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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Compared widowed spouses who joined (n = 40) bereavement support groups (BSGs) during the first 13 months of bereavement with those who declined to join (n = 96). Controlling for gender, age, and socioeconomic status, no differences were found for perceived levels of social support, but joiners, compared with nonjoiners, reported experiencing more stressful events and scored significantly higher on measures of depression, anger, anxiety, and subjective stress. Nonjoiners and, to a lesser extent, joiners viewed those attending groups as less self-sufficient (e.g., need help, lonely), suggesting a mildly stigmatizing image of BSGs. A dialectical model is proposed in which BSG utilization rates are seen as the product of an avoidance-avoidance conflict involving the choice between suffering emotional distress on one's own or the perceived stigma of joining a BSG. Implications for future research on participation in self-help and mutual support groups are discussed.
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PMID:Bereavement support groups: who joins; who does not; and why. 148 15

Starting from a prior study, in which cognitive and coping variables proved to be related to well-being, the use of medical resources and the absence from work in asthmatic patients, the authors constructed a cognitive-educational (a combination of health education and rational emotive behaviour modification) intervention programme aiming at altering coping behaviour in asthmatic patients in order to influence emotional distress and use of medical resources. The effects of the programme were assessed by means of a pre-test-post-test control group design. The programme was offered to ten patients and their partners. Both before and after the intervention cognitive attitudes (optimism, locus of control, and shame or stigma), coping behaviour in attack situations (minimizing the seriousness of the attack, rational action and reacting emotionally), coping in daily life (maintaining a restrictive life-style, focussing on asthma and hiding asthma), emotional distress (anxiety, anger, and depression), and the use of medication were measured in the experimental and control group. It was found that patients who received the programme became less preoccupied with their asthma and reported significantly less emotional distress (anxiety and anger) in daily life. In addition, they used less maintenance medication (corticosteroids). The authors wish to stress the importance of using medical variables such as the number of attacks as covariates in this type of research.
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PMID:Changing health behaviour outcomes in asthmatic patients: a pilot intervention study. 334 56

In addition to prolonging life, successful treatment by laryngectomy also results in functional disability (loss of speech) and physical disfigurement (stoma). It was hypothesized that these after-effects contribute to perceived stigma which, in turn, compromises quality of life. The hypothesis that the psychosocial impact of perceived stigma operates through illness intrusiveness--illness-induced disruptions that interfere with continued involvements in valued activities and interests--was tested. Data were collected from 51 laryngectomy recipients via standardized interviews. As hypothesized, results indicated that: 1. both perceived stigma and illness intrusiveness are related to psychosocial well-being and emotional distress; 2. illness intrusiveness mediates the relation between perceived stigma and psychosocial outcomes; 3. the psychosocial impact of illness intrusiveness is most devastating in the context of highly stigmatized self-perception; and 4. unique profiles of illness intrusiveness across individual life domains may be associated with specific psychosocial outcomes. Findings are discussed in relation to the hypothesis that illness intrusiveness is a common underlying determinant of the psychosocial impact of chronic illness.
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PMID:Psychosocial impact of laryngectomy mediated by perceived stigma and illness intrusiveness. 782 12

This article presents a paradigm case of a problematic work re-entry experience of a breast cancer survivor (Kathy). The case was drawn from a qualitative descriptive study of 25 long-term survivors of breast cancer. The study describes the lived experience and practical "know how" of survivors. Study participants completed three in-depth process interviews that were transcribed and analyzed for common themes. The paradigm case presented here is one of five paradigms that emerged from the data. The case demonstrates the profound impact of a negative work re-entry experience on a cancer survivor's reformulating sense of self. In addition to pericarditis and lymphedema, Kathy experienced long-term emotional distress. Although work provided a primary source of meaning, Kathy ultimately gave up her desire to return to work. Predominant features of the case include: a breach of confidentiality of medical information in the work setting; absence of resources and support to assist with work re-entry and the management of social stigma; difficulty in talking with colleagues and others about her health; and difficulty in asking for and receiving assistance. The understandings set forth from Kathy's experience can guide clinicians to explore the meaning of work in the lives of their patients and can encourage the development and use of work re-entry programs.
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PMID:Surviving breast cancer: a problematic work re-entry. 805 15

This study examined the role of psychological factors as mediators of the impact of HIV-related stressors on emotional distress of a clinic-based sample of 264 HIV+ women. Based upon Lazarus and colleagues' cognitively oriented theory of stress and coping, causal modeling was used to test for mediating effects of cognitive appraisal (intrusive thoughts and perceived stigma) and coping variables (avoidance and fatalism) on emotional distress within the context of HIV-related stressors (functional impairment and work performance impairment). The findings supported the mediating effects of cognitive appraisal but not of the coping variables. Consistent with theory, the effect of HIV-related stressors on emotional distress was indirect through cognitive appraisal; however, there were no significant direct effects of HIV-related stressors, fatalism or avoidance on emotional distress. The causal model accounted for significant portions of variance in emotional distress (R2 = .49) and the model fit, as a whole, was more than adequate. The findings indicate that how HIV+ women think about HIV-related stressors is an important factor that may account for individual variability in the ability to maintain a sense of subjective well-being in the face of a devastating fatal disease.
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PMID:The impact of HIV on emotional distress of infected women: cognitive appraisal and coping as mediators. 932 75

