Search

The present study aimed to explore the lived experience of fertile Iranian mothers who adopted children. In a qualitative phenomenological method, 13 participants were selected by purposive sampling and interviewed in depth. Data were analyzed by Colaizzi's method. The results showed that although adoption was reported to be a positive experience for most mothers, it is still a kind of social stigma in Iran, and adoptive mothers face many challenges due to insufficient support and help from society and families. Also, the results will help professionals design pre-adoption interventions, prevent the termination of adoption, and help adoptive mothers solve their issues. [ABSTRACT FROM AUTHOR]

Objective: Online pro‐ana communities encourage, rather than denounce, eating disorder (ED) behaviours. Most research analyses online pro‐ana content. Fewer studies have interviewed bloggers directly. To the authors' knowledge, no previous studies have analysed both posts and interview data from pro‐ana bloggers. This study aimed to explore bloggers' experiences of online pro‐ana communities, analysing posts and interview data. Method: Five pro‐ana bloggers participated in semi‐structured interviews over Skype or Telegram. Bloggers' posts and interview data were analysed using interpretative phenomenological analysis, a qualitative method of analysis that emphasises the detailed exploration of participants' individual experiences and how they make sense of these experiences. Results: Five superordinate themes were identified: ambivalence towards pro‐ana; social support; 'Ana' way of life; body/weight desperation; and hidden ED identity. Participants reported hiding their pro‐ana blog, for fear of judgement from offline others. In contrast, participants experienced online pro‐ana communities as a source of understanding, connection and solidarity that counteracted stigma experienced in the offline world. All participants idealised 'Ana' (anorexia), either as an admirable lifestyle or as the idealised, personification of anorexia, named 'Ana'. Simultaneously, participants experienced pro‐ana communities as deceptive and/or harmful, demonstrating ambivalence towards pro‐ana. Conclusions: Findings suggest that community and shared understanding are important to individuals accessing pro‐ana content. Therapists may explore this further with clients, alongside any ambivalence towards pro‐ana and/or alternative supportive environments, such as online support groups. This may reduce isolation, without idealising ED behaviours. Future research could explore bloggers' relationships with the personified 'Ana' and experiences of non‐Western and male users. [ABSTRACT FROM AUTHOR]

Background: One of the main challenges facing individuals with an intellectual disability is the stigma associated with the various obstacles that hinder their process of full integration. Despite the efforts made, more research is called for to explore the reference environments and reveal how public and self-stigma are perceived in higher education. This scientific paper's overriding aim is to analyse how different university stakeholders (students, lecturers, and admin and service staff) perceive the presence of young people with intellectual disability. Method: An ex post facto design has been used with a sample of 306 participants and a validated instrument for measuring the perception of individuals with an intellectual disability. Results: Our findings reveal that women perceive less stigma than men, and when the analysis is broken down into the collectives involved, students with disability are clearly more conscious of public or self-stigma than their peers without any disability. Conlcusion: The disparity between gender and roles underscores the need for socioeducational interventions to promote inclusion in higher education and address self-stigma, thereby fostering self-sufficiency and emotional wellbeing among young individuals with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This study assesses how wearing an EM affects stereotype-consistent delinquent attitudes and cognitions, and whether feeling stigmatized for wearing an EM contributes to broader negative functioning for youth enrolled in an EM program. A total of 98 juveniles currently enrolled in an EM program were randomly assigned to one of two conditions: (a) Stigma Salience (prompted to think about and describe wearing an EM), and (b) Stigma Non-salience (prompted to think about and describe their day). As hypothesized, youth with greater personal and group stigma for wearing an EM, also reported greater negative experiences while wearing an EM. This research can inform evidence-based practitioners, academics, and policymakers considering and crafting regulations for youth on EM or consider alternatives to EM. [ABSTRACT FROM AUTHOR]

Children growing up with a parent with mental ill-health are a hidden and vulnerable group. Positioned at the intersection between adult and children services, and health and social care, these children fall between the gaps, rarely acknowledged in policy or practice. This is exacerbated when the young person is excluded under the auspices of patient confidentiality and age appropriateness. This article reports findings from research which captured young carers' retrospective accounts of professional support when caring for a parent with mental illness. Participants in this research study described being 'involved but not included'; they provided significant care to their parent and were relied on by professionals to provide support. However, they were simultaneously omitted from any discussion or understanding of the decisions made. This article explores the relevance of these accounts for current service provision. It concludes with recommendations for involving young carers in care planning and ensuring that young carers have their own needs assessed and acknowledged by professionals. [ABSTRACT FROM AUTHOR]

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article examines the distinct vulnerabilities faced by musical theatre performers, highlighting the intense physical and psychological pressures they endure. Topics include the physical demands of musical theatre, the high incidence of vocal pathologies among young performers, and the impact of physical and emotional stress on their well-being.

Background: Depression is a major mental health problem. High school-age adolescents living in the hill tribe villages are especially susceptible to depression due to their remote living environment and stigmatization, a situation that has been exacerbated by the COVID-19 pandemic. Objective: To estimate the prevalence and determine the associations of individual and contextual factors with depression among hill-tribe high school students in Chiang Rai Province, Thailand, during the COVID-19 crisis. Materials and Methods: A school-based, multilevel cross-sectional study was conducted. Participants were randomly selected from 18 classes of six high schools located in the hill tribe villages of Chiang Rai Province, Thailand. A validated questionnaire and the Patient Health Questionnaire for Adolescents (PHQ-A) were used to collect data. The present study was conducted between May and September 2022. The data were analyzed by the multilevel binary logistic regression at a significance level of α<0.05. Results: A total of 540 hill tribe high school students were recruited for the analysis, 71.3% were female, 81.7% were Thais, and the mean age was 16.81 years. The overall prevalence of depression was 21.9% (95% CI 18.4 to 25.4). In the multivariate multilevel analysis, nine variables were found to be significantly associated with depression: underlying disease, perceived stress, negative life events, smartphone addiction, family functioning, peer group relationship, social stigma, and study program. Conclusion: A substantial proportion of the hill-tribe high school students suffered with depression during the COVID-19 pandemic. Appropriate public health interventions should be developed and implemented to reduce the problem by focusing on those who had underlying diseases, perceived stress, negative life events, anxiety, and smartphone addiction. Moreover, implementation should be integrated into their families, peers, and social environments. [ABSTRACT FROM AUTHOR]

