Stigmatization has shown to negatively impact service members with Posttraumatic Stress Disorder (PTSD). Published research has shown stigma to significantly affect service members through increased suicide, homicide, unemployment, homelessness, and criminal justice system interaction rates. Additionally, stigma also affects overall readiness and cohesion of the military organization. However, little research has focused on the perceptions of Reserve Officer Training Corps (ROTC) cadets about service members with a combat-related stress disorder in which they will eventually be charged with leading. The purpose of this quantitative study was to measure a cohort of ROTC cadets and determine their perceptions about service members serving with PTSD. Socialization theory was used as the lens to measure ROTC cadet's acceptance into the military culture. The study population consisted of 14 cadets within 5 ROTC battalions in Louisiana. Fisher's exact test revealed no significant relationships among ROTC cadet's overall perceptions. However, valuable insight was discovered regarding religion and branch of service the cadets intended to commission with as potential significant variables regarding their perceptions about PTSD. Further research, including a larger population size, is still needed to determine how these perceptions impact currently serving service members. Implications for positive social change include improved knowledge about PTSD and the stigma associated with negative perceptions, which will improve education through socialization into the military culture and reduce suicide, homicide, criminal justice system interaction, homelessness, and unemployment rates in addition to improving the overall readiness and cohesion of the Armed Forces.

Självstigmatisering är en komplex process som innebär att personer riskerar att ta till sig negativa stereotyper och attityder som riktas mot dem. Under de senaste årtiondena har intresset ökat kring självstigmatisering men det finns fortfarande lite forskningen kring fenomenet. Syftet med studien var att beskriva självstigmatisering hos personer med schizofreni. Studien utfördes som en litteraturstudie, där åtta vetenskapliga artiklar har granskats och analyserats. Resultatet visade att det finns ett flertal olika faktorer som påverkar graden av självstigmatisering hos personer med schizofreni, bland annat antalet psykiatriska inläggningar och sjukdomens svårighetsgrad. Självstigmatisering visade sig också resultera i en negativ syn på sig själv och sina egna förmågor. Ytterligare kvantitativ forskning behövs, men det finns också ett stort behov av kvalitativ forskning som fokuserar på individens egna erfarenheter och upplevelser av självstigmatisering. Vården behöver bli bättre på att förstå och uppmärksamma självstigmatisering. Evidensbaserad omvårdnad behöver utvecklas utifrån omvårdnadsprocessens alla steg för att minska självstigmatisering. / Self-stigmatization is a complex process which implies that the person might internalize negative stereotypes and attitudes that are directed towards them. The interest for self-stigmatization has increased during the last decade, but there is still little research on the phenomenon. The aim of this study was to describe self-stigmatization amongst people with schizophrenia. The study was conducted as a literature study, where eight scientific articles were reviewed and analyzed. The results showed that the degree of self-stigmatization amongst people with schizophrenia was affected by a various of factors, including the number of psychiatric hospitalizations and the severity of the illness. Self-stigmatization also proved to result in a negative view on oneself and the own abilities. Further quantitative research is needed, but there is also a great need for qualitative research that focuses on individual’s own experiences. The health care needs to better understand and pay attention to self-stigmatization. Efforts in evidence-based nursing also needs to be developed based on all the steps in the nursing process to reduce self-stigmatization.

