Stigma perceived by family members of psychiatric patients attending outpatient department of a teaching hospital

Lamichhane, Rama Kumari

doi:10.3126/jpahs.v6i2.27234

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…This means that the caregivers felt stigmatised while caring a relative with mental illness. The findings of this study were in line with the study conducted in Nepal (2019), 11 (2014), 12 and Vellore, India (2019) 10 which showed that caregivers felt burden and stigma having a relative with mental illness.…”

Section: Discussionsupporting

confidence: 90%

“…Convenience sampling technique was used while selecting the caregivers of mentally ill patient. Two hundred and seventeen caregivers were included in the study after taking the prevalence of perceived stigma as 83%, statistical formula of n= Z 2 pq/d 2 , where d (allowable error) = 0.05, z (confidence level) = 1.96, p (prevalence of perceived stigma) 11 = 0.83 and q (1-p) = 0.17 but one of the respondent withdrew from the study thus 216 caregivers were taken. Data was collected using face to face interview technique from either of parents, siblings, family members and friends aged above 18 years whose duration of stay with the patient should be at least six months.…”

Section: Methodsmentioning

confidence: 99%

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Perceived stigma among caregivers of mentally ill patient: A descriptive cross-sectional study

Khanal

2021

J. Kathmandu Med. Coll.

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Background: Stigmatising experience related to mental illness is not only confined to the patient but also experienced by their caregivers such as family members and friends. Caregivers feel down and helpless about their affiliation with stigma related to mental illness. Various research studies show that stigma related to mental illness have negative influence on caregivers which leads to concealing the status of mentally ill relatives. Objective: This study aimed to assess the level of perceived stigma among the caregivers of mentally ill patients. Methods: A descriptive cross-sectional study was conducted at Psychiatric outpatient and inpatient department of Psychiatry, Kathmandu Medical College from 30th January to August 30th 2020. Two hundred and sixteen respondents were chosen conveniently. Face to face interview was conducted using standard tool ‘Devaluation Consumers Families Scale’ to assess the perceived stigma among caregivers of mentally ill patients. Results: Perceived stigma among the caregivers of mentally ill patients was found to be medium (mean score 15.8±2.8). The caregivers perceived the community looking down on the families with mentally ill relatives (community rejection). The mean score was low (2.1±0.8) on “uncaring parents” which indicates that the respondents did not agree that parents of mentally ill patients were less responsible and caring than others. Conclusion: Caregivers of mentally ill patient perceive stigma in various forms which affects the usages of health facilities, care and support towards mentally ill relatives. Objective: This study aimed to assess the level of perceived stigma among the caregivers of mentally ill patients. Methods: A descriptive cross-sectional study was conducted at Psychiatric outpatient and inpatient department of Psychiatry, Kathmandu Medical College from 30th January to August 30th 2020. Two hundred and sixteen respondents were chosen conveniently. Face to face interview was conducted using standard tool ‘Devaluation Consumers Families Scale’ to assess the perceived stigma among caregivers of mentally ill patients. Results: Perceived stigma among the caregivers of mentally ill patients was found to be medium (mean score 15.8±2.8). The caregivers perceived the community looking down on the families with mentally ill relatives (community rejection). The mean score was low (2.1±0.8) on “uncaring parents” which indicates that the respondents did not agree that parents of mentally ill patients were less responsible and caring than others. Conclusion: Caregivers of mentally ill patient perceive stigma in various forms which affects the usages of health facilities, care and support towards mentally ill relatives.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Perceived stigma among caregivers of mentally ill patient: A descriptive cross-sectional study

Khanal

2021

J. Kathmandu Med. Coll.

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“…Most of the qualitative studies with stigma as the major theme or domain focused on public stigma of either general community members or healthcare workers. Quantitative or mixed methods studies predominantly focused on self or internalised stigma of people with lived experiences of mental disorders (PWLE) (Adhikari, 2015; Neupane et al ., 2016; Amatya et al ., 2018; Rathod et al ., 2018; Maharjan and Panthee, 2019; Shrestha, 2019), public stigma (family and community members) (Neupane et al ., 2016; Amatya et al ., 2018; Koirala et al ., 2019; Luitel et al ., 2019; Pandey, 2019), health workers’ stigma (Gartoulla et al ., 2015; Pathak and Montgomery, 2015; Kohrt et al ., 2018 b , 2020), medical and pharmacy students’ stigma (Panthee et al ., 2010; Adhikari, 2018; Jalan, 2018; Shakya, 2018), and perceived stigma among PWLE and family members (Adhikari et al ., 2008; Lamichhane, 2019). Four studies exclusively focused on courtesy stigma (Angermeyer et al ., 2003).…”

Section: Resultsmentioning

confidence: 99%

“…Health workers reported that mental disorders were life-long conditions that had no effective treatment. The general public stated that mental disorders could not be cured by Western biomedicine but only through traditional healing (Kisa et al ., 2016; Simkhada et al ., 2016; Koirala et al ., 2019; Lamichhane, 2019; Kaiser et al ., 2020). This was also reflected in conceptions about the use of psychotropic medications for mental health conditions; most people described that once a person starts taking medications, she/he must take it for life (Upadhaya et al ., 2018).…”

