Asuka Kato1, Yuko Fujimaki2, Shin Fujimori3, Yoshihiko Izumida4, Ryo Suzuki5, Kohjiro Ueki6, Takashi Kadowaki7, Hideki Hashimoto8. 1. The University of Tokyo, Graduate School of Medicine, Division of Social Medicine, Tokyo, Japan; The Health Care Science Institute, Tokyo, Japan. Electronic address: asukakato-tky@umin.ac.jp. 2. Teikyo University, School of Medicine, Department of Internal Medicine, Tokyo, Japan. Electronic address: yukofuji@med.teikyo-u.ac.jp. 3. Teikyo University, School of Medicine, Department of Internal Medicine, Tokyo, Japan. Electronic address: fujimori@med.teikyo-u.ac.jp. 4. The University of Tokyo, Graduate School of Medicine, Department of Diabetes and Metabolic Diseases, Tokyo, Japan. Electronic address: yoshiiz-tky@umin.ac.jp. 5. The University of Tokyo, Graduate School of Medicine, Department of Diabetes and Metabolic Diseases, Tokyo, Japan. Electronic address: ryosuzuki-tky@umin.ac.jp. 6. The University of Tokyo, Graduate School of Medicine, Department of Diabetes and Metabolic Diseases, Tokyo, Japan. Electronic address: ueki-tky@umin.net. 7. The University of Tokyo, Graduate School of Medicine, Department of Diabetes and Metabolic Diseases, Tokyo, Japan. Electronic address: kadowaki-3im@h.u-tokyo.ac.jp. 8. The University of Tokyo, School of Public Health, Department of Health and Social Behavior, Tokyo, Japan. Electronic address: hidehashimoto-circ@umin.ac.jp.
Abstract
OBJECTIVE: To explore how patients with type 2 diabetes (T2DM) psychologically and behaviorally respond to internalized stigma through social stigma. METHODS: A qualitative study with semi-structured interviews was recorded on audiotapes, transcribed verbatim, and analyzed using a grounded theory approach. Participants were adults aged 30-64 years and diagnosed with T2DM. A total of 26 patients participated. RESULTS: The qualitative data revealed that participants' responses to social stigma, although varied, could be organized into a four-step process: Encountering Negative Experiences, Reevaluating the Self with Type 2 Diabetes, Reconstructing a Sense of Identity, and Maintaining Balance between Patient and Social Roles. When participants form a negative image of and relationship to their illness, they tend to internalize stigma, which can affect their sense of self-worth, attitude toward social participation, and compliance. CONCLUSION: Participants who internalize stigma tend to have a lower sense of self-worth and their social participation falls somewhere between severely limited (Social Avoidance) and highly active (Role Conflict). This can hinder devotion to their treatment regimen and affect their degree of compliance with physicians. PRACTICE IMPLICATIONS: Internalized stigma can be assessed by observing a patient's illness-related negative self-image.
OBJECTIVE: To explore how patients with type 2 diabetes (T2DM) psychologically and behaviorally respond to internalized stigma through social stigma. METHODS: A qualitative study with semi-structured interviews was recorded on audiotapes, transcribed verbatim, and analyzed using a grounded theory approach. Participants were adults aged 30-64 years and diagnosed with T2DM. A total of 26 patients participated. RESULTS: The qualitative data revealed that participants' responses to social stigma, although varied, could be organized into a four-step process: Encountering Negative Experiences, Reevaluating the Self with Type 2 Diabetes, Reconstructing a Sense of Identity, and Maintaining Balance between Patient and Social Roles. When participants form a negative image of and relationship to their illness, they tend to internalize stigma, which can affect their sense of self-worth, attitude toward social participation, and compliance. CONCLUSION:Participants who internalize stigma tend to have a lower sense of self-worth and their social participation falls somewhere between severely limited (Social Avoidance) and highly active (Role Conflict). This can hinder devotion to their treatment regimen and affect their degree of compliance with physicians. PRACTICE IMPLICATIONS: Internalized stigma can be assessed by observing a patient's illness-related negative self-image.
Authors: Christy J W Ledford; Charisse Villareal; Elizabeth W Williams; Lauren A Cafferty; Jeremy T Jackson; Dean A Seehusen Journal: Diabetes Spectr Date: 2022-01-25
Authors: Mythily Subramaniam; Edimansyah Abdin; S Bhuvaneswari; P V AshaRani; Fiona Devi; Kumarasan Roystonn; Peizhi Wang; Ellaisha Samari; Saleha Shafie; Janhavi Ajit Vaingankar; Rob M van Dam; Eng Sing Lee; Chee Fang Sum; Siow Ann Chong Journal: Front Psychol Date: 2021-07-09
Authors: Catherine Henshall; Parth Narendran; Robert C Andrews; Amanda Daley; Keith A Stokes; Amy Kennedy; Sheila Greenfield Journal: BMJ Open Date: 2018-07-17 Impact factor: 2.692