Bakgrund: Psykisk ohälsa är ett växande samhällsproblem. Attityder och upplevelse av stigmatisering inom hälso- och sjukvården kan påverka relationen i vårdmötet både positivt och negativt. För personer med psykisk ohälsa kan detta vara av särskilt betydelse. Syfte: I denna studie var syftet att undersöka patienters upplevelser av attityder hos vårdpersonal samt patienters upplevelser av självstigmatisering. Metod: En litteraturstudie med en kvalitativ ansats utfördes. Artiklar söktes i databaserna PubMed, CINAHL och PsychInfo och 22 vetenskapliga originalartiklar valdes ut primärt. Efter granskning utgjordes ett definitivt urval av 13 artiklar. Hildegard Peplaus omvårdnasteori valdes som arbetets teoretiska referensram. Resultat: Negativa attityder skildrades i interaktionen mellan patient och vårdpersonal i form av brist på visat intresse och upplevelser av att bli ifrågasatt, inte bli lyssnad på eller bli tagen seriös. Maktskillnader i relationen och diskriminering beskrevs även som negativa attityder. Positiva attityder innefattade stöd och empati, erfarenheter av att bli tagen seriös, lyssnad på och sedd bortom sjukdomen. Självstigmatisering framställdes som olika aspekter av en negativ självbild präglad av rädsla och skam, vilket medförde att deltagarna tvekade på sina förmågor. Undanhållande av sin psykiska ohälsa och upplevelser av att bli märkt med etiketter var också erfarenheter av självstigmatisering. Slutsats: Verksamheter inom vården bör arbeta kontinuerligt med personalens bemötande och attityder för att skapa en god vårdande miljö för patienten. En miljö där patienten upplever goda attityder minimerar risken att denne drabbas av negativa konsekvenser, såsom en negativ självbild. För att också ge bästa möjliga omvårdnad bör patientens upplevelse tas i beaktande i omvårdnadsprocessen. / Background: Mental illness is a growing societal problem. Attitudes and experiences of stigmatization in health care services can have both positive and negative effects on the patient-staff-relationship. For people with mental illness, this can be of particular importance.  Aim: The purpose of this study was to identify patients’ experiences of attitudes among health care personnel, along with patients’ experiences of self-stigmatization. Method: A litterary study based on qualitative research was formed. PubMed, CINAHL and Psychinfo were used as databases for the literary search and 22 scientific originalarticles were chosen. After further inspection, the final selection consisted of 13 articles. Hildegard Peplau’s theory of nursing was chosen as the theoretical reference frame. Results: Negative attitudes were depicted in the patient-staff interaction in form of staff showing lack of interest and experiences of being questioned, not listened to or taken seriously. Power-imbalance and discrimination were also described as negative attitudes. Positive attitudes involved being given support and empathy, and experiences of being taken seriously, listened to and seen as beyond the disease. Self-stigma emerged in different aspects of negative self-image incused by fear and shame causing hesitancy of the participants’ abilities. The illness being withheld and feelings of being labeled also depicted experiences of self-stigma. Conclusion: In order to create a good caring environment for the patient, health care services should work continuously with attitudes of health care personnel. An environment where patients experience positive attitudes, decreases the risk of they being affected by negative consequenses, such as a negative self-image. In addition, in order to yield best possible nursing, the patients’ experiences should be considered in the nursing process.

Denna kvalitativa studie har i syfte att förstå hur stereotypa föreställningar påverkar unga kvinnor med ursprung i Mellanöstern. Studien är baserad på sex unga kvinnors tolkningar av samhällets stereotypa föreställningar kring denna grupp.  Resultatet visar att majoriteten av informanterna blev någorlunda påverkade av dessa föreställningar. Fyra av respondenterna påverkades mer och upplevde att de många gånger var i behov av att bevisa att de negativa föreställningarna inte alltid stämmer. Föreställningarna om invandrarfamiljen är enligt informanterna överdramatiserade. Majoriteten ansåg att reglerna som fanns i hemmet inte handlade om kontroll, istället betonade de att föräldrar gör det av omsorg. Dock påvisades det under intervjuernas gång att de negativa föreställningarna som de unga kvinnorna talade om ibland stämde överens med några av respondenternas familjeförhållande. Vidare visar studien på mångfald och variation bland de unga kvinnornas levnadssätt. Invandrarkvinnan som de unga intervjuade kvinnorna själva benämner sig som, är inte en homogen grupp, och behöver inte leva under samma villkor bara för att man kommer från samma land eller har en gemensam kultur eller religion. / This qualitative study aims to understand how stereotypes affect young women, with Middle Eastern roots, living in Sweden. The study is based on six young women's interpretations of society’s stereotypes regarding young women originating from the Middle East. The result shows that the majority of the respondents were somewhat affected by these stereotypes. A majority of the respondents also came to the conclusion that the social stereotypes were not accurate and they often felt the need to prove those negative perceptions wrong. Moreover, the respondents felt that the perceptions of the stereotypical immigrant family present in today’s society are exaggerated. The majority stated that the rules existing in those families were not about control of young girls. They instead highlighted that the perceived “controlling” aspect was grounded in the parents need for the care and protection of their children rather than having a cultural connection. It became however apparent during the interviews that some of the negative perceptions that the young women talked about, occasionally coincided with some of the respondents' family conditions. Furthermore, this study shows diversity and variation among the respondents and their ways of life. “Immigrant women”, as the respondents call themselves, aren’t a homogeneous group and its members do not necessarily live under the same conditions, even if they come from the same country or have a common culture or religion.

