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既是问题的一部分,也是解决问题的一部分:精神卫生专业人员的精神分裂症耻辱感因素。

Part of the solution yet part of the problem: factors of schizophrenia stigma in mental health professionals.

机构信息

LabPsy, Univ. Bordeaux, Bordeaux, France.

Adult Psychiatry Department, Jonzac Hospital, Jonzac, France.

出版信息

Int J Psychiatry Clin Pract. 2023 Jun;27(2):134-144. doi: 10.1080/13651501.2022.2129068. Epub 2022 Oct 6.

Abstract

BACKGROUND

Stigma is highly prejudicial to persons with schizophrenia, their families, the society and the health care system. Mental health professionals (MHP) are considered to be one of the main sources of schizophrenia stigma.

OBJECTIVES

The aim of the study was to identify individual and contextual factors associated with stigma in MHP in its three dimensions (stereotypes, prejudices, discrimination, Fiske, 1998).

METHODS

An online survey was conducted with specific measures of MHP stigma (stereotypes, prejudices and discrimination). Four categories of potential associated factors were also measured: sociodemographic characteristics, contextual characteristics (e.g., Work setting), individual characteristics (e.g., Profession, Recovery-oriented practices) and theoretical beliefs (e.g., Biological beliefs, Perceived similarities, Continuum Categorical beliefs).

RESULTS

Responses of 357 MHP were analysed. Factors that were the most strongly associated with MHP stigma were Perceived similarities, Categorical beliefs, Biological beliefs, Recovery-oriented practice and Work setting (independent practice). Conversely, Gender, Specific trainings in stigma or recovery and Cognitive aetiology beliefs showed no association with any of MHP stigma dimension. Remaining factors show associations with a weak effect size.

CONCLUSIONS

The survey results suggest that MHP stigma is more influenced by individual factors such as theoretical beliefs and recovery-oriented practices than contextual factors. These original results provide perspectives for reducing stigma in mental health practices.Key pointsMental health professionals (MHP) considering they share similarities with persons with schizophrenia or believing that schizophrenia is not a discrete social category but rather the extreme on a continuum between 'normal' and 'pathologic' reported less stigmatisation.MHP holding higher professional utility beliefs and using recovery-oriented practice reported fewer stereotypes, prejudice and discrimination.Other factors such as age, academic level, contact frequency, familiarity and multidisciplinary practice show associations with a weak effect size.

摘要

背景

污名化对精神分裂症患者、他们的家人、社会和医疗保健系统都有极大的危害。精神卫生专业人员(MHP)被认为是精神分裂症污名的主要来源之一。

目的

本研究旨在确定与 MHP 三个维度(刻板印象、偏见、歧视,Fiske,1998)相关的个体和环境因素。

方法

采用 MHP 污名的特定测量方法(刻板印象、偏见和歧视)进行在线调查。还测量了四个潜在相关因素类别:社会人口特征、环境特征(例如,工作环境)、个体特征(例如,专业、以康复为导向的实践)和理论信念(例如,生物信念、感知相似性、连续体分类信念)。

结果

分析了 357 名 MHP 的回应。与 MHP 污名最相关的因素是感知相似性、分类信念、生物信念、以康复为导向的实践和工作环境(独立实践)。相反,性别、特定的污名或康复培训以及认知病因学信念与 MHP 污名的任何维度都没有关联。其余因素与弱效应大小相关。

结论

调查结果表明,MHP 污名更多地受到个体因素的影响,如理论信念和以康复为导向的实践,而不是环境因素。这些原始结果为减少精神卫生实践中的污名化提供了视角。

关键点

  • MHP 认为他们与精神分裂症患者有相似之处,或者认为精神分裂症不是一个离散的社会类别,而是介于“正常”和“病理”之间的连续体上的极端情况,报告的污名化程度较低。

  • 持有更高的专业效用信念并使用以康复为导向的实践的 MHP 报告的刻板印象、偏见和歧视较少。

  • 其他因素,如年龄、学历、接触频率、熟悉程度和多学科实践,与弱效应大小相关。

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