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Fulltext Teenage pregnancy and its health implications

Hayward G

Int J Public Health Res, 2011;1(2):100-102.
MyJurnal

The World Health Organisation (WHO, 2006) defines teenage pregnancy as a 'teenaged or underaged girl (usually within the ages of 13-19) becoming pregnant.' The term usually refers to women who become pregnant, who have not reached legal adulthood; legal adulthood varies in different countries. The term teenage pregnancy is widely used however, to mean unmarried adolescent girls who become pregnant. Pregnant teenagers face many additional obstetric, medical & social issues compared to women who give birth in their 20s and 30s. Most at risk are mothers under fifteen and those living in developing countries. Complications during pregnancy and delivery are the leading causes of death for girls aged 15 to 19 in developing countries; they are twice as likely to die in childbirth as women in their twenties, with adolescents accounting for 13% maternal deaths worldwide. There is evidence to show (UNICEF Malaysia, 2008) that teenage pregnancy is associated with lower educational levels, higher rates of poverty and that the situation is often repeated with children of teenage parents. In addition, teenage pregnancy is often outside of marriage and therefore carries a social stigma in many cultures and community.

Matched MeSH terms: Social Stigma
Fulltext Poor adherence to antiretroviral therapy and associated factors among people living with HIV in Omdurman City, Sudan

Yassin Ibrahim, Rosnah Sutan, Khalib Bin Abdul Latif, Al - Abed A. Al - Abed, Amara, Ahmed, Adam, Ishag

Malaysian Journal of Public Health Medicine, 2014;14(1):90-101.
MyJurnal

Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46-8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02-1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51-23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74-73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44-18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27-12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.

Matched MeSH terms: Social Stigma
Fulltext Physical and psychosocial impacts of pregnancy on adolescents and their coping strategies: a descriptive study in Kuala Lumpur, Malaysia

Su XV, Muhammad NA, Tan PS, Tan KTM, Tohid H, Omar K

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

Teenage pregnancy carries serious impacts on adolescent health. This study aimed to examine the effects of pregnancy on adolescents and to explore how they cope with the problems they faced during the pregnancy. It involved 26 adolescents residing in a government shelter home in Kuala Lumpur. A self-administered questionnaire containing a mixture of open- and closed-ended questions was used. Among physical (sleeping problem and self-care problem), psychological (emotional difficulties and low self-efficacy) and social (stigma and discrimination, financial difficulty, friendship problem and school dropout) problems, emotional difficulties were the most common problems, whereas stigma and discrimination was the least common. Young adolescents aged less than 16 years old were significantly associated with poor self-care (p=0.01). To cope with their problems, the adolescents generally used avoidance, withdrawal, and social support, particularly from parents and peers. Doctors were the least popular among all. In conclusion, holistic and individualised care is needed. Strategies to reduce emotional problem experienced by pregnant adolescents should be implemented. The available healthcare services for teenage pregnancy should also be promoted.

Matched MeSH terms: Social Stigma
Fulltext Reducing stigma towards people with mental illness in Malaysia

Lim, Sheri

ASEAN Journal of Psychiatry, 2015;16(2):261-264.
MyJurnal

Mental illness accounts for 12% of the global burden of disease with a reported 1 in 5 Malaysians suffering from a psychological disorder. Sufferers have been long plagued by stigma, which results in social isolation, low-selfesteem, lower opportunities for employment, housing, and ability to achieve life goals. This essay aims to suggest strategies to overcome such stigma in the local setting. Methods: Literature search was conducted through PubMed (http://www.ncbi.nlm.nih.gov/pubmed) and Google Scholar (http://scholar.google.com.my). Data obtained was compiled as an opinion piece. Results: Thefactors contributing to stigma in Malaysia include a lack of public knowledge, language and cultural influences, inaccurate media portrayal, doctors’ attitudes towards the field of psychiatry, and psychiatrists themselves. Stigma can be tackled in four areas: society, media, medical education, and the field of psychiatry. Firstly, psychiatric terminology can be adapted to local languages and cultural beliefs in order to avoid misconceptions. Secondly, public education is more effective if focused to targeted key groups. The media is crucial in influencing the public mind-set, and needs to be creatively engaged. Thirdly, more positive medical practitioner attitudes to mental illness can be moulded through early psychiatric postings during medical school. Finally, psychiatrists play a role in correcting misconceptions, avoiding misdiagnosis and ineffective treatments. Cultural competency leads to better management of patients by awareness towards socio-cultural and religious influences. Conclusion: A multifaceted, united coalition of effort is needed in order to tackle stigma in different contexts, and will require concerted leadership from different parties.

Matched MeSH terms: Social Stigma
Fulltext A better mental health for all

Jasraj, S., Viknesh, N.