The aim of this novel piece of research was to explore experiences of self-stigma amongst a group of older people (aged 65+) currently using mental health services. In order to try and identify possible contributing factors to internalized stigma it was also decided to gather information on optimism and a baseline measure of distress. These scores were all compared with the individual’s likeliness to continue to use the mental health services as it was hypothesized that higher levels of self-stigma would be linked with a lower likelihood to continue to use services. Fourteen participants (age range 65-92) from three different geographical areas agreed to take part having been approached by a mental health professional known to them. Interviews were then arranged directly with each participant, with each interview being made up of three questionnaire measures to rate levels of distress, optimism and experiences of mental health stigma, a Likelihood to Continue to Use Services rating scale, and a repertory grid. The repertory grids had been specifically designed to explore the construct systems of the participants in relation to their age. The main finding was that experiences of mental health stigma were minimal, but that participants showed some signs of internalizing ageist attitudes. However, neither of these variables was correlated with a likelihood to continue to use services, suggesting that it is factors other than mental health stigma and age stigma and selfstigmatization that impact on an older person’s decision to continue to engage with mental health services or not. The small sample size also meant that power was lacking from the findings, indicating that further research needs to be carried out. This study has opened up a research area which needs further ongoing investigation in order to fully explore the clinical implications of self-stigma in relation to age and mental health problems. Areas of potential future research are offered and briefly explored.

Titel: Erfarenheter av stigmatisering i hälso- och sjukvården bland personer som drabbats av HIV - En litteraturstudie. Bakgrund: HIV (Humant Immunbrist Virus) har länge varit förknippat med stigmatisering eftersom okunskap och osäkerhet fortfarande förekommer beträffande smittvägar och smittbarhet.                                                                                                           Syfte: Syftet med studien var att belysa erfarenheter av stigmatisering i hälso- och sjukvården bland personer som drabbats av HIV. Metod: En litteraturstudie genomfördes med tio stycken kvalitativa artiklar från åtta olika länder. Artiklarna granskades, analyserades och sammanställdes.                                                                                                               Resultat: I resultatet presenteras två kategorier och fem underkategorier. Kategorierna är: Att bli bemött med bristande vård handlingar och upplevelser av integritetskränkning. Underkategorierna är: Överdrivna säkerhetsåtgärder, ignorant bemötande, bristande sekretess, kränkande kroppsspråk och kränkande verbal kommunikation. Konklusion: Bristande kunskap om HIV kan internationellt ses som en bidragande faktor till att patienter än idag upplever varierande stigmatiserade bemötande från vårdpersonal. För att motverka stigmatiseringen krävs forskning som kan generera kunskap om hur vårdpersonal kan ge ett bättre bemötande och att denna kunskap sprids till vårdpersonal. Nyckelord: HIV, stigmatisering, patientupplevelse, diskriminering. / Title: Experiences of stigma in health care among people affected by HIV- A literature review Background: HIV (Human Immunodeficiency Virus) has been associated with stigmatization for a long time because of ignorance and uncertainty still exists regarding the transmission routes and infectivity. Aim: The aim for the study was to highlight experiences of stigma in health care among people affected by HIV. Method: A literature study was conducted with ten qualitative articles from eight different countries. The articles were examined, analyzed and compiled. Results: The result generated two categories and five subcategories. The categories are: To be treated with a lack of care actions and experiences of integrity violation. The sub-categories are: excessive security measures, ignorant attitudes, lack of secrecy, offensive body language and abusive verbal communication.                                                                   Conclusion: Lack of knowledge about HIV can be seen internationally seen as a contributing factor to the patients still experiencing varying stigmatized treatment by health professionals. To counteract the stigma requires research that can generate knowledge on how health professionals can provide better treatment and that this information is disseminated to the medical staff. Keywords: HIV, stigmatization, patient-experience, discrimination.

