• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.349-363
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• 2016

Purpose: This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. Methods: The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group =32, control group =32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using ${\chi}^2-test$, t-test, repeated measures ANOVA with the SPSS program. Results: Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. Conclusion: Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.

• Human Ecology Research
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• v.61 no.1
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• pp.123-139
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• 2023

The study examined the mediating effect of internalized shame on the relationship between affiliate stigma and interpersonal anxiety among adolescents with siblings who had autism spectrum disorder (ASD) and the moderated mediating effect of mother-adolescent communication openness. The participants consisted of 139 adolescents (boys 48.9%, high-school students 79.8%) who had siblings with ASD. Interpersonal anxiety, affiliate stigma, internalized shame, and mother-adolescent communication openness were measured using the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998), the Affiliate Stigma Scale (Mak & Cheung, 2008), the Internalized Shame Scale (Cook, 1988), and the Parent-Adolescent Communication Scale (Barnes & Olson, 1982), respectively. The data were analyzed using descriptive statistics and Pearson's correlation coefficients. Process Macro Models 4 and 7 were used to examine the mediating effect and the moderated mediating effect. The results indicated that internalized shame mediated the effect of affiliate stigma on interpersonal anxiety among adolescents who had siblings with ASD. However, there was no significant moderated mediating effect of mother-adolescent communication openness on the relationship between affiliate stigma, internalized shame and interpersonal anxiety. These findings suggest that it is necessary to improve social awareness of individuals with ASD and their family members to prevent adolescents who have siblings with ASD from having affiliate stigma and to help them reduce interpersonal anxiety. The results also highlight the importance of counseling programs for adolescents with siblings with ASD as a way of preventing or alleviating their interpersonal anxiety by reducing internalized shame, even where they experience affiliate stigma.

• Journal of East-West Nursing Research
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• v.24 no.1
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• pp.70-80
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• 2018

Purpose: This study was conducted to explore the mediating effects of internalized stigma on the relationship between hospitalization stress and quality of life among patients with mental illness in closed wards. Methods: A cross-sectional study design was employed. The participants were 141 hospitalized patients with mental illness in the closed wards of K university hospital and Y psychiatric hospital in Korea. Data were collected using self-report questionnaires including hospitalization stress, internalized stigma and quality of life. Data were analyzed using SPSS 21.0 and AMOS 21.0 programs and the mediating effects were examined by the method suggested by Baron and Kenny. Results: There was a significant correlation between hospitalization stress, internalized stigma and quality of life of psychiatric patients. In addition, internalized stigma was found to have a partial mediating effect on the relationship between hospitalization stress and quality of life. Conclusion: The results suggest that the internalized stigma plays an important role in improving the quality of life of the people with mental illness in a closed unit. Therefore, it is necessary to develop a program focusing on internalized stigma for improving the quality of life in hospitalized patients in a closed unit.

• Korean Journal of Occupational Health Nursing
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• v.22 no.2
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• pp.140-148
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• 2013

Purpose: The purpose of this study was to identify turnover intentions in workers with mentally disabilities working in manufacturing industry. Methods: Participants were 147 workers with mentally disabled living in B-city and Y-city. The data were collected from September 1st to November 30th, 2011 using self-report questionnaires including measurements of turnover intentions, family support, work volition, working environment, job satisfaction and internalized stigma. Data analysis was done using the SPSS/WIN 18.0 program. Results: The average score for turnover intention was $2.9{\pm}0.7$. Turnover intention was related to job satisfaction, working environment, family support and internalized stigma. The predicting factors for turnover intention were job satisfaction, internalized stigma and gender. Those factors accounted for 41.9% of turnover intention. Conclusion: The results imply that workers with mentally disabled need to reduce internalized stigma as well as to increase job satisfaction in order to decrease turnover intention.

• Journal of Home Health Care Nursing
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• v.26 no.2
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• pp.189-198
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• 2019

Purpose: The purpose of this study was to investigate the associations of mental health recovery to internalized stigma and meaning in life of community-dwelling people with mental disorder. Methods: Participants were 150 people with mental disorder who were enrolled at one of the community mental health institutions in D, S, and U cities, South Korea. Data analyses included a descriptive analysis, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using SPSS 25.0 software. Results: There were significant mean differences in mental health recovery according to education, religion, residential status, diagnosis, and day program use status of people with mental disorder living in the community. The significant predictors of mental health recovery included presence of meaning, stigma resistance, diagnosis (Major depressive disorder), and search for meaning. The regression model explained 58.7% of mental health recovery. Conclusion: Improving meaning in life and stigma resistance will increase the chances of mental health recovery among community- dwelling people with mental disorder.

• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.56-65
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• 2019

Objectives: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. Methods: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. Results: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. Conclusion: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.216-225
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• 2023

Background: Tuberculosis (TB)-related stigma has been well-documented. Since the emergence of the coronavirus disease 2019 (COVID-19), different organizations have been alerted to the fact that stigma could arise again. Due to stigma's negative effects, this qualitative study aimed to explore the stigma felt by patients by evaluating the following: COVID-19 stigma and its temporal progression through the pandemic; stigma perceived by different patients with TB before and during COVID-19 pandemic; and difference perceived by individuals who contracted both diseases. Methods: A semi-structured interview was developed according to the available literature on the theme. It was performed individually in 2022 upon receiving signed informed consent. Participants were recruited with a purposive sampling approach by searching medical records. Those who currently or previously had pulmonary TB and/or COVID-19 were included. Data were subjected to thematic analysis. Results: Nine patients were interviewed, including six (66.7%) females. The median age of patients was 51±14.7 years. Four participants (44.4%) had completed high school and four (44.4%) were never smokers. Three had both TB and COVID-19. Four only had TB and two only had COVID-19. Interviews identified eight main themes: knowledge and beliefs, with several misconceptions identified; attitudes towards the disease, varying from social support to exclusion; knowledge and education, assumed as of extreme importance; internalized stigma, with self-rejection; experienced stigma, with discrimination episodes; anticipated stigma, modifying actions for avoiding stigma; perceived stigma, with judgment by others prevailed; and temporal evolution of stigma. Conclusion: Individuals expressed strong stigma for both diseases. De-stigmatization of respiratory infectious diseases is crucial for limiting stigma's negative impact.

• Korean Journal of Schizophrenia Research
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• v.20 no.2
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• pp.37-43
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• 2017

Objectives : This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. Methods : This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). Results : Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. Conclusion : Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

• Journal of Industrial Convergence
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• v.21 no.7
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• pp.93-104
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• 2023

This study was designed to evaluate effects of Patients Empowerment Program for Schizophrenia (PEPS) on Empowerment, Internalized Stigma, Self-esteem, and Quality of Life, in people with chronic schizophrenia living in a rural community. A non-equivalent control group repeated measures design was used. Participants were 22 persons with chronic schizophrenia enrolled from O Province Mental Health Welfare Center, South Korea. (experimental group= 10, control group = 12). The PEPS was administered to the experimental group, consisting of 16 sessions delivered twice a week for 8 weeks. SPSS/WIN 26.0 was used to analyze the collected data using χ²-test, independent t-test, Fisher's exact test, and repeated measures ANOVA. Upon completion of PEPS, the experimental group showed a significantly increased in Self-esteem (F=6.09, p=.005) and Quality of Life (F=3.37, p=.044) as compared to the control group. However, there was no significant difference between the two groups between Empowerment and Internalized Stigma. The results suggest that the PEPS may be an effective intervention for improving Self-esteem and Quality of Life.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.243-253
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• 2023

Purpose: This study conducted a concept analysis to clarify the meaning of anxiety in hospitalized patients with infectious diseases who have been placed in isolation. Methods: This study used Walker and Avant's process of concept analysis. Results: Anxiety in hospitalized patients with infectious diseases who have been placed in isolation can be defined by the following attributes: 1) fear, 2) guilt, 3) isolation, 4) discrimination, 5) frustration, 6) shame, and 7) uncertainty. The antecedents of anxiety were as follows: 1) a lack of information about infectious diseases, 2) restrictions of movement, 3) blockage of the social support system, 4) helplessness, and 5) negative biases. The consequences of anxiety were 1) internalized stigma, 2) loss of confidence, 3) lack of social activities and avoidance, 4) insomnia, 5) poor quality of life. Conclusion: The definition and attributes of anxiety identified in this study can be applied to enhance the understanding of anxiety in hospitalized patients with infectious diseases who have been placed in isolation. Systematic suppose should also be provided to reduce anxiety in these patients.