquel Helena Hernandez; Bobbili, Sireesha J.; Ventura, Carla Aparecida Arena

doi:10.1177/0020764020985891

Cited by 42 publications

(23 citation statements)

References 64 publications

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“…Although it is undeniable that stigma is difficult to eliminate, it can be dramatically reduced with positive interventions. 65 It is urgent to develop a scale with good reliability and validity in order to assess the effectiveness of the intervention. To this end, following the requirements of psychometrics using conceptualizing stigma theory as the theoretical framework, the present study combined semi-structured interviews and expert reviews to develop an initial questionnaire with 26 items.…”

Section: Discussionmentioning

confidence: 99%

Development of the Chinese Version of the Physician Internalized Occupational Stigma Scale (PIOSS)

Fan¹,

Cong²,

Tao³

et al. 2022

PRBM

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Background/Objective Internalized occupational stigma may develop in physicians as a result of their identification with the public negative labels and stereotypes about them, and then internalization of them as a part of their self-concept. This study aims to develop the Physician Internalized Occupational Stigma Scale (PIOSS) and to examine its reliability and validity. Methods In study 1, the initial scale was used to investigate 356 physicians. While in study 2, a total of 346 physicians were investigated with the survey tools named the PIOSS, the Career Commitment Scale (CCS), the Workplace Well-Being Scale (WWBS), the Scale for the Doctor with Patient-doctor Relationship (DDPRQ-10), the Intent to Leave Scale (ILS) and the Occupational Disidentification Scale (ODS). Results The PIOSS includes 19 items divided into 3 dimensions: label identification, status loss, and career denial. The results of confirmatory factor analysis (CFA) reveal that the three-factor model fitted well ( χ 2 /df=2.574, RMSEA= 0.068, CFI= 0.931, IFI= 0.931, TLI= 0.919, PNFI= 0.762, PCFI= 0.795). The PIOSS total and each dimension scores were significantly negatively correlated with the CCS and the WWBS scores and remarkably positively associated with the DDPRQ-10, the ILS, and the ODS scores. Cronbach’s α coefficients for the PIOSS total scale and dimensions ranged from 0.775 to 0.914, and split-half reliability coefficients ranged from 0.801 to 0.931. In addition, the PIOSS exhibited cross-gender invariance. Conclusion Having good reliability and validity, the PIOSS can serve as a valid tool for the assessment of physician internalized occupational stigma.

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Section: Discussionmentioning

confidence: 99%

Development of the Chinese Version of the Physician Internalized Occupational Stigma Scale (PIOSS)

Fan¹,

Cong²,

Tao³

et al. 2022

PRBM

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“…Nevertheless, it is important to consider alternative ways to reduce mental illness stigma amongst the public and HCPs. This should include campaigns focused on and directly discussing stigmatizing attitudes toward mentally ill patients, which based off previous evidence, may be more helpful compared to knowledge-based campaigns (Carrara et al , 2020).…”

Section: Discussionmentioning

confidence: 99%

Social stigma among health-care providers toward patients with schizophrenia and obsessive-compulsive disorders at tertiary hospital in Makkah, Saudi Arabia

