Family Care giving in Bipolar disorder: Experiences of Stigma
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Abstract
Background: Stigma is a serious impediment to the well-being of those who experience it. Many family- caregivers are challenged by the stereotypes and prejudice that result from misconceptions about bipolar disorder. Objective: The purpose of this study was to explore the stigma experienced by family caregivers of patients with bipolar disorder.
Methods: This was a qualitative and phenomenological study. In this study, we selected the family caregivers of patients with bipolar disorder in a psychiatric hospital (Iran) using purposive sampling in 2011. By reaching data saturation, the number of participant was 12. Data were gathered through in-depth interviews and analyzed by the "Collaizi" method .
Result: Stigma was a pervasive concern to almost all participants. Family caregivers of patients with Bipolar disorders reported feelings and experiences of stigma and were most affected by them. Analysis of the interviews revealed 3 themes: Negative judgment, Shame, Stigmatization and Social Isolation.
Conclusion: For a person with bipolar disorder, this illness is associated with the following problems: worse recovery, difficulty accessing health services, receiving poor treatment and support, and difficulty gaining community acceptance. Rejection of people with mental illness might also affect their family caregivers at various levels.
Palpant RG, Steimnitz R, Bornemann TH, Hawkins K. The carter center mental health program: Addressing the public health crisis in the field of mental health through policy change and stigma reduction. Prev Chronic Dis 2006; 3: 1-6.
Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RMA, Petukhova M, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the national comorbidity survey replication. Arch Gen Psychiatry 2007; 64: 543–552.
Bauer M, Pfennig A. Epidemiology of Bipolar Disorders. Epilepsia 2005; 46 Suppl 4: 8-13.
Waraich P. Goldner EM, Somers JM, Hsu L. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004; 49: 124-138.
Stang P, Frank C, Ulcickas Yood M, Wells K and Burch S. Impact of Bipolar Disorder: Results from a Screening Study. Prim Care Companion J Clin Psychiatry 2007; 9: 42-47.
Miklowitz DJ. Bipolar Disorder: A Family-Focused Treatment Approach, 2nd. New York: The Guilford Press; 2008.
Corrigan PW, Watson AC. Understanding the Impact of Stigma on People with Mental Illness. World Psychiatry (WPA) 2002; 1: 16-20.
Phillips MR, Pearson V, Li F, Xu M, Yang L. Stigma and Expressed Emotion: A Study of People with Schizophrenia and Their Family Members in China. Br J Psychiatry 2002; 181: 488-493.
Struening EL, Perlick DA, Link BG, Hellman F, Herman D, Sirey JA. Stigma as a Barrier to Recovery: The Extent to Which Caregivers Believe Most People Devalue Consumers and Their Families. Psychiatr Serv 2001; 52: 1633-1638.
Gonzalez JM, Perlick DA, Miklowitz DJ, Kaczynski R, Hernandez M, Rosenheck RA, et al. Factors Associated with Stigma among Caregivers of Patients with Bipolar Disorder in the Step-Bd Study. Psychiatr Serv 2007; 58: 41-48.
Van Brakel WH. Measuring Health-Related Stigma--a Literature Review. Psychology, health & medicine 2006; 11: 307-334.
Suto M, Livingston JD, Hole R, Lapsley S, Hinshaw SP, Hale S, et al. Stigma shrinks my bubble: a qualitative study of understandings and experiences of stigma and bipolar disorder. Stigma Res Action 2012; 2: 85-92.
Corrigan P. How stigma interferes with mental health care. Am Psychol 2004; 59: 614–25.
Perlick DA, Miklowitz DJ, Link BG, Struening E, Kaczynski R, Gonzalez J, et al. Perceived stigma and depression among caregivers of patients with bipolar disorder. Br J Psychiatry 2007; 190: 535-60.
Link BG, Yang LH, Phelan JC, Collins PY. Measuring mental illness stigma. Schizophr Bull 2004; 30: 511-541.
