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At least 1,531 records · Page 85Linked to original sources
PubMed1990

When a colleague commits suicide: how the staff reacts.

1. A literature review on the subject of suicide by mental health professional indicates that research has been limited to family member survivors. There is some data on reactions to patient suicide by psychiatrists and psychologists. 2. The results of this study show that mental health professional survivors of peer suicide experience similar reactions to the studied groups. These include anger, guilt, loss of self-esteem, disruption of relationships, and concern about assessing for suicidality. 3. Subjects felt the victim did not reach out for help because she feared stigmatization; mental health professionals are not permitted to have serious problems. 4. The clinical nurse specialist can perform an important role by addressing this dynamic and working to provide a supportive and nonpunitive environment for mental health professionals experiencing problems.

Attitude to Health↗
PubMed1994

Adult survivors of childhood sexual abuse: survivor's disclosure and nurse therapist's response.

Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem, and that disclosure is on the rise. The aftereffects of childhood sexual abuse can cause dysfunction in various aspects of the survivor's physical and mental health. Understanding the traumagenic dynamics of childhood sexual abuse and its aftereffects provides direction for the nurse therapist during both the client's disclosure and intervention planning. This knowledge assists the therapist in promoting mental health and healing, as well as providing comfort for the therapist. The nurse therapist's reactions to the client's disclosure can affect the way the client feels about disclosure and the therapeutic relationship. If a negative message is conveyed to the survivor at the time of disclosure, the feelings of betrayal, stigmatization, and powerlessness that the survivor experienced as a child will be replicated. This can damage the therapeutic relationship and delay the healing process. When disclosure is received and acted upon in a sensitive, therapeutic manner, the survivor is empowered and can enter with the nurse therapist into an effective therapeutic alliance. Nurse therapists should gain awareness of the types of emotional responses that can be engendered in the health professional during disclosure. Awareness of these emotional reactions can lead to the identification of coping strategies useful to both the therapist and the adult survivor. Coping strategies useful to the therapist include maintaining adequate boundaries, understanding oneself and one's responses to sexual-abuse issues, utilizing ongoing consultation or supervision, and preventing burnout.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1999

Assessment & treatment of persons with pedophilia.

1. Like any other form of major mental disorders, pedophilia is an AXIS-I diagnosis that warrants psychiatric treatment. 2. The combination of anti-androgenic medications and individual/group psychotherapy are common treatments for pedophilia. 3. The social stigmatization of pedophilia brands mental health professionals who provide treatment for pedophiles as supporters of illegal sexual acts against children rather than as professionals treating a psychiatric disorder.

Adolescent↗
PubMed2003

Positive attitude. An essential element for effective care of people with mental illnesses.

It is well known that attitudes influence behavior, and attitudes toward people with mental illnesses have been described as negative, stigmatizing, uninformed, and fearful. The general public view people with mental illnesses as dangerous, prone to violence, unpredictable, and in some measure responsible for their illnesses. Health care professionals share these attitudes to a surprising extent, which compromises their ability to deliver competent, compassionate care. Nursing students' perceptions of people with mental illnesses are reflective of those held by the general public. The purpose of this descriptive study was to determine whether a curriculum that embeds psychiatric nursing principles in a course focused on care of people with chronic illnesses and uses specific fear-reduction teaching strategies, would have a positive effect on students' attitudes toward people with mental illnesses. Using an adaptation of Yucker's attitude scale, a test of nursing students' (n = 38) attitudes before and after completion of the course was conducted. Students' attitudes were significantly more positive at the completion of the course. The findings suggest that exposure to factual information about mental illnesses, the opportunity to interact with people with mental illnesses, emphasis on treatment options, and use of fear-reduction strategies positively affected students' attitudes toward people with mental illnesses.

Adult↗
PubMed2000

Clozapine in the treatment of neuroleptic-induced blepharospasm: a report of 4 cases.

