Browsing by Subject "stigma"
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Item Advocacy as an Environmental Modification: Occupational Therapy’s Role in Stigma Reduction to Increase Occupational Performance in Children with Learning Disabilities(2022-05) Klukken, Angela; Petrenchik, Terry; Department of Occupational Therapy, School of Health and Human Sciences; Petrenchik, TerryOccupational therapists have a pivotal role in advocating for their clientele across various settings. The present study adds direction and suggestion for enhancing occupational therapy’s role in client advocacy, through the use of therapeutic skills utilized in teacher training to reduce the harmful effects of disability-based stigma for children with learning disabilities in a public elementary school setting. The author suggests that stigma reduction may serve as a powerful environmental modification; as disability accommodations and self-advocacy alone do not always permit equitable occupational participation. Teacher training in the area of pediatric learning disabilities with an emphasis on bias reduction, information, empathy, self-reflection and interpretation of anonymous student school experiences was implemented in a public elementary school by an occupational therapy doctoral capstone student. Medium effect sizes were found among some aspects of psychological flexibility with regard to stigmatizing thoughts among teachers. Significant results were found among students answering questions in class, and teachers’ awareness and ability to identify learning disabilities in their students. Results suggest that teachers were overall satisfied with training and have implemented changes in support of learning disability accessibility in their classrooms following intervention.Item Anticipated Stigma and Defensive Individualism during Post-Incarceration Job Searching(Wiley, 2016-08) Ray, Bradley; Grommon, Eric; Rydberg, Jason; School of Public and Environmental AffairsObtaining employment is one of the most difficult challenges for individuals released from prison. This research explores the strategies recently released male parolees employ in attempting to find work, with specific attention to the role of anticipated stigma from their ex-convict status. Through the use of in-depth longitudinal interviews, this research contributes to our understanding of returning prisoner's experiences in job searching. We find that although a majority of the sample anticipated stigma as a barrier to employment, those who did expressed an extreme self-reliance consistent with defensive individualism. This reluctance to draw on social networks may ultimately be counter-productive to the search for employment.Item Barriers to mental health service use among distressed family caregivers of lung cancer patients(Wiley, 2015) Mosher, Catherine E.; Given, B. A.; Ostroff, J. S.; Department of Psychology, School of ScienceAlthough family caregivers of patients with lung and other cancers show high rates of psychological distress, they underuse mental health services. This qualitative study aimed to identify barriers to mental health service use among 21 distressed family caregivers of lung cancer patients. Caregivers had not received mental health services during the patient's initial months of care at a comprehensive cancer centre in New York City. Thematic analysis of interview data was framed by Andersen's model of health service use and Corrigan's stigma theory. Results of our analysis expand Andersen's model by providing a description of need variables (e.g. psychiatric symptoms), enabling factors (e.g. finances), and psychosocial factors associated with caregivers' non-use of mental health services. Regarding psychosocial factors, caregivers expressed negative perceptions of mental health professionals and a desire for independent management of emotional concerns. Additionally, caregivers perceived a conflict between mental health service use and the caregiving role (e.g. prioritising the patient's needs). Although caregivers denied stigma associated with service use, their anticipated negative self-perceptions if they were to use services suggest that stigma may have influenced their decision to not seek services. Findings suggest that interventions to improve caregivers' uptake of mental health services should address perceived barriers.Item Bridging the Humanities and Health Care With Theatre: Theory and Outcomes of a Theatre-Based Model for Enhancing Psychiatric Care via Stigma Reduction(APA, 2022-12-22) Wasmuth, Sally; Pritchard, Kevin T.; Belkiewitz , Johnna; Occupational Therapy, School of Health and Human SciencesObjective: This article describes the rational, methods, implementation, and effectiveness of Identity Development Evolution and Sharing (IDEAS), an evidence-supported, narrative theater-based training that reduces stigma among health care providers to increase health care equity in psychiatric rehabilitation. Method: