ISSN 1302-6631
 

Original Research (Original Article) 


Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach

Meral Demirören, Yeşim Şenol, Ayşen Melek Aytuğ-Koşan, Meram Can Saka.

Cited by (1)

Abstract
Stigmatization towards mental illness is common both in society and healthcare personnel. This study aims to determine attitudes of medical students towards mental illness, the effective factors in their attitudes and to reveal their educational needs.
The mixed model consisting of qualitative and quantitative methods was used to design the study. The study group of this cross-sectional research consisted of 744 2nd year and 5th year students, 21 healthcare personnel and 10 faculty working in psychiatry clinic in Medical Schools at Ankara University and Akdeniz University. Socio-demographic information form, stigma scales (Characteristics Scale, Affective Reaction Scale, Social Distance Scale) for alcohol-substance dependence, schizophrenia and depression, focus group discussion and individual interview methods were used to collect data. Stigma scales were applied on medical students and healthcare personnel. Four focus group discussions was conducted with the 5th year students and semi-structured individual interview was made with psychiatric faculty. Students' T-Test, ANOVA, Chi-square test and regression analysis were applied for quantitative data and content analyses were conducted for focus group discussions and individual interviews.
It is observed that medical students have stigmatization tendency mostly to alcohol-substance dependence which is followed by schizophrenia and depression, respectively. "Characteristics Scale" scores of the 5th year students for alcohol-substance dependence and schizophrenia exhibit statistically less stigmatization than "Social Distance Scale" scores of the 2nd year students for depression. According to the regression analysis, variables related to stigmatization are gender (male), economic status of family (middle income), presence of mental ilness in family (not available), education period (2nd year) and having mental ilness (non available). Qualitative data indicated that "being diagnosed with mental ilness", "danger-uncertainty", "appearance", "affinity-relationship", and "belief and culture" are effective factors in attitudes of medical students towards mental ilnesss; their knowledge increase with psychiatry clerkship; however, their attitudes and behaviors do not change to a great extent.
In light of the research findings, it can be recommended that a program which aims to enable students to achieve metacognitive and behavioral skills; to approach stigmatization in the context of humanism and patient-physician relationship; continues during medical education should be used in stigmatization education.
Key words: Stigma, mental ilnesss, medical education

Key words: Key words: Stigma, mental ilnesss, medical education



Tıp eğitiminde ruhsal bozukluklara karşı damgalama eğitimi gereksiniminin değerlendirilmesi: Nitel ve nicel yaklaşım

Ozet
Ruhsal hastalıklara karşı stigmatizasyon hem genel toplum içinde hem de sağlık çalışanları arasında yaygındır. Çalışmanın amacı, tıp fakültesi öğrencilerinin ruhsal hastalıklara karşı stigmatizasyon tutumlarını ve etkileyen faktörleri belirlemek ve eğitim gereksinimlerini ortaya koymaktır.
Araştırma nicel ve nitel araştırma yöntemlerinin birlikte kullanıldığı karma model ile tasarlanmıştır. Kesitsel nitelikteki araştırma, Ankara Üniversitesi Tıp Fakültesi ve Akdeniz Üniversitesi Tıp Fakültelerinde 744 ikinci ve beşinci sınıf öğrencisi, 21 sağlık çalışanı ve 10 öğretim üyesi ile yürütülmüştür. Veriler, sosyo-demografik bilgi formu, alkol-madde bağımlılığı, şizofreni ve depresyon için stigma ölçekleri (Karakteristikler Ölçeği, Duygusal Tepki Ölçeği, Sosyal Mesafe Ölçeği), odak grup görüşmesi ve bireysel görüşme yöntemleri ile toplanmıştır. Stigma ölçekleri öğrenciler ve sağlık çalışanlarına uygulanmıştır. Beşinci sınıf öğrencileri ile dört odak grup görüşmesi, öğretim üyeleri ile yarı yapılandırılmış bireysel görüşme yapılmıştır. Nicel veriler için Student’s T Testi, ANOVA, Ki-Kare testi ve regresyon analizi uygulanmış, odak grup görüşmeleri ve bireysel görüşmeler için içerik analizi yapılmıştır.
Tıp öğrencileri en fazla alkol-madde bağımlığına karşı stigmatizasyon eğilimi gösterirken, bunu sırasıyla şizofreni ve depresyon izlemektedir. 5.Sınıf öğrencileri sadece alkol-madde bağımlılığı ve şizofreni için “Karakteristikler Ölçeği” puanlarında ve depresyon için “Sosyal Mesafe Ölçeği” puanlarında 2. sınıf öğrencilerine göre anlamlı olarak daha az stigmatizasyon göstermektedir. Regresyon analizine göre stigmatizasyon ile ilişkili bulunan değişkenler, cinsiyet (erkek), ailenin ekonomik durumu (orta düzey), ailede ruhsal hastalık varlığı (var olmaması), eğitim dönemi (2. sınıf) ve kendinde ruhsal hastalık varlığıdır (var olmama). Nitel veriler, tıp öğrencilerinin ruhsal hastalıklara karşı tutumlarında “ruhsal hastalık tanısı alma”, “tehlikeli olma-bilinmezlik”, “görünüm”, “yakınlık-akrabalık” ve “inanç ve kültür”ün etkili olduğunu; psikiyatri stajı ile bilgilerinin arttığını, ancak tutum ve davranışlarının çok fazla değişmediğini ortaya koymuştur.
Araştırma bulgularından yola çıkılarak, stigmatizasyon eğitiminin öğrencilerde metabilişsel ve davranışsal beceriler kazandırmayı amaçlayan; stigmatizasyonu humanizm ve hasta-hekim ilişkisi bağlamında ele alan; tıp eğitimi süresince devam eden entegre bir programla uygulanması önerilebilir.

