The Impact Of Stigmatisation On Patients: How Healthcare Professionals Can Promote Understanding And Compassion In Healthcare Settings

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Mecha Priscilla Avatar

(Writer, Healthcare & Well-being)

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The Heavy, Crushing Burden Of Stigmatisation

In the dimly lit hospital room, Sophia, 54, lay curled up on the sterile sheets, hugging her pillow.

Her tired eyes counted the ceiling boxes as she tried to block out the hushed voices slithering through the half-closed door.

The nurses’ muffled voices outside the door about recent developments in her condition detailing the little progress in treatment made her heart pound faster as they discussed in tones laced with judgement and scepticism.

“Are we sure this woman is really sick?”

One of the nurses spoke to the other.

“She looks like she’s pretending or just wants attention…”

The discussion continued. It was the early hours of the morning. They thought she was asleep.

But she could hear them clearly as if they were lying with her on the same bed.

Tiny, hot tears tumbled down her wrinkled cheeks, soaking into her pillow.

Their scepticism hung heavy in the air, a palpable barrier that isolated her further in her struggle with her mental health.

Sophia could feel their piercing eyes on her whenever she ventured out, the uncomfortable scrutiny like a weight pressing down on her fragile frame.

The pity in their gazes felt more like condemnation than compassion, as though her illness had stripped her of dignity in their eyes.

During rounds, the doctors exchanged knowing glances that spoke volumes about their doubts regarding Sophia’s condition.

Their clipped hallway conversations, shielded behind forced smiles and professional courtesy, betrayed an undercurrent of disbelief and mortal disgust.

Though apparently supportive, the psychiatrist assigned to her case often subtly glanced at his watch during their sessions, silently conveying his impatience and scepticism.

“We’ve been seeing this patient for over a month now, and nothing seems to be changing about her condition.”

“It looks as if she’s just malingering. Maybe we have to transfer her to another facility; she’s been here for too long, and we need bed space for patients with more serious issues.”

The two primary specialists handling her case discussed over the phone during morning rounds while she was drifting in and out of drowsiness induced by the numerous medications given to her to make her sleep–or numb her from connecting with reality.

“Maybe they think I can’t hear them.” Sophia always thought to herself.

Sophia, already battling her own inner demons, now found herself grappling with the added burden of trying to prove her illness to those whose acceptance and understanding she desperately needed.

Even the caregivers tasked with her daily routines seemed to treat her with an uneasy mix of caution and disregard.

Their interactions were perfunctory at best, starkly contrasting the warmth and reassurance Sophia longed for in her moments of vulnerability.

The casual dismissal of her concerns about medication side effects and the curt responses to her questions about her treatment plan only reinforced her growing sense of alienation.

She couldn’t even say anything to her son, who always came to see her once a week because he, too, gave her that haunting look of disbelief, boredom and scepticism.

Sophia felt as though she was not just battling her illness but also the pervasive stigma that pervaded every corner of the hospital, clinging to her like a second skin, crushing, biting and suffocating her. To her, the stigma was even more killing than her actual illness.

When she was finally going home after a long time, she felt as if she was coming out of a lengthy prison sentence.

She felt liberated outside the hospital walls and vowed she was never going to seek help at the hospital again.

Stigmatisation in healthcare facilities or environments can take many forms, from outright denial of care, provision of substandard care, and physical or verbal abuse to even more subtle forms, like making people wait longer, passing their care to junior or inexperienced colleagues, or deliberately gossiping about them while they are around. These actions can have severe consequences, leading to shame, withdrawal and misdiagnosis, in the case of Sophia.

Stigmatisation can be defined as publicly disapproving of someone on account of their circumstances.

It can be more harmful than the disease itself, as patients heal better when they receive comfort and support.

Healthcare professionals must understand how to avoid throwing stigma on those they care for.

Sometimes, they don’t even know that they are displaying stigmatisation behaviours toward patients.

It can almost become involuntary, prevalent with healthcare professionals working with patients suffering from diseases or illnesses that are often stigmatised, such as HIV, Tuberculosis, COVID-19, and mental illnesses. These conditions are usually associated with misconceptions, fear, and discrimination, making it crucial for healthcare professionals to be trained and equipped with the right skills to avoid stigmatising patients and clients.

