Certain individual and institutional factors such as knowledge about stigma and discrimination, fear of infection, social judgement, legal and policy environment act as actionable drivers and facilitators of HIV-related stigma and discrimination. These factors may hinder the utilisation and quality of care provided to people living with HIV. Purpose: The purpose of the study was to establish the actionable drivers and facilitators that determine the different forms of HIV-related stigma and discrimination among healthcare professionals at a district hospital in Malawi. Methods: The study used a descriptive correlational study. Data was collected through self-administered questionnaire. Data were analysed using SPPS and STATA 12. Fisher's Exact Test was used to conclude the association and binary logistic regression was used to model the degree of the statistical relationships. Results: The results showed statistically significant relationship between knowledge of stigma and discrimination, social judgement and awareness of workplace policy and HIV-related stigma and discrimination. Recommendations: Interventions aimed at increasing knowledge about HIV-related stigma, reducing social judgement, reinforcing HIV-related workplace policies are needed to reduce HIV-related stigma and discrimination in healthcare settings. / Health Studies / M. Ph. (Health Studies)

Women in the sex industry struggle with emotional turmoil, drug and alcohol addiction, poverty, and spiritual disillusionment. Their lived experiences as stigmatized individuals engender feelings of powerlessness, which inhibits their attempts to leave the sex industry. This study illuminates how personal narratives develop throughout the process of shedding stigmatized identities and how mutual support functions as a tool in life transformation. Social identity theory and feminist standpoint theory are used as theoretical frameworks of this research, with each theory adding nuanced understanding to life transformations of female former sex workers. Results indicate that women in the sex industry share common narratives that reveal experiences of a "Living Hell", transitional language, and ultimate alignment with traditional norms. Implications of SIT and FST reveal the role of feminist organizations as possible patriarchal entities and adherence to stereotypical masculine ideology as an anchoring factor in continued sex work.

Made available in DSpace on 2017-06-01T18:18:12Z (GMT). No. of bitstreams: 1 pre-textuais.pdf: 1014264 bytes, checksum: 068105074e07468e188f1bbb5761b974 (MD5) Previous issue date: 2011-01-10 / The dissertation discusses how the disability, as a stigma, is socially established, the ways how the identities of people with disabilities are made into the social environment and what is the function of education in its potential of reproduction and transformation of the society, to the production and reproduction of the disabilities' stigmas. The dissertation also discusses how the right to education of persons with disabilities can make an deconstruction of the stigmas, and can build an inclusive society, and some of the ways can be followed for the realization of this right. The data were obtained through review of the literature relevant to the theme and study and reflection on the discourse of people with disabilities, to which we had access reading of works written by people with disabilities and by ethnographic research, which gave us access with reports that, although not formally transcribed, permeate all lines of this dissertation / A dissertação aborda como a deficiência, enquanto estigma, é socialmente estabelecida, os processos através dos quais as identidades das pessoas com deficiência são construídas dentro do meio social e qual a função da educação, em seu potencial reprodutor e transformador da sociedade, para a (re) produção dos estigmas de deficiência. Aborda, ainda, como direito a educação das pessoas com deficiência pode se prestar à desconstrução dos estigmas, construção de uma sociedade inclusiva, e alguns dos caminhos que podem ser seguidos para a realização de tal direito. Os dados foram obtidos através da revisão da bibliografia pertinente ao tema e estudo e reflexão sobre os discursos das pessoas com deficiência, aos quais tivemos acesso com base na leitura de obras escritas por pessoas com deficiência e através de pesquisa etnográfica, a qual nos deu acesso a relatos que, embora não estejam formalmente transcritos, permeiam todas as linhas e entrelinhas da presente dissertação

The purpose of this study was to measure correlations of stigma with self-esteem among individuals who are receiving treatment for a mental illness.

