Bedaso Asres, Workie Keralem, Gobena Mulugeta, Kebede Emnet
Hawassa University, College of Medicine and Health Sciences, School of Nursing, Ethiopia.
Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Heliyon. 2022 May 14;8(5):e09431. doi: 10.1016/j.heliyon.2022.e09431. eCollection 2022 May.
Internalized stigma is an ongoing process of psychological assimilation of the community labels towards mental illness, in which people with mental illness (PWMI) gradually lose their current positive belief and confidence in themselves and their future wishes. It affects the treatment and help-seeking behavior which leads to poor drug adherence, social marginalization, unemployment, socio-economic devastation, and poor quality of life for PWMI. Therefore, the current study aimed to determine the magnitude and correlates of high internalized stigma among People with Mental Illness (PWMI) attending the outpatient department of Amanuel mental specialized hospital, Addis Ababa, Ethiopia.
Institution based cross-sectional study was conducted from March 03 to March 28, 2019. A consecutive sampling technique was used to select an estimated 406 study participants. Internalized stigma was assessed using a 29 Item Internalized Stigma of Mental Illness (ISMI-29) tool. Data were entered and analyzed using SPSS 22 software. A Binary logistic regression model was fitted to identify correlates of internalized stigma. An adjusted odds ratio (AOR) with a 95% confidence interval was computed to determine the strength of association and the level of significance was declared with a p-value <0.05.
Of the total study participants, 388 respondents agreed to participate in the study giving a response rate of 96%. The magnitude of high internalized stigma among the study participants was 61.3% (95% CI: 58.2, 64.4). Poor social support (AOR = 1.973; 95%CI = 1.189, 3.27) and being unemployed (AOR = 2.87, 95% CI = 1.192-6.931) were significant correlates of high internalized stigma among PWMI.
Overall, around three in five PWMI experienced high internalized stigma. Poor social support and being unemployed were significant correlates of high internalized stigma. Large scale community-based study supplemented by qualitative design is highly recommended to identify additional correlates of internalized stigma and understand perspectives of PWMI.
内化耻辱感是社区对精神疾病标签进行心理同化的一个持续过程,在此过程中,患有精神疾病的人(PWMI)逐渐失去他们当前对自己的积极信念以及对未来愿望的信心。它会影响治疗和求助行为,进而导致药物依从性差、社会边缘化、失业、社会经济破坏以及PWMI的生活质量低下。因此,本研究旨在确定在埃塞俄比亚亚的斯亚贝巴阿马努埃尔精神专科医院门诊部就诊的患有精神疾病的人(PWMI)中高度内化耻辱感的程度及其相关因素。
于2019年3月3日至3月28日进行了基于机构的横断面研究。采用连续抽样技术选取了约406名研究参与者。使用29项精神疾病内化耻辱感量表(ISMI - 29)工具评估内化耻辱感。数据录入并使用SPSS 22软件进行分析。采用二元逻辑回归模型来确定内化耻辱感的相关因素。计算调整后的优势比(AOR)及95%置信区间,以确定关联强度,并以p值<0.05宣布显著性水平。
在所有研究参与者中,388名受访者同意参与研究,回复率为96%。研究参与者中高度内化耻辱感的程度为61.3%(95%CI:58.2,64.4)。社会支持差(AOR = 1.973;95%CI = 1.189,3.27)和失业(AOR = 2.87,95%CI = 1.192 - 6.931)是PWMI中高度内化耻辱感的显著相关因素。
总体而言,约五分之三的PWMI经历了高度内化耻辱感。社会支持差和失业是高度内化耻辱感的显著相关因素。强烈建议开展大规模的基于社区的研究,并辅以定性设计,以确定内化耻辱感的其他相关因素并了解PWMI的观点。