Voices of the unheard: A qualitative survey exploring bereaved parents experiences of stillbirth stigma

BackgroundEvery year, 2.6 million babies are stillborn worldwide. Despite these figures, stillbirth remains a relatively ignored public health issue. The wider literature suggests that this is due to the stigma associated with stillbirth. The stigma of stillbirth is seen as possibly one of the greatest barriers in reducing stagnant stillbirth rates and supporting bereaved parents. However, empirical evidence on the extent, type, and experiences of stillbirth stigma remain scarce.AimThis study aimed to explore the stigma experiences of bereaved parents who have endured a stillbirth.MethodsAn online survey of closed and open-questions with 817 participants (n = 796 female; n = 17 male) was conducted in high-income countries.FindingsBased on self-perception, 38% of bereaved parents believed they had been stigmatised due to their stillbirth. Thematic data analysis revealed several themes consistent with Link and Phelan’s stigma theory- labelling, stereotyping, status loss and discrimination, separation, and power. One more theme outside of this theory- bereaved parents as agents of change was also discovered.ConclusionBereaved parents after stillbirth may experience stigma. Common experiences included feelings of shame, blame, devaluation of motherhood and discrimination. Bereaved parents also reported the silence of stillbirth occurred during their antenatal care with many health care providers not informing them about the possibility of stillbirth. Further research needs to be undertaken to explore further the extent and type of stigma felt by bereaved parents after stillbirth, and how stigma is impacting the health care professional disseminating and distributing resources to pregnant women.     

Internalized Homophobia,HIV Knowledge,and HIV/AIDS Personal Responsibility Beliefs: Correlates of HIV/AIDS Discrimination among MSM in the Context of Institutionalized Stigma

ABSTRACT

There exists a paucity of research on the psychosocial risk factors of HIV/AIDS among men who have sex with men (MSM) in settings where they are stigmatized or face prosecution. The present study investigates discrimination against people living with HIV (PLHIV), internalized homophobia, HIV/AIDS personal responsibility beliefs and HIV knowledge in a purposive sample of 106 self-identified MSM obtained through a web-based survey disseminated by two voluntary welfare organizations. Results indicate that internalized homophobia is positively associated with discrimination against PLHIV. Internalized homophobia also substantially mediates the effect of HIV/AIDS personal responsibility beliefs on discrimination against PLHIV, highlighting the confounded nature of HIV/AIDS and homosexual stigma in a setting where stigma is deep-rooted and institutionalized. Internalized homophobia may thus serve as a barrier to the effectiveness of HIV prevention efforts among MSM in Singapore.     

Family Experiences of Caring for Relatives Who Have Received Electroconvulsive Therapy (ECT)

The research literature on family members’ experiences of the use of electroconvulsive therapy (ECT) is limited. This article explores the perspectives of family members whose relatives had received ECT. Drawing on a social constructionist perspective, this qualitative study collected data using in-depth interviews with nine families in South Australia, to examine how family members constructed the supports and challenges they experienced. The research found that families experienced a range of social and service system barriers, including social stigma and isolation, and limited support from health professionals. They had to negotiate caring expectations within a social context that stigmatised both mental illness and ECT. A need for ECT-specific mental health support groups was identified.

IMPLICATIONS

• Social workers’ roles in Australian hospitals could be further expanded to accommodate supporting families whose relatives have received ECT, referring families to community support, and advocating for specialist support post-ECT treatment.

• Social workers can further articulate their unique contribution to community care post-ECT treatment and advocate for supporting families.

• Increased focus on ongoing and preventative care for supporting families is a potential growth area for social workers in mental health.

     

听障青少年的污名及其应对策略

任何人类差异都可能成为污名的对象。在社会差别的分类审视下,听障青少年遭遇的污名类型多种多样。从综合视角来看,可分为三类:形象可怕怪异,令人恐惧;身体无用低能,形同朽木;境遇窘迫不堪,让人可怜。在面对这些污名威胁时,他们管理身体与预设的规则体系进行周旋,业已发展出三种污名应对技术:一是身体改造,常态身体的追求;二是身体装扮,秘密信息的管理;三是身体抗争,弱者的对话方式。研究此问题,不仅有利于我们走进听障群体的世界,帮助他们远离污名的困扰,也可以增加社会的相互理解、信任与支持,推动社会的和谐融合。     

Understanding stillbirth stigma: A scoping literature review

BackgroundThe World Health Organization, and the 2011 and 2016 Lancet Stillbirth series as well as medical and scientific literature, have all called for stillbirth stigma to be reduced. However, few studies have explored or attempted to conceptualise the meaning of stigma in the context of stillbirth.AimTo explore the current knowledge surrounding stillbirth stigma, specifically the extent, type and experiences of bereaved parents.MethodsA five-stage scoping review framework was utilised. A search of relevant databases (MedLine, EMBASE, PsychInfo, PsychArticles, and Ovid Emcare) was undertaken with several key words related to ‘stillbirth’ and ‘stigma.’ The reference lists of included studies were also searched.FindingsA total of 23 resources met the inclusion criteria for this review. A thematic analysis regarding how stigma was conceptualised and/or experienced within results and/or discussion was employed on these studies. Five over-arching themes, with several sub-themes, were discovered: Type of stigma, identity, silence, bereaved mothers’ experiences of stigma in low-income countries and transformation.DiscussionStillbirth stigma remains an under-researched topic. Few articles conceptualised the experiences of the bereaved parent within a stigma framework. However, examples of bereaved parents enduring stigma were found within the literature. Common stigmatising experiences included, bereaved parents’ identities being challenged; and feelings of shame, guilt, and blame after their stillbirth. Stigmatising experiences could be different based on the bereaved parent’s cultural background.ConclusionFurther research which attempts to conceptualise stillbirth stigma and explores those experiences from a bereaved parent perspective is needed to help inform stigma reduction strategies.     