BACKGROUND: Blepharospasm, the forcible closure of eyelids, is an infrequent consequence of neuroleptic treatment that, when severe, can interfere with the ability to walk, drive, or work. Like tardive dyskinesia, blepharospasm can be disfiguring and aesthetically distressing, contributing to the increased stigmatization of patients. CASE REPORTS: We report 4 patients with DSM-IV schizoaffective disorder, paranoid schizophrenia, or chronic undifferentiated schizophrenia who developed neuroleptic-induced blepharospasm. In all patients, blepharospasm remitted without the reemergence of psychosis within 3 to 5 months of treatment with clozapine, 100-200 mg/day. CONCLUSION: The results suggest that clozapine may successfully treat neuroleptic-induced blepharospasm without the reemergence of psychosis in patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder.

Adult↗
PubMed2002

A sociological study of children with albinism at a special school in the Limpopo province.

This article maintains that it is the social context, as much as, and sometimes more than the physical condition, that largely structures and limits the lives of people with albinism. It deals with albinism from a sociological, rather than a medical perspective. Viewed as such the problems experiencing by affected people stem primarily not from their physical differences but from the way others respond to those differences and from the social and physical environments they have to cope with. The article is based on a study of 32 children with albinism from a special school in the Limpopo province. Educational, health and social problems, attitude and perceptions about albinism were tested by way of structured interviews. The data reveal an acute lack of information about the causes and consequences of albinism. It projects it as a condition still deeply immersed in myths and superstition resulting in the stigmatizing and rejection of affected people. It also discloses a physical environment which is preventing rather than supporting people with albinism from reaching their potential. It calls for a reorientation in dealing with albinism--away from just medical intervention to treating it as a social construct requiring a holistic approach.

Africa South of the Sahara↗
PubMed2004

A strategy for the management of HIV/ AIDS in the health sector of the city of Johannesburg.

The HIV/AIDS pandemic is posing major challenges to all sectors in South Africa, including the health sector of the city of Johannesburg. The health sector of the city of Johannesburg, as a result of the pandemic, is faced with increasing demands on its scarce resources at a time of major reform at local government level including transformation of the health sector. The overall objective of the study is to explore and describe a strategy for the management of HIV/AIDS by the health sector of the city of Johannesburg. An exploratory, descriptive and quantitative research design was utilized and the UNAIDS "Guide to the strategic planning process for a national response to HIV/AIDS" (1998), was employed to formulate the strategy. The content validity of the strategy was determined according to the process originally described by Lynn (1986) and adopted by Muller (in Booyens, 1998:607-609). The research was conducted in two phases. The first phase, the developmental phase, involved the exploration and description of the theoretical framework and the response to the pandemic, and formulation of a draft strategy. The second phase, the quantification phase, involved the assertion of the content of the strategy by a group of experts and determination of the content validity index (CVI). The final strategy focused on the following: to lead and facilitate intersectoral collaboration; to strengthen primary health care services to provide comprehensive community-based care; prevention of new infections; community mobilization towards prevention, non discrimination and non stigmatization and empowerment of the health sector to deal with the AIDS.pandemic. The CVI results showed that the average content validity index determined during this study was adequate: full score (1.0) for acceptability and technical soundness, and 0.89 for feasibility and perceived affordability. The strategy formulated for the management of HIV/AIDS by the health sector of the city of Johannesburg is therefore acceptable, technically sound and feasible and perceived as affordable. It was finally recommended that the strategy be adopted for implementation within the health sector of the city of Johannesburg.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Attitude and social consequences of tuberculosis in Addis Ababa, Ethiopia.

