Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STIGMATIZATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources
PubMed2001

Leprosy. Recognition and treatment.

Leprosy is a slowly progressive, chronic infectious disease caused by the bacillus Mycobacterium leprae. It is a very serious, multilating and stigmatizing disease in many parts of the world and early diagnosis and therapy is the most important strategy for its control. The skin and peripheral nerves are the most affected organs. It is highly infective, but has low pathogenicity and low virulence with a long incubation period. The geographical distribution of leprosy has varied greatly with time and it is now endemic only in tropical and subtropical regions such as India and Brazil. The diagnosis of leprosy is made from the clinical picture, but must be complimented by skin bacilloscopy and histopathology. Leprosy has a number of distinct clinical presentations. Indeterminate leprosy is frequently the initial form consisting of a few lesions that either evolves into the other forms or resolves spontaneously. Lepromatous leprosy is the more contagious form and affects mainly the skin. In addition, some peripheral nerves may be thickened and other symptoms maybe present. The tuberculid form affects the skin and nerves, although usually there are few lesions. There is also a form borderline between the lepromatous and tuberculoid forms. Current treatment of leprosy involves use of 3 drugs: rifampicin (rifampin); clofazimine; and dapsone. Multidrug therapy aims to effectively eliminate M. leprae in the shortest possible time to prevent resistance from occurring. The duration of therapy was recently reduced from 24 to 12 months. Other treatment options are under evaluation in both preclinical and clinical trials and a number show promise. The combination of rifampicin, ofloxacin and minocycline given as a single dose has been recommended for the treatment of paucibacillar leprosy. Only when physicians, other health workers, and the population in endemic countries become fully aware of, and able to recognize, the disease in its initial phase, will it be possible for therapy to be instituted at the very beginning with either the standard scheme or the newer ones. Intervention at such an early stage will avoid the onset of the more serious signs and symptoms, meaning that leprosy will eventually become a less important public health problem. Therefore, efforts must be made to alert populations at risk and all health workers of the importance of an early diagnosis and treatment in leprosy infection.

Adolescent↗
PubMed2005

The psychosocial burden of psoriasis.

BACKGROUND: Skin diseases such as psoriasis can profoundly influence a patient's self-image, self-esteem, and sense of well-being. Psoriasis is a multifactorial inflammatory condition with a disease burden that extends beyond the physical symptoms experienced by patients. Psoriasis affects all aspects of quality of life, including physical, psychologic, social, sexual, and occupational elements. OBJECTIVE: The goal of this article was to review the published literature on the impact of psoriasis on quality of life. METHODS: Relevant studies were identified through a comprehensive search of MEDLINE, EMBASE, and the Derwent Drug File databases of English-language articles published between 1993 and 2005 using the terms psoriasis in combination with quality of life, cost, cost-benefit analysis, economic, employment, days lost, healthcare, hospitalization, managed care, outcomes research, occupation, payers, and psychosocial. The reference lists of identified articles were checked for additional studies that might have been missed in the original searches. RESULTS: Data suggest that social stigmatization, high stress levels, physical limitations, depression, employment problems and other psychosocial co-morbidities experienced by patients with psoriasis are not always proportional to, or predicted by, other measurements of disease severity such as body surface area involvement or plaque severity. CONCLUSION: It is essential to include measures of psychosocial morbidity when assessing psoriasis severity and treatment efficacy because of the substantial role that psychosocial burden plays in patient perception of disease severity, quality of life, and disease course.

Adaptation, Psychological↗
PubMed2000

Stopping drug therapy in epilepsy.

In most of the epilepsies and epileptic syndromes, the decision to initiate antiepileptic drug (AED) therapy is often a far simpler one than the decision to stop it. The primary factor that drives a patient to want to discontinue therapy, and a doctor to endorse or recommend this, is a fear of long-term adverse events, a consideration that may be entirely justified as the side effects of vigabatrin and felbamate have proved. On the other hand, seizure recurrence with the attendant implications in employment, driving regulations and social stigmatization is a strong deterrent that discourages withdrawal of therapy. The absence of a clearer understanding of the natural history and prognosis of many individual epilepsy syndromes somewhat hampers the resolution of this dilemma. Hopefully, as our understanding of the epilepsies grows and the prediction of the chances of seizure relapse becomes a more precise science, stopping medication will become a less fraught exercise for both the patient and the doctor.

Animals↗
PubMed1997

Self-concepts of low-income older women: not old or poor, but fortunate and blessed.