The IDEAS model has been used to reduce provider bias toward patients. From May 2017 to January 2020, we interviewed people from three patient groups who have been harmed by stigma, including Black women, transgender, and gender-diverse people, and people with substance use disorders. These interviews informed the creation of three theatrical scripts that were performed by professional actors for audiences of health care providers from January 2020 to May 2022. The performances aimed to raise conscious awareness of implicit provider biases and to provide a reflective opportunity to ameliorate these biases. The purpose of IDEAS is to improve experiences in health care settings such as psychiatric rehabilitation of patients from groups who have been harmed by stigma. We used paired-samples t tests to compare pre/postprovider stigma, measured via the Acceptance and Action Questionnaire-Stigma (AAQ-S). Results: Sociodemographic factors for providers who viewed IDEAS were similar across all three performances. IDEAS significantly decreased AAQ-S scores (t = 11.32, df = 50, M = 13.65, 95% confidence limit: [11.32, 15.97], p < .0001). Conclusions and implications for practice: IDEAS reduces provider stigma to support positive clinical encounters with diverse patient populations. These findings are relevant for psychiatric rehabilitation settings, which seek to establish positive rapport between providers and patients.Item Clinical and Psychological Correlates of Two Domains of Hopelessness in Schizophrenia(2008-12) Lysaker, Paul H.; Salyers, Michelle P.; Tsai, Jack; Spurrier, Linda Yorkman; Davis, Louanne W.Hopelessness is a widely observed barrier to recovery from schizophrenia spectrum disorders. Yet little is known about how clinical, social, and psychological factors independently affect hope. Additionally, the relationships that exist between these factors and different kinds of hope are unclear. To explore both issues, we correlated two aspects of hope, expectations of the future and agency, with stigma, clinical symptoms, anxiety, and coping preferences in 143 persons with a schizophrenia spectrum disorder. Multiple regressions revealed that hope for the future was predicted by lesser alienation, lesser preference for ignoring stressors, and lesser emotional discomfort and negative symptoms, accounting for 43% of the variance. A greater sense of agency was linked to lesser endorsement of mental illness stereotypes, fewer negative symptoms, lesser social phobia, and lesser preference for ignoring stressors, accounting for 44% of the variance. Implications for research and interventions are discussed.Item Commentary: Pain, Stigma, and the Politics of Self-Management(Oxford, 2020-05) Jain, Andrea R.; Religious Studies, School of Liberal ArtsItem The development and validation of a new measure of stigma resistance(2016) Firmin, Ruth L.; Salyers, Michelle P.STUDY 1: Objective: Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Methods: Twenty-four individuals with SMI who were either peer-service-providers (those with lived experience providing services; n = 14) or consumers of mental health services (n = 10) engaged in semi-structured interviews regarding experiences with stigma, self-stigma, and stigma resistance, including key elements of this process and examples of situations in which they resisted stigma. Results: Stigma resistance is an ongoing, active process that involves using one’s experiences, knowledge, and sets of skills at the 1) personal, 2) peer, and 3) public levels. Stigma resistance at the personal level involves a) not believing stigma or catching and challenging stigmatizing thoughts, b) empowering oneself by learning about mental health and recovery, c) maintaining one’s recovery and proving stigma wrong, and d) developing a meaningful identity beyond mental illness. Stigma resistance at the peer level involves using one’s experiences to help others fight stigma and at the public level, resistance involved a) education, b) challenging stigma, c) disclosing one’s lived experience, and d) advocacy work. Discussion: Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services. STUDY 2: Background: Despite strong links between stigma resistance and recovery outcomes, limitations of existing measures of stigma resistance have contributed to this construct remaining largely under-studied. This study sought to develop and validate an improved measure of mental illness stigma resistance, grounded in the perspectives of people with lived experience. Method: An item pool was developed from qualitative interviews (Study 1) and items were piloted in an online MTurk sample with people self-reporting a mental illness diagnosis (n=489). Best performing items were selected and preliminary factor structure was examined using exploratory factor analysis in a subset of the sample (30%, n=161). The new measure was then administered to individuals at two state mental health consumer recovery