Depression is a common and disabling mental illness, but the loneliness, isolation, and poor quality of life associated with depression may improve with treatment. Depressive patients adhere to their treatment and experience better outcomes when their family members are involved with their treatment. At the project mental health facility, patients with depression had the highest non-compliance rate to treatment and no educational program existed for their families. This observation led to the current practice-focused question which examined how an evidenced-based educational program can be developed for family members or caregivers of patients diagnosed with depression. The purpose of this project was to assemble a team of experts to develop and plan an educational program about living with depression for family members or caregivers of patients diagnosed with depression. This project was guided by Jean Watson's theory of human caring and the view of health as harmony of mind, body, and soul. The educational program was planned using reviewed research studies with the input of a team of local experts consisting of a psychiatrist, a licensed therapist, a mental health nurse practitioner, registered nurses, and medical assistants. The project resulted in a four session educational program, a manual of policies and procedures, and recommendations for implementation and evaluation of the education. The educational program resulting from this project has the potential to improve the health and well-being of patients with depression and their families, decrease the stigma they face, and contribute to positive social change.

Even before 9/11, there has been a long history of attitudes and public policies that were biased against people of Middle East descent in the United States--regardless of whether or not they are Muslim. This research uses Status Characteristics Theory (SCT) and stigma theory to examine whether there is low status or stigma associated with the Muslim religion and Middle Eastern ethnicity in the United States. By doing so, the research expands upon previous studies of stigma to explore the social psychological processes involved during interactions between the stigmatized and non-stigmatized. This study used experimental data, survey data and qualitative data collected from samples of undergraduate students using designs conceptualized specifically for this research. I conducted an experiment and a Web vignette-survey using undergraduate students from a Midwestern university. The findings of the experiment showed that that European American subjects paired with the Middle Eastern female partner not wearing a hijab and the Muslim Middle Eastern female partner wearing a hijab were influenced more and held more positive perceptions of their partners than did the subjects paired with the European American female partner. In contrast, the results of the Web vignette-survey indicate that the European American target applicant is more likely to be selected for the leadership position than either of the Middle Eastern target applicants (with or without hijab). Furthermore, the results of the social distance measures indicate that knowing someone from the Middle East (e.g. previous contact with a Middle Easterner) decreased the likelihood of social distance from the Middle Eastern target with hijab and without hijab across the vignette conditions. This suggests that there might be less of a tendency for individuals who have had personal contact and interacted with people from the Middle East to take the "us versus them" perspective, which is necessary in order to carry out the process of stigmatization.

Background Loneliness, or the perceived discrepancy between the quantity and quality of ones’ actual social relationships and desired level of connectedness, is a potentially important psychosocial factor in lung cancer patients. The purpose of the current study was to investigate the relationship of loneliness to depressive symptoms, quality of life, and social-cognitive variables and to explore the role of loneliness in mediating relationships between social-cognitive variables and depressive symptoms and quality of life. Finally, the study examined whether loneliness predicted change over time in depressive symptoms and quality of life. Methods Lung cancer patients were recruited from the Moffitt Cancer Center Thoracic Oncology Clinic to complete two study questionnaires via hard copy or online. Participants completed measures of loneliness (UCLA V3), depressive symptoms, (CES-D) and quality of life (FACT-L) at baseline and 30 days later. Participants also completed measures of demographic characteristics and social-cognitive variables, including cancer-related stigma (CLCSS), cancer-related negative social expectations (CNSES), social constraint (SCS), avoidant coping (CRI – avoidant coping), and beliefs about one’s ability to cope with cancer (CBI-B) at baseline. Clinical characteristics were assessed via medical record review. Results Participants (n = 109) reported a low to moderate level of loneliness (M = 33.8), and 38% reported clinically significant (CES-D > 16) depressive symptoms. Quality of life in the current study (M = 98.1) was consistent with normative FACT-L data collected from a sample of lung cancer patients. Loneliness was positively correlated with depressive symptoms (r = .44) and negatively correlated with quality of life (r = -.59). In addition, loneliness was positively correlated with social-cognitive variables in the expected directions and social-cognitive variables were related to depressive symptoms and quality of life in the expected directions (p’s < .001). Mediation analyses yielded evidence for partial mediation, with loneliness mediating the relationships of social-cognitive variables with depressive symptoms and quality of life for nine of the ten models tested. The exception was findings showing that loneliness did not mediate the relationship between beliefs about one’s ability to cope with cancer and depressive symptoms. Loneliness at Time 1 predicted additional variance in depressive symptoms at Time 2 (Β = .38, Adj R2 = .31) after accounting for depressive symptoms at Time 1, but loneliness at Time 1 did not account for additional variance in quality of life at Time 2 after accounting for quality of life at Time 1. Conclusions Results suggest that consideration of loneliness is important in order to understand differences in depressive symptoms and quality of life in lung cancer patients. Beyond its direct impact on clinically relevant outcomes, the experience of loneliness may be the mechanism by which social-cognitive factors influence depressive symptoms and quality of life. Investigation of the relationship between stigma and loneliness in the context of lung cancer is particularly novel and warrants further exploration.