Riebschleger J, Scheid J, Luz C, Mickus M, Liszewski C and Eaton M. How Are the Experiences and Needs of Families of Individuals with Mental Illness Reflected in Medical Education Guidelines? Acad Psychiatry 2008; 32: 119-126.
Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people with mental illness: A review of population stud¬ies. Acta Psychiatr Scand 2006; 113: 163–179.
Ghanean H. Nojomi M. Jacobsson L. Internalized Stigma of Mental Illness in Tehran, Iran. Stigma Res Action 2011; 1:11-17.
Lim L, Nathan P, O’Brien-Malone A, Williams S. A qualitative approach to identifying psychosocial issues faced by bipolar patients. J Nerv Ment Dis 2004; 192: 810–817.
Pollack LE, Aponte M. Patients’ perceptions of their bipolar illness in a public hospital setting. Psychiatr Q 2001; 72: 167–179.
Michalak E, Livingston JD, Hole R, Suto M, Hale S, Haddock C. ‘It’s something that I manage but it is not who I am’: Reflections on internalized stigma in individuals with bipolar disorder. Chronic Illn 2011; 7: 209–224.
Ng CH. The stigma of mental illness in Asian cultures.Aust N Z J Psychiatry 1997; 31: 382-390.
Speziale HS, Carpenter DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative, 3nd. Philadelphia: Lippincott Williams& Wilkins; 2007.
Manen MV. Researching lived experience: Human science for an action sensitive pedagogy. Albany: State University of New York Press; 1990.
Lopez KA, Willis DG. Descriptive versus interpretive phenomenology: Their contributions to nursing knowledge. Qual Health Res 2004; 14: 726-735.
Wojnar DM, Swanson KM. Phenomenology: An Exploration. J Holist Nurs 2007; 25: 172-180.
Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1978.
Polit DF, Beck CT. Essentials of Nursing Research: Methods, Appraisal, and Utilization, 6eds. Philadelphia: Lippincott Williams & Wilkins; 2006.
Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Soc Sci Med 2010; 71: 2150–2161.
Goossens PJ, Van Wijngaarden B, Knoppert-van Der Klein EA, Van Achterberg T. Family Caregiving in Bipolar Disorder: Caregiver Consequences, Caregiver Coping Styles, and Caregiver Distress. Int J Soc Psychiatry 2008; 54: 303-316.
Gonzalez-Torres MA, Oraa R, Aristegui M, Fernandez-Rivas A and Guimon J. Stigma and Discrimination Towards People with Schizophrenia and Their Family Members. A Qualitative Study with Focus Groups. Soc Psychiatry Psychiatr Epidemiol 2007; 42: 14-23.
Larson JE, Corrigan P. The Stigma of Families with Mental Illness. Acad Psychiatry 2008; 32: 87–91.
Angermeyer MC, Schutze B, Dietrich S. Courtesy stigma: a focus group study of relatives of schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 2003; 38: 593-602.
Phelan JC, Bromet EJ, Link BG: Psychiatric illness and family stigma. Schizophr Bull 1998; 24: 115–126.
Ohaeri JU, Fido AA. The opinion of caregivers on aspects of schizophrenia and major affective disorders in a Nigerian setting. Soc Psychiatry Psychiatr Epidemiol 2001; 36: 493–499.
Raguram R, Raghu TM, Vounatsou P, Weiss MG. Schizophrenia and the cultural epidemiology of stigma in Bangalore, India. J Nerv Ment Dis 2004; 192: 734-744.
Srinivasan TN, Thara R. Beliefs about causation of schizophrenia: Do Indian families believe in supernatural causes? Soc Psychiatry Psychiatr Epidemiol 2001; 36: 134-140.
| Files | ||
| Issue | Vol 8 No 4 (2013) | |
| Section | Articles | |
| Keywords | ||
| Bipolar disorder Family caregiver Phenomenology Stigma | ||
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