conferences (n=202) and confirmatory factor analyses were conducted to assess factor structure and refine the measure. Validity of the new scale was then examined through correlations with theoretically relevant measures. Results: The EFA suggested possible models of either 1, 3, or 5 factors. CFA demonstrated that the 5-factor model best fit the remaining MTurk data (n=328) and this was replicated in the conference sample; these samples were then combined to refine the measure across a heterogeneous sample (n=530). The final 20-item measure demonstrated good internal consistency for the total score (.93) and each of the 5 subscales (.71 - .88), good test-retest reliability (.74), and strong construct validity. Discussion: This study produced an improved measure of stigma resistance with strong psychometric properties and construct validity. Use of this new measure will allow for a more nuanced assessment of stigma resistance across important domains of recovery.Item Development of a Short Version of the Cataldo Lung Cancer Stigma Scale(Taylor and Francis, 2015) Carter-Harris, Lisa; Hall, Lynne A.; IU School of NursingLung cancer stigma is an important phenomenon experienced by many lung cancer patients that can be a barrier to medical help-seeking behavior. The purpose of this study was to shorten the Cataldo Lung Cancer Stigma Scale (CLCSS). The original 31-item scale had excellent internal consistency reliability but item redundancy. The majority of lung cancer patients are diagnosed at an advanced stage, and patient burden with survey completion may be higher in this population. To reduce patient burden with participation in lung cancer stigma-related research, a psychometrically sound short measure of lung cancer stigma is valuable. Factor analysis was used to evaluate the dimensionality of the CLCSS. Results were used to shorten the measure to 21 items. The shortened scale showed strong evidence of internal consistency reliability (Cronbach's alpha =.93). Results also indicate the scale is three dimensional with reliable subscales: stigma and blame, social isolation, and discrimination.Item Effects of Intergenerational Trauma on Motherhood Post Incarceration: Implications for Occupational Therapy Services During the Reentry Process(2023-05) Fischer, Keeley S.; Annie, DeRolf; Department of Occupational Therapy, School of Health and Human Sciences; Vest, BreeaCommunity reentry is the process of reintegrating individuals who have been incarcerated back into society. It is a challenging process that requires a multitude of resources to be successful. Unfortunately, individuals who have been released from jail or prison lack the necessary resources for successful reentry. Individuals with justice system involvement commonly face external barriers such as discrimination in housing, employment, and education. Common internal barriers include negative or limiting personal beliefs, roles, and habits. For mothers who have been incarcerated, the community reentry process can be particularly difficult, facing unique challenges related to their role as caregivers. Judgment and stigma from society, along with mothers often bearing the primary responsibility for the care and well-being of their children, often results in increased difficulty securing stable housing, employment, and access to resources required for the care and provide for their children.Item The Everyday Lives of Adolescent Girls with Epilepsy: A Qualitative Description(2009-11-04T18:21:53Z) MacLeod, Jessica S.; Swenson, Melinda M.; Foote, Carrie; Austin, Joan Kessner; Sims, Sharon L.This study is a qualitative description of the everyday lives of adolescent girls with epilepsy. The primary purpose of the research was to determine whether or not elements of stigma were present in narratives about participants’ day-to-day living. The researcher used open-ended and semi-structured interview techniques in a series of interviews with four adolescent girls with epilepsy. Elements of stigma were present in some of the constructed themes; however, the researcher also uncovered other unexpected themes. Themes constructed by the researcher included: 1) I Am Like Everyone Else (Except for my Seizures); 2) There are Worse Things than Epilepsy; 3) My Parents Trust Me; 4) Am I Having a Seizure?; 5) Bullying Because of Seizures; 6) Bullying Because of Something other than Seizures; 7) Coping with Bullying; 8) Academic Difficulties;9) Disclosure Management; 10) Seizures are Scary to Have and to See; and 11)If I have a Seizure, Don’t Attract Attention to Me! The researcher considers topics thought to be important to adolescents with epilepsy about which the participants kept silent. The researcher makes suggestions about how the research can be used to improve health care practice and guide educational policies for adolescent students with epilepsy. Based on the findings, the researcher suggests areas for future research in nursing and educational policy.