Section: Resultsmentioning

confidence: 99%

“…More than 50% slightly or strongly agreed to being avoided by others, asked to resign from work and neglected by health professionals (Adhikari et al ., 2008). Several studies also reported how PWLE are isolated in the communities, often avoided and considered ineligible to take part in social activities and festivities (Kisa et al ., 2016; Lamichhane, 2019). PWLE are also considered ineligible for work or marriage and even if they do get married, mental disorders are considered acceptable grounds for divorce (Drew et al ., 2011; Hagaman et al ., 2018).…”

Section: Resultsmentioning

confidence: 99%

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Stigma against mental health disorders in Nepal conceptualised with a ‘what matters most’ framework: a scoping review

Gurung

Poudyal

Wang

et al. 2022

Epidemiol Psychiatr Sci

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Aims Stigma related to mental disorders is a barrier to quality mental healthcare. This scoping review aimed to synthesise literature on stigma related to mental disorders in Nepal to understand stigma processes. The anthropological concept of ‘what matters most’ to understand culture and stigma was used to frame the literature on explanatory models, manifestations, consequences, structural facilitators and mitigators, and interventions. Methods We conducted a scoping review with screening guided by the Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR). A structured search was done using three international databases (PsycINFO, Medline and Web of Science), one Nepali database (NepJol) and cross-referencing for publications from 1 January 2000 through 24 June 2020. The search was repeated to include structural stigma-related terms. Quality of quantitative studies was assessed using the Systematic Assessment of Quality in Observational Research (SAQOR) tool. The review was registered through the Open Science Framework (OSF) (osf.io/u8jhn). Results The searches yielded 57 studies over a 20-year period: 19 quantitative, 19 qualitative, nine mixed methods, five review articles, two ethnographies and three other types of studies. The review identified nine stigma measures used in Nepal, one stigma intervention, and no studies focused on adolescent and child mental health stigma. The findings suggest that ‘what matters most’ in Nepali culture for service users, caregivers, community members and health workers include prestige, productivity, privacy, acceptance, marriage and resources. Cultural values related to ‘what matters most’ are reflected in structural barriers and facilitators including lack of policies, programme planning and resources. Most studies using quantitative tools to assess stigma did not describe cultural adaptation or validation processes, and 15 out of the 18 quantitative studies were ‘low-quality’ on the SAQOR quality rating. The review revealed clear gaps in implementation and evaluation of stigma interventions in Nepal with only one intervention reported, and most stigma measures not culturally adapted for use. Conclusion As stigma processes are complex and interlinked in their influence on ‘what matters most’ and structural barriers and facilitators, more studies are required to understand this complexity and establish effective interventions targeting multiple domains. We suggest that stigma researchers should clarify conceptual models to inform study design and interpretations. There is a need to develop procedures for the systematic cultural adaptation of stigma assessment tools. Research should be conducted to understand the forms and drivers of structural stigma and to expand intervention research to evaluate strategies for stigma reduction.

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Investigation the effect of Acceptance and Commitment Therapy (ACT) training on stigma and family functioning in family members of patients with psychiatric disorders: a randomized controlled clinical trial

Parvin,

Dehghan,

Masoumi

et al. 2024

BMC Psychiatry

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Background Regarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness. Methods This randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group ( N = 20) or a control group ( N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23. Results A statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups ( P < 0.05). The intervention group’s mean scores showed a rising trend, whereas the control group’s mean scores showed a declining trend. This was evident from within-group comparisons of the mean post-test and follow-up stigma scores. Repeated measures ANOVA indicated that the pattern of change in stigma for the intervention group was significant, in contrast to control group, suggesting a reduction in stigma ( P < 0.001). Conclusion In light of the findings presented in this study, ACT emerges as a promising intervention for mitigating stigma, and enhancing the family functioning of individuals afflicted with mental disorders. To improve the generalizability of the study results, comparable studies using this therapy method should be undertaken on family caregivers of patients with mental illnesses. Iranian Registry of Clinical Trials IRCT registration number: IRCT20190917044802N10. Registration date 14/9/2023. Supplementary Information The online version contains supplementary material available at 10.1186/s12888-024-06114-2.

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Stigma perceived by family members of psychiatric patients attending outpatient department of a teaching hospital

Cited by 3 publications

References 5 publications

Perceived stigma among caregivers of mentally ill patient: A descriptive cross-sectional study

Perceived stigma among caregivers of mentally ill patient: A descriptive cross-sectional study

Stigma against mental health disorders in Nepal conceptualised with a ‘what matters most’ framework: a scoping review

Investigation the effect of Acceptance and Commitment Therapy (ACT) training on stigma and family functioning in family members of patients with psychiatric disorders: a randomized controlled clinical trial

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