Objective Youth living with HIV (YLHIV) in the southern United States experience poor outcomes across the HIV care continuum and are at high-risk for virologic failure. This study used a qualitative, community-engaged approach to inform the development of a tailored mobile Health (mHealth) tool for YLHIV in South Carolina (SC). Methods Semistructured qualitative interviews were conducted with YLHIV in SC (n  = 16) and their HIV care providers (n  = 15). Focus group discussions (FGDs) were also conducted with HIV-focused community-based organization staff (n  = 23). Interviews and FGDs queried desired components for a future mHealth tool tailored for YLHIV. Data were analyzed using a team-based rapid qualitative approach. Results Across informants, key themes emerged related to medical management of HIV, including a desire for connections with medical providers, appointment and medication reminders, and accurate HIV information. In addition, informants voiced a desire for mental health resources to be integrated into the app. Connection with HIV-positive peers also emerged as a key desire from youth informants. In terms of app design, informants emphasized the need for strict privacy practices, a youth-friendly design, compensation for use, and integration with existing healthcare systems. Conclusions mHealth interventions developed for YLHIV should meet the mental health and social needs of YLHIV in addition to their medical needs. In addition, the highly stigmatized nature of HIV requires careful consideration when designing digital tools—youth want their privacy prioritized, but also express strong desire for social support to help cope with the isolation and stigma of this chronic health condition. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This grounded theory study aimed to explore the subjective experiences of children living with Human Immunodeficiency Virus (HIV) from the perspective of children and their families in Indonesia. Twenty participants were interviewed, consisting of 12 children aged 9–18 years and eight family members. Using grounded theory analysis, this study identified three categories: 'coping with diagnosis', 'disclosing their status' and 'living with the stigma of HIV'. Participants responded with shock, denial, sadness, secrecy and often had misconceptions about the virus to the diagnosis of themselves or their children. After diagnosis, children with HIV and their families continuously lived with stigma stemming from individual and societal beliefs about the virus. This stigma manifested in actions such as isolation, disclosure avoidance, secrecy, deception and social rejection. Because of these stigmatisations, many of the participants decided not to disclose the child's HIV status and used status strategies such as telling lies, keeping secrets and keeping their distance. The participants offered insight into the need for comprehensive programs to address care gaps. This study highlights that health professionals need to develop practical guidelines to support families during the disclosure process, provide psychosocial care for children, and create stigma reduction interventions for children with HIV. [ABSTRACT FROM AUTHOR]

LGBTQIA+ youth often face stigma from society as they develop their personal identities. In the United States, legislation has recently been focusing on reducing protections in schools for queer youth and limiting access to resources like gender affirming healthcare. Youth have increasingly been targeted for identifying as queer and have experienced verbal and physical violence for expressing their gender identities. Research links stigmatization with increased mental health and substance use problems. However, there is limited information on how stigma experienced during adolescence may continue to impact young adults over time. Using a qualitative retrospective framework, LGBTQIA+-identified undergraduates (N = 8) at a 4-year university participated in one-hour virtual focus groups. Data were recorded and anonymized using individual participant codes with names of people or places removed from transcripts. Students were asked to reflect on their experiences as queer youth in secondary school including access to resources; interactions with teachers, staff, and peers; recommendations for supporting LGBTQIA+ students; and personal coping skills. The researchers used a thematic analysis to examine key issues students raised. Results provide insight into the challenges LGBTQIA+ youth face and highlight the strengths of these college-age young adults. [ABSTRACT FROM AUTHOR]

This study explored conceptualizations of disability pertaining to peer relationships versus romantic relationships, as well as type of physical disability, using story-completion methods. Seventy-four graduate and undergraduate students from a Canadian university completed one of two versions of a story stem featuring an individual with a physical disability who was either a classmate or a potential romantic partner. Through the process of thematic analysis, three themes were generated as patterns across stories: (1) assumptions about disability present from first glance; (2) uncertainty in navigating negative assumptions of disability; and (3) from discomfort to acceptance of disability through social connection. Storylines differed depending on the type of relationship (i.e., peer or romantic) in both story length and outcome of the relationship. Findings suggest the usefulness of the relatively infrequently used method of story completion for assessing students' narratives and discussion of meanings surrounding differing relationships with persons with a disability. This study further develops our understanding of cultural norms of disability, as well as highlights the importance of disability knowledge and interaction between persons with and without a disability, to foster positive change in representations and perceptions of disability. [ABSTRACT FROM AUTHOR]

There is a mental health crisis in the United States that shows no signs of abating. Prevalence rates of mental disorders among both adults and children are rising and there are simply not enough mental health professionals to meet the growing demand. To address this problem, digital programs are being designed to diagnose and treat mental health conditions either adjunctively to a human clinician or as stand-alone treatments. Such developments hold great promise in ameliorating the mental health professional supply shortage. However, certain limitations of digital programs may prevent many users from desiring a digital psychotherapist. This paper surveys both the promise, and limitations, of digital psychotherapies. [ABSTRACT FROM AUTHOR]

Patients with substance use disorders may view healthcare professionals as capable of supporting them through their suffering and experience. Although numerous studies have focused on the roles, approaches, and attitudes of healthcare professionals, there is a lack of information on the nursing perspective. This study aims to explore the experiences and nursing approaches towards patients with psychoactive substance dependence admitted to an Italian acute hospital ward. A qualitative phenomenological study was conducted. Data were collected using semi-structured face-to-face interviews. The interviews were transcribed, read thoroughly, and analysed. Fifteen nurses were interviewed. Six main themes were extracted: (1) origin context, (2) participants' personal thoughts, (3) type of approach provided, (4) school education received on the topic, (5) effectiveness of rehabilitative therapy, and (6) methods that can improve nursing care. The findings suggest that most respondents experience stigma and discrimination when providing care to these patients. In response to the results obtained, models have been suggested, such as Jean Watson's Human Caring Theory, which shows how practising a holistic approach based on empathy and active listening can improve the relationship between nurses and patients. Furthermore, to eliminate stereotypes, it would be appropriate to act on the university education of nurses. This study was not registered. [ABSTRACT FROM AUTHOR]

