Heyam F. Dalky

Mental Illness Stigma Reduction Interventions Review of Intervention Trials

This article reviews the literature evaluating the effectiveness of various stigma reduction interventions related to mental health illnesses. An integrated search of the English language literature from 1998 to May 2008 was done using CINAHL, Medline, PubMed, Scopus, and PsychINFO databases. The results of this review emphasize that experimental clinical trials hold promise for providing evidence-based data that can be used in mental health practice. Educational and contact-based strategies used in various stigma reduction programs resulted in the most durable gains in knowledge as well as positive attitudinal and behavioral changes needed to decrease the stigma associated with mental illness. Special stigma reduction programs are to be planned for adolescent and elderly targets. Future studies have yet to be designed to identify cost-effective stigma reduction programs. Moreover, interventional studies from different cultures are encouraged. Cross-cultural interventions need to be evaluated and modified to ensure providing culturally relevant interventions.

Perception and Coping with Stigma of Mental Illness: Arab Families’ Perspectives

Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families’ perception of stigma related to mental illness, and to compare Arab families’ approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families’ perceptions of stigma: What impacts does stigma perception have on those families and on their relatives’ care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families’ perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members’ perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives.

Arabic translation and cultural adaptation of the stigma-devaluation scale in Jordan

Background A review of the literature on measuring the concept of stigma related to caring for a relative with mental illness yielded no instrument appropriate for use in Jordan. Aims To translate and culturally modify the stigma-devaluation scale (SDS) into Arabic, and to test the reliability, content and construct validity of the Arabic version of the SDS. Method The SDS was translated into the Arabic language, modified and culturally adapted by a translation model. Estimation of internal consistency was used to assess the reliability of the SDS. Construct validity was determined by confirmatory factor analysis (CFA). Measurements of content validity and reading level of the Arabic SDS were included. The Arabic SDS was evaluated in a sample of 164 family caregivers in Jordan. Results Content validity index was determined to be 1.0. Reading level of the Arabic SDS was deemed to be at a sixth grade level or higher. Cronbachs alpha coefficient of the Arabic SDS total scale was 0.87. The results of the CFA revealed that the factor structure of the SDS had a satisfactory fit. Conclusion This study provided psychometric evidence that the modified Arabic SDS is valid and conceptually consistent with the content of the original English SDS.

Factors affecting help-seeking attitudes regarding mental health services among attendance of primary health care centers in Jordan

ABSTRACT Despite the availability of effective treatment and services for mental health problems, a few members of the affected population utilize mental health services (MHS) in which many remain untreated. This study examined the factors influencing attitudes toward seeking formal MHS among attendance of primary health care centers. It was hypothesized that individuals’ cultural beliefs about mental problems and perceived level of stigma toward formal MHS would be the dominant factors affecting individuals’ attitudes toward formal MHS. A structured questionnaire was distributed to clients attending 25 primary care centers in Jordan, during the period July–September 2015 to measure the attitudes toward seeking formal mental help, cultural beliefs about mental health problems, and perceived level of Societal Stigma. Descriptive statistics and Hierarchical Regression analysis were used to analyze the data. Participants were 482 clients, 52.9% (n = 254) females, with an average age was 34.75 years (SD = 11.755 years). Sixty-six percent of the participants tend to use informal MHS as the treatment strategy for psychiatric disorders. The results of the analysis of the hierarchical regression model indicated that cultural beliefs about mental illness and perceived societal stigma were the factors most likely to affect individuals’ attitudes toward seeking formal MHS. This study highlights the importance of designing pragmatic mental health strategies to improve the use of MHS.

Quality of Life, Stigma and Burden Perception Among Family Caregivers and Patients with Psychiatric Illnesses in Jordan.

The literature reported several factors which could impact the quality of life of caregivers and patients with psychiatric illnesses. This study aimed to determine the level of quality of life among a sample of 532 of caregivers and patients with psychiatric illness at two out-patient mental health clinics in Northern Jordan, and to examine the relationships of sociodemographic characteristics, stigma and caregiver perceptions of burden with quality of life. A correlational descriptive design was utilized. Three self-administered questionnaires were used. Results indicated that patients had low to moderate QOL, and they suffered moderate to high stigma. Also, family caregivers perceived low to moderate QOL. Patients’ and family caregivers’ stigma perception correlated negatively and significantly with WHOQOL-BREF. Family caregivers’ burden correlated negatively and significantly with all domains of WHOQOL-BREF, total QOL-100, and self-reported general health. Health care providers should assure the importance of focusing more toward minimizing stigma and promoting physical and general health to maintain a good quality of life of caregivers and patients with mental illnesses.

Eating Habits and Associated Factors Among Adolescent Students in Jordan

The study aimed to assess adolescent patterns of eating habits, determine factors influencing these patterns, and identify male and female differences related to eating habits. Using a cross-sectional study approach, a sample of adolescents (N = 423) in randomly selected clusters chosen from government and private schools in the south of Jordan completed self-administered questionnaires relating to socio-demographic data and personal eating habits. Results showed that parents, peers, and mass media are contributing factors, with peer pressure likely outweighing parental guidance. Males were more likely to be influenced by peers than females, whereas females were more likely to be influenced by media-based advertising. Lower body mass indices correlate with eating breakfast, which a majority of adolescents reported they do not do. Interventions targeted toward improving eating and active behaviors should involve peers as well as parents.

Psychosocial Burden and Stigma Perception of Jordanian Patients With Epilepsy

Epilepsy requires long-term treatment that interferes with individuals’ social relationships. Because the effects of psychosocial burden and stigma perception on patients with epilepsy in Jordan have not been explored, the study assessed the relationship among psychosocial burden, stigma of epilepsy, and demographic variables. Subjects were adult patients with epilepsy (N = 200) registered at hospital clinics. Two published instruments were used to measure outcomes. The participants in the study perceived the burden and stigma of epilepsy as moderate. A strong, positive correlation between psychosocial burden and stigma perception among participants was found. Stigma perception, employment, and education variables explained 31.6% of variation of the level of psychosocial burden. The results showed a relationship between stigma perception and psychosocial level, and this provides information that may assist health care providers in formulating strategic plans to improve the care, safety, and quality of life of patients with epilepsy in Jordan.