Vicarious humiliation as a devaluing intergroup event is a rather common experience, which has the potential to adversely influence present and future intergroup relations. Based on an extensive literature review and previous research, we hypothesised that highly identified group members experience an intensified feeling of humiliation after witnessing an ingroup member being humiliated when compared to low identifiers (Hypothesis 1), that the role of visual exposure as situational determinant of humiliating events, the appraisals, and the emotional patterns elicited, differ between personally and vicariously humiliating events (Hypotheses 2a, 2b, 3 and 4), and lastly, that vicarious humiliation regulated through emotional blends leads to behavioural intentions that influence future intergroup relations (Hypotheses 5a to 5c). Evidence for our hypotheses was exploratively and experimentally provided in six studies. Results implied that vicarious humiliation is a common experience, that visual exposure as situational determinant is more important for personally than vicariously humiliating events, and that humiliation is indeed a blended emotion (Study 1, N = 1048). Moreover, results showed that highly identified group member feel relatively stronger humiliated (Study 2, N = 175), that the appraisal and emotional patterns are related to identity processes (i.e., personal and vicarious humiliation) (Study 3, N = 74; Study 4, N = 359; Study 5 = 376), and that the feeling of humiliation and accompanying emotions regulate the relationship between vicariously humiliating events and the intentional responses such as avoidance, non-normative approach, dehumanisation and social exclusion (Study 6, N = 998). Overall, our results imply that vicarious humiliation as an emotional experience has the potential to provoke intergroup conflict. SUMMARY The present research studied a phenomenon that we are all familiar with – being humiliated. Unfortunately, this is an experience that is rather common as we might not only experience to be humiliated personally but also to be humiliated on behalf of others. It is this vicarious experience of humiliation that the present research aimed at studying. We firstly explored people’s experiences with and understandings of humiliation through a cross-sectional survey (Study 1). Results indicated that vicarious humiliation is indeed a rather common experience, that personally and vicariously humiliating events differ in terms of the situational determinants that characterise these events, and that the feeling of humiliation is experienced as a blended emotion. We furthermore tested experimentally the effects of ingroup identification, identity processes and the presence of an audience on the appraisal processes of and the emotional and motivational responses to vicarious humiliation. We found that people who highly identified with the group they share with the humiliated person, experienced stronger feelings of humiliation (Study 2), and that being personally humiliated and being vicariously humiliated resulted in different appraisal patterns, which consequently elicited the different emotional blends of humiliation with self-focused and other-focused emotions, respectively (Studies 3 to 5). We were, however, unable to provide evidence that the presence of an audience aggravated the appraisal processes and the feeling of humiliation (which we attributed to methodological limitations of our studies). That the emotional blends of humiliation regulate the behavioural intentions, that people engage in as a result of being vicariously humiliated, was demonstrated in our last study (Study 6). More specifically, we found that humiliation accompanied by self-focused emotions was related to intentions to avoid, to non-normatively approach, and/or to socially exclude the humiliator(s) through dehumanising them. It is this latter finding that provides evidence for both the role of the social context that might determine the appropriateness of certain behaviours (e.g., social norms) and for the proposed cycle of humiliation in that humiliated persons are often believed to retaliate by humiliating the humiliator(s) in return, which has the potential to provoke intergroup conflicts. / Psychology / D. Phil. (Psychology)