Introduction: One way that transgender and gender diverse (TGD) people may affirm their gender is through a legal name and/or gender marker change. Legal gender affirmation is associated with less psychological distress, but research has yet to expand upon the mechanisms that may help explain this association. We examined associations between legal gender affirmation, psychological distress, and physical health in TGD people, as well as the mediating effect of exposure to enacted stigma. Methods: Data are from the baseline portion of a longitudinal mixed-methods study of how sociopolitical contexts influence marginalization, health, and resilience for TGD people. The study included 158 TGD participants from Oregon, Michigan, Nebraska, and Tennessee. Baseline data were collected September 2019–March 2020 (the overall study concluded Fall 2021). Results: Latent variable structural equation model analyses revealed that participants who had legally affirmed their gender reported less enacted stigma, which was associated with less psychological distress and physical health issues. There was a significant indirect effect via enacted stigma, such that this variable may partially help explain why legal gender affirmation is associated with better health outcomes. Conclusions: Legal gender affirmation is likely to influence TGD people's health and well-being by shaping exposure to minority stress—specifically, enacted stigma. Our findings demonstrate the importance of sociopolitical factors in health outcomes for TGD people. Policy Implications: Given the health benefits of legal gender affirmation and the potential protection from enacted stigma, policies should be revised to make legal name and/or gender marker changes more accessible for TGD people. [ABSTRACT FROM AUTHOR]

Language is crucial for successful service exchange, yet it can also become a source of chronic social exclusion for nonnative speakers in the host country. This research examines how language‐based chronic social exclusion affects nonnative consumers' experiences and consequently, their tipping behavior. The results from a survey with 355 nonnative speakers in the USA and 355 nonnative speakers in the UK, along with a field study, reveal that these customers feel threatened in terms of their relational and efficacy needs, influencing their desire to restore their self‐image. This, in turn, positively influences their tipping behavior. This study is the first to empirically explore language‐based chronic social exclusion and its psychological and behavioral effects from the speakers' (nonnative customers') perspective in a service exchange setting. It highlights the importance of inclusive practices and policies to support socially excluded customers based on their language. [ABSTRACT FROM AUTHOR]

Background: Health care professionals (HCPs) historically exhibit high rates of stress, burnout, and low rates of service utilization from Employee Assistance Programs (EAPs) and Professional Health Programs (PHPs). New and magnified stressors that accompanied COVID-19 exacerbated HCPs' risk of burnout. Purpose: During the pandemic, this study examined Ohio HCP's utilization of EAPs and PHPs, knowledge of available services, barriers to accessing services, and likelihood of future service utilization. Conditions needing to change to increase likelihood of future utilization were also explored. Methods: A one-time survey was administered in July and August of 2021 to HCPs from 13 licensing boards in Ohio. This study used a subset of data to examine the extent of convergence between quantitative results—analyzed using frequency calculations—and results from thematic analysis of corresponding open-ended survey items. Qualitative results supported and elaborated the quantitative findings. Results: Fewer than 25% of respondents (N = 12,807) utilized EAPs or PHPs to address mental health concerns. Obstacles impeding service utilization included issues around awareness, time commitment, and confidentiality—a concern encompassing issues of stigma and fear of employment repercussions. Noting multiple obstacles to accessing EAPs and PHPs, HCPs in Ohio reported low rates of support service utilization and low likeliness to use services in the future despite their experiences of extreme stress and burnout. Conclusions: Addressing the time commitment and confidentiality concerns could increase the likelihood of accessing services. Employers of HCPs should explore additional support mechanisms such as comprehensive wellness programs and innovative, brief intervention strategies to combat burnout, especially during viral outbreaks and other high-stress events. [ABSTRACT FROM AUTHOR]

Sensibility to stigma in child welfare systems is important to prevent harmful acts against marginalised groups in society. This case analysis centres around one family in the child welfare service (CWS) that could be considered marginalised across several dimensions. The empirical material consists of three separate in-depth interviews with the child, their parents and their caseworker. We explore how the stigma attributed to the family was enhanced through the relationship with the CWS and the role stigmatisation played in the interactions between the family and the CWS. The analysis showed how the parents were constructed as 'outsiders', compared to the ideal; they lacked money, good looks, and character. Although the parents were somehow subjugated and the caseworker perceived them as submissive, they also resisted stigma in both open and subtle ways. However, this was not always sensed by the CWS. We discuss the importance of addressing stigma in all its forms and acknowledge that stigma is power, which is also intertwined with the broader policy. This is crucial knowledge to mitigate the role of the CWS in the stigma machine and in turn reduce structural bias within the CWS. [ABSTRACT FROM AUTHOR]

Relatively few children are born with HIV in this country, however, evidence suggests that a new population of U.S. children living with perinatally-acquired HIV are emerging: internationally adopted children. This unique population has intersecting identities that place them at risk for stigma, discrimination, and adverse mental health outcomes. This longitudinal study explores parental perspectives of their child's resilience across various settings including school, community, doctors' offices, and at home. Parents of internationally adopted children with perinatally-acquired HIV (IACP) were recruited through snowball sampling from two tertiary care hospitals and closed Facebook groups. From 2018 to 2021, 11 parents each participated in three semi-structured interviews annually. Parent interviews focused on 12 IACP, (mean age at time of adoption = 5.86 years, range 7 months to 15 years). At the time of the parent's first interview, mean age of IACP was 9.62 years (range 4 to 18 years). Five IACP were female (42%), and seven were male (58%). Interviews were analyzed using the Sort, Sift, Think, Shift qualitative approach. Results from the three parent interviews suggest that parents of IACP are crucial in fostering resilience through open conversations about HIV and community challenges. Parents highlighted stigmatization around HIV in their community and with friends. Parents further revealed techniques they used to promote resilience, such as strengthening teacher and IACP relationships. Additionally, they discussed how IACP showed resilience in medical settings by tolerating blood work and developing medication independence through the support of their healthcare providers. Future research should prioritize engaging with IACP to gather their perspectives to further support their growth and development. [ABSTRACT FROM AUTHOR]

Purpose: Psychosocial distress negatively impacts coping and adaptation among young men (aged 18 to 44 years) who have sex with men (YMSM) with, or at risk of acquiring, HIV. However, the stressors and risky behaviors associated with psychosocial distress that impair viral suppression have not been clearly explicated. The current scoping review was conducted to explore the extant literature and identify research gaps. Method: PubMed and CINAHL were searched for peer-reviewed publications, with a total of eight articles meeting inclusion criteria. Results: Stressors that contributed to psychosocial distress included HIV+ status, stigma, discrimination, insufficient resources, exposure to community violence, and incarceration. Risky behaviors impacting viral suppression were condomless anal sex, drug use, and medication nonadherence. Conclusion: Understanding and addressing psychosocial distress is imperative for providing holistic care tailored to the unique health care needs of YMSM. A better understanding of stressors and associated risky behaviors will aid efforts to mitigate psychosocial distress and reduce viral load among YMSM. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 11–17.] [ABSTRACT FROM AUTHOR]