OBJECTIVE: To gain a better understanding of the attitude and social consequences of tuberculosis (TB) in Addis Ababa, Ethiopia. DESIGN: A cross sectional survey using a structured questionnaire and a qualitative study based on the focus group discussion (FGD) technique. SETTING: Eight different kebeles (urban dwellers' associations) of six woredas (next higher administrative level to kebele). SUBJECTS AND METHODS: Seven hundred and three participants, comprising 326 males and 377 females were interviewed using the written questionnaire and 36 recent and current TB patients through focus group discussion. Data were analysed using SPSS/PC statistical package. The proportions were compared using univariate and bivariate analyses to show the frequency distribution and evaluate the relationship among different variables. In FGD, topics relevant to the research questions were identified, sorted and analysed. Conclusions were then formulated. MAIN OUTCOME MEASURES: Attitude of participants towards TB and its victims and social consequences of being a TB patient. RESULTS: Eighty three per cent of the respondents were aware that TB is a disease transmitted from one person to another and 80.1% perceived TB as an extremely severe disease. Of the total, 81.5% answered that TB is caused by cold, 69.0% feel that TB patients are not accepted in the community and 78.3% fear physical contact with TB patients. Most participants of the FGD sessions agreed that TB is a very dangerous, contagious but curable disease and the community has a generally negative attitude towards them. They also think that TB is associated with HIV/AIDS in the society. These attitudes have social consequences particularly the stigmatization and social isolation of TB patients. Four hundred and four (57.5%) respondents were found to be in favour of the short course chemotherapy against 226 (32.1%) choosing the longer course. Clinical improvement and unavailability of some drugs or their cost were the first and second main reasons indicated, respectively, for defaulting by respondents. CONCLUSION: The perception by most respondents that tuberculosis is incurable, transmittable and associated with HIV/AIDS, led to the understanding that TB is a very dangerous disease. This, in turn, contributes to social avoidance and the resultant consequences in TB patients. Health education must be stepped-up within the TB control programme, and the psychosocial implications of TB should be given due attention.

Adolescent↗
PubMedDate not supplied

Trauma related to sexual assault in Calabar, south eastern Nigeria.

BACKGROUND: A woman who is sexually assaulted experiences intense anxiety and fear. The associated stigmatization often results in under reporting and management difficulties. The aims of this study are to document the types of injuries seen in victims of sexual assault and to highlight problems in management of cases. METHOD: Twenty-two case files of sexual assault victims between January 1998 and December 2001 were reviewed for age, types of injuries sustained and treatment received. RESULT: Age range of all victims was 4 to 23 years. The knife was used by the perpetrator in 8 (36.4%) cases. Time interval between assault and presentation to hospital was up to 12 hours in 13 (59.1%) cases. Superficial abrasions, bruises, and lacerations were observed in 12 (54.6%) cases. Six (27.3%) victims paid for human immunodeficiency virus screen and the results were non-reactive. Ten (45.5%) victims had primary repair of perineal tear. CONCLUSION: Sexual assault is associated with multiple bruises, lacerations, and perineal tears. Commercialization of medical services was a hindrance to proper management of cases.

Adolescent↗
PubMedDate not supplied

A controlled study of anxiety and depression in mothers of children with learning disability in Lagos, Nigeria.

BACKGROUND: Parents of children with learning disability have been reported to suffer great stress and frustration due to increased burden of care. The manifestation of stigmatization by familial environment and the collective effect of the children with adverse impact on mothers predispose them to mental shock or a variety of neurotic symptoms and other psychiatric conditions including anxiety and depression. The objectives of the study were: to determine the general Health Questionnaire (GHQ) score of mothers of children with learning disability. To identify sociodemographic variables and to assess anxiety and depression in them. METHODS: Using structured questionnaires between March and May 2002, 106 mothers of children with learning disability in a Mentally Handicapped Home for children in Lagos, Nigeria were assessed and compared with mothers of normal healthy children in Lagos. RESULTS: The mean age of the subjects was 40.0 +/- 6.6 years. More of the subjects (26.4%) compared with mothers of normal healthy children (9.9%) had a high GHQ score and high levels of anxiety (25.5%) and depression (10.4%). Marital difficulties were associated with learning disability. CONCLUSION: Mothers of children with learning disability are prone to emotional and psychological disorders. In order to improve the well-being of children with learning disability, there is need to look into the mental and physical health of mothers. Early and prompt treatment of associated anxiety and depression will no doubt help the children.

