PPN201 - Week 12 Stigma/Career planning

Article 1 - Earnshaw and Quinn, 2011 - impact of stigma on chronic illness (CI)

Approx half of adults are livng with CI, many whom may feel stigmatized by their CI in different context
- explored impact of internalized, experienced and anticipated stigma in healthcare setting

3 types of stigma

Internalized
Experience
Anticipated

Internalized stigma

- ppl endose negative beliefs/feelings associated w their stigmatized attribute and apply them to the self
- feelings of shame, guilt, diminished self worth, embarrasment, dirty/diseased
- intrapersonal phenomenon
- embodied by ppl w CI, may be brought into healthcare stting

Experienced/encated stigma

Percieved discrimination
- extent to which ppl percieve that they have exp. stereotyping, prejudice, discrimination
- percieved by ppl w CI thru interpersonal lens

Anticipated stigma

experience of stereotyping, prejudice, discrimination directed at them from others in futures
- Increased anticipated stigma = increased physiological stess
- originates from internalized/exp. stigma = intra/interpersonal pheonmenon

Article 2 - Jerpseth et Al. - Body as a mirror of shame

COPD study
- Growing and large health problem
- 11.8% of men and 8.5% of women
- Shed light on pt w COPD and their exp of shame

3 main themes identified in Jerpseth et al.

1. Body as a mirror of shame
2. Sense of being unworthy
3. Sharing burden = difficult

1. Body as a mirror of shame

- own bodies viewed as disgusting, a tradegy, decitful and shameful
- pt worries linked to their loss of a body that they once could trust in and gave them an identity of being strong
- decreased self image

2. Sense of being unworthy/invisibile/powerless

- Disease as a weakness in themselves as humans
- Took it for granted that disease was proof they did something wrong (e.g. smoking) and therefore got what they deserved
- Felt that they had no right to complain and/or make any requests/demans

3. Sharing the burden is too difficult

- Repeated exacerbations made pt feel concerned about their bodily signals and gave them feelings of loss of control/solitude
- Some exp that they had no one to talk to or share burden w

Discussion in Jerpseth et al.

Burden of disease further reinforced by exp. of shame d/t disease/bodily deterioration
- A little dot, a burden, reduced to zero = being unworthy
- Self-criticisim = a form of problem solving strat, wherby emotions may be regulated if feeling of shame justified

Conclusion of Jerpseth et al.

Shame, Guilt, and self blame d/t peoples own perceptions of themselves
- in doubt whether worthy to recieve care/comfort
- internalized the moral norms of society and understanding that the disease, and especially a self-inflicted disease = personal weakness