Purpose: Caring for a child or youth with special health care needs (CYSHCN) can be overwhelming. Parents and caregivers may experience psychosocial distress, such as depression, frustration, and hopelessness. The purpose of the current study was to gain further insight into families' perspectives on the psychosocial impacts of caring for CYSHCN to identify gaps in health care systems and strengthen systems of support. Method: A qualitative descriptive design was used in 16 parents and caregivers. Colaizzi's method of analysis and semi-structured interviews were used. Results: Six themes emerged from this study: (1) Stigma and Isolation, (2) Religion as a Coping Mechanism, (3) Financial Challenges, (4) Bearing the Burden, (5) Familial Denial, and (6) System-Related Concerns. Conclusion: Psychiatric–mental health nurses (PMHNs) are in a pivotal position to use their knowledge, skills, and experiences to guide families. PMHNs can also engage communities and enhance mental health promotion to break the stigma associated with having a CYSHCN. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 37–46.] [ABSTRACT FROM AUTHOR]

To explore the transition from correctional facilities to community among women living with HIV in Vancouver, Canada, we interviewed 19 recently incarcerated women and 6 service providers. Findings highlighted heightened risk of violence at release, a lack of immediate supports, challenges accessing safe housing and addictions treatment, and interruptions in HIV treatment and care. In the face of structural barriers, women blamed themselves for not being able to break the cycle of incarceration. There is a critical need for enhanced pre-release planning with a priority on housing and substance use services, alongside supports that are trauma-and violence-informed and culturally safe. [ABSTRACT FROM AUTHOR]

Rape survivors face stigma when disclosing their experiences. We hypothesized that a rape survivor who formally reports their rape would experience more stigma than one who does not, and that this effect will be stronger when the perceiver is a man or low in support for sexual consent. Across two studies using self-report, observational, and psychophysiological measures, we found that a reporting survivor was seen more negatively than an identical survivor who did not report their rape. Men and those low in support for sexual consent also responded more negatively to the survivor. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Neglected tropical diseases (NTDs) are a group of illnesses which usually present with a chronic clinical picture. NTDs can lead to permanent disability and are often associated with social stigma. In many developing countries where NTDs are endemic, there are no diagnostic tools for the safe storage and transport of biological samples, and there are no specialist diagnostic centers where the samples could be processed. The transport of biological samples (blood, urine) collected in field conditions and brought to laboratories located in developed countries requires the maintenance of the cold chain during transportation. Ensuring temperature control during transport could be problematic or even impossible to achieve; it is also expensive. A helpful solution to this problem is to use the dried matrix spot (DMS) technique, which seems to be a reliable method for collecting biological samples to be used for screening purposes and conducting epidemiological surveillance of NTDs in developing countries. This article is an overview of how DMSs can be used in the diagnosis of most neglected tropical diseases. [ABSTRACT FROM AUTHOR]

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024. Included studies were based upon original quantitative, qualitative, or mixed-methods data; conducted in one or more European countries; and published in one or more of the following languages: English, Spanish, French, Portuguese, or Romanian. A quality assessment was conducted using the CASP checklist for qualitative studies and the NHLBI Study Quality Assessment Tools for quantitative studies. The findings revealed numerous access barriers, including refusal of care, lack of knowledge about national healthcare schemes, bureaucratic hurdles, and affordability issues. Even when care was available, stigma, fear of deportation, socio-economic precarity, and abuse further hindered utilization. These barriers contributed to generally worse reproductive health outcomes for undocumented migrants in Europe, though the findings may not generalize to all EU-EFTA countries. [ABSTRACT FROM AUTHOR]

The review examines the long-term impact of community psychiatric care on improving the quality of life of people with schizophrenia. It addresses the global burden of this disorder and the need for effective community-based care strategies. A systematic literature search was conducted in databases such as CINAHL, Medline, Web of Science, Sage and ScienceDirect, with the search lasting until March 2024 and following the PRISMA guidelines. The inclusion criteria targeted studies that addressed the long-term effects of community mental health care for people aged 18 years and older with schizophrenia and included both quantitative and qualitative research designs. Studies unrelated to the research question or with significant methodological flaws were excluded. The risk of bias was assessed using GRADE and GRADECERqual, in addition to critical appraisal using the Joanna Briggs Institute (JBI) checklists. Independent screening and data extraction was performed, with results summarised by thematic analysis. In total, 11 studies met the inclusion criteria and included cross-sectional, cohort, qualitative and randomised controlled trial designs. The results showed that community psychiatric care significantly improves the quality of life, well-being and social integration of people with schizophrenia. Effective interventions identified include psychoeducation, cognitive behavioural therapy, social skills training and individualised care plans. However, challenges such as limited resources, labour shortages and social stigma, particularly in low-income neighbourhoods, were also identified. This study highlights the importance of continuous, personalised, multidisciplinary community-based care for sustainable mental health outcomes. Further research is recommended to investigate the long-term impact and strategies to overcome implementation challenges. [ABSTRACT FROM AUTHOR]

Background: Attribution models have been examined in Western countries. However, little is known about the applicability of the attitude–emotion–behavior model within Chinese culture. This study aimed to examine the association between familiarity, perceived dangerousness, fear, and social distance towards persons with mental illness (PMI) in the Chinese context. Methods: An online cross-sectional survey was conducted from October to November 2022 in mainland China. A total of 1493 college students completed a questionnaire evaluating familiarity, perception of dangerousness, fear, and social distance regarding PMI. Path analysis was employed to validate the model proposed in this study. Results: Participants expressed moderate to high levels of stigma towards PMI. Familiarity was negatively associated with social distance (p < 0.01). Participants who perceived PMI as dangerous were more prone to exhibit a reaction of fear (p < 0.001), consequently leading to social distance (p < 0.01). However, the mediating effect of perceived dangerousness and fear on the relationship between familiarity and social distance was not significant (p > 0.05). Conclusions: The results of this study provide support for Corrigan's attributional model of stigma in the Chinese context. Contact-based interventions for stigma reduction should emphasize multiple elements of contact, including the quality of contact, rather than familiarity. [ABSTRACT FROM AUTHOR]

