A Study Of Stigma Of People With Schizophrenia And Relationships Wth Self-esteem And Social Support

Objectives1.To describe the status and experience of stigma of people with schizophrenia in China.2.To identify the factor interefered with stigma from patients's general data.3.To analyze the relationships of patients's stigma with self-esteem,social support.MethodsThis study used Link's labeling theory as direction, and used quantitative research and qualitative research method of combining,selected 208 inpatients with schizophrenia in recovered period in a mental illness hospital in Shandong Province.Perceived Devaluation- Discrimination, Coping Orientations and Stigma-Related Feelings Scales were administer- ed to assess the stigma of patients,and the relative factors of stigma were evaluated by using a self-made questionnaire,Self-Esteem Scale and Social Support Scale. And selected 10 typical patients from 208 for intensive interview,to describe the stigma experiences of patients.Results1.The average score of the perceived devaluation-discrimination scale was 2.63±0.31, significant higher than the 2.50 midpoint(P<0.01). Prompted that patients strongly perceived derogatory and discriminatory attitudes of others,especially in terms of job and marriage friends. The means of five coping dimensions were significant higher than the2.50 midpoint, most patients accepted the five coping styles; When faced with the threat of demeaning and discriminatory, the schizophrenic patients were the primary way to respond to the challenge and education, and most patients were being misunderstood, The only dimension with average score lower than the midpoint was the stigma-related feelings of different and ashamed. 2.In eight dimensions of stigma,there were different in age, education level, marriage condition, profession, family economic status, course of disease, incidence of disease, number of admissions factors significantly(P<0.05). Patients's education level, place of residence, incidence of disease were the influencing factors of stigma, but these factors affected the stigma of patients slightly.3.Five dimensions of stigma(perceived devaluation-discrimination, secrecy, with- drawal, misunderstanding, different dimensions of shame) in schizophrenia patients were significantly negatively correlated to self-esteem(r=-0.161～-0.458, P<0.05), challenges dimension were positively related to self-esteem(r=0.269, P<0.05).4.Two dimensions of stigma(perceived devaluation-discrimination, misunderstood) in schizophrenia patients were significantly negatively correlated to social support (r=-0.140～-0.350, P<0.05), Three dimensions of stigma (education, challenges, separation) were positively related to social support(r=0.157～0.241, P<0.05).5.Through the analysis of interviews, refined five themes of the stigma experiences: passive treatment;painful experiences of discrimination;negative emotional experience; helpless sense of stigma;confusion and expectations for the future.Conclusions1.People with schizophrenia frequently suffered from stigma, and stigma to the patient's life had a negative effect.2.The factors related to stigma of schizophrenia patients may include self-esteem, social support status. Therefore,improving the patients's social support, improve self- esteem levels of patients, repling positively for stigma, can reduce the stigma of patients.3.Suggestions generated by the study to nursing care:results of this study provided insight into the psychological of people with schizophrenia, provided information on adherence for mental health workers to carry out community-based rehabilitation inter- ventions and to provide new clues and ideas. In addition, provided reference information for the development of Chinese cultural characterized phenomenological psychiatric nursing research.