Malaysian Journal of Psychiatry, 2017;26(1):0-0.
MyJurnal

Psychiatric services have progressed well throughout history, marked by a shift from heavily inpatient asylums to outpatient management via deinstitutionalization, and advances in psychopharmacology. An overview of important themes is discussed at public mental health level. Firstly, differences between sexes are touched upon from theoretical and societal perspectives. Next, among the disabled, the phenomenon of diagnostic overshadowing, attributing apparent mental health problems to learning disability, contributes to their overall poorer quality of life. Mental health at both extremes of age is another important theme, whereby dementia and depression are keenly observed in the older age group, while maternal risk factors and parenting play a role in the mental well-being of the younger age group. Fourthly, inequalities, stigma and discrimination, are rife among people living with mental illness, and thereby detrimental in their road to recovery. Deinstitutionalization is explained as being more than just downsizing the inpatient load, gaining prominence with the emergence of community psychiatry services, and found to be helpful in overcoming stigma. Demographically, it was demonstrated that developing countries, as opposed to developed countries, have advantages in their approaches to psychiatric services, including better integration of people living with mental illness into society. Lastly, the psychological well-being of mental health workers should not be discounted, with measures such as stress management and resilience training proving to be key in combating burnout.

Matched MeSH terms: Social Stigma
Fulltext Acceptability of a microfinance-based empowerment intervention for transgender and cisgender women sex workers in Greater Kuala Lumpur, Malaysia

Lall P, Shaw SA, Saifi R, Sherman S, Azmi NN, Pillai V, et al.

J Int AIDS Soc, 2017 08 02;20(1):21723.
PMID: 28782331 DOI: 10.7448/IAS.20.1.21723

INTRODUCTION: Cisgender and transgender woman sex workers (CWSWs and TWSWs, respectively) are key populations in Malaysia with higher HIV-prevalence than that of the general population. Given the impact economic instability can have on HIV transmission in these populations, novel HIV prevention interventions that reduce poverty may reduce HIV incidence and improve linkage and retention to care for those already living with HIV. We examine the feasibility of a microfinance-based HIV prevention intervention among CWSW and TWSWs in Greater Kuala Lumpur, Malaysia.
METHODS: We conducted 35 in-depth interviews to examine the acceptability of a microfinance-based HIV prevention intervention, focusing on: (1) participants' readiness to engage in other occupations and the types of jobs in which they were interested in; (2) their level of interest in the components of the potential intervention, including training on financial literacy and vocational education; and (3) possible barriers and facilitators to the successful completion of the intervention. Using grounded theory as a framework of analysis, transcripts were analysed through Nvivo 11.
RESULTS: Participants were on average 41 years old, slightly less than half (48%) were married, and more than half (52%) identified as Muslim. Participants express high motivation to seek employment in other professions as they perceived sex work as not a "proper job" with opportunities for career growth but rather as a short-term option offering an unstable form of income. Participants wanted to develop their own small enterprise. Most participants expressed a high level of interest in microfinance intervention and training to enable them to enter a new profession. Possible barriers to intervention participation included time, stigma, and a lack of resources.
CONCLUSION: Findings indicate that a microfinance intervention is acceptable and desirable for CWSWs and TWSWs in urban Malaysian contexts as participants reported that they were ready to engage in alternative forms of income generation.

Matched MeSH terms: Social Stigma
Fulltext Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV

Lazarus JV, Safreed-Harmon K, Kamarulzaman A, Anderson J, Leite RB, Behrens G, et al.

Nat Commun, 2021 07 16;12(1):4450.
PMID: 34272399 DOI: 10.1038/s41467-021-24673-w

Health systems have improved their abilities to identify, diagnose, treat and, increasingly, achieve viral suppression among people living with HIV (PLHIV). Despite these advances, a higher burden of multimorbidity and poorer health-related quality of life are reported by many PLHIV in comparison to people without HIV. Stigma and discrimination further exacerbate these poor outcomes. A global multidisciplinary group of HIV experts developed a consensus statement identifying key issues that health systems must address in order to move beyond the HIV field's longtime emphasis on viral suppression to instead deliver integrated, person-centered healthcare for PLHIV throughout their lives.

Matched MeSH terms: Social Stigma
Fulltext Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study

Wong LP

AIDS Care, 2013;25(11):1356-69.
PMID: 23406514 DOI: 10.1080/09540121.2013.766302

The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD±2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics.

Matched MeSH terms: Social Stigma*
A Qualitative Study of HIV "Test-and-Treat" Experience Among Men Who Have Sex With Men in Malaysia

Lim SH, Alias H, Kien JKW, Akbar M, Kamarulzaman A, Wong LP

AIDS Educ Prev, 2019 06;31(3):193-205.
PMID: 31145000 DOI: 10.1521/aeap.2019.31.3.193

This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.

