1 Africa Mental Health Foundation, Nairobi, Kenya.
2 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Int J Soc Psychiatry. 2017 Sep;63(6):508-517. doi: 10.1177/0020764017716953. Epub 2017 Jul 6.
The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities.
This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs).
Participants ( n = 44 HWs and n = 60 CHVs) completed the self-report Mental Health Knowledge Schedule and the Reported and Intended Behavior Scale, along with sociodemographic questions. Multiple regression models were used to assess predictors of mental health knowledge and stigmatizing behaviors.
HWs had significantly higher mean mental health knowledge scores than CHVs, p < .001, and significantly higher mean positive attitudes scores than CHVs, p = .042. When controlling for relevant covariates, higher positive attitudes was the only significant predictor of higher mental health knowledge, and self-rating of sense of belonging to the community and mental health knowledge remained the main predictors of positive attitudes.
Results suggest that stigma-related mental health knowledge and attitudes are associated, and interventions should target these areas with health workers. There is scope for intervention to increase knowledge and positive attitudes for individuals who feel a strong sense of community belonging. Future studies should test feasible ways to reduce stigma in this population.
该研究在肯尼亚农村进行，评估了初级卫生保健机构卫生工作者的污名化情况。
本研究比较了初级卫生工作者（HWs）和社区卫生志愿者（CHVs）之间与污名相关的心理健康知识和态度的差异。
参与者（HWs 组 n=44，CHVs 组 n=60）完成了自我报告的心理健康知识量表和报告及预期行为量表，以及社会人口学问题。采用多元回归模型评估心理健康知识和污名化行为的预测因素。
HWs 的心理健康知识得分显著高于 CHVs，p<.001，积极态度得分显著高于 CHVs，p=.042。在控制相关协变量后，更高的积极态度是更高心理健康知识的唯一显著预测因素，自我评定的社区归属感和心理健康知识仍然是积极态度的主要预测因素。
结果表明，与污名相关的心理健康知识和态度是相关的，干预措施应针对卫生工作者的这些领域。对于那些有强烈社区归属感的人，增加知识和积极态度的干预措施是有空间的。未来的研究应检验可行的方法来减少这一人群的污名化。