Adult↗
PubMed2006

A duplication dup(4)(q28q35.2) de novo in a newborn.

We report here a case of a newborn with hypotrophy and somatic stigmatization: microcephaly, facial dysmorphism, heart defect and immunodeficiency syndrome. The proband's karyotype was 46,XY,dup(4)(q28q35.2) de novo with chromosomal breaks in 4% of metaphases. We demonstrate the usefulness of a combination of physical examination, classical cytogenetics, FISH and PCR techniques in order to establish correct diagnosis because of overlap of some clinical and cytogenetic features of Nijmegen breakage syndrome (NBS) and duplication 4q in our patient. Although FISH technique detected translocation t(14q;21q) in 4 metaphases, deletion 657del5 in exon 6 of the NBS1 gene associated with NBS in Slavic population was not confirmed. We compare in this report similarity of the clinical picture of our patient, NBS cases and other patients carrying a duplication of the distal part of 4q as described in the literature.

Abnormalities, Multiple↗
PubMedDate not supplied

Clinic-based treatment for opioid dependence: a qualitative inquiry.

OBJECTIVES: To identify barriers and facilitators to treatment of opioid dependence in primary care clinics. METHODS: In-depth interviews with 27 New York State clinic directors. RESULTS: Stigmatizing attitudes emerged as a major barrier. Respondents often viewed opioid-dependent persons as manipulative, demanding, and disruptive. Commonly cited facilitators were physician training, increased office staffing, and greater mental health, social services, and addictions support. CONCLUSIONS: Our study reveals attitudinal barriers to address and supportive factors to promote in order to increase the limited availability of office-based treatment of opioid dependence in the United States compared with other countries.

Ambulatory Care Facilities↗
PubMed1996

Congenital syphilis: still a reality in 1996.

Despite the widespread use of penicillin for more than 50 years, syphilis continues to be a problematic health issue in many parts of the world. In Australia, congenital syphilis is again a significant cause of stillbirth, preterm labour and neonatal disease in some areas (including central and northern Australia). Control mechanisms based on screening, reliable treatment protocols, contact-tracing and adequate follow-up appear to be less effective than they were in the past. It is difficult to discuss such a socially stigmatizing disease when it is clear that some community groups are at high risk, and may be offended by and feel disempowered in the face of well-meaning medical debate. If congenital syphilis is to be eradicated, new approaches are required. These include public-awareness campaigns to stress the need for antenatal care in affected communities; involving the community in efforts to prevent syphilis; providing culturally appropriate services; improving notification and surveillance systems; improving the management of pregnant women who present to maternity units without prior booking; and improving the management of syphilis in pregnancy. There is a need to raise awareness that antenatal care is important not only for the mother's health but also for the wellbeing of the baby.

Australia↗
PubMed1990

Carvable silicone rubber prosthetic implant for atrophy of the first web in the hand.

Muscular atrophy of the first web space in the hand is a common finding following ulnar nerve palsy and this deformity is very stigmatizing among leprosy patients in some countries and cultures. We present our experience with the carvable soft-silicone rubber block implant to correct this deformity. We discuss the procedure, results and advantages over other techniques. Fifteen operations were performed at the 'Lauro de Souza Lima' Research Institute, Bauru, Brazil during a period of six years. One complication was encountered due to an implant that was too large. The results were considered good in twelve instances and fair in three.

Adult↗
PubMed1992

Community-based rehabilitation: an evaluation study.