Matched MeSH terms: Social Stigma*
Meta-synthesis of Qualitative Research of Pre-exposure Prophylaxis (PrEP) Adherence Among Men Who Have Sex With Men (MSM)

Ching SZ, Wong LP, Said MAB, Lim SH

AIDS Educ Prev, 2020 10;32(5):416-431.
PMID: 33112675 DOI: 10.1521/aeap.2020.32.5.416

The aim of the study was to consolidate evidence on barriers and facilitators to PrEP adherence among men who have sex with men. PubMed, Science Direct, and EBSCO host were utilized to search for relevant articles. Six articles from PubMed, published between 2010 and 2018, were reviewed. Thematic analysis was employed to synthesize findings. At the individual level, HIV susceptibility, knowledge of PrEP, and individual lifestyle affected PrEP adherence. At the organizational level, cost of PrEP and quality of PrEP services influenced adherence to PrEP. At the societal level, social stigma, financial assistance or medical insurance, and family and peer support were determinants of PrEP adherence. Facilitators included perceived high risk of HIV infection and payment assistance, while barriers included social stigma and high cost of PrEP. Social stigma and structural level factors such as payment assistance and cost of PrEP need to be examined to ensure optimal adherence to PrEP.

Matched MeSH terms: Social Stigma*
A Qualitative Study of Young Men Who Have Sex With Men and Multilevel Factors Related to HIV Risks in Malaysia

Burch WJ, Hart GJ, Lim SH

AIDS Educ Prev, 2018 04;30(2):85-95.
PMID: 29688771 DOI: 10.1521/aeap.2018.30.2.85

Young men who have sex with men (YMSM) are a group at high risk for HIV infection, yet no research has been conducted to understand this population in Malaysia. Semistructured interviews from a combination of YMSM aged 18-25 (n = 20) and local service providers of sexual health services (n = 4) were conducted from May to June 2015. Thematic analysis was used to identify common themes in participant responses from transcripts. Participants reported societal and internalized homophobia, an absence of sex education and difficulty accessing confidential HIV testing. This study provides insights into how homophobia in Malaysian society influences individual risk behavior for HIV in Malaysian YMSM, and makes practical suggestions for more effective HIV prevention in this population.

Matched MeSH terms: Social Stigma*
Fulltext A Moderated Mediation Model of HIV-Related Stigma, Depression, and Social Support on Health-Related Quality of Life among Incarcerated Malaysian Men with HIV and Opioid Dependence

Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL

AIDS Behav, 2017 Apr;21(4):1059-1069.
PMID: 28108877 DOI: 10.1007/s10461-017-1693-x

Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p social support and HRQoL was positive (β = 0.4352, p = 0.0433), whereas the interaction between HIV-related stigma and depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.

Matched MeSH terms: Social Stigma*
Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia

Wong LP, Syuhada AR

Southeast Asian J. Trop. Med. Public Health, 2011 Sep;42(5):1119-29.
PMID: 22299438

Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.

Matched MeSH terms: Social Stigma*
Fulltext Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?

Earnshaw VA, Jin H, Wickersham JA, Kamarulzaman A, John J, Lim SH, et al.

AIDS Behav, 2016 Jan;20(1):98-106.
PMID: 26324078 DOI: 10.1007/s10461-015-1168-x

Men who have sex with men (MSM) living in countries with strong stigma toward MSM are vulnerable to HIV and experience significant barriers to HIV care. Research is needed to inform interventions to reduce stigma toward MSM in these countries, particularly among healthcare providers. A cross-sectional survey of 1158 medical and dental students was conducted at seven Malaysian universities in 2012. Multivariate analyses of variance suggest that students who had interpersonal contact with MSM were less prejudiced toward and had lower intentions to discriminate against MSM. Path analyses with bootstrapping suggest stereotypes and fear mediate associations between contact with prejudice and discrimination. Intervention strategies to reduce MSM stigma among healthcare providers in Malaysia and other countries with strong stigma toward MSM may include facilitating opportunities for direct, in-person or indirect, media-based prosocial contact between medical and dental students with MSM.

Matched MeSH terms: Social Stigma*
Fulltext The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons

Culbert GJ, Bazazi AR, Waluyo A, Murni A, Muchransyah AP, Iriyanti M, et al.

AIDS Behav, 2016 05;20(5):1026-38.
PMID: 26400080 DOI: 10.1007/s10461-015-1198-4

Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.