This article examines the extent to which low-income older women define themselves in stigmatizing terms, then explores the strategies they use to preserve a positive sense of self. Instead of considering themselves "old" or "poor," the sixty-two women interviewed defined themselves as "fortunate" and/or "blessed." The ability to see oneself as fortunate may be a significant component of successful aging.

Activities of Daily Living↗
PubMed2005

Family attitudes toward transgendered people in Turkey: experience from a secular Islamic country.

OBJECTIVE: In Turkey, an individual with gender identity disorder is stigmatized and isolated from society. The family largely reflects and reinforces these negative views because gender crossing poses a threat to the normatively sanctioned gender classification. METHODS: We examined the acceptance of gender identity differences by the families in 47 relatives of 39 transgendered individuals who applied to a psychiatry clinic for sex reassignment. RESULTS: Half of the relatives who came to the interview were mothers. While 85.1% of the families considered themselves as secular muslims, 14.9% were very religious. They first noticed the gender identity disorder during puberty (70.2%) or prepuberty (17%). In 63.8% it was remarked that it was a shocking experience. One-third of them felt responsible for it. While 65.9% tried to change the situation by coercion, only 27.7% adopted a supportive attitude. The majority of families tried to conceal the situation from their immediate environment and one-third did not even inform their closest relatives. For half of relatives the mass media was their only source of information whereas one-third received information from doctors. Most of the families were satisfied with the treatment. Family members also reported that the conformity of the transgendered relative within the family improved. Of the family members, 40.4% accepted the transgendered identity and approved the sex reassignment surgery as a final step. CONCLUSION: Involvement of family members in the process of change for the transgendered individual is important for both the family as well as the individual concerned.

Adult↗
PubMed2001

A farewell to Australia's welfare state.

For much of the postwar period, the Australian welfare state has been misunderstood by overseas social policy commentators. The lack of generosity of welfare payments has been substantially compensated for by a system of wage regulation that has prevented waged poverty and delivered a reduced disparity of incomes. The strong emphasis on means-testing of benefits has not had the stigmatizing effects of benefit selectivity elsewhere, since Australian means tests are designed to exclude the well-off rather than focus benefits exclusively on the very poor and Australian means-testing has been nondiscretionary in character. Policy changes in the 1980s and 1990s, and most particularly under the present Liberal Coalition government, have undermined these distinctive aspects of welfare Australian-style, and it is no longer possible to defend the Australian welfare state from its critics.

Australia↗
PubMed1991

We are all people living with AIDS: myths and realities of AIDS in Brazil.

Although AIDS was expected in Brazil, no serious efforts were undertaken to prevent AIDS from taking root. Irresponsible press and media coverage highlighted the spread of AIDS within the gay community of the United States, creating an aura of immunity in Brazil to what was characterized as a "foreign" disorder. When AIDS did surface in 1983, the official response was to adopt an abstract, inappropriate, and ideological "Western" model, in which only stigmatized "others" and "minorities" were at risk of HIV infection. Brazilian health authorities subsequently downplayed the significance of the sale of contaminated blood in HIV transmission, and likewise ignored the rising rates of AIDS among Brazil's one unarguable majority group: the poor. An analysis of efforts to force the "facts" of AIDS to fit a false model's predictions leads to a clearer definition of the broader context of the Brazilian epidemic: we all are people living with AIDS, precisely because we live in this age of AIDS; it is sheer folly to discriminate against persons infected by HIV and to obstruct their participation in efforts to curtail the epidemic's spread; and the necessary response to AIDS is solidarity, not because it is poetic, but because no other response will suffice.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Parent participation in an adolescent drug abuse prevention program.

This study reports the level of participation of parents in a parent-targeted school-based drug prevention program, the differences between students whose parents participate and those who don't, and the implications for involving parents in future drug prevention programs. Among 1761 eligible seventh grade families, 1263 students (72%) and 1142 parents (65%) completed surveys assessing the quality of parent-child relationships as well as tobacco and alcohol use. Ten percent of eligible families attended at least one of the evening sessions. Compared to students whose parents completed the survey, students whose parents did not complete a survey were more likely to report they used tobacco, had more friends who used substances, were monitored less by their parents, had more risk-taking behaviors, had lower grade-point averages, and their parents had higher rates of tobacco and alcohol use. Parents who attended evening sessions had the lowest rates of tobacco use and reported spending the most time with their children. Parent-targeted drug preventions programs may stigmatize attending parents and may be unlikely to attract the highest risk families.

Adolescent↗
PubMed2000

Stereotypes and stigma: biased attributions in matching older persons with drawings of viruses?