This research explores areas of contention in the mental heath field in Australia through a qualitative analysis of voices and practices that can broadly be seen as talking with and talking back to psychiatry. The thesis is informed by key shifts in thinking that underpin postpsychiatry and analyses a set of materials through an interpretive lens of reading psychiatry against the grain (Bracken & Thomas, 2005; Lewis, 2006). In particular, it examines a failed ethics application to conduct research with people diagnosed with a mental illness, an anti-stigma campaign, the practices of some prominent mental health organisations in Australia, a conversation with two members of an emerging consumer/survivor network in Australia, and a television documentary and online discussion forum about an antidepressant medication. The research draws from discourse analytic methods and concepts from social movement framing research to identify factors shaping conformity and resistance to psychiatric doxa in the Australian mental health field. The research identifies the discursive repertoires that characterise the mental health field as a "game" in which competing perspectives vie for recognition. In relation to research ethics committees, the thesis argues that deference to clinical expertise is a potential barrier to cultural studies of psychiatry and a more inclusive agenda in mental heath research and practice. Some practices for ethics committees to consider when reviewing research that involves people who may have been diagnosed with a mental illness are proposed. The research also identifies problematic features of anti-stigma campaigns that direct their efforts toward protecting and promoting the discourse of biomedical psychiatry. A critique of this type of campaign is offered in relation to perspectives from postpsychiatry and social constructionism. On the basis of this research, it is argued that organisations that champion "mental health literacy" are limited in their ability to give voice to the goals and priorities of those who are calling for a more open, reflexive and democratic debate in mental health. The central argument of this thesis is that elevating first-person and postpsychiatry perspectives is necessary in order to interrogate and address the dominance of the medical model in psychiatry and its consequences.

This thesis explores the impact of hepatitis C on women’s childbearing decisions and experiences of motherhood. A partial grounded theory approach was used, in which 34 women living with hepatitis C participated in semi-structured interviews to determine the direct and indirect effects of hepatitis C on their own personal decisions regarding childbearing and to describe their lived experiences of motherhood. The qualitative interview data were analysed thematically, in which common themes were identified and explored.¶ Three key areas are explored: women’s social experience of hepatitis C; hepatitis C and childbearing decisions; and the meaning of motherhood for women with hepatitis C.¶ The interviews revealed that living with hepatitis C had direct effects on the childbearing decisions of women. The direct effects of the virus which impacted on women’s childbearing decisions included poor physical and emotional hepatitis C related health, the perceived risk of vertical transmission of hepatitis C, concerns their future hepatitis C related health might impact upon their mothering abilities, and childbearing can conflict with treatment for hepatitis C. However, of greater importance to these women, appeared to be the indirect effects of living with a virus which is so highly stigmatised within our society. In particular, hepatitis C is closely associated with injecting drug use, which means these women are often assumed to possess the stereotypical characteristics associated with injecting drug users. As a result, they experience widespread medical discrimination and social rejection. Hepatitis C also impacts indirectly upon a wide range of factors that most women in contemporary society take into consideration in their childbearing decisions, for example, available social support, financial security and age.¶ The experiences reported by these women are discussed in terms of their concordance or discord with prevailing theories of deviance, stigma and the social construction of motherhood. The interview data, considered in light of such theories reveal that possibly the greatest impact that hepatitis C can have upon women is to prevent them from achieving a legitimate adult female status through childbearing and becoming a ‘good mother’.¶ The implications of these findings are discussed in terms of public health and social policy.