Causes Of Stigmatisation

Many factors can cause stigmatisation:

  1. Fear
    Fear is arguably the most common cause of stigmatisation. No one wants to contract a disease and risk premature death. In the given scenario, the healthcare professional’s fear of contracting HIV led her to rebuke patients who came too close to her. If the patient had been suffering from leprosy, the healthcare professional might have feared infection already. Fear often compels people to distance themselves from sick family members or close friends, not entirely out of hatred but as a precaution.
  2. Unattractiveness
    Beauty is often equated with confidence, as people naturally admire beauty in various forms. However, when an accident or illness causes a person to lose their looks, it can lead to stigmatisation from friends or acquaintances. Genuine smiles and social interaction may decrease, and communication can suffer as a result.
  3. Discomfort
    Obvious health conditions can cause your associates discomfort, making them feel uneasy around you during conversations, making eye contact challenging and affecting communication. This stigma can be prevalent among individuals who are deaf or mute, as well as those who have experienced accidents that affect prominent facial features such as the eyes, nose, or entire face. Due to this discomfort, people may tend to avoid interactions.
  4. Association
    Stigma by association, known as “symbiotic stigma,” occurs with diseases like HIV/AIDS or tuberculosis, causing people to avoid those affected. For instance, in the case of tuberculosis, persistent coughing for an extended period can lead others to suspect and distance themselves from the individual. Patients with HIV/AIDS require regular medical attention and cannot self-medicate. Consequently, health professionals may hesitate to associate with them outside hospital settings due to concerns about patient confidentiality and their medical history.
  5. Values And Beliefs
    Certain traditions and beliefs can also contribute to stigmatisation, as some health professionals may be influenced by their cultural beliefs and inadvertently stigmatise a patient. For instance, certain types of mental illness may carry different meanings within a person’s tribe or community, which can affect the healthcare provider’s judgments and decision-making.

Impact Of Stigmatisation

Stigmatisation
  1. Shame
    This feeling can make a patient withdrawn and sad. The patient may feel useless and meaningless, reducing their self-esteem and self-confidence.
  2. No Participation In Social Activities (Anti-Socialisation)
    When a patient is often stigmatised, it leads to depression, isolation and withdrawal. They may never want to be seen in public. They will rarely feel the need to have fun or feel among. They think less about themselves and want to stay alone.
  3. Suicide
    There are many cases of suicide yearly, and most of them come from the adverse effects of stigmatisation. Most people can’t bear the pain of being an outcast forever, so they just end their life.

How can health professionals promote understanding and compassion?

First and foremost, health professionals or clinicians, e.g. nurses, doctors, pharmacists, etc., should be adequately trained to interact with patients with high-stigma label diseases or illnesses.

Practising ethics and having empathy are crucial to healthcare interactions. By considering everyone as equals, showing empathy, and being non-judgmental, healthcare professionals can create a more compassionate and understanding healthcare environment.

Practical Ways Include:

  1. Considering Everyone As Equals
    Health professionals should never discriminate against patients. Instead, they should learn to treat all patients with love and care, no matter their problems.
  2. Showing Empathy
    Some people are born handicapped, while others may have contracted a disease without knowing how or when. Putting yourself in their shoes (Empathy) can help them better understand their predicament and make more compassionate decisions. For instance, a healthcare professional could ask patients about their feelings and concerns or offer a comforting touch or a reassuring smile.
  3. Being Non-judgmental
    Take care not to judge a patient hastily, particularly those who contracted a disease through sexual intercourse. Offer them advice with gentleness and treat them with love and care. For instance, a healthcare professional could use non-judgmental language when discussing a patient’s sexual history or provide information about safe sex practices without making the patient feel ashamed or uncomfortable.

Conclusion

Stigmatisation can be more damaging than the disease itself. Whether a person is ill, disabled, a survivor of sexual abuse, or facing any other challenge, healthcare professionals attending to them should treat them with care and compassion.

It’s crucial never to make them feel diminished or withdrawn; instead, they should be encouraged, motivated, supported, and helped to heal faster.

This approach to care benefits the patient, enhances work productivity, and fosters societal growth.

Further Reading


Mecha Priscilla Avatar

(Writer, Healthcare & Well-being)

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