Background: HIV is one of the biggest global epidemics. Historically the HIV-infected persons have faced a discriminative and stigmatizing attitude inside the health care-sector. That form of negative reception has been seen as one of the biggest obstacles to decrease the spread of HIV and to create an equal healthcare sector. Aim: The aim is to highlight how HIV-infected persons experience the reception from health care professionals in countries with low prevalence of HIV. Method: A literature review with nine scientific articles, seven articles were qualitative, one was quantitative and one with mixed method. Results: Two main topics arised: The negative reception and The positive reception. The HIV-infected are still experiencing situations where they are treated with a stigmatized and discriminative attitude from the health care-professionals. The result, however, indicates that the reception has improved. The HIV-infected experienced that the positive interactions widely exceeded the negative. Conclusion: HIV-stigmatization is still a major issue within the health care sector. The HIV- infected, however, experience the stigmatizing reception in more isolated cases today and the positive reception widely exceeded the negative stigmatizing reception. The HIV-infected experienced health care professionals with high knowledge to give a better reception. / Bakgrund: HIV är en av de största globala epidemierna. HIV-drabbade personer har historiskt bemötts av en diskriminerande och stigmatiserande attityd inom hälso- och sjukvårdssektorn. Den formen av negativt bemötande har ansetts vara ett av de största hinder som finns för att minska spridningen av HIV och för att skapa en likvärdig hälso- och sjukvårdssektor. Syfte: Syftet är att belysa hur HIV-drabbade personer upplever bemötandet från hälso- och sjukvårdspersonalen i länder med låg prevalens av HIV. Metod: Litteraturöversikt med nio vetenskapliga artiklar varav sju var kvalitativa, en var kvantitativ och en med mixad metod. Resultat: Två huvudteman framkom: Det negativa bemötandet och Det positiva bemötandet. De HIV-drabbade upplever fortfarande situationer där de blir bemötta med en stigmatiserande och diskriminerande attityd från hälso-och sjukvårdspersonal. Resultatet tyder dock på bemötandet har förbättrats. De HIV-drabbade upplevde att det positiva bemötandet vida överskred de negativa. Slutsats: HIV-stigmatiseringen är ett fortsatt stort problem inom hälso- och sjukvårdssektorn. De HIV-drabbade upplever dock det stigmatiserande bemötandet i mer enstaka situationer idag och det positiva bemötandet överskred vida det negativa stigmatiserande bemötandet. HIV-drabbade upplevde att hälso- och sjukvårdspersonal med hög kunskap generellt gav ett bättre bemötande.

This essay is based on an interest in how certain residential areas are portrayed in the public debate as "problem areas" which allows other to stigmatization these neighborhoods with negative prejudices. The residential area Ersboda is one of the major residential area in the Swedish town Umeå, that can stand as an example of this phenomenon.  The unique with the residential area Ersboda is that the area don’t have much problem compare to other areas and it therefore interesting to ask why the residential area Ersboda are stamped with negative prejudices? The purpose of this essay is therefore to create an understanding why and how the residential area Ersboda in Umeå are stigmatised by the surroundings. The essay aims to answer the following questions: • When did the stigmatization of the residential area Ersboda begin? • How does the stigmatization of the residential area Ersboda manifest itself? • What could be the underlying factors for the stigmatization of Ersboda? In this study, qualitative interviews have been conducted with residents and working people in the residential area Ersboda. The result showed that one contributing reasons why Ersboda and its inhabitants become stigmatized is that there is a relatively large influx of immigrants in the 1990s. The second factor is based on the violent disturbances among a small part of the area's young residents during the same time period. The reason why Ersboda still are stigmatized depends possibly not only on the surrounding prejudices about the area's ethnic inhabitans and the media's negative reports. The underlying factor can be due to a power difference between established (the surrounding) and outsiders (those living and working on Ersboda). The conclusion is therefore that the stigma of Ersboda not depend on the number of problems, but rather on the basis that it has established a power relationship between "us" and "them" and where residents lack the means of power to break the stigmatization.

