An Anti-Stigma Course for Occupational Therapy Students in Taiwan: Development and Pilot Testing

Hui-Ing Ma, Chu-En Hsieh, Hui-Ing Ma, Chu-En Hsieh

Abstract

Attitudes of healthcare professionals towards people with disorders/disabilities are important for the development of therapeutic relationships, as well as to the evaluation and intervention processes. Therefore, it is critical to be aware and reduce stigmatizing attitudes in future healthcare professionals. An 18-week anti-stigma course was developed for occupational therapy students based on literature review and focus group interview. The course consisted of three components, including social contact, roleplaying, and critical reflection strategies. A quasi-experimental design was implemented to evaluate participants at three time points (i.e., pre-test, post-test, and one year after completion) using the Social Distance Scale and several questionnaires (i.e., stigmatising attitudes towards mental illness, physical disabilities, and children with emotional behavioural disorders). A total of 16 students completed the course and had significantly decreased social distance and stigmatising attitudes towards mental illness and emotional behavioural disorders in the post-test. These decreases remained one year later. The results support the provision of an anti-stigma course for occupational therapy students to reduce stigmatising attitudes. Future research should extend the anti-stigma course to occupational therapy students at other universities to increase both the sample size and overall generalisability.

Keywords: anti-stigma; medical education; occupational therapy students.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Themes constructed from focus-group interview transcript to develop the anti-stigma course for occupational therapy students.

