School of Nursing, Jichi Medical University, Tochigi, Japan.
Psychiatry Clin Neurosci. 2012 Mar;66(2):113-20. doi: 10.1111/j.1440-1819.2011.02307.x.
'Internalized stigma' is a construct that reflects the degree to which a person accepts beliefs endorsed by society about mental illness. Among people with schizophrenia spectrum disorders, internalized stigma has been found to moderate the associations between insight and social function, hope, and self-esteem. Among families of patients with schizophrenia, internalized stigma may not only hinder help-seeking but also result in the families attempting to provide care themselves, without assistance from mental health services. Little is known about internalized stigma among service providers, especially psychiatric nurses in Japan. Therefore, we investigated the correlation between internalized stigma and 'beliefs about the most appropriate form of hospitalization' among psychiatric nurses.
The subjects were 215 psychiatric nurses employed in psychiatric hospitals who completed the personal stigma scale, perceived stigma scales, and Difficulty of Community Living Scale (DCLS) with respect to a chronic schizophrenia case vignette.
Internalized stigma was positively correlated with greater 'beliefs about the most appropriate form of hospitalization' among psychiatric nurses. We also showed that stronger 'beliefs about the social disadvantages of schizophrenia patients in the community' was positively correlated with stronger 'beliefs about the most appropriate form of hospitalization'.
The present findings suggest that the psychiatric nurses employed at Japanese psychiatric hospitals have a pessimistic view of the community living of people with schizophrenia and their families. And these psychiatric nurses' beliefs were related to their understanding of the deeply dependent relationship between patients and families, and was related to the Confucian ideal.
“内化的污名”是一个反映个体对社会对精神疾病所持信念的接受程度的概念。在精神分裂症谱系障碍患者中，内化的污名被发现可以调节洞察力、社会功能、希望和自尊之间的关系。在精神分裂症患者的家庭中，内化的污名不仅可能阻碍寻求帮助，还可能导致家庭试图在没有心理健康服务机构的帮助下自行提供照顾。然而，对于服务提供者（尤其是日本的精神科护士）中的内化污名现象，我们知之甚少。因此，我们调查了精神科护士内化污名与“对最合适住院形式的信念”之间的相关性。
本研究的对象是 215 名在精神科医院工作的精神科护士，他们完成了个人污名量表、感知污名量表和针对慢性精神分裂症病例描述的社区生活困难量表（DCLS）。
精神科护士的内化污名与对最合适住院形式的信念呈正相关。我们还表明，对社区中精神分裂症患者的社会劣势的信念越强，对最合适住院形式的信念就越强。
本研究结果表明，日本精神科医院的精神科护士对精神分裂症患者及其家庭的社区生活持悲观态度。这些精神科护士的信念与他们对患者和家庭之间高度依赖关系的理解有关，并且与儒家理想有关。