People with HIV continue to experience HIV stigma. Quantitative data on HIV stigma perpetrated by healthcare providers of hospitals providing HIV care in high-income countries are limited. The aim of this study is to investigate factors associated with HIV stigma in Dutch healthcare settings from the healthcare providers' perspective. We conducted a cross-sectional study using the questionnaire 'Measuring HIV Stigma and Discrimination Among Health Facility Staff – Monitoring Tool for Global Indicators' to assess HIV stigma among healthcare providers (n = 405) in two academic hospitals. Healthcare providers licensed to provide medical care were eligible for inclusion. The primary outcome was the self-reported prevalence of at least one manifestation of HIV stigma measured by six stigma indicators (four individual, two institutional). Secondary outcomes were the prevalence of HIV stigma per indicator, per occupation, per department, and factors associated with individual stigma indicators. HIV stigma was prevalent among 88.1% (95%CI 84.5% − 91.2%) of participants. Stigma was mostly driven by negative attitudes towards people with HIV and worry to acquire HIV. Multivariate analysis showed that several factors were associated with HIV stigma, including younger age, male sex, working at one of the surgical departments, and working as a nurse. Having received any training on HIV stigma and/or discrimination was associated with less HIV stigma among all indicators. In conclusion, HIV stigma is highly prevalent among Dutch healthcare providers. Targeted approaches, including training on HIV stigma and discrimination, are needed to reduce HIV stigma in healthcare and should, among others, focus on younger healthcare providers. [ABSTRACT FROM AUTHOR]

In 2022, 54% of 1.5 million children (age 0–14) living with HIV had access to anti-retroviral medication (ART). Adherence to ART for pregnant or breastfeeding HIV + women is critical for maintaining their personal health and to prevent mother-to-child-transmission (MTCT). For HIV + infants, adherence is essential to establish early viremic control and is contingent on caregiver administration. We conducted a scoping review to systematically identify and categorize the influences on ART adherence for pregnant or breastfeeding HIV + women and their HIV + infants. We searched databases in June 2023 and employed the Social-Ecological Model (SEM) to organize facilitators and barriers to adherence referenced in published articles. All articles published before 2016 were excluded due to updated guidelines from WHO on MTCT and ART. Our analysis included 52 articles. 50/52 took place in Africa and used cross-sectional and mixed-methods design. Barriers to adherence for pregnant or breastfeeding HIV + women included maternal education, self-efficacy, social support, and social/economic context. Barriers to infant adherence included development, nutrition, age of treatment initiation, disclosure, and ART side effects. Additional facilitators and barriers to adherence are presented at family, extra-familial, and socio-cultural SEM levels. Stigma was the most salient barrier referenced across the entire continuum of HIV care and all SEM levels. This review revealed a dearth of literature focusing on HIV + infants who are dependent on their caregivers for ART adherence and lack of a standard adherence measure. We identified multi-leveled influences on adherence impacting both the mother and infant and are amenable to public health intervention. [ABSTRACT FROM AUTHOR]

Mental health-related stigma is a prominent barrier to improved mental health outcomes globally and may be particularly harmful to populations with other stigmatized identities. We aimed to understand intersectional depression- and HIV-related stigma among people with HIV (PWH) entering HIV care in Cameroon. Using baseline data from a cohort of PWH entering HIV care in Cameroon between 2019 and 2020, we characterized depression- and HIV-related stigma in the population overall and by sociodemographic sub-group. We also explored substantively meaningful variation in stigma endorsement by depressive symptom severity (Patient Health Questionnaire-9 [PHQ-9]) and causal attribution of depression. Among those with elevated depressive symptoms (PHQ-9 scores > 4), we estimated the association between stigma type and depressive symptom severity using binomial regression. Among 398 participants, 49% endorsed low HIV- and depression-related stigma (N = 195), 10% endorsed high HIV- and depression-related stigma (N = 38), 29% endorsed high depression-related stigma only (N = 116), and 12% endorsed high HIV-related stigma only (N = 49). Respondents with and without heightened depressive symptoms commonly believed depressive symptoms were caused by HIV (N = 140; 32.9%). Among those with elevated depressive symptoms, the prevalence of moderate to severe symptoms was higher among those endorsing high HIV-related stigma only (prevalence ratio 1.55; 95% confidence interval: 1.01, 2.37) compared to those reporting low HIV- and depression-related stigma. HIV- and depression-related stigma are both common among PWH entering HIV care in Cameroon. The consistent association between HIV-related stigma and poor psychosocial well-being among people with HIV necessitates the urgent scale-up of evidence-based HIV-related stigma interventions specifically. [ABSTRACT FROM AUTHOR]

This article aims to provide an illustrated account of layered stigmatisation processes and consequences for those who experience chronic pain and accompanying suicidality. Using constructivist grounded theory, I draw from 20 in-depth interviews conducted from 2022 to 2023 to explore how chronic pain and suicidality operate within people’s social worlds. Findings demonstrate how layered stigmatising processes, occurring based on chronic pain and suicidality, operate consistently across multiple social arenas to create interactional troubles, which result in enduring negative social, emotional, and financial impacts. Three themes were constructed, including (1) self-stigma and the multiple roles of the family, (2) missed connections, and (3) anticipated stigma and workplace discrimination. Taken together, themes support the overarching category, ‘interactional troubles’. Findings suggest a need for attunement to stigmatising processes’ omnipresence and the depth of their consequences. Clinical interventions may benefit from emphasizing participants’ social worlds and incorporating the complexity of navigating social arenas given layered stigmatisation. Moreover, policies that support those with chronic pain and mental illness could offset the long-term negative economic consequences of discrimination. [ABSTRACT FROM AUTHOR]

During the early stages of the global COVID-19 pandemic, governments searched for effective means to rapidly disseminate information about how to prevent the disease and care for sick household members. In June 2020, the government of Kenya considered sending text messages, a behavioral nudging approach, to inform and persuade the public to practice home-based care for those who were infected. We conducted a randomized evaluation of simple informational messages compared to messages targeting personal and social benefits for those receiving the messages. We hypothesized that those that received messages tailored around social or personal benefit would be more likely to undertake the promoted behaviors of isolating if infected with COVID-19 and intending to care for an infected family member. While fear and perceptions of stigma were widespread, more than two-thirds of respondents in the control condition expressed an intention to care for an infected family member at home. Despite greater recall of the personal benefit message, which used reciprocity as its key behavioral lever, intentions to provide care at home and perceptions of stigma did not differ across study groups. Rather, capabilities such as wealth and having sufficient room at home were the key determinants. While text messages as behavioral nudges may be useful for some behaviors, policymakers should consider a broader range of tools for behaviors that are influenced by people's capabilities, since even low-cost interventions may crowd out the time and energy needed for other responses during an emergency. [ABSTRACT FROM AUTHOR]

AbstractSexual assault and abuse have detrimental impacts on gay and bisexual (GB) men’s mental health. Nevertheless, many GB men survivors avoid seeking services due to concerns about non-affirming treatment from mental-health professionals and negative perceptions of masculinity if one seeks help for sexual trauma. This study investigated the impact of anticipated sexual assault stigma from mental-health professionals and masculine threat (the degree to which not feeling masculine lowers self-esteem) on help-seeking self-stigma among GB men survivors (N = 99). Both anticipated stigma and masculine threat associated with greater self-stigma of seeking help. When examining gay and bisexual men separately, anticipated stigma and masculine threat were significant for bisexual men, whereas anticipated stigma was the only significant variable for gay men. Implications discuss increasing attention toward the role of masculinity and anticipated stigma in help-seeking for sexual-minority men survivors and examining the unique experiences of these two populations rather than a one-size-fits-all approach. [ABSTRACT FROM AUTHOR]