<p>Упркос значајном напретку који је остварен на пољу разумевања природе епилепсије и њеног лечења, већина људи са епилепсијом је и даље изложена стигматизацији. Спроведене студије у различитим земљама показују да стигма има снажан утицај на економски статус, социјалне интеракције и свеукупно здравље. Стигма може ометати благовремено обраћање здравственој служби и придржавање препоручене терапије, те оболели приступају алтернативним начинима лечења. Уз претходно наведено, стигма је повезана са широким спектром психосоцијалних последица, укључујући губитак самопоштовања, социјално повлачење и изолацију. Значајан проблем представља и стигма од стране здравствених радника која може негативно утицати на начин пружања услуге лечења и здравствену негу оболелих од епилепсије. Поред улоге у пружању здравствене заштите, здравствени радници су важни друштвени субјекти у одређивању понашања шире друштвене заједнице. Знање и ставови о епилепсији здравствених радника и оболелих од епилепсије су важни фактори за редукцију последица напада, потенцијално штетних поступака за самопомоћ и емоционалних последица болести. Основни циљеви овог истраживања били су анализа стигматизације особа оболелих од епилепсије, како из њиховог сопственог угла, тако и из угла здравствених радника, као и анализа знања о самој болести. Истраживање је спроведено у свим објектима Дома здравља &bdquo;Нови Сад&ldquo;, анкетирањем здравствених радника и особа са постављеном дијагнозом епилепсије. За процену знања о епилепсији, за обе групе је кориштен Упитник о познавању епилепсије, а за испитивање степена стигме и стамостигме је кориштена стандардизована Скала стигме за епилепсију, посебно прилагођена за обе испитиване групе. Резултати овог истраживања показују да више од половине здравствених радника примарне здравствене заштите има низак степен стигматизације према особама оболелим од епилепсије. Такође, наши резултати указују да постоји статистички значајна негативна корелације између степена самостигматизације и нивоа знања о епилепсији код особа оболелих од епилепсије, али и да не постоји статистички значајна корелације између степена стигматизације здравствених радника примарних здравственох установа према особама оболелим од епилепсије и нивоа знања о епилепсији. Степен стигме здравствених радника, према нашем истраживању статистички је нижи од степена самостигме испитаника оболелих од епилепсије, док је ниво знања о епилепсији здравствених радника статистички виши од нивоа знања о епилепсији испитаника оболелих од поменуте болести. На основу резултата овог рада могу се донети препоруке засноване на доказима, а које представљају реалне и оствариве циљеве смањивања стигматизације особа оболелих од епилепсије, које су свакако неопходне. Резултати овог рада указују и на неопходност имплементације образовних програма које би спроводили здравствени радници са позитивним порукама о болести, чиме би се подигао ниво знања о епилепсији, смањила постојећа стигматизација и самостигматизација оболелих од епилепсије те би се омогућило комплетно укључивање особа оболелих од епилепсије у ширу друштвену заједницу и осигурало поштовање основних људских права.</p> / <p>Uprkos značajnom napretku koji je ostvaren na polju razumevanja prirode epilepsije i njenog lečenja, većina ljudi sa epilepsijom je i dalje izložena stigmatizaciji. Sprovedene studije u različitim zemljama pokazuju da stigma ima snažan uticaj na ekonomski status, socijalne interakcije i sveukupno zdravlje. Stigma može ometati blagovremeno obraćanje zdravstvenoj službi i pridržavanje preporučene terapije, te oboleli pristupaju alternativnim načinima lečenja. Uz prethodno navedeno, stigma je povezana sa širokim spektrom psihosocijalnih posledica, uključujući gubitak samopoštovanja, socijalno povlačenje i izolaciju. Značajan problem predstavlja i stigma od