Leprosy gives rise to two types of stigmatization, one from the disease and its neuropathetic manifestations, with their resultant disability and handicaps, and the other due to social ostracism. The process of rehabilitation should begin from the moment the disease is diagnosed, and the earlier its detection the better the prognosis for patients. The family unit to which the patient belongs plays a vital role in his social life, ensuring and enhancing his self-respect and dignity in society, and this fact must be recognized when evolving a strategy for rehabilitation. In no circumstances should a patient be removed from his natural home environment. It is important that the community is made leprosy conscious and gets more involved in hastening the social assimilation of patients. Communication plays an important role throughout the rehabilitation process. One of the major functions is the removal of the social stigma in the family and in the community and this involves communication skills to ensure interaction between the staff and patients' families and the education of the community. A highlight of community-based rehabilitation is the excellent rate of repayment of loans by the patients to whom they were made. Also of note is the extent to which former defaulters make repayments due to the continuous rapport and good interpersonal relationship between the staff and patients. Most of the subjects of this study were drawn from the lower economic strata of society and for them the most essential consideration is to make a living, however meagre.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Disabilities of hands, feet and eyes in newly diagnosed leprosy patients in eastern Nepal.

The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a regional clinic in Biratnagar and 5 mobile clinics in surrounding districts. The study comprised of all new and previously untreated patients who presented at the clinics over a 10-week period who were diagnosed as leprosy sufferers. Of the 260 leprosy patients examined 12 (4.6%) had sight-threatening lesions (lagophthalmos, iris involvement, corneal anaesthesia); 3 patients were blind due to cataract; 96/260 patients (37.0%, 95% confidence interval 35.0-43.0%) had 1 or more disabilities of their hands and/or feet. The most frequently found disabilities were sensory loss of the hands and feet, claw hand and plantar ulcers. According to the WHO disability grading 60% had no disabilities, 19% had grade 1 and 21% had grade 2 disability. Disability assessment is very important not only to evaluate the effectiveness of the control programme but also for the patient, whose most important worry is the stigmatizing deformities leprosy patients suffer. The earlier detection of sensory loss might reduce these secondary deformities.

Adult↗
PubMed1995

Problems, acceptance and social inequality: a study of the deformed leprosy patients and their families.

Though the impact of social inequality on health conditions is widely known, its impact on the chronic and stigmatized disease, leprosy, has received little attention. Deformity sometimes leads to disabilities and to handicaps causing problems to the patient and his family. In this paper an attempt has been made to understand the impact of social inequality, prevalent in the form of the caste system in India on the deformed leprosy patients and on their families. This impact was examined in terms of the problems faced by the patients. A sample of 150 deformed patients and their families, drawn from two districts in Tamil Nadu, was selected for the study. About 57% of the deformed patients experienced their deformity as a handicap which caused social and economic problems while the rest did not. Of the three caste groups, the Lower Caste group experienced more severe economic problems while the Upper Caste group faced more social problems. The extent of acceptance of deformed patients in their family varied significantly among those facing and not facing problems due to their deformity. The deformed patients without any handicap were accepted in a large majority of their families (82%) regardless of their caste status. In contrast the deformed but handicapped patients were accepted differentially among the three caste groups with the Upper group accepting them in most of their families (80%) while in the Lower group much less number of families (54%) did. All the families of the deformed but not handicapped patients desired to keep their patients till their death irrespective of their caste status. On the contrary, while all the families in the Upper Caste group expressed their willingness to keep their handicapped patients in the family till their death, 10% in the Middle and 22% in the Lower Caste groups did not want to do so. This suggests the gradual marginalization, rejection and dehabilitation of the affected. Thus, one's caste status can be a broad indicator of the nature and the extent of handicaps and acceptance in the family. This factor needs to be appropriately taken care of for rehabilitation and disability management in leprosy control programmes.

Adolescent↗
PubMed1997

Women and leprosy: a review.

Gender inequalities in health have a significant impact on women's health. In leprosy gender inequalities could be even more serious, as it is a highly stigmatized disease. A review has been made of the most recent literature dealing with gender and leprosy. First some data are presented on gender inequalities in rates of case detection, deformities and reversal reactions among leprosy patients. Then the major factors contributing to those differences are discussed. The paper ends with some recommendations for further research on gender and leprosy.

Female↗