Anahtar kelimeler: Stigma, ruhsal hastalıklar, tıp eğitimi

Anahtar Kelimeler: Anahtar kelimeler: Stigma, ruhsal hastalıklar, tıp eğitimi


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Meral Demirören
Articles by Yeşim Şenol
Articles by Ayşen Melek Aytuğ-Koşan
Articles by Meram Can Saka
on Google
on Google Scholar
Article Statistics
 Viewed: 7518
Downloaded: 2944
Cited: 1


REFERENCES
1. Shulze B, Angermeyer MC. Subjective experi-ences of stigma. A Focus groups study of shizo-phrenic patients, their relatives and mental health prefessionals. Soc Sci Med 2003; 56:299-312. [DOI via Crossref]   
2. Thornicroft G. Most people with mental illness are not threated. Lancet 2007; 70:807-808. [DOI via Crossref]   
3. Jorm AF, Christensen H, Medway J. Korten AE, Jacomb PA, Rodgers B. Public belief systems about the helpfulness of interventions for depreþ-sion: Associations with history of professional help-seeking. Soc Pscyciatry Epidemiol 2000; 35:211-219. [DOI via Crossref]   
4. Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Social 2001; 27:363-385. [DOI via Crossref]   
5. Lauber C, Nordt C, Braunschweig C, Rossler W. Do mental health professionals stigmatize their patients? Acta Psychiatr Scand 2006; (Suppl.429):51-59. [DOI via Crossref]    [Pubmed]   
6. Nordt C, Rossler W, Lauber C. Attitudes of mental health professionals toward people with schizo-phrenia and major depression. Schizophr Bull 2006; 32:709-714. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
7. Dickerson FB, Sommerville J, Origoni AE, Ringel NB, Parente F. Experiences of stigma among outpatients with schizophrenia. Schizophr Bull 2002; 28:143-145. [DOI via Crossref]    [Pubmed]   
8. Baxter H, Singh SP, Standen P, Duggan C. The attitudes of ‘tomorrow’s doctors’ towards mental illness and psychiatry: changes during the final undergraduate year. Med Educ 2001; 35:381-383. [DOI via Crossref]    [Pubmed]   
9. Mino Y, Yasuda N, Tsuda T, Shimodera S. Effects of a one-hour educational programs on medical students’ attidudes to mental illness in medical students. Psychiatr Clin Nuerosci 2001; 55:501-507. [DOI via Crossref]    [Pubmed]   
10. Chung KF. Changing the attitudes of Hong Kong medical students toward people with mental illness. J Nerv Ment Dis 2005; 193:766-768. [DOI via Crossref]    [Pubmed]   
11. Penn DL, Komana S, Mansfield M, Link BG. Dispelling the stigma of Schophrenia: II. The im-pact of information on dangerousness. Schizophr Bull 1999; 25:437-446. [DOI via Crossref]    [Pubmed]   
12. Altýndað A, Yanýk M, Uçok A, Alptekin K, Ozkan M. Effects of on antistigma program on medical students’ attitudes towards people with schizo-phrenia. Psychiatr Clin Nuerosci 2006; 60:283-288. [DOI via Crossref]    [Pubmed]   
13. Arýkan K, Uysal O. Emotional reactions to the mentally illare positively influenced by personal acquaintance. Isr J Psychiatry Relat Sci 1999; 36:100-104.
14. Arýkan K, Uysal O, Þenocak M, Dirican A, Oran O, Erdem Ý. The influence of information on social and occupational outcome in mental illness on the attitudes of students in Turkey. Isr J Psychiatry Relat Sci 2000; 37:320-325.
15. Savrun MB, Arýkan K, Uysal O, Çetin G, Poyraz BC, Aksoy C, et al. Gender effect on attitudes towards the mentally ill: A survey of Turkish University Students. Isr J Psychiatry Relat Sci 2007; 44:57-61. [Pubmed]   
16. Aydýn N, Yiðit A, Ýnandý Y, Kýrpýnar I. Attitudes of hospital staff toward mentally ill patient in a teaching hospital, Turkey. Int J Soc Psychiatry 2003; 49:17-26. [DOI via Crossref]   
17. Mukherje R, Fialho A, Wijetunge K, Checinski K, Surgenor T. The stigmatization on psychiatric illness: the attitudes of medical students and doctors in a London teaching hospital. Psychiatr Bull 2002; 26:178-181. [DOI via Crossref]   
18. Fernanado SM, Deane FP, Mcleod HJ. Srilankan doctors’ and medical undergraduates’ attitudes towards mental illness. Soc Psychiatry Psychiatr Epidemiol 2010; 45:733-739. [DOI via Crossref]    [Pubmed]   
19. Jorm AF, Oh E. Desire for social distance from people with mental ilnesss: A review. Aust N Z J Psychiatry 2009; 43:183-200. [DOI via Crossref]    [Pubmed]   
20. Holmes EP, Corrigan PW, Williams P, Canar J, Kubiak M. Changing public attitudes about schizophrenia. Schizophr Bull1999; 25:447-456. [DOI via Crossref]    [Pubmed]   
21. Ay P, Save D, Fidanoglu O. Does stigma con-cerning mental ilnesss differ through medical education? Soc Psychiatry Psychiatr Epidemiol 2006; 41:63-67. [DOI via Crossref]    [Pubmed]   
22. Reddy JP, Tan SMK, Azmi MT, Shaharom MH, Rosdinom R, Maniam T, et al. The effect of a clinical posting in psychiatry on the attitudes of medical students towards psychiatry and mental illness in a Malaysian Medical School. Ann Acad Med Singapore 2005; 34:505-510. [Pubmed]   
23. Totic S, Stojiljkovic D, Pavlovic Z, Zaric N, Zarkovic B, Malic L, Miheljevic M, Jasovic-Gasic M, 24. Maric NP. Stigmatization of ‘psychiatric label’ by medical and non medical students. IntJ Soc Psychiatry 2011; 58:455-462. [DOI via Crossref]    [Pubmed]   
24. Finkelstein J, Lapshin O, Reducing depression stigma using a web-based program. Int J Med Inform 2007; 76:726-734. [DOI via Crossref]    [Pubmed]   
25. Kassam A, Glozier N, Leese M, Lougran J, Thornicroft G. A controlled trial of mental illness related stigma training for medical students. BMC Med Educ 2011; 11:51. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
26. Paksoy-Erbaydar N, Çilingiroðlu N. Týp eðitimi geleceðin hekimlerinin ruh saðlýðý sorunu olan bireylere yönelik tutumlarýný etkilemekte midir? Türk Psikiyatri Dergisi 2012; 21:114-125.2214
27. Brosnan C, Turner BS, (Eds.). Handbook of the Sociology of Medical Education. USA: Taylor & Francis Group, 2009.