Although attitudes toward stigmatised groups are difficult to change, education programs and opportunities that promote direct contact with people who have experienced mental illness have demonstrated success in increasing mental health literacy and reducing stigma surrounding mental illness. The present study examined the effectiveness of a mental illness education program directed at adolescents and the factors influencing its impact. A sample of 694 students (251 males, 443 females), aged between 11 and 19 years, across 13 public and private high schools and colleges throughout the ACT was obtained. Students completed self-report questionnaires relating to stigma, mental health knowledge and help-seeking intentions before and after participating in the education program and their results were compared with a control group. Students participating in the program also completed measures of empathic concern and affect immediately following the program. Results indicated the program was effective in decreasing stigma and increasing knowledge and intentions to seek help. The impact of knowledge, empathy, affect, and similarity to program presenters, on program outcomes was also examined. While the results showed that the combination of contact and education was effective in promoting attitude change, suggestions for improving the impact of the program are discussed.

Chronic pain has been identified as a major and underestimated health care problem, with extensive individual, social and economic ramifications. It has been estimated that the annual economic cost of chronic pain in Australia exceeds AU$34 billion. The available epidemiological evidence suggests chronic pain is a relatively common health problem in Australia which is a significant public health issue. Chronic pain is a complex phenomenon which is not easily defined. However, it is important to consider the ways in which chronic pain is conceptualised, as this can have significant implications for the individual in terms of how they think about their pain, and the way they are treated within the health care system and the broader society. In the late nineteenth and early twentieth centuries, pain was predominantly considered a symptom of a biological problem in the body. Absence of physical disease was thought to indicate pain was the result of aberrant psychological processes. However, chronic pain proved resistant to this ‘mind-body’ approach, and the lack of efficacy of many biomedical interventions, combined with an apparently increasing prevalence of chronic pain, pointed to the inadequacy of purely biomedical approaches to pain treatment. The latter part of the twentieth century saw the recognition of pain as a multidimensional experience influenced by the interaction of numerous biological, psychological and social factors. Consequently, the biopsychosocial model of health, which emphasised such a ‘holistic’ perspective, gained substantial recognition in the pain management domain, and was endorsed as the preferred model of pain management. This has contributed to the development of new approaches to chronic pain treatment, particularly in the area of cognitive behavioural therapy and the establishment of multidisciplinary pain centres. There is evidence, however, that the ‘promise’ of the multidimensional conceptualisation and treatment of chronic pain has not been realised in the daily lives of people with chronic pain. Review of the literature indicates a tendency for research and practice to focus on the biological and psychological aspects of chronic pain, while minimising social environmental factors, such as the health care system and cultural belief systems regarding pain, which may also be significant. This thesis proposes that in order to more comprehensively respond to the complex phenomenon of chronic pain, it is necessary to further develop the social domain of the biopsychosocial model. A study was conducted to explore and describe individual experiences of living with chronic pain, as a basis for improving knowledge about the influence of the social environment on the individual. The thesis focuses not only on the individual descriptions of living with chronic pain, but also on the inter-relatedness between the individual and their social environment. Further, this thesis uses a process of critical interpretive analysis to identify aspects of the social environment which can exert a constraining or enabling effect on the individual with chronic pain. The thesis draws on critical realism theory, particularly the morphogenetic approach developed by Archer (1995), to guide the analysis process and to develop potential strategies for addressing identified social disadvantages. The integration of the individual stories of living with chronic pain with an interpretive analysis process, and the underlabouring philosophical perspective of critical realism, provided the framework to investigate the influence of the social environment on individual experience of living with chronic pain. In this thesis, a journey metaphor is used as an overarching framework to tie together the three principal themes identified through the analysis of the interview transcripts. The themes focused on the biomedical, psychological and cultural paths that participants followed in search of understanding and cure for their pain; the social suffering they experienced through lack of understanding and legitimation of their condition; and the identification and development of strategies for living with chronic pain. The thesis highlights the critical importance of focusing not only on the individual with chronic pain but also on the social environment within which the individual lives, and the ways in which these domains intersect and influence each other. The social environment was found to condition the individual and others in society, including health care practitioners, in relation to how they think and behave regarding pain, which in turn can have enabling or constraining consequences for the individual with pain. In particular, cultural beliefs about ‘normal’ pain, and the material structures of the health care system and employment and work places, were found to have a potentially negative impact on the individual with pain. It is concluded that these aspects of society will continue to exert constraining influences on people’s lives until the focus of policy and practice is expanded to include not just the individual with pain, but also the social environment in which they live. To address this, a number of policy and practice improvements are suggested.