To test whether germs are perceived as more harmful and threatening in stigmatized groups, photographs of young Black, young Hispanic, young White, and older White persons were shown for five seconds. Participants (N = 62) matched photographs with five drawings of viruses. The viruses were pre-rated by a separate sample (N = 39) and it was determined that the viruses formed a continuum along a 5-point scale from benign to threatening. Utilizing ANOVA, statistical significance was found (F(3,183) = 3.77,p < .05) between the four groups of photographs, with post-hoc analysis indicating differences between young Hispanic and older White persons. Perceptions of attractiveness (r = .5) may have influenced choice of virus matched with person.

Adult↗
PubMed1991

A critical historical analysis of the medical construction of lesbianism.

Lesbians are frequently treated with insensitivity, antagonism, and discrimination in health care encounters. The authors argue that contemporary health care experiences of lesbian clients cannot be understood apart from a critical examination of the historical construction of medical ideologies that pathologized lesbianism. An excavation of historical data about medical conceptualizations of lesbian women is undertaken to demonstrate how cultural and medical ideologies throughout the century have reinforced each other to shape lesbians' health care experiences and influence public policies. By illuminating both the prejudical content of medical theories as well as the emancipatory actions of lesbian and gay communities to change stigmatizing diagnostic and treatment situations, the authors attempt to demystify ideologies about lesbians that motivate clinicians, administrators, educators, researchers, and theorists in the delivery of health services.

Female↗
PubMed2000

Panic disorder in primary care: patients' attributions of illness causes and willingness to accept psychiatric treatment.

OBJECTIVE: This study assessed the causes that primary care patients with panic disorder (PD) attribute to their panic symptoms, and their acceptance of various psychiatric treatment options. METHODS: In a cross-sectional assessment of 306 patients treated at two primary care clinics, 42 met criteria for DSM-IV PD in the past year. The authors classified these 42 PD-positive patients to one of two groups: those receiving both primary and specialty mental health care (PC+MH; n = 19) and those receiving only primary care (PC-only; n = 23). Patients rated the probability of four possible causes of their panic symptoms, and level of acceptability of three psychiatric and two medical treatments for PD. To place primary care patients' ratings into a broader context, a third contrast group of PD-positive patients, recruited from clinical trials of investigational PD pharmacotherapies (n = 31), also rated causes and treatment acceptability. RESULTS: Participants of the three treatment groups attributed psychiatric causes for their panic symptoms in approximately the same proportion (78 percent to 90 percent; p = ns). PC-only participants attributed medical causes for panic symptoms more frequently than PC+MH and PD Clinical Trials participants (48 percent vs. 5 percent and 32 percent; p = .01). Remarkably, the great majority of patients across all groups expressed willingness to see psychiatrists (84 percent to 94 percent) and psychotherapists (95 percent to 100 percent), and to take psychotropic medications (87 percent to 100 percent). CONCLUSIONS: In this study most patients attributed a psychiatric cause for panic symptoms and communicated strong acceptance of psychiatric treatment. Thus, we recommend that primary care clinicians more assertively inform their patients of PD diagnoses and recommend psychiatric treatments with less fear about stigmatizing and alienating them.

Adult↗
PubMed1985

Genetic screening of prospective parents and of workers: some scientific and social issues.

Genetic screening programs are based on assumptions and values that reflect the history of racial and social eugenics in the United States and Europe. They stigmatize individuals by shifting the focus from social, economic, and political decisions that affect the health of prospective parents, newborns, and workers to "bad genes," that is, intrapersonal factors that are given the status of "causes" of disease. Prenatal screening, at best, can help the relatively few individuals who know that their future children are at risk for a particular inherited disease or disability; it has little positive value for the average person. Workplace genetic screening has not been shown to reduce occupational disease, but it has led to employment discrimination and has drawn attention away from controlling exposures to toxic chemicals in the workplace.

Amniocentesis↗
PubMed1990

Feeling fat: motivations, knowledge, and attitudes of overweight women and men.

This study concerned obesity from the perspective of 47 women and 8 men who considered themselves overweight. They responded to a questionnaire about various aspects of motivation to lose weight, knowledge about obesity, and personal and societal attitudes toward the obese. Although they reduced calorie intake and increased exercise when trying to lose weight, they reported various reasons why their exercise levels were less than optimal. Verbal motivation to lose was only partially reflected in willingness to change lifestyle, even though respondents had spent substantial sums of money on weight-loss attempts. Knowledge about obesity was imperfect, with women and thinner subjects somewhat more knowledgeable. Subjects were aware of and shared some of the negative social stereotypes of the obese, blaming themselves for their overweight. However, most would not trade their obesity for other handicaps found less stigmatizing in other research. As expected, women expressed a greater desire for thinness than men. Implications for health care professionals are discussed.