Introduction: People living with HIV (PLHIV) have a 20-fold risk of tuberculosis (TB) disease compared to HIV-negative people. In 2021, the uptake of TB preventive treatment among the children and adolescents living with HIV at the Baylor-Uganda HIV clinic was 45%, which was below the national target of 90%. Minimal evidence documents the enablers and barriers to TB preventive treatment (TPT) initiation and completion among children and adolescents living with HIV(CALHIV). We explored the facilitators and barriers to TPT initiation and completion among CALHIV among adolescents aged 10-19years and caretakers of children below 18years. Methods: We conducted a qualitative study from February 2022 to March 2023, at three paediatric and adolescent HIV treatment centers in Uganda. In-depth interviews were conducted at TPT initiation and after completion for purposively selected health workers, adolescents aged 10–19 years living with HIV, and caretakers of children aged below 18years. Results: The desire to avoid TB disease, previous TB treatment, encouragement from family members, and ministry of health policies emerged as key facilitators for the children and adolescents to initiate TPT. Barriers to TPT initiation included; TB and HIV-related stigma, busy carer and adolescent work schedules, reduced social support from parents and family, history of drug side effects, high pill burden and fatigue, and perception of not being ill. TPT completion was enabled by combined TPT and ART refill visits, delivery of ART and TPT within the community, and continuous education and counseling from health workers. Reported barriers to TPT completion included TB and HIV-related stigma, long waiting time. Non-disclosure of HIV status by caretakers to CALHIV and fear of side effects was cited by health workers as a barrier to starting TPT. Facilitators of TPT initiation and completion reported by healthcare workers included patient and caretaker health education, counselling about benefits of TPT and risk of TB disease, having same appointment for TPT and ART refill to reduce patient waiting time, adolescent-friendly services, and appointment reminder phone calls. Conclusion: The facilitators and barriers of TPT initiation and completion among CALHIV span from individual, to health system and structural factors. Health education about benefits of TPT and risk of TB, social support, adolescent-friendly services, and joint appointments for TPT and ART refill are major facilitators of TPT initiation and completion among CALHIV in Uganda. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral and mental health conditions present significant challenges in the United States where access to care is limited. Family medicine physicians play a crucial role in addressing these challenges, often serving as frontline clinicians for behavioral and mental health conditions. Methods: This study examined the current behavioral and mental health system in a predominantly rural 10-county region in the Southeastern United States through gap analysis in addition to a survey of preparedness and barriers among family medicine physicians in the region. Results: Gap analysis results indicated that (1) stigma and lack of accessible education about behavioral and mental health, (2) fragmented resources, (3) inaccessible care, and (4) workforce shortage and burnout were primary drivers of poor outcomes in the region. Survey results indicated that physicians feel prepared to treat anxiety and depression but feel less prepared to manage bipolar disorder, schizophrenia, and substance use disorders. Respondents disagreed that there are adequate local resources and referral options for patients with behavioral and mental health conditions. Lack of timely access, distance, cost/insurance status, were all cited by respondents as barriers to appropriate care. Conclusion and Recommendations: Findings underscore the importance of supporting family medicine physicians to enhance behavioral and mental healthcare outcomes. Behavioral health integration in primary care settings is a promising strategy to improve care accessibility and clinician preparedness. Bridging gaps in health care outcomes requires collaborative efforts, enhanced training, and policy advocacy within the family medicine community to ensure comprehensive and equitable behavioral and mental healthcare delivery. [ABSTRACT FROM AUTHOR]

This study aims to gain more insight in the lived experience of men who became father at an advanced age (40 years or older). Advanced Parental Age (APA) is becoming an increasingly widespread phenomenon as the average age at which people have children has been increasing for decades now. However, the psychosocial dimension of APA-fatherhood in particular remains a highly understudied topic. This Interpretive Phenomenological Analysis presents findings from a qualitative interview study with seven men who fathered their (now teenage) children in their early 40s to early 50s. Interviews were semi-structured and focused on lived experiences of the participants and their normative stances regarding the topic of parenting at an advanced age. Three themes were identified: The fathers in our sample describe their APA as a result of life events rather than an intentional postponement. Second, they managed how they were perceived as APA-fathers by distancing themselves from 'too old' parents. However, these fathers did not perceive fatherhood at a younger age as better than their current APA. Three fathers, who also had an earlier fatherhood experience, provided a rich account of how they made sense of their fatherhood roles in both families. Third, the seven fathers encountered social stigma, leading to various coping strategies. These findings contribute to better understanding the psychosocial dimension of APA-fatherhood. [ABSTRACT FROM AUTHOR]

Infertility refers to the inability to conceive after 12 months of regular, unprotected sexual intercourse. Psychosocial aspects of infertility research are predominant in developed countries. A scoping review of psychosocial aspects of infertility research conducted in Africa between 2000 and 2022 was conducted. Twelve databases and grey literature were searched for articles. Studies were included if they were published in English and included findings from patients diagnosed with primary or secondary infertility. A total of 2 372 articles were initially found and screening resulted in 116 articles being included in the scoping review. Most of the studies (81%) were conducted in Nigeria, Ghana and South Africa. Psychosocial aspects explored included quality of life, barriers to treatment, attitudes and stigma, and sociocultural and religious aspects of infertility, among others. The review maps published psychosocial research in the context of infertility in Africa and identifies gaps for future research. Plain language summary: Our aim was to review published studies on psychological and social research conducted among men and women who were seeking treatment for infertility in Africa between 2000 and 2022. We initially found 2 373 articles that seemed appropriate but after screening these articles only included 116 in this review. We found that in Africa, Nigeria, Ghana and South Africa produced the most studies on the psychological and social impact of infertility. Common areas of research include exploring patients quality of life, barriers to seeking fertility treatment, stigma and attitudes around infertility, social, cultural and religious issues relating to infertility. This review is therefore helpful in understanding where psychological and social research on infertility is being conducted, what it is focused on and what the gaps in research are. [ABSTRACT FROM AUTHOR]