Saad

Bshawri

Alsaedi

et al. 2022

MHRJ

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Purpose Several previous studies showed strong social stigma toward mental illness patients from the health-care providers (HCPs) in Saudi Arabia. This stigma affects the level of care provided by HCPs. Stigma is a major barrier in treating schizophrenia and obsessive-compulsive disorder (OCD) patients. Thus, it is important to clarify the difference regarding the social stigma between both diagnoses. This study aimed to identify and compare the existence of social stigma among HCPs towards schizophrenia patients compared to OCD patients. Design/methodology/approach A total of 283 HCPs from King Abdullah Medical City (KAMC), Makkah, Saudi Arabia, were enrolled in this cross-sectional questionnaire-based study between middle and end of January 2021. The scale included a demographic questionnaire plus two vignette cases reflecting OCD and schizophrenia patients’ symptoms without mentioning diagnosis. Each case was followed with 18 questions, which measured some of the thoughts and attitudes of the social stigma of mental illnesses including negative stereotypes, discrimination, social distancing and emotional and cognitive prejudices against mental illness patients. The scale was validated by a pilot study (which included 15 other participants) with acceptable validity and reliability (Cronbach’s alpha: 81.4%). Findings Most participants’ responses were “low” in the total score of their stigma score for both diagnosis [OCD (84.1%), mean ± SD (1.15 ± 0.366) and schizophrenia (74.2%), mean ± SD (1.25 ± 0.438)]. However, those who responded “high” in their stigma score regarding the schizophrenia section were higher in their number than those who responded “high” in the OCD section (25.8% vs 15.9%). Most participants had “low” total stigma scores for both diagnoses [OCD (84.1%), mean ± SD (1.15 ± 0.366) and schizophrenia (74.2%), mean ± SD (1.25 ± 0.438)]. However, of those with “high” stigma score responses, more were for the schizophrenia section compared to the OCD section (25.8% vs 15.9%). Being flexible to recruit any of them was more related to promoting them if they deserve promotion. The sample that answered wrong regarding OCD vignette diagnosis and had “high” stigma score was higher (n = 40) than the sample that answered correctly and had “high” stigma score (n = 5). In contrast, the sample that answered wrong regarding the schizophrenia case diagnosis and had “high” stigma score (n = 41) was not significantly different in terms of its number compared to the one that answered correctly and had “high” stigma score (n = 32). Research limitations/implications One aspect that reduces the strength of this study is that the target number of the participants could not be reached, meaning a 95% confidence level with a ±5% margin of error could not be reached. Another limitation is the lack of contact between HCPs at the KAMC in Makkah with mental illness patients owing to lack of psychiatric inpatient departments. However, this limitation may be a strength for this study, as we were able to primarily measure medical HCPs rather than psychiatric HCPs. Although the vignette methodology in stigma studies has many benefits, the participants do not respond to real patients, and therefore miss appearance and other nonverbal cues that are typically present in real interactions. Originality/value The social stigma level among HCPs against schizophrenia patients is higher than that against OCD patients. The factor of knowing the diagnosis of the case has a positive effect on decreasing stigma toward OCD patients but not toward schizophrenia patients. Educational awareness about stigma against mental illness patients to HCPs, rather than focusing on increasing literature knowledge, may decrease stigma among HCPs.

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“…As general ward nurses more frequently interact with patients with mental illness, intergroup contact theory (Allport, 1954; Pettigrew & Tropp, 2006) suggests that nurses may have less stigmatizing attitudes toward mental illness than the public (Carrara et al, 2021; Mårtensson et al, 2014). However, health care professionals are often rated as one of the most stigmatizing groups users of mental health services encounter (Thornicroft et al, 2007).…”

Section: Relationship Between Nurses and Patientsmentioning

confidence: 99%

Affective, cognitive, and behavioral mental illness stigma in health care: A comparison between general ward nurses and the general population.

Birtel¹,

Oldfield²

2022

Stigma and Health

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Stigma from health professionals and the general population can be a barrier in health care for people with mental illness. The aim of this study was to compare experiences with and perceptions of people with mental illness between general ward nurses and the general population in the United Kingdom as well as to examine the associated mechanisms. Participants were general ward nurses (n = 101) and the general population (n = 116) in the United Kingdom who completed a survey for this cross-sectional study. Nurses reported poorer contact experiences with people with mental illness (less frequent positive contact, more frequent negative contact, lower contact quality, fewer friendships) than the general population. They also reported greater stigma (more negative attitudes, higher attribution of negative and lower attribution of positive human uniqueness traits to people with mental illness, greater differences between themselves and people with mental illness, lower behavioral intentions). Intergroup anxiety and intergroup empathy mediated the associations between group and contact quality, attitudes as well as behavioral intentions. Understanding differences in stigma between health professionals and the general population will be important to support people with mental illness in seeking treatment and receiving optimal physical and mental health care as well as to support health professionals in their roles.

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Health care providers and people with mental illness: An integrative review on anti-stigma interventions

Cited by 42 publications

References 64 publications

Development of the Chinese Version of the Physician Internalized Occupational Stigma Scale (PIOSS)

Development of the Chinese Version of the Physician Internalized Occupational Stigma Scale (PIOSS)

Social stigma among health-care providers toward patients with schizophrenia and obsessive-compulsive disorders at tertiary hospital in Makkah, Saudi Arabia

Affective, cognitive, and behavioral mental illness stigma in health care: A comparison between general ward nurses and the general population.

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