Matched MeSH terms: Social Stigma*
Fulltext Evaluating Physicians' Intention to Discriminate Against Patients Living with HIV in Malaysia

Tee YC, Earnshaw VA, Altice FL, Jin H, Kamarulzaman A, Wickersham JA

AIDS Behav, 2019 Apr;23(4):1039-1047.
PMID: 30560483 DOI: 10.1007/s10461-018-2362-4

People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.

Matched MeSH terms: Social Stigma*
Fulltext An assessment of health-care students' attitudes toward patients with or at high risk for HIV: implications for education and cultural competency

Jin H, Earnshaw VA, Wickersham JA, Kamarulzaman A, Desai MM, John J, et al.

AIDS Care, 2014;26(10):1223-8.
PMID: 24625279 DOI: 10.1080/09540121.2014.894616

Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p < 0.001), PWID (mean = 37.50; p < 0.001), and MSM (mean = 32.13; p < 0.001) patients were significantly lower and significantly different between each group comparison. Within group differences, most notably religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.
Site site: online surveys at seven universities: University of Malaya, National University of Malaysia, International Islamic University Malaysia, Universiti Malaysia Sarawak, Penang International Dental College, Universiti Teknologi MARA Malaysia, and Universiti Sains Malaysia.

Matched MeSH terms: Social Stigma*
Self-stigma and its associations with stress and quality of life among Malaysian parents of children with autism

Chu SY, Park H, Lee J, Shaharuddin KKB, Gan CH

Child Care Health Dev, 2020 07;46(4):485-494.
PMID: 32396218 DOI: 10.1111/cch.12771

BACKGROUND: This study explored the relationship between self-perceived stigmatization (affiliate stigma), stress and quality of life among parents of children with autism spectrum disorder (ASD).
METHOD: Participants (N = 110) filled-in the Affiliate Stigma Scale, the Caregiver Burden Inventory and the CarerQOL scale.
RESULTS: Parents reported low scores on stigma and fair levels of stress and quality of life, indicating that parents do not feel stigmatized by affiliation with a child with ASD nor are they stressed from affiliate stigma. After controlling for demographic factors, both the relationships of affiliate stigma with stress and with quality of life were weak, indicating that stigma may have little to no effect on stress and quality of life.
CONCLUSION: Cultural and religious beliefs may play a part in the acceptance of a child's condition, resulting in less impact of stigma on the parents.

Matched MeSH terms: Social Stigma*
Linguistic validation of stigmatisation degree, self-esteem and knowledge questionnaire among asthma patients using Rasch analysis

Ahmad S, Ismail AI, Khan TM, Akram W, Mohd Zim MA, Ismail NE

J Asthma, 2017 04;54(3):318-324.
PMID: 27410725 DOI: 10.1080/02770903.2016.1208222

BACKGROUND AND OBJECTIVE: The stigmatisation degree, self-esteem and knowledge either directly or indirectly influence the control and self-management of asthma. To date, there is no valid and reliable instrument that can assess these key issues collectively. The main aim of this study was to test the reliability and validity of the newly devised and translated "Stigmatisation Degree, Self-Esteem and Knowledge Questionnaire" among adult asthma patients using the Rasch measurement model.
METHODOLOGY: This cross-sectional study recruited thirty adult asthma patients from two respiratory specialist clinics in Selangor, Malaysia. The newly devised self-administered questionnaire was adapted from relevant publications and translated into the Malay language using international standard translation guidelines. Content and face validation was done. The data were extracted and analysed for real item reliability and construct validation using the Rasch model.
RESULTS AND CONCLUSION: The translated "Stigmatisation Degree, Self-Esteem and Knowledge Questionnaire" showed high real item reliability values of 0.90, 0.86 and 0.89 for stigmatisation degree, self-esteem, and knowledge of asthma, respectively. Furthermore, all values of point measure correlation (PTMEA Corr) analysis were within the acceptable specified range of the Rasch model. Infit/outfit mean square values and Z standard (ZSTD) values of each item verified the construct validity and suggested retaining all the items in the questionnaire. The reliability analyses and output tables of item measures for construct validation proved the translated Malaysian version of "Stigmatisation Degree, Self-Esteem and Knowledge Questionnaire" as a valid and highly reliable questionnaire.
Study site: Respiratory clinics, Hospital Selayang, Hospital Sungai Buloh, Selangor, Malaysia

Matched MeSH terms: Social Stigma*
Fulltext Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia

Ibrahim N, Amit N, Shahar S, Wee LH, Ismail R, Khairuddin R, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):544.
PMID: 31196033 DOI: 10.1186/s12889-019-6862-6

BACKGROUND: Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated.
METHODS: University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI).
RESULTS: Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p stigma on seeking help (F (2,199) = 8.207, p stigma and negative beliefs toward mental illness compared to secondary school students.
CONCLUSION: Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.

Matched MeSH terms: Social Stigma*

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