strane zdravstvenih radnika koja može negativno uticati na način pružanja usluge lečenja i zdravstvenu negu obolelih od epilepsije. Pored uloge u pružanju zdravstvene zaštite, zdravstveni radnici su važni društveni subjekti u određivanju ponašanja šire društvene zajednice. Znanje i stavovi o epilepsiji zdravstvenih radnika i obolelih od epilepsije su važni faktori za redukciju posledica napada, potencijalno štetnih postupaka za samopomoć i emocionalnih posledica bolesti. Osnovni ciljevi ovog istraživanja bili su analiza stigmatizacije osoba obolelih od epilepsije, kako iz njihovog sopstvenog ugla, tako i iz ugla zdravstvenih radnika, kao i analiza znanja o samoj bolesti. Istraživanje je sprovedeno u svim objektima Doma zdravlja &bdquo;Novi Sad&ldquo;, anketiranjem zdravstvenih radnika i osoba sa postavljenom dijagnozom epilepsije. Za procenu znanja o epilepsiji, za obe grupe je korišten Upitnik o poznavanju epilepsije, a za ispitivanje stepena stigme i stamostigme je korištena standardizovana Skala stigme za epilepsiju, posebno prilagođena za obe ispitivane grupe. Rezultati ovog istraživanja pokazuju da više od polovine zdravstvenih radnika primarne zdravstvene zaštite ima nizak stepen stigmatizacije prema osobama obolelim od epilepsije. Takođe, naši rezultati ukazuju da postoji statistički značajna negativna korelacije između stepena samostigmatizacije i nivoa znanja o epilepsiji kod osoba obolelih od epilepsije, ali i da ne postoji statistički značajna korelacije između stepena stigmatizacije zdravstvenih radnika primarnih zdravstvenoh ustanova prema osobama obolelim od epilepsije i nivoa znanja o epilepsiji. Stepen stigme zdravstvenih radnika, prema našem istraživanju statistički je niži od stepena samostigme ispitanika obolelih od epilepsije, dok je nivo znanja o epilepsiji zdravstvenih radnika statistički viši od nivoa znanja o epilepsiji ispitanika obolelih od pomenute bolesti. Na osnovu rezultata ovog rada mogu se doneti preporuke zasnovane na dokazima, a koje predstavljaju realne i ostvarive ciljeve smanjivanja stigmatizacije osoba obolelih od epilepsije, koje su svakako neophodne. Rezultati ovog rada ukazuju i na neophodnost implementacije obrazovnih programa koje bi sprovodili zdravstveni radnici sa pozitivnim porukama o bolesti, čime bi se podigao nivo znanja o epilepsiji, smanjila postojeća stigmatizacija i samostigmatizacija obolelih od epilepsije te bi se omogućilo kompletno uključivanje osoba obolelih od epilepsije u širu društvenu zajednicu i osiguralo poštovanje osnovnih ljudskih prava.</p> / <p>Despite the significant progress made in understanding the nature of epilepsy and its treatment, most people with epilepsy remain exposed to stigmatization. Studies conducted in different countries shows that stigma has a strong impact on economic status, social interactions and overall health. Stigma can interfere with timely addressing the health service and adhering to the recommended therapy, and patients approach alternative treatments. In addition to the above, the stigma is associated with a wide range of psychosocial consequences, including loss of self-esteem, social retreat and isolation. A significant problem is the stigma of health workers, which can negatively affect the way in which the treatment service and the care of epilepsy sufferers are provided. In addition to the role in providing health care, health workers are important social factor in determining the behavior of the wider community. Knowledge and attitudes about the epilepsy of health workers and epilepsy sufferers are important factors in reducing the consequences of epilepsy attacks, potentially harmful self-help and emotional impacts. The main objectives of this study were the analysis of the stigmatization of epilepsy patients both from their own perspective and from the perspective of health professionals, as well as analysis of knowledge about the disease itself. The research was carried out in all facilities &quot;Dom zdravlja Novi Sad&quot; in the form of a cross section study, interviewing health workers and