Adult↗
PubMed2006

Desperately seeking targets: the ethics of routine HIV testing in low-income countries.

The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic, and responses to it, have exposed clear political, social and economic inequities between and within nations. The most striking manifestations of this inequity is access to AIDS treatment. In affluent nations, antiretroviral treatment is becoming the standard of care for those with AIDS, while the same treatment is currently only available for a privileged few in most resource-poor countries. Patients without sufficient financial and social capital -- i.e., most people with AIDS -- die each day by the thousands. Recent AIDS treatment initiatives such as the UNAIDS and WHO "3 by 5" programme aim to rectify this symptom of global injustice. However, the success of these initiatives depends on the identification of people in need of treatment through a rapid and massive scale-up of HIV testing. In this paper, we briefly explore key ethical challenges raised by the acceleration of HIV testing in resource-poor countries, focusing on the 2004 policy of routine ("opt-out") HIV testing recommended by UNAIDS and WHO. We suggest that in settings marked by poverty, weak health-care and civil society infrastructures, gender inequalities, and persistent stigmatization of people with HIV/AIDS, opt-out HIV-testing policies may become disconnected from the human rights ideals that first motivated calls for universal access to AIDS treatment. We leave open the ethical question of whether opt-out policies should be implemented, but we recommend that whenever routine HIV-testing policies are introduced in resource-poor countries, that their effect on individuals and communities should be the subject of empirical research, human-rights monitoring and ethical scrutiny.

Botswana↗
PubMed2002

The College Link Program: evaluation of a supported education initiative in Great Britain.

The article presents an outcome evaluation of a supported education initiative in London, Great Britain, for adults with longer term mental health needs. Qualitative and quantitative data was collected from the leavers at the end of the college course and data was also collected from students 10-22 months after completing the course. The study found increases in self-esteem, social functioning, independence, cognitive abilities, and confidence, using non-standardized measures. Some students also reported that they felt less stigmatized by their problems and that their assertiveness had improved. In-patient and day-patient hospitalization rates decreased dramatically, representing cost-effectiveness and the opportunity for substantial savings to Great Britain's National Health Service. Most of the students planned to continue with further education and/or do some voluntary work. Some were looking for paid work. The data from past students suggested that gains were maintained except in one instance where there had been a major negative life event. Most past students were in continuing education. There were methodological limitations to the study that there are plans to correct for in further studies.

Education↗
PubMed2002

Introducing structured dialogue with people with mental illness into the training of social work students.

This paper presents the findings from an innovative project in which people with mental illness were incorporated in the classroom setting of social work students in Israel. This project was based on a model that was defined as "Structured Dialogue." Its objective was to create opportunities for students to relate to persons with mental illness in a less stigmatic and more hopeful way. One hundred and eighty five students participated in this evaluation that was conducted in fifteen social work classes. The findings indicate the potential of the Structured Dialogue model to eliminate the one-dimensional representation of people with mental illness and change preexisting stereotypes and stigma with which the students came to the meetings. Implications for training future mental health professionals are discussed.

Adult↗
PubMed2004

Target-specific stigma change: a strategy for impacting mental illness stigma.

In the past decade, mental health advocates and researchers have sought to better understand stigma so that the harm it causes can be erased. In this paper, we propose a target-specific stigma change model to organize the diversity of information into a cogent framework. "Target" here has a double meaning: the power groups that have some authority over the life goals of people with mental illness and specific discriminatory behaviors which power groups might produce that interfere with these goals. Key power groups in the model include landlords, employers, health care providers, criminal justice professionals, policy makers, and the media. Examples are provided of stigmatizing attitudes that influence the discriminatory behavior and social context in which the power group interacts with people with mental illness. Stigma change is most effective when it includes all the components that describe how a specific power group impacts people with mental illness.

Attitude to Health↗
PubMed2005

How do people who receive assertive community treatment experience this service?

Using a participatory research approach this study examined Assertive Community Treatment as experienced by service recipients. Overall participants were positive about their involvement with ACT and their experiences reflected critical ingredients of the model. The analysis revealed seven ways the ACT promoted community adjustment. Unhelpful aspects of the experience included staff requiring more training in particular service areas, conflicts over money and medications, stigmatizing aspects of the service, and authoritative practices of individual staff. Services promoting community participation were less well-developed than clinical approaches. Tensions inherent in receiving ACT services were related to the participants' negotiation of personal and social consequences of mental illness while striving for autonomy, community participation and inclusion.

Activities of Daily Living↗