<p>Syftet med denna uppsats är att undersöka hur ungdomarna med utländsk bakgrund upplever sin arbetslöshet, hur arbetslösheten påverkar deras identitet och livsvillkor samt vilken inverkan det sociala nätverket har på deras arbetssökning. Eftersom syftet med studien var att generera kunskap baserad på ungdomars subjektiva erfarenheter valdes en kvalitativ metod intervjuer med sex arbetslösa unga invandrare i åldern 20 till 30 år. Syftet med denna metodstrategi var att via en temainriktad intervjuguide möjliggöra en ingående detaljbeskrivning av ungdomarnas identitetsupplevelser i olika sociala kontexter, samt att undersöka hur respondenternas livsvillkor och identitet påverkades av att vara arbetslösa och arbetssökande. Samtidigt utforskades andra förhållanden som syftade till att se hur respondenternas bakgrund påverkade deras förmåga att komma in på arbetsmarknaden, och vilka förväntningar respondenterna hade om framtiden på den svenska arbetsmarknaden.</p><p>Empirin analyserades mot bakgrund av mitt metodologiska tillvägagångssätt samt mina teoretiska teorier som har sin utgång i bl.a. Bourdieus begrepp om olika kapital, formella och informella kanaler, etnicitet samt stigmateorier. Vid analysen av data användes en hermeneutisk tolkningsstrategi för att identifiera och tolka innebörden i de centrala teman som ungdomarna berättade.</p><p>Resultatet visar att bristen på sysselsättning påverkar respondenternas välfärd negativt. Det framgick även att ungdomarna generellt har en positiv syn på möjligheten att inom en snar framtid få ett arbete, detta genom att ihärdigt fortsätta söka jobb parallellt med kompetensutveckling. Ungdomarna i studien uppfattar det sociala nätverkets vara av störst betydelse för deras möjlighet att få arbete, dock framgår det att de har ett begränsat socialt nätverk som är ytterst resurssnålt. Generellt uppfattar ungdomarna sin arbetssökning som stressade, även det rådande samhällsklimatet som resulterat i omfattande ekonomiska restriktioner skapar en stressfylld osäkerhet i ungdomarnas framtidsvisioner</p>

<p>The aim of the study was to reach a deeper understanding and knowledge about how women with an experience of prostitution perceive what this has meant for them and how it has influenced their lives. The questions of the study were: (1) How has the prostitution experience affected the women in their lives? (2) How have they learnt to deal with this experience? To answer these questions a qualitative method was used where interviews were conducted with four women with experience of prostitution. All women experienced that the prostitution had affected their lives. Examples given that inter alia relationships, sexuality, and self-image had been affected. This is largely dependent on that prostitution is stigmatized in our society and, hence, shameful. The women have dealt with their prostitution through therapy for a long duration. Through it they have received a new point of view on themselves, their relationships and their life. Today they are content with their lives, even so they can see that they host and have been affected by their experience. The results of the study have been analyzed from a fenomenological-hermeunutic research perspective and the tools for the analysis were symbolic interactionism, stigma theory and shame. The results are in concordance with earlier studies.</p>

<p>Många människor lockas av utmaningen att bilda familj och bli föräldrar. Denna C-uppsats handlar om hur politiker och tjänstemän anser sig kunna säkerställa funktionshindrade människors möjlighet att kunna välja och fullfölja föräldraskap och vilket samhällsstöd som erbjuds. Jag har använt mig av en kvalitativ metod nämligen halvstrukturerade kvalitativa intervjuer. Intervjuerna visade att detta var ett område som det inte har forskats eller pratats om i någon större utsträckning. Intervjupersonerna har inte arbetat med frågeställningen trots att flera av dem varit engagerade i handikappolitiken. Samhällets och arbetslivets tillgänglighet för människor med funktionshinder har varit i fokus men de har inte beaktat att vissa av de funktionshindrade även varit föräldrar. Genom delar av Goffmans teori om stigma och Luhmanns systemteori har intervjumaterialet nalyserats. Analysen visade att det sätt som vi kommunicerar om föräldrar med unktionshinder påverkar hur stigmatiserad föräldern ska bli samt att det är vi alla tillsammans – privatpersoner, politiker och tjänstemän med eller utan funktionshinder– som sinsemellan skapar denna kommunikation inom de olika sociala system vi ingår i och därmed vilka värderingar och attityder som blir rådande i samhället.</p>