Background: Studies have shown that patients suffering from mental illness often feel that they are less well treated in health care than patients who do not suffer from a mental illness. What causes this is that patients with mental illness often become subject to stigmatization in healthcare in general. Aim: The aim of this study was to illuminate the experience of stigmatization in the healthcare encounter between nursing staff and patients with a mental illness. Method: Six qualitative and one quantitative article were analyzed to create a literature review. Results: Through the analysis two main-themes and seven sub-themes were identified. The two main-themes were: The feeling of powerlessness and The feeling of deviating. The seven sub-themes were: Not to be taken seriously, Not to be considered to have a real illness, Being malpracticed, Getting a worse response, To live with the fear of being labeled, To be identified with the diagnosis and To repress symptoms. Conclusions: Patients find that they are not taken seriously regarding their mental or physical problems and that they do not receive care on the same terms as patients without a psychiatric diagnosis. Healthcare professionals need better knowledge about experiences of stigmatization, in order to establish a better relationship between patient and nursing staff and to strengthen the patients' self-esteem. / Alla patienter ska få ett lika gott bemötande i mötet med vården oavsett vilken sjukdom de lider av. Idag finns det fortfarande många fördomar och en utbredd brist på kunskap gällande psykisk sjukdom, vilket leder till att patienter många gånger blir föremål för stigmatisering från hälso- och sjukvårdspersonal och genom detta får ett sämre bemötande än patienter som inte lider av psykisk sjukdom. Sjuksköterskan har en viktig roll när det gäller att få patienten att känna sig trygg och utifrån detta kunna skapa en förtroendefull relation med patienten där hen kan känna tillit. Detta för att kunna ge bästa möjliga omvårdnad. När patienten på grund av stigmatisering mister detta förtroende för vården minskar möjligheten för tillfrisknande och till att leva ett, för patienten, optimalt liv med en god upplevelse av hälsa. Syftet med det här examensarbetet var därför att belysa upplevelsen av stigmatisering i mötet med hälso- och sjukvården hos patienter med en psykisk sjukdom. I resultatet har sju vetenskapliga artiklar, sex kvalitativa och en kvantitativ, analyserats. Artiklarna som valdes till resultatet skulle utgå från ett patientperspektiv och därför exkluderades artiklar som belyste närståendes eller vårdpersonals upplevelser. Artiklarna granskades och analyserades med hjälp av Fribergs (2017) analysmetod för litteraturöversikt som syftar till att belysa likheter och skillnader i inkluderade artiklar. Resultatet visar att patienterna ofta känner att de inte blir tagna på allvar och att de inte bemöts på samma villkor som patienter utan en psykiatrisk diagnos. De känner sig även många gånger avvisade när de söker vård genom att de inte blir trodda eller att de upplevs som besvärliga. I tillägg till detta kämpar många patienter med sina egna fördomar kring psykisk sjukdom som får konsekvenser i deras dagliga liv och i mötet med vården. Sjuksköterskor behöver få kunskap om hur de ska bemöta dessa patienter på ett professionellt vis. Stigmatisering, det vill säga olika typer av fördomar kring psykisk sjukdom som får en negativ effekt för dessa patienter, bör lyftas fram och synliggöras inom såväl sjuksköterskeutbildningen som i det kliniska arbetat ute på sjukhus, primärvård och kommunal vård. Det är även viktigt att öka omvårdnadspersonalens kunskaper gällande patienternas upplevelser av stigmatisering, för att kunna arbeta för en bättre relation mellan patient och omvårdnadspersonal samt arbeta för att stärka patientens självkänsla vilket i sin tur kan leda till en bättre återhämtning och livskvalitet.

Abstract Throughout history, many diseases have carried considerable stigma, including leprosy tuberculosis, cancer, mental illness and many STDs. Now HIV/AIDS is the topmost in the list of diseases that leads to devastating patient stigmatization. Despite international efforts to tackle HIV/AIDS, stigma and discrimination remain among the most poorly understood aspects of the epidemic. In the face of numerous intervention strategies, HIV/AIDS continues to spread and to pose a threat to the socio-economic transformation of South Africa. The broad objective of this study was to investigate how the stigmatisation of HIV-Positive women is made manifest and look at how successful the National Association of people living with HIV/AIDS (NAPWA) in South Africa has been in achieving their objectives and goals of changing the perceptions people have about HIV/AIDS and creating awareness about the debilitating effect stigmatisation has in the society, especially when it viciously targets HIV-positive women. A case study approach was used to examine the experiences of HIV/AIDS infected/affected women and NAPWA administrators. Methods used in the collection of data were self-administered questionnaires, participant observation and archival evidence in the form of documents. Through these methods, the study investigated ways in which the stigmatisation of HIV-positive women was made manifest, the role of NAPWA in fighting HIV/AIDS stigmatisation, how successful NAPWA has been in the fight against the stigmatisation of people infected and affected by HIV/AIDS in South Africa, challenges faced by NAPWA in the fight against HIV stigmatisation and discrimination, weaknesses of NAPWA and what impact all these have in the spread of HIV/AIDS. The research results show that HIV-positive women suffer stigmatisation and that; organisations of people living with HIV/AIDS (e.g. NAPWA-SA) play a major role in eradicating the stigma attached to HIV/AIDS. It also suggests that APWAs in effect help to reduce the spread of the disease and prolong the life span of those infected by it. All this not withstanding, the study also discovered that APWAs like NAPWA-SA need the support of government and stakeholders in South Africa to fully implement their strategies and programmes geared towards reducing stigma and the spread of HIV/AIDS.