References

    1. Jones N., Corrigan P.W. Understanding Stigma. In: Corrigan P.W., editor. The Stigma of Disease and Disability: Understanding Causes and Overcoming Injustices. American Psychological Association; Washington, DC, USA: 2014. pp. 9–34.
    1. Morgan A.J., Reavley N.J., Jorm A.F., Beatson R. Experiences of discrimination and positive treatment from health professionals: A national survey of adults with mental health problems. Aust. N. Z. J. Psychiatry. 2016;50:754–762. doi: 10.1177/0004867416655605.
    1. Satchidanand N., Gunukula S.K., Lam W.Y., McGuigan D., New I., Symons A.B., Withiam-Leitch M., Akl E.A. Attitudes of healthcare students and professionals toward patients with physical disability: A systematic review. Am. J. Phys. Med. Rehabil. 2012;91:533–545. doi: 10.1097/PHM.0b013e3182555ea4.
    1. Schulze B., Angermeyer M.C. Subjective experiences of stigma. a focus group study of schizophrenic patients, their relatives and mental health professionals. Soc. Sci. Med. 2003;56:299–312. doi: 10.1016/S0277-9536(02)00028-X.
    1. Corrigan P. How stigma interferes with mental health care. Am. Psychol. 2004;59:614–625. doi: 10.1037/0003-066X.59.7.614.
    1. Riffel T., Chen S.P. Exploring the knowledge, attitudes, and behavioural responses of healthcare students towards mental illnesses-a qualitative study. Int. J. Environ. Res. Public Health. 2019;17:25. doi: 10.3390/ijerph17010025.
    1. Ay P., Save D., Fidanoglu O. Does stigma concerning mental disorders differ through medical education? A survey among medical students in Istanbul. Soc. Psychiatry Psychiatr. Epidemiol. 2006;41:63–67. doi: 10.1007/s00127-005-0994-y.
    1. Abbey S., Charbonneau M., Tranulis C., Moss P., Baici W., Dabby L., Gautam M., Paré M. Stigma and discrimination. Can. J. Psychiat. 2011;56:1–9.
    1. Sherwood D.A. Healthcare curriculum influences on stigma towards mental illness: Core psychiatry course impact on pharmacy, nursing and social work student attitudes. Curr. Pharm. Teach. Learn. 2019;11:198–203. doi: 10.1016/j.cptl.2018.11.001.
    1. Chang S., Ong H.L., Seow E., Chua B.Y., Abdin E., Samari E., Teh W.L., Chong S.A., Subramaniam M. Stigma towards mental illness among medical and nursing students in Singapore: A cross-sectional study. BMJ Open. 2017;7:e018099. doi: 10.1136/bmjopen-2017-018099.
    1. Patten S.B., Remillard A., Phillips L., Modgill G., Szeto A.C., Kassam A., Gardner D.M. Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students. BMC Med. Educ. 2012;12:120. doi: 10.1186/1472-6920-12-120.
    1. Papish A., Kassam A., Modgill G., Vaz G., Zanussi L., Patten S. Reducing the stigma of mental illness in undergraduate medical education: A randomized controlled trial. BMC Med. Educ. 2013;13:141. doi: 10.1186/1472-6920-13-141.
    1. Martinez-Martinez C., Sanchez-Martinez V., Sales-Orts R., Dinca A., Richart-Martinez M., Ramos-Pichardo J.D. Effectiveness of direct contact intervention with people with mental illness to reduce stigma in nursing students. Int. J. Ment. Health Nurs. 2019;28:735–743. doi: 10.1111/inm.12578.
    1. Knaak S., Patten S.B. Building and Delivering Successful Anti-Stigma Programs for Healthcare Providers. Mental Health Commission of Canada; Calgary, AB, Canada: 2014.
    1. Knaak S., Patten S. A grounded theory model for reducing stigma in health professionals in Canada. Acta Psychiatr. Scand. 2016;134:s53–s62. doi: 10.1111/acps.12612.
    1. Knaak S., Ungar T., Patten S. Seeing is believing: Biological information may reduce mental health stigma amongst physicians. Aust. N. Z. J. Psychiatry. 2015;49:751–752. doi: 10.1177/0004867415584643.
    1. Knaak S., Mantler E., Szeto A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc. Manag. Forum. 2017;30:111–116. doi: 10.1177/0840470416679413.
    1. Mezirow J. How Critical Reflection Triggers Transformative Learning. In: Mezirow J., editor. Fostering Critical Reflection in Adulthood. Jossey-Bass Publishers; San Francisco, CA, USA: 1990. pp. 1–6.
    1. Sukhera J., Chahine S. Reducing mental illness stigma through unconscious bias-informed education. MedEdPublish. 2016;5 doi: 10.15694/mep.2016.000044.
    1. Sukhera J., Watling C. A framework for integrating implicit bias recognition into health professions education. Acad. Med. 2018;93:35–40. doi: 10.1097/ACM.0000000000001819.
    1. Deb T., Lempp H., Bakolis I., Vince T., Waugh W., Henderson C., INDIGO READ Study Group Responding to experienced and anticipated discrimination (READ): Anti-stigma training for medical students towards patients with mental illness—Study protocol for an international multisite non-randomised controlled study. BMC Med. Educ. 2019;19:41. doi: 10.1186/s12909-019-1472-7.
    1. Bamgbade B.A., Barner J.C., Ford K.H. Evaluating the impact of an anti-stigma intervention on pharmacy students’ willingness to counsel people living with mental illness. Community Ment. Health J. 2017;53:525–533. doi: 10.1007/s10597-016-0075-6.
    1. Radmanović M.B., Burgić S. Stigma and mental disorders in developmental age. Psychiatr. Danub. 2017;29:906–909.
    1. Link B.G., Cullen F.T., Frank J., Wozniak J.F. The social rejection of former mental patients: Understanding why labels matter. Am. J. Sociol. 1987;92:1461–1500. doi: 10.1086/228672.
    1. Lien Y.J., Kao Y.C. Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey. Psychiatry Res. 2019;273:435–442. doi: 10.1016/j.psychres.2019.01.062.
    1. Ma H.I., Hsieh C.E. Questionnaires on stigmatizing attitudes among healthcare students in Taiwan: Development and validation. BMC Med. Educ. 2020;20:59. doi: 10.1186/s12909-020-1976-1.
    1. Ericsson K.A., Simon H.A. Protocol Analysis: Verbal Reports as Data. Revised ed. MIT Press; Cambridge, MA, USA: 1993.
    1. Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med. Teach. 2011;33:200–205. doi: 10.3109/0142159X.2010.507714.
    1. Siegel S., Castellan N.J. Nonparametric Statistics for the Behavioural Sciences. 2nd ed. McGraw-Hill; New York, NY, USA: 1988.
    1. Helmus K., Schaars I.K., Wierenga H., de Glint E., van Os J. Decreasing stigmatization: Reducing the discrepancy between “us” and “them”: An intervention for mental health care professionals. Front. Psychiatry. 2019;10:243. doi: 10.3389/fpsyt.2019.00243.
    1. Friedrich B., Evans-Lacko S., London J., Rhydderch D., Henderson C., Thornicroft G. Anti-stigma training for medical students: The Education Not Discrimination project. Br. J. Psychiatry. 2013;202:s89–s94. doi: 10.1192/bjp.bp.112.114017.
    1. Stier A., Hinshaw S.P. Explicit and implicit stigma against individuals with mental illness. Aust. Psychol. 2007;42:106–117. doi: 10.1111/ap.2007.42.2.106.
    1. Fisher R.J., Katz J.E. Social-desirability bias and the validity of self-reported values. Psychol. Mark. 2000;17:105–120. doi: 10.1002/(SICI)1520-6793(200002)17:2<105::AID-MAR3>;2-9.
    1. Henderson C., Evans-Lacko S., Flach C., Thornicroft G. Responses to mental health stigma questions: The importance of social desirability and data collection method. Can. J. Psychiatry. 2012;57:152–160. doi: 10.1177/070674371205700304.
    1. FitzGerald C., Hurst S. Implicit bias in healthcare professionals: A systematic review. BMC Med. Ethics. 2017;18:19. doi: 10.1186/s12910-017-0179-8.
    1. Heim E., Henderson C., Kohrt B.A., Koschorke M., Milenova M., Thornicroft G. Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: A systematic review. Epidemiol. Psychiatr. Sci. 2019;29:e28. doi: 10.1017/S2045796019000167.
    1. Ungar T., Knaak S., Szeto A.C. Theoretical and Practical Considerations for Combating Mental Illness Stigma in Health Care. Community Ment. Health J. 2016;52:262–271. doi: 10.1007/s10597-015-9910-4.
    1. Ma H.I., Saint-Hilaire M., Thomas C.A., Tickle-Degnen L. Stigma as a key determinant of health-related quality of life in Parkinson’s disease. Qual. Life Res. 2016;25:3037–3045. doi: 10.1007/s11136-016-1329-z.
    1. Verhaeghe M., Bracke P. Associative stigma among mental health professionals: Implications for professional and service user well-being. J. Health Soc. Behav. 2012;53:17–32. doi: 10.1177/0022146512439453.
    1. Braveman P. What are health disparities and health equity? We need to be clear. Public Health Rep. 2014;129:5–8. doi: 10.1177/00333549141291S203.

Source: PubMed

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