Background: Preventive treatment of tuberculosis infection (TBI) is considered a crucial strategy to prevent and control tuberculosis (TB). However, the acceptance and completion rates of preventive therapy for TBI are still far from optimistic. Evidence is mounting that TB knowledge and stigma may have a substantial effect on acceptance of TBI treatment. This study aimed to explore the effect of stigma on the relationship between the level of TB knowledge and acceptance of TBI treatment. Methods: 7017 general population were included in the study. We adjusted for the covariates at the individual. Stepwise logistic regression was used to examine the moderating role of TB stigma and also explore the association between TB knowledge and acceptance of TBI treatment. Results: The acceptance rate of TBI treatment among the respondents was 84.38% (n = 5921). Among respondents, a significant positive correlation between acceptance of TBI treatment and TB knowledge (OR = 1.096,95%CI = 1.073,1.118). Additionally, the association between TB knowledge and acceptance of TBI treatment was found to be moderated by TB stigma. In other words, TB stigma was found to weaken the impact of TB knowledge on acceptance of TBI treatment (OR = 0.994,95%CI = 0.991,0.996). Conclusion: The findings of the study indicated that having a high level of awareness about TB can enhance the general population's acceptability of TBI treatment. TB stigma moderated this association; it weakened the relationship between TB knowledge and individuals' willingness to accept TBI treatment. To mitigate TB stigma and enhance the intention of individuals with TBI to accept preventive therapy, it is imperative to enhance TB-related health education. [ABSTRACT FROM AUTHOR]

Introduction: Scabies undermines quality of life through its highly disturbing disease symptoms, by distorting self-perception, and secondary to social stigma. Knowledge of its effect on quality of life in general and on specific aspects of day-to-day life is key to addressing the health needs of individual patients and to evaluating gains from community-based disease control interventions. Objectives: To measure the effect of scabies on the quality of life of people with the infestation. Methods: A community-based cross-sectional study was conducted in a scabies outbreak-affected district in north-western Ethiopia. The study involved 381 households and 86 adults with scabies. We used the ten-item Cardiff Dermatology Life Quality Index (DLQI) tool to collect data. Cronbach's alpha value was used to determine the internal consistency of the Amharic version of the scale. Overall and Dermatology Life Quality (DLQ) domain specific mean scores were calculated. The association between sociodemographic characteristics and scabies-related life quality impairment was tested using Kruskal-Wallis test. Results: Scabies moderately affected the quality of life of adults with scabies. The overall mean DLQI (mDLQI) score was 9.2 (SD = 7.6). 'Symptoms and feelings' and 'daily activity' DLQ domains had the highest mDLQI scores (3.5, SD = 1.9 and 2.2, SD = 2.5, respectively). 'Leisure activities' was the least affected domain 0.8 (SD = 1.1). In terms of severity, scabies had moderate or severe effect on DLQ of 54.7% of the participants and extremely severe effect was reported among 27% of the participants. However, no association was observed between sociodemographic characteristics and quality of life impairment. Conclusion: Quality of life was moderately impaired among people affected by scabies. Refocusing attention on management of disease symptoms, using standard scabies treatment, and providing psychosocial support to improve self-perception of people affected with scabies may help reduce quality of life impairment. Author summary: Scabies is a parasitic infestation of the outermost layer of the skin. Disease symptoms such as papular rash (mainly involving the crevices of the body), severe generalized itch and stigma attached to the infestation are believed to impair the quality of life of scabies patients. Despite the need for data, there is limited evidence about the relationship between scabies and quality of life. This study presents novel data on quality of life impairment associated with scabies and which aspects of patients' day-to-day lives are the most affected. This study was conducted in an outbreak-affected area of north-western Ethiopia where scabies had a moderate impact on the quality of life of the affected people. Disease symptoms and their psychosocial impact contributed the most to quality of life impairment. Participants in this study came from different sociodemographic backgrounds. Nonetheless, there were no major differences in DLQI scores by background characteristics. [ABSTRACT FROM AUTHOR]

This article focuses on the workplace experiences of peer workers with a diagnosis of borderline personality disorder (BPD) in mental healthcare settings in Australia. Our article is located at the intersection of political, social, cultural, and legislative forces that have fostered the development of peer work as a paid profession. We draw on the concept of stigma to analyse findings from qualitative interviews with peer workers conducted in [state], Australia. By examining peer work in the broader context of lifeworlds of BPD, we address the interplay of work and professional identity, and the experience of a profoundly stigmatised diagnosis at this intersection.Our findings demonstrate the physical and emotional effects of stigma and how it produces boundaries and inequalities between peer workers and other health practitioners. These boundaries are reinforced by invisible markers that delineate what is expected, ‘normal’ and deemed professional in the workplace. Moreover, these same medico-socio-political relations help shape peer workers’ identities and experiences. The development of peer workforces in mental healthcare service delivery is a prominent area of reform in Australia and internationally. Our research highlights the urgency of efforts to transform current socio-cultural-political relations that inhibit peer workers in their roles and impact workplace experiences. [ABSTRACT FROM AUTHOR]