The purpose of this study was to evaluate the relative importance of social (social support, material resources, disclosure, and family functioning) and psychological factors (stigma, emotional distress, intrusion, avoidance, and fatalism) as predictors of the quality of life of women infected with HIV. The cross-sectional data were drawn from interviews of a sample of 264 women recruited from 8 HIV/AIDS treatment sites in a south-eastern state. Variance in quality of life variables, included limited daily functioning, general anxiety, and HIV symptoms was analyzed using ANOVA, correlations, and hierarchical multiple regression analysis. Limited daily functioning was predicted by stigma, fatalism, employment status, and stage of disease (R2 = 0.179). General anxiety was predicted by emotional distress, intrusion, and marital status (R2 = 0.503). Reported HIV symptoms were predicted by material resources, disclosure, intrusion, age, employment status, and race (R2 = 0.294). The results of this study support that social and, particularly, psychological factors are important in their influence on quality of life in women with HIV infection and suggest the need for interventions which address such factors.
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PMID:Quality of life in HIV-infected women in the south-eastern United States. 940 93

The Self-Appraisal Questionnaire (J. C. Coyne & M. M. Calarco, 1995) was used to examine how primary care and psychiatric outpatients with recent or past major depression appraised their prospects and structured their lives. They were compared with nondistressed and distressed primary care patients. Both depressed groups scored higher than the nondistressed patients for Lack of Energy, Management of Burden on Others, Need to Maintain a Balance in Life, Fear of Taking Risks, Imposition of Limitations on Life, and Sense of Stigma. The distressed group fell between the depressed psychiatric and the nondistressed groups, and generally did not differ from the depressed primary care group. Past depression did not explain differences associated with more recent depression and distress. Distress entails a need to manage its effects on others, but depression in psychiatric patients may produce a more profound reorganization of self-concept, relationships, and coping.
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PMID:Effects of recent and past major depression and distress on self-concept and coping. 950 41

Women seen in public gynecology settings are at very high risk of developing psychiatric disorders. Because low-income and ethnic minority women seen in such settings underutilize mental health services, it is important to better understand treatment preferences and obstacles among this high-risk patient population. Public women's clinic patients (N = 105) who reported psychological or emotional distress were asked about their interest in medication, psychotherapy, and psychoeducational classes, as well as perceived obstacles to using these services. The vast majority were interested in receiving some form of mental health treatment, with the most interest shown for individual therapy and general psychoeducational classes about health and stress. Less interest was expressed in group therapy and medication. Women anticipated more instrumental barriers to using services, such as lack of money, transportation, and childcare, than stigma-related barriers, such as fear of embarrassment or rejection. However, Latinas, women with less education, and those with a current mood or anxiety disorder were more likely to anticipate stigma-related barriers to treatment than other women. Implications of these findings for referral and treatment of mental health problems among public women's clinic patients are discussed.
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PMID:Distressed women's clinic patients: preferences for mental health treatments and perceived obstacles. 1057 75

The mental and physical health care issues of medical students are increasingly recognized as both prevalent and complex. Emotional distress, symptoms of mental illness, and maladaptive substance use are widespread and may often be driven by training-related stressors. The data suggest that nearly all medical students identify physical health concerns as well. The care of medical students as patients is complex because of problems associated with the stigma of various illnesses and the dual role of trainee and patient in medical school. A written confidential survey assessed students longitudinally near the end of their first and third years of training regarding their perceived health care needs, health concerns, attitudes toward care, access to services, and care-seeking practices (161 items). A subset of students (n = 33) were reassessed 1 month after the second survey to measure reliability. McNemar's chi-square (chi2) tests, repeated-measures multivariate analysis of variance (MANOVA), and K and Pearson correlations were used to evaluate outcomes. Almost all students reported health care needs during both training phases, and their mental and physical health concerns were stable over time. However, the preference for obtaining health care at a site other than their training institution and concerns about confidentiality increased, although students were marginally more likely to obtain care at their medical school during clinical versus preclinical training. The students' tendency to seek informal care from colleagues remained consistent, as did their high level of concern about professional jeopardy relating to personal health issues. Their tendency to accept the dual patient-student role depended on the particular health care issue; they expressed a strong tendency to protect other students' confidentiality, even in cases of potential significant impairment. Responses were reliable across a 1-month retest interval. We conclude that medical students' perspectives on their mental and physical health care across the transition from preclinical to clinical training reveal the importance of pursuing, not neglecting, a number of clinical and educational initiatives. Through their specialized expertise, psychiatrists may help to ensure sound mental and physical health care for the more than 69,000 medical students in training in this country.
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PMID:Medical students' evolving perspectives on their personal health care: clinical and educational implications of a longitudinal study. 1092

An out-of-court settlement was reached between [name removed] and both [name removed], a pharmacy technician, and her employer, Arbor Drugs. [Name removed], who has AIDS, filed suit for breach of pharmacist-patient confidentiality and emotional distress. According to the suit, when [name removed] realized that Mr. [Name removed] was taking an AIDS medication, she told her teenage son who subsequently teased the [name removed] children about their father's condition. The family had wanted to keep the diagnosis a secret because of the stigma associated with AIDS. [Name removed] denies telling her son about [name removed]'s condition. The settlement was reached three days into the trial in this civil suit.
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PMID:Michigan man with AIDS settles suit against pharmacy chain. 1136 69


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