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      Evolución del estigma hacia salud mental en especialistas sanitarios en formación en Asturias Translated title: Evolution of the stigma towards mental health in training health specialists in Asturias

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          Abstract

          RESUMEN: Introducción: Diversos estudios analizaron el estigma en estudiantes o en profesionales sanitarios hacia personas con enfermedades mentales. Sin embargo, no hay evidencia que lo estudie en residentes en Formación Sanitaria Especializada (FSE). Objetivo: Este trabajo pretende evaluar el grado de estigma de residentes en especialidades clínicas, la formación recibida en materia «antiestigma» durante la residencia y su influencia sobre las creencias y actitudes que tenían en el primer y último año de la especialidad. Material y métodos: Diseño descriptivo transversal en una muestra de 250 residentes de enfermería, medicina y psicología clínica: 141 en el primer año de especialidad y 109 en el último, seleccionados por muestreo aleatorio proporcional al total de residentes en cada año. Para medir el estigma se utilizó la escala CAMI-S y para las variables sociodemográficas un cuestionario de elaboración propia. Ambos se crearon en la aplicación FORMS y se enviaron por correo electrónico. Se obtuvo la media y desviación estándar (DE) en «Integración y contacto», «Distancia social», «Peligrosidad y evitación», y Estigma global. Puntuación global sin estigma entre 80-100. Resultados: Tasa de respuesta del 57,6%: 72,2% mujeres, 23-28 años el 64,6%, 54,2% en primer año, 51,4% especialidad médica y de enfermería el 29,9%. El 20,1% había recibido formación «antiestigma». Media global de estigma de 86,7 (DE=8,5); de 87,3 (DE=7,9) en primer año y 86,1(DE=9,1) en último año (P=0,398); de 90,0 (DE=8,2) si recibieron formación y 86,1 (DE=8,4) si no la recibieron (p=0,027). Conclusiones: Se obtuvieron puntuaciones globales favorables al «antiestigma» hacia personas tanto en el primero como en el último año de especialidad. Cuando hubo formación «antiestigma» durante la residencia los resultados aún son más favorables. Resultaría por lo tanto beneficioso incluir contenidos en materia «antiestigma» en los programas formativos de FSE.

          Translated abstract

          ABSTRACT: Introduction: Several studies have analysed social stigma among medical and nurse students or health care workers towards people with mental disorders. However, there is no evidence of social stigma training in residents during their specialised health training (FSE). Objective This study aims to evaluate social stigma in residents in clinical specialities, the “anti-stigma” training during their residency, and its influence on the beliefs and attitudes they had in the first and last year of specialisation. Materials and Methods: A cross-sectional descriptive study in a sample of 250 residents of nursing, medicine, and clinical psychology: 141 in the first year of speciality and 109 in the last year, selected by random sampling proportional to the total number of residents in each year. The CAMI-S scale was used to measure social stigma, and a self-made questionnaire was used for sociodemographic variables. Both were created in the FORMS app and sent via email. The mean and standard deviation (SD) were obtained for “integration and contact”, “social distance”, “dangerousness and avoidance”, and overall stigma. Overall score for no stigma was between 80-100. Results: Response rate of 57.6%: 72.2% women, 64.6% 23-28 years old, 54.2% in the first year, 51.4% medical specialisation and 29.9% nursing. Only 20.1% had received “anti-stigma” training. Overall mean stigma of 86.7 (SD=8.5); 87.3 (SD=7.9) in the first year and 86.1 (SD=9.1) in the last year (P=0.398); 90.0 (SD=8.2) if they received training and 86.1 (SD=8.4) if they did not (p=0.027). Conclusions: Overall scores favourable to "anti-stigma" were obtained for people both in their first and last year of specialty. When there was "anti-stigma" training during residency, the results were even more favourable. It would therefore be beneficial to include content on "anti-stigma" in residency training programmes.

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          Most cited references27

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          Stigma in health facilities: why it matters and how we can change it

          Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. Addressing stigma is fundamental to delivering quality healthcare and achieving optimal health. This correspondence article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge—both approaches and methods—regarding interventions to reduce stigma in health facilities, and explores the potential to concurrently address multiple health condition stigmas. It is supported by findings from a systematic review of published articles indexed in PubMed, Psychinfo and Web of Science, and in the United States Agency for International Development’s Development Experience Clearinghouse, which was conducted in February 2018 and restricted to the past 5 years. Forty-two studies met inclusion criteria and provided insight on interventions to reduce HIV, mental illness, or substance abuse stigma. Multiple common approaches to address stigma in health facilities emerged, which were implemented in a variety of ways. The literature search identified key gaps including a dearth of stigma reduction interventions in health facilities that focus on tuberculosis, diabetes, leprosy, or cancer; target multiple cadres of staff or multiple ecological levels; leverage interactive technology; or address stigma experienced by health workers. Preliminary results from ongoing innovative responses to these gaps are also described. The current evidence base of stigma reduction in health facilities provides a solid foundation to develop and implement interventions. However, gaps exist and merit further work. Future investment in health facility stigma reduction should prioritize the involvement of clients living with the stigmatized condition or behavior and health workers living with stigmatized conditions and should address both individual and structural level stigma.
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            Understanding the impact of stigma on people with mental illness.

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              Mental health-related stigma in health care and mental health-care settings.

              This Review considers the evidence for mental-health-related stigma in health-care and mental-health-care settings. Do mental-health-care and other health-care professionals stigmatise people using their services? If so, what are the effects on quality of mental and physical health care? How can stigma and discrimination in the context of health care be reduced? We show that the contact mental-health-care professionals have with people with mental illness is associated with positive attitudes about civil rights, but does not reduce stigma as does social contact such as with friends or family members with mental illness. Some evidence suggests educational interventions are effective in decreasing stigma especially for general health-care professionals with little or no formal mental health training. Intervention studies are needed to underpin policy; for instance, to decrease disparity in mortality associated with poor access to physical health care for people with mental illness compared with people without mental illness.
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                Author and article information

                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                2023
                : 22
                : 69
                : 105-133
                Affiliations
                [1] Asturias orgnameÁrea Sanitaria III del Principado de Asturias orgdiv1Área de Gestión Clínica de Salud Mental España carla25@ 123456outlook.es
                [2] Asturias orgnameConsejería de Salud del Principado de Asturias orgdiv1Servicio de Transformación y Gestión del Conocimiento de la Dirección General de Calidad, Transformación y Gestión del Conocimiento España
                Article
                S1695-61412023000100004 S1695-6141(23)02206900004
                10.6018/eglobal.525701
                2e67443c-78fc-43b3-9c59-379488880de8

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 21 September 2022
                : 28 May 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 29
                Product

                SciELO Spain

                Categories
                Originales

                Social stigma,mental health,residence,social change,estigma social,salud mental,residencia,cambio social

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