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一项关于精神疾病污名化对新加坡护理角色及经历影响的定性研究。

A qualitative enquiry on the impact of mental illness stigma on caregiving role and experiences in Singapore.

作者信息

Ong Wei Jie, Goh Chong Min Janrius, Tan Gregory Tee Hng, Shahwan Shazana, Subramaniam Mythily

机构信息

Research Division, Institute of Mental Health, Singapore, Singapore.

出版信息

Front Psychiatry. 2024 Jul 8;15:1417514. doi: 10.3389/fpsyt.2024.1417514. eCollection 2024.

Abstract

INTRODUCTION

Given that mental illness stigma is a common occurrence amongst people with mental illness and caregivers (CGs) can be a potential victim of stigma themselves, there is a need to examine caregivers' perspective on the phenomenon. This study is part of a larger study which aims to qualitatively examine the concept of mental illness stigma amongst different stakeholders in Singapore.

METHODS

Focus group discussions (FGDs) were conducted amongst 21 informal caregivers to explore the experience of stigma encountered by them and their care recipients, and how it may implicate their caregiving experience. Both inductive and deductive thematic analyses were employed to analyze the data.

RESULTS

Three overarching themes of stigma encounters that may have implication on caregiving experience were identified: 1) Stigma within the family; 2) Structural stigma; and 3) Stigma by association. Experience of stigma within family (e.g., social exclusion and lack of understanding) limits the caregiving supports available to CGs. CGs also took up a mediating role between their care recipients and other family who may hold stigmatizing views. Witnessing their care recipients being subjected to structural disadvantages (e.g., employment, school, and mandatory conscription) can induce emotional stresses amongst CGs and motivate them to protest and seek redress on their behalf. Furthermore, encounters of stigma themselves (e.g., being judged or blamed for their loved one's condition) also led to feelings of guilt and self-blame amongst the CGs.

DISCUSSION

These findings can aid the formulation of interventions in informing CGs on what to expect on their caregiving journey and supporting them in dealing with issues relating to stigma and highlight the importance of anti-stigma efforts in organizational settings such as schools, corporations, and government agencies.

摘要

引言

鉴于精神疾病污名化在精神疾病患者中普遍存在,而照顾者自身也可能成为污名化的潜在受害者,因此有必要审视照顾者对这一现象的看法。本研究是一项更大规模研究的一部分,该研究旨在对新加坡不同利益相关者对精神疾病污名化的概念进行定性研究。

方法

对21名非正式照顾者进行了焦点小组讨论,以探讨他们及其照顾对象所遭遇的污名化经历,以及这可能如何影响他们的照顾体验。采用归纳和演绎主题分析法对数据进行分析。

结果

确定了可能对照顾体验产生影响的三个总体污名化主题:1)家庭内部的污名化;2)结构性污名化;3)因关联而产生的污名化。家庭内部的污名化经历(如社会排斥和缺乏理解)限制了照顾者可获得的照顾支持。照顾者还在其照顾对象与其他可能持有污名化观点的家庭成员之间起到了调解作用。目睹他们的照顾对象遭受结构性劣势(如就业、上学和义务兵役)会给照顾者带来情感压力,并促使他们为照顾对象抗议并寻求补救。此外,照顾者自身遭遇污名化(如因亲人的病情而受到评判或指责)也会导致他们产生内疚和自责感。

讨论

这些发现有助于制定干预措施,让照顾者了解在照顾过程中可能遇到的情况,并支持他们应对与污名化相关的问题,同时凸显在学校、企业和政府机构等组织环境中开展反污名化工作的重要性。

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