Kolmos, Laura. Experiences of stigma among family members of persons living with schizophrenia: a systematic review. Retrieved from https://doi.org/doi:10.7282/t3-9psf-g535
DescriptionPurpose of Project: This systematic review sought to explicate the experiences of stigma among family members of persons living with schizophrenia.
Methodology: This review followed the Joanna Briggs Institute (JBI) approach for qualitative systematic reviews. Studies included in the first search were those published in full text, English between 1963, when Erving Goffman published his major work on stigma, and 2017. This step of the search was subsequently updated in May of 2020 to search for all articles published between 2017 and May of 2020. The main databases searched for published and unpublished studied included: Academic Search Premier, CINAHL, EMBASE, HealthStar, JSTOR, MEDLINE (medical literature on-line), PsycINFO, Psychology and Behavioral Sciences Collection, Sociology Abstracts Web of Science, ProQuest Dissertations and Theses, Virginia Henderson Nursing Library, Robert Wood Johnson Foundation Research and Publications and Health Resources and Services Administration Special Projects of National Significance.
Results: Thirty-six papers, representing studies conducted in 18 countries and involving 676 family members met the criteria for inclusion. From these, a total of 114 findings were extracted and combined to form 17 categories based on similarity in meaning. Four final syntheses were derived: i) Held hostage by stigma hiding the secret: ii) Isolated and constrained by stigma imposed by others: iii) Family carries the burden with little support: iv) What do I need?
Implications for Practice: Schizophrenia is a mental illness that is most prevalent in young adults and can have a significant impact on the person’s ability to function independently. As a result, family members often take on the role of caretaker. Healthcare workers need to recognize that stigma associated with schizophrenia and severe mental illness is extended to these family members and has a significant impact on their quality of life often leaving them feeling isolated and helpless. Incorporating the family as part of the treatment plan can provide the support needed to minimize these feelings of isolation and helplessness and improve the care they are able to provide to the person living with schizophrenia. The following recommendations require a commitment on an individual and organizational level.
1)Healthcare organizations need to procure polices and procedures and establish systems to support family involvement in the plan or care. This will provide a supportive atmosphere for family members and minimize their feelings of helplessness and loneliness.
2)Healthcare organizations need to provide ongoing education and support to all employees on the topic of stigma and mental illness and how this impacts the entire family system. Education should include the untrue depictions of schizophrenia, such as they are violent, and promote skill development on assessing the families coping strategies. This should include recognizing signs and symptoms of maladaptive coping mechanisms as well as cultural factors that may influence these coping mechanisms.
3)A hallmark symptom of schizophrenia is the odd behavior that can be exhibited. This can cause feelings of embarrassment and shame for the family member(s). Providing anticipatory guidance and skills on how to respond and prepare for this would be beneficial to families.