Mandibular reconstruction has historically been challenging due to the complex, highly functional, and esthetic nature of the anatomy. The most common etiologies of these defects requiring resection include trauma, benign tumors, and malignant pathology. Mandibular defects have been treated with little consideration for neural reconstruction, leaving patient’s orally incompetent with associated social stigma. Although recent advances in reconstructive techniques improve oral rehabilitation, immediate inferior alveolar nerve (IAN) reconstruction has not been widely adapted.Here-in we seek to discuss the innovations of neural reconstruction of large segment mandibular defects and associated IAN defects and present an example case performed at Naval Medical Center San Diego (NMCSD).Pertinent literature discussing maxillofacial reconstruction and nerve repair using autogenous nerve harvest and allograft was queried from available online resources.Six patients have received immediate reconstruction of the IAN using processed nerve allograft over the past three years. All obtained sensation to S3 within six months of surgery.IAN repair using nerve allografts in conjunction with free flap reconstruction for large mandibular defects is a viable treatment and should be the new paradigm in maxillofacial reconstruction as it provides substantial quantifiable and qualitative improvements in social, functional, and esthetic outcomes of care. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsCannabis consumption has increased across all demographics following legalization in Canada. While cannabis is becoming increasingly more prevalent, prevailing stigma in the community has been highlighted as a concern. The purpose of this study was to determine the context in which Canadians stigmatize cannabis use to inform policy and harm-reduction campaigns.An experimental vignette design aimed to quantify cannabis-related stigma and explore the impact of the following items on stigma (1) reason for use (recreational/medical/self-medication); (2) method of consumption (smoking joints/edibles); (3) frequency (monthly/almost daily/multiple times daily); and (4) source (unregulated/regulated market). Canadian citizens 18 years and older were recruited through public opinion agency (N = 1118). Participants were randomly assigned two vignettes altering the independent variables and completed the Social Distance Questionnaire following each vignette as the dependent measure of stigma.2x3 ANOVAs revealed that stigma toward cannabis consumption increased when cannabis was used recreationally, by smoking joints, more frequently, and purchased from the neighborhood.Stigma may be a barrier to help-seeking for consumers who use riskier methods of administration. Stigmatization may also impact purchasing from regulated suppliers. Findings can help inform cannabis policies and education strategies to reduce stigma and barriers regarding consumption behaviors. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of studies examining quality of life (QoL) in people with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Methods: A cross-sectional, online, self-administered survey was distributed. Data elements included demographic and clinical characteristics, and QoL in Neurological Disorders (Neuro-QoL) short form questionnaires. Neuro-QoL domain scores were compared to reference populations, yielding standardized T-scores. Symptom severity was categorized as mild, moderate, or severe, using standard Neuro-QoL cut points. Results: A total of 259 participants completed the survey. Neuro-QoL domain impairment was present in a significant proportion of respondents (anxiety: 58.1%, depression: 30.7%, stigma 29.8%, cognition: 58.5%, social function: 57.7%). T-scores were significantly worse than the reference population for anxiety (p<0.001), stigma (p=0.005), cognitive function (p<0.001) and social interactions (p<0.001). There was no clear association between QoL domains and demographics, disease-modifying therapy class, or type of clinical presentation. A relapsing vs monophasic disease course was associated with worse anxiety, stigma, cognition, and social interactions (p<0.05). Conclusion: People with MOGAD may exhibit impairment in multiple domains of QoL. Practicing clinicians should be aware of this burden in MOGAD. Further research is needed to better understand factors associated with QoL impairment in MOGAD. [ABSTRACT FROM AUTHOR]

Background: Affiliate 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. Method: A 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. Result: More 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. Conclusion: The 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. [ABSTRACT FROM AUTHOR]

Receiving a diagnosis of schizophrenia can be a life-changing experience with both negative and positive consequences. Previous research has identified important aspects of diagnosis, such as disagreement with the label, diagnostic shifts, stigma, and communication of the diagnosis. There is, however, relatively little research from the lived experience perspective. In this study, we investigated the lived experiences of receiving a schizophrenia diagnosis utilising a popular Reddit discussion forum. We used inductive thematic analysis to consider posts from 105 unique usernames and identified five themes. These were (i) Denial and acceptance; (ii) Stigma of diagnosis and selective disclosure; (iii) The complicated process of diagnosis; (iv) Losing, maintaining, and finding a sense of self; and (v) Receiving, finding, and providing support. Diagnosis is a complex personal experience where the same person can simultaneously accept and reject the diagnostic label. Greater attention is required to the lived experience of this diagnostic journey. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of women in low-and middle-income countries experience common perinatal mental disorders. Yet, many women, even if diagnosed with mental health conditions, are untreated due to poor quality care, limited accessibility, limited knowledge, and stigma. This paper describes how mental health-related stigma influences pregnant women's decisions not to disclose their conditions and to seek treatment in Vietnam, all of which exacerbate inequitable access to maternal mental healthcare. Methods: A mixed-method realist study was conducted, comprising 22 in-depth interviews, four focus group discussions (total participants n = 44), and a self-administered questionnaire completed by 639 pregnant women. A parallel convergent model for mixed methods analysis was employed. Data were analyzed using the realist logic of analysis, an iterative process aimed at refining identified theories. Survey data underwent analysis using SPSS 22 and descriptive analysis. Qualitative data were analyzed using configurations of context, mechanisms, and outcomes to elucidate causal links and provide explanations for complexity. Results: Nearly half of pregnant women (43.5%) would try to hide their mental health issues and 38.3% avoid having help from a mental health professional, highlighting the substantial extent of stigma affecting health-seeking and accessing care. Four key areas highlight the role of stigma in maternal mental health: fear and stigmatizing language contribute to the concealment of mental illness, rendering it unnoticed; unconsciousness, normalization, and low literacy of maternal mental health; shame, household structure and gender roles during pregnancy; and the interplay of regulations, referral pathways, and access to mental health support services further compounds the challenges. Conclusion: Addressing mental health-related stigma could influence the decision of disclosure and health-seeking behaviors, which could in turn improve responsiveness of the local health system to the needs of pregnant women with mental health needs, by offering prompt attention, a wide range of choices, and improved communication. Potential interventions to decrease stigma and improve access to mental healthcare for pregnant women in Vietnam should target structural and organizational levels and may include improvements in screening and referrals for perinatal mental care screening, thus preventing complications. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To explore reactions to and preferences for words/phrases used in communications about diabetes among adults with diabetes and parents of children with diabetes.Eligible adults (aged 18+ years) living with diabetes, or parenting a child with diabetes, were recruited via social media to complete an online cross‐sectional, mixed‐methods survey. Study‐specific items were used to examine 22 commonly used diabetes words/phrases in terms of participants' cognitive perceptions (‘helpful’, ‘respectful’, ‘accurate’, ‘harmful’, ‘judgmental’ and ‘inaccurate’) and emotional reactions (‘optimistic’, ‘motivated’, ‘supported’, ‘understood’, ‘offended’, ‘blamed’, ‘distressed’ and ‘angry’). Open‐ended questions invited further feedback on (non‐)preferred language and its impact(s). Data were analysed using descriptive statistics and inductive thematic analysis.Participants (N = 865) included adults with diabetes (type 1: n = 519; type 2: n = 180, other types: n = 48) and parents of children with diabetes (n = 118). Words/phrases most commonly associated with negative perceptions/emotional responses were ‘non‐compliant’ (60% judgmental; 47% felt blamed) and ‘…good/bad’ (54% judgmental; 43% blamed). Positive perceptions were reported for ‘managing diabetes’ (73% helpful, 47% felt understood), ‘person with diabetes’ (72% respectful; 49% understood), ‘…within/outside target range’ (60% helpful, 44% understood), and ‘condition’ (58% respectful; 43% understood). Participants' qualitative responses illuminated perceptions, experiences and impacts across five themes: (1) accuracy and simplicity; (2) identity; (3) blame, judgement and stigma; (4) respect and trust and; (5) support, hope and feeling understood. Themes were consistent across diabetes types.These findings provide novel evidence into (non‐)preferred, and potential (negative and positive) impacts of, commonly used diabetes words/phrases, supporting the international #LanguageMatters movement. [ABSTRACT FROM AUTHOR]