Stigmatizing Experience and Structural Discrimination Associated with the Treatement of Schizophrenia in Hong Kong  

Oleh:

Sing, Lee ; Chiu, Marcus Y. L. ; Tsang, Adley ; Chui, Helena ; Kleinman, Arthur

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 7 (Apr. 2006), page 1685-1696.
Topik: SCHIZOPHRENIA; schizophrenia; stigma; antiphsychotic medication; non adhesive adherence; structural discrimination; china; hong kong

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.3 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

This research examines the experience of stigma associated with psychiatric treatment among chinese patients with schizophrenia in hong kong. In focus groups patients described stigma experiences related to clinic visits and the side effects of antipsychotic medications. Additionally, they revealed various adverse treatment experiences during hospitalization which point to the presence of structural discrimination, Based on the focus group findings, a questionnaire was developed and completed by 320 and 160 patients with schrizphrenia and diabetes mellitus repsectively. Results showed that patients with schizophrenia were more likely to anticipate stigma, conceal illness and default of clinic visits than patients with diabetes. Medication induced stigma occured in 48% of patients with treatment non adherence. Adverse experiences during hospitalization were reported by 44% of patients with schizophrenia. They included negative staff attitudes, excessive physical / chemical restrains, inadequate information / complaint systems and limited rights. We conclude that stigma, at both individual and structural levels, represents a central experience of the treatment of schizophrenia in hong kong. Because inequaitable health policy, resource allocation, and service organization privilege service providers control over users, treatment related stignma may be a prime example of the social production of stigma and discrimination based on power difference between the stigmatizers and the stigmatized. To examine this critically we need to redirect stigma research to tractable clinical circumstances and structural mechanisms that produce and maintain stigmatizing and discriminatory psychiatric practice. Destigmatization prgorams must be evaluated not only by change in public attitudes but also by how much they reduce structural stigma and improve patients' lives.

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