persons with diagnosed epilepsy. For the assessment of epilepsy knowledge, the Epilepsy Questionnaire was used for both groups, and a standardized Scala stigma of epilepsy was used to test the degree of stigma and self stigma, specifically designed for both examined groups. The results of this study show that more than half of health care workers in primary health care have low stigmatization rates for people with epilepsy. Also, our results indicate that there are statistically significant negative correlations between the degree of self stigma and knowledge about epilepsy, in epilepsy patients, but also that there are no statistically significant correlations between the degree of stigmatization of health workers in primary health care institutions against people with epilepsy and knowledge about epilepsy. The degree of stigma of health workers, according to our research, is statistically lower than the degree of self stigma of respondents suffering from epilepsy, while the level of knowledge about the epilepsy of health workers is statistically higher than the level of knowledge about the epilepsy of respondents with epilepsy. Based on the results of this paper, recommendations based on evidence can be made, which represent real and achievable goals of reducing stigmatization of people with epilepsy, which are certainly necessary. The results of this paper also point to the necessity to implement educational programs that would be carried out by healthcare workers with positive messages about the disease, which would increase the knowledge about epilepsy, reduce the existing stigmatization and self stigma of people with epilepsy, and enable complete inclusion of persons suffering from epilepsy in the wider social community and ensure respect for basic human rights.</p>

Introduction. The Apple shelf is an established concept at public libraries in Sweden. These shelves contain accessible books and other media for disabled people of varying ages. A recent discussion within the librarian profession challenges the name – is there a better alternative to “The Apple shelf”? Our study aimed to gather both librarian and target group opinions of the current name and its suggested alternatives, and attempts to understand potential stigmatization with the application of Goffmans stigma theory.      Method. A multimethod (triangulation) approach was applied to collect data. An online survey was sent to all public libraries in the regions of Västerbotten, Västmanland and Uppsala; semi-structured interviews were conducted with librarians, parents of disabled children, and a disabled youth accompanied by an aide; and an instance of participant observation was done in a network meeting setting. Recorded and transcribed interviews, survey responses, and meeting notes respectively formed the basis for the study’s analysis.  Analysis. A qualitative thematic analysis of the collected data found 4 common themes: (1) User and Target Group, (2) Name, (3) Shelf Arrangement, and (4) Awareness and Marketing. Goffman’s stigma theory was applied to each theme to highlight stigmatization risks related to both the existing name and proposed alternatives. Results. The Apple Shelf caters to a wider audience than originally intended. Both the current ”Apple Shelf” name and its proposed alternatives have advantages and disadvantages related to stigmatization.  Conclusion. Regardless of what name is chosen for Apple shelf it must be explained and marketed to the public. We argue that including disabled people in library changes, as well as actively updating and promoting the shelf locally, are more important than this change of name.     This is a two-year master’s thesis in Library and Information Science.