This Article Cited By the following articles

Attitudes towards the people with mental illness: comparison between Czech medical doctors and general population
Soc Psychiatry Psychiatr Epidemiol 2016; 51(9): 1265.

1
 
How to Cite this Article
Pubmed Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anadolu Psikiyatri Derg. 2015; 16(1): 22-29. Turkish. doi:10.5455/apd.45731


Web Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. http://www.anadolupsikiyatri.net/?mno=45731 [Access: April 01, 2020]. Turkish. doi:10.5455/apd.45731


AMA (American Medical Association) Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anadolu Psikiyatri Derg. 2015; 16(1): 22-29. Turkish. doi:10.5455/apd.45731



Vancouver/ICMJE Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anadolu Psikiyatri Derg. (2015), [cited April 01, 2020]; 16(1): 22-29. Turkish. doi:10.5455/apd.45731



Harvard Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka (2015) [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anadolu Psikiyatri Derg, 16 (1), 22-29. Turkish. doi:10.5455/apd.45731



Turabian Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. 2015. [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anatolian Journal of Psychiatry, 16 (1), 22-29. Turkish. doi:10.5455/apd.45731



Chicago Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. "[Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]." Anatolian Journal of Psychiatry 16 (2015), 22-29. Turkish. doi:10.5455/apd.45731



MLA (The Modern Language Association) Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka. "[Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]." Anatolian Journal of Psychiatry 16.1 (2015), 22-29. Print.Turkish. doi:10.5455/apd.45731



APA (American Psychological Association) Style

Meral Demiroren, Yesim Senol, Aysen Melek Aytug-Kosan, Meram Can Saka (2015) [Educational needs assessment of stigmatization towards mental illness in medical education: qualitative and quantitative approach]. Anatolian Journal of Psychiatry, 16 (1), 22-29. Turkish. doi:10.5455/apd.45731