残疾污名的研究进展与展望

残疾污名是针对残疾人负面的刻板印象而引发的偏见和歧视,其消极影响渗透残疾人个人生活和社会参与的诸多方面。现有研究对其成因的解释越来越注重社会文化背景因素。公众污名和自我感知污名是污名测量的主要内容,使用的方法以外显态度测量和内隐社会认知方法为主。当下残疾污名干预的研究主要围绕增加群际接触来改变公众对残疾群体的偏见,采用积极心理干预改变个体自我认知,通过融合教育塑造包容、共享的社会文化三个方面来进行。未来研究可以围绕污名影响的保护机制、残疾人内化污名的差异、残疾污名测量的优化、污名干预效果的评估及干预方式的改进等方面进行。     

Stigma mitigation and the importance of redundant treatments

Disgust can evoke strong behavioral responses. Sometimes these extreme visceral responses can lead to stigmatization—an overreaction to a risk. In fact, disgust may be so inhibiting that it leads people to refuse to consume completely safe items, such as treated drinking water, leading to important economic and policy implications. Using economic experiments, we provide a measure of the behavioral response to disgust. Our findings suggest that when monetary incentives are provided, the behavioral response may have been exaggerated by previous studies that have relied on survey methods. Furthermore, mitigation steps successfully reduce the stigma behavior. In fact, the results suggest that stigma is primarily reduced not by a specific mitigation step taken but by how many steps are taken consecutively. These results have important implications for policies addressing issues such as the global shortage of drinking water. Some efforts to resolve the shortage have involved recycled water that is completely safe to drink but is often rejected because of reactions of disgust.     

An in-depth mixed-methods approach to Ryan White HIV/AIDS care program comprehensive needs assessment from the Northeast Georgia Public Health District: The significance of patient privacy,psychological health,and social stigma to care

We apply a social-ecological interpretive framework to understanding relationships among patient privacy, psychological health, social stigma, and continuity in care in the HIV treatment cascade in the rural southeastern US. This research was conducted as part of the 2013 comprehensive needs assessment for the Northeast Georgia Ryan White Consortium using an anthropologically informed mixed-methods design, and a deductive-inductive approach to thematic analysis of qualitative data obtained in interviews and focus groups with service providers and service utilizers. Our comprehensive needs assessment yielded two key components. First, we identified salient phenomena influencing introduction to, retention among, and satisfaction of patients in the Ryan White-coordinated treatment cascade in NE-GA. Second, we formulated actionable recommendations around leverage points identified in the current district-wide system of care. Results highlight spatial, institutional, and interpersonal aspects of the system of care that intersect around issues of patient privacy, psychological health, and social stigma. These intersections constitute pathways by which persons living with HIV are exposed to stigma and other negative social signals regarding their health status without sufficient access to behavioral health services. These negative issues, in turn, can erect significant barriers to long-term continuity in care.     

The Mark of Madness

Abstract

Stigma is a major barrier to recovery for individuals with mental illnesses. It interferes with community living and attainment of resources and goals and damages self-esteem and self-efficacy. Given that social workers provide much of the mental health care to individuals with mental illnesses, and that actions to reduce stigma support the social justice mission of social work, addressing stigma should be a focus of social work interventions. The goals of this paper are to explore stigma theory in general and for individuals with serious mental illnesses, discuss the implications of this stigma analysis for social work, and make recommendations for action in both practice and research.     

How do health professionals support pregnant and young mothers in the community? A selective review of the research literature

BackgroundThe cultural phenomenon of “teenage pregnancy and motherhood” has been socially constructed and (mis)represented in social and health care discourses for several decades. Despite a growing body of qualitative research that presents an alternative and positive view of young motherhood, there remains a significant gap between pregnant and young women's experience of young motherhood and current global health and social policy that directs service delivery and practice.AimThis paper aims to heighten awareness of how a negative social construction of young motherhood influences global health and social policy that directs current community health models of practice and care for young mothers in the community.DiscussionThere is clear evidence on the vital role social support plays in young women's experience of pregnancy and motherhood, particularly in forming a positive motherhood identity. This discussion paper calls us to start open and honest dialogue on how we may begin to re-vision the ‘deficit view’ of young motherhood in order to address this contradiction between research evidence, policy discourse and current practice and service provision. Qualitative research that privileges young women's voices by considering the multidimensional experiences of young motherhood is an important step towards moving away from universally prescribed interventions to a non-standard approach that fosters relational and responsive relationships with young mothers that includes addressing the immediate needs of young mothers at the particular time.