近年来，针对就业和就学中遭遇歧视的困境，中国乙肝携带者发起一场要求消除歧视、维护合法权益的抗争运动。为什么乙肝携带者就业歧视问题在中国如此显著？面对国家和市场这两大最具权势的系统，公民社会将何以对抗？本文旨在从社会学的视角对这场“将‘乙肝’去除"的运动进行解读。 / 本文采用个案研究方法，以北京益仁平中心为主要研究对象，围绕 “乙肝"在中国的建构和重构过程，将研究聚焦于三个方面：第一，乙肝污名化过程以及国家、市场中的话语权；第二，反乙肝歧视维权运动的条件和动员机制；第三，“将‘乙肝’去除"中的政治和权力话语三角。 / 本文从社会运动理论中的资源动员、政治机会结构和框架理论出发解读中国乙肝携带者的维权运动；将运动中的微观景象与宏观社会结构结合起来，考察影响乙肝携带者维权运动的主要因素以及运动的动员机制。研究伊始分别从国家和市场两个领域审视乙肝歧视问题在中国的建构过程，阐明乙肝污名化是政府权威以及市场中医药商和医学权威共谋下的合力作用，从而为乙肝携带者反歧视抗争运动的后续研究选择一个合适的立足点。笔者在案例中发现，组织在维权运动中将乙肝携带者群体动员起来，采取有效的策略，充分利用其在资源获得方面的优势、建立乙肝维权组织网络、善于把握时机营造政治机会空间、并能够吸纳律师和媒体的专业力量是维权行动能取得成功的重要因素。 / 组织在维权行动中的话语框架对运动的发展至关重要。乙肝携带者群体对组织运动框架的认同是动员成功的基础；掌握定义“乙肝"的主动权、运动领袖的可信性、框架话语表达的日常化、与媒体的良好关系等策略有助于框架在动员中与参与者、旁观者产生共鸣；抗争精英通过话语框架为抗争活动提供合法性。 / 反乙肝歧视维权运动可以看作是一个“将‘乙肝’去除"的“去污名化"运动。一方面，中央政府与地方政府有着各自自主性利益；另一方面，乙肝携带者群体内部就抗争形式也难以统一，这两种分裂情况交叉形成了一个围绕“将‘乙肝’去除"的，以规则、效益和权利为话语的权力三角，支撑反歧视行动的抗争空间。权力三角的多变性决定去除“乙肝"的行动是有策略的、冒险的，但却相对稳定。 / Hepatitis B Virus carriers (HBVers) have launched series social movements targeting at eliminating discriminations against HBVers in job market and promoting fair employment in recent decade of years. Why does nowhere match the HBV discrimination in such country like China? How is contentious politics possible when the powerless engage in struggles with power holders, like state and market in China? The thesis attempts to learn the intricacies of body politics with sociological approaches. / Yirenping, a NGO located in Beijing, is selected as research object in this case study. Concentrating on the political nature of the HBV confrontations, this thesis is comprised of three parts: first, the stigmatization of HBV in China; second, tactics and strategies that employed against the system of discrimination; third, the politics of “Removing HBV" and the power triangle among state, market and civil society. / The analysis of the HBV movement is informed by three sociological theories of social movements: resource mobilization, political opportunity structure and framing, meanwhile macro structure and micro interaction are combined. It is postulated that this disease discrimination in China occurs when confronting an entrenched stigmatization conjoined from both state and market dedicated to keeping the HBVers excluded and marginalized, which serves as a departure point for further analysis of the struggles for power against this discrimination. Resources mobilized, leaderships and organizations, networks among HBVers and outside supporters, strategies in mobilization positively facilitate the anti-discrimination movements. Utilizing the institutional advocacies as well as informal networks with officials, NPC & CPCCC delegates open more political opportunities within the preexisting political environment. / Framing is essential to the movement mobilization. Identifying closely with the visions and missions in movements, the self conceptualization of HBV-discrimination, charismatic leaders, the everyday narrative of the frame, as well as strategic media coverage help promoting resonance among movement participants and standers-by. Framing strategies provide legitimacy for HBV selves in collective movements. / Finally, the thesis came to the conclusion that anti-discrimination-against-HBVers social movements in China can be interpreted as a process of struggle to “Removing HBV" power. Central government and local ones have their autonomies and interests respectively, while weak but observed divisions in protesting strategies also exist within the HBVers, which shape a triangle of power struggles among the dominant and dominated groups. The power triangle is flexible, and the “Removing HBV" movements are strategic, risk-taking, while being routinized. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / 郭娜. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 137-156) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Guo Nuo. / 中文摘要 --- p.i / 英文摘要 --- p.ii / 引言 --- p.1 / Chapter 第一章 --- 导论 乙肝：作为医学问题和作为社会问题 --- p.3 / Chapter 1.1 --- 作为医学问题的乙型肝炎及其全球地理分布 --- p.3 / Chapter 1.2 --- 乙型肝炎在中国 --- p.6 / Chapter 1.3 --- 作为社会问题的乙肝歧视 --- p.8 / Chapter 1.4 --- 研究方法 --- p.10 / Chapter 1.5 --- 小结 --- p.14 / Chapter 第二章 --- 研究问题与文献回顾 --- p.15 / Chapter 2.1 --- 社会运动理论的发展脉络 --- p.16 / Chapter 2.2 --- 认同与社会运动的动员 --- p.21 / Chapter 2.3 --- 中国底层社会与维权抗争研究回顾 --- p.24 / Chapter 2.4 --- 中国反乙肝歧视运动的分析框架 --- p.26 / Chapter 2.5 --- 小结 --- p.34 / Chapter 第三章 --- 政府与入职体检 --- p.35 / Chapter 3.1 --- 新中国成立之初的公共卫生政策 --- p.35 / Chapter 3.2 --- 中国人事制度改革和公务员职业声望 --- p.39 / Chapter 3.3 --- 体检标准与强制乙肝检测 --- p.43 / Chapter 3.4 --- 小结 --- p.47 / Chapter 第四章 --- 市场话语权与定义“乙肝" --- p.49 / Chapter 4.1 --- 市场中的虚假广告 --- p.50 / Chapter 4.2 --- 体检经济 --- p.54 / Chapter 4.3 --- 医药商与医学权威 --- p.56 / Chapter 4.4 --- 小结 --- p.58 / Chapter 第五章 --- 乙肝携带者的个人经验 --- p.61 / Chapter 5.1 --- 疾病的社会建构 --- p.62 / Chapter 5.2 --- 乙肝携带者的认知过程 --- p.66 / Chapter 5.3 --- 乙肝携带者的抗争选择 --- p.68 / Chapter 5.4 --- 小结 --- p.74 / Chapter 第六章 --- 从个体经验到集体行动：公民社会的回应 --- p.76 / Chapter 6.1 --- 从个人困境到集体行动 --- p.76 / Chapter 6.2 --- 反乙肝歧视运动中的资源动员 --- p.80 / Chapter 6.3 --- 反乙肝歧视组织网络 --- p.82 / Chapter 6.4 --- 反乙肝歧视运动中的机会空间 --- p.86 / Chapter 6.5 --- 小结 --- p.90 / Chapter 第七章 --- 框架策略：反乙肝歧视运动中的动员 --- p.91 / Chapter 7.1 --- 认同与社会运动 --- p.91 / Chapter 7.2 --- 反乙肝歧视运动的行动框架 --- p.95 / Chapter 7.3 --- 反乙肝歧视运动的动员策略 --- p.100 / Chapter 7.4 --- 小结 --- p.107 / Chapter 第八章 --- 身体的政治：将“乙肝"去除 --- p.108 / Chapter 8.1 --- 权力的维度 --- p.108 / Chapter 8.2 --- 反乙肝歧视行动的抗争轨迹 --- p.111 / Chapter 8.3 --- 国家、市场与公民社会：将“乙肝"去除 --- p.116 / Chapter 8.4 --- 小结 --- p.130 / Chapter 第九章 --- 总结与讨论 --- p.131 / 参考文献 --- p.137 / Chapter 附录A --- 访谈提纲 --- p.157 / Chapter 附录B --- 64名被访者基本信息概况 --- p.160 / 致谢 --- p.162

Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.

This thesis explores how the general public understands and responds to dementia. In the context of this study the word ‘understanding' is used to convey the complex co-construction of knowledge and establishing of beliefs that constitutes public understandings of dementia. The study also examines the responses of members of the public to dementia, in the context of their understanding. Data were collected over a 12 month period and included a module in the Northern Ireland Life and Times (NILT) survey, five focus groups and nine interviews with participants from the focus groups. The survey module included thirty measures examining levels of knowledge and attitudes towards dementia. 1200 participants were targeted and the survey was administered by the Northern Ireland Research & Statistics Agency with a response rate of 58%. The focus groups and interviews provided the mechanism to gather a more nuanced picture, exploring the beliefs behind the attitudes and the self-reported responses of participants to people with dementia. Findings indicate that the general public has a reasonable knowledge of the symptoms and pathway of dementia in line with a bio medical model. However the findings also indicate that the general public holds a mix of theoretical and empirical knowledge and that this is often contradictory. A complex mix of scientific or medical information, experience, anecdote and assumptions contribute to the discourse. This information is stored and conveyed in the form of stories and a consequence of this interplay is that individual experiences told in the form of stories are generalised to become building blocks in the construction of what the general public understands dementia to be. The current construction of dementia among the general public is found to be both nihilistic and ageist with clear evidence that dementia is stigmatised. I will argue that that the relationship between dementia and ageing in the minds of the general public is a symbiotic one. Dementia has become a cultural metaphor for unsuccessful ageing marking entry to the fourth age. The stigmatising response of the general public is the result of a complex interplay of multiple factors. I have expanded on previous ideas of multiple jeopardy and intersectionality, suggesting that the stigma associated with dementia is unique and driven as much by emotional responses as by the social location of the person with dementia. I have borrowed Brooker’s (2003) term “Dementia-ism’ to describe this stigma. This thesis argues for a more complex and sophisticated approach to changing public attitudes and reducing stigma. Dementia-ism must be addressed with the same strength of purpose currently applied to sexism, racism and ageism.