PURPOSE: The purpose of this study was to find the relationship and conceptual model of discrimination, stress, support, and depression among the elderly in South Korea. METHODS: This was a cross-sectional descriptive study involving 207 community-dwelling elders. Data were collected through questionnaires from May 5 to May 31, 2014 in community senior centers, and analyzed using descriptive statistics, t test, analysis of variance, Scheffè test, and structural equation modeling. RESULTS: There were significant effects of discrimination on stress, support on stress and stress on depression. Moreover, there were two significant indirect effects observed between discrimination and depression, and between support and depression. For each indirect effect, the mediating factor was stress. Additionally, there was no direct effect between discrimination and depression or support. CONCLUSIONS: This study found that social support and discrimination had indirect effects on depression through stress. More specifically, decreased stress led to a reduction of depression. Therefore, social support based on a thorough understanding of stress is very important for caring elderly who are depressive.
Aged ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*psychology ; Female ; Humans ; Models, Psychological ; Prejudice/psychology ; Republic of Korea/epidemiology ; Rural Health ; Social Class ; Social Discrimination/*psychology ; Social Support ; Stress, Psychological/epidemiology/*etiology

OBJECTIVES: Nurses and social workers are key persons connecting patients with psychotic disorders to psychiatric treatment. This study investigated the attitude of college students majoring in nursing science and social welfare toward psychiatric medication and stigma toward the mentally ill. METHODS: The study enrolled 553 college students (369 nursing science, 184 social welfare). We administered a five-item questionnaire to assess attitude toward psychiatric medication and a 20-item scale to assess stigma (prejudice regarding the dangerousness of the mentally ill and discrimination against the mentally ill). Factors associated with attitude toward psychiatric medication were identified. In addition, the stigma scale scores were compared with each item on attitude toward psychiatric medication. RESULTS: In the multivariate analysis, students majoring in social welfare had a significantly poorer attitude toward psychiatric medication than those majoring in nursing science. Age, senior grade, and experience to contact the mentally ill were also significantly associated with a good attitude toward medication, while attending psychiatry lectures, having a religion, and gender were not significantly associated with attitude toward psychiatric medication, although they showed relationships in the univariate analyses. For three of the five items, a negative attitude toward psychiatric medication was significantly associated with higher scores on the prejudice and discrimination scales. CONCLUSION: Prejudice toward and discrimination against the mentally ill are closely associated with a negative attitude toward psychiatric medication. An anti-stigma campaign should be developed that includes education to promote knowledge about psychiatric medications and reduce the stigma against the mentally ill. In addition, our findings suggest that experience to contact the mentally ill might improve attitudes toward psychiatric medication.
Dangerous Behavior ; Discrimination (Psychology) ; Education ; Humans ; Lectures ; Mentally Ill Persons ; Multivariate Analysis ; Nursing* ; Prejudice ; Psychotic Disorders ; Surveys and Questionnaires ; Schizophrenia ; Social Welfare* ; Social Workers ; Weights and Measures

PURPOSE: The purpose of this study was to explore the subjective experience of Highly active Antiretroviral therapy (HAART) adherence in Korean patients with HIV. METHODS: A phenomenological methodology was used for the study. Data were collected from March to December, 2013 using open-ended questions during in-depth interviews. Participants were taking HAART for HIV, and were contacted through purposive techniques. RESULTS: Four men and 4 women whose average treatment period was 5.9 years participated in this study. Seven themes emerged from the analysis using Colazzi's method: (a) Seizing life in a deep sense of despair, (b) Struggling with medication, (c) Facing harsh treatment from health care providers, (d) Spoiling healthy pattern, (e) Hungering for communication and emotional support, (f) Turning to accepting HIV, (g) Becoming adherent to HIV treatment. CONCLUSION: Prejudice from health care providers and lack of emotional support were barriers to HAART in Korea. Intervention strategies are needed to decrease prejudices from health care providers and to increase family support.
Adaptation, Psychological ; Adult ; Antiretroviral Therapy, Highly Active ; Antiviral Agents/*therapeutic use ; Attitude to Health ; Communication ; Female ; HIV Infections/*drug therapy/*psychology ; Health Services Needs and Demand ; Humans ; Interviews as Topic ; Male ; *Medication Adherence ; Middle Aged ; Prejudice ; Republic of Korea

PURPOSE: The purpose of this study was to investigate the teachers' attitudes, discrimination, and causes of prejudice towards people with mental illnesses. METHODS: A cross-sectional study design was used and participants included 158 teachers who were recruited from four schools in S and G cities, Korea. From October to December, 2011, data on general characteristics, attitudes, discrimination and causes of prejudice towards people with mental illnesses were collected using self-administered questionnaires. SPSS/WIN 18.0 version was used for descriptive analysis, t-test, one-way ANOVA, and Pearson correlation. RESULTS: The mean scores of teachers' attitudes towards people with mental illness were, authoritarianism, 3.24, benevolence, 2.96, social restrictiveness, 3.44 and community mental health ideology, 2.75. There were significant differences in benevolence according to age. The experience of meeting people with mental illness contributed to positive attitudes towards people with mental illness in the benevolence subscale. There were significant differences in social restrictiveness according to residence. There were significant differences in discrimination according to age. Subscales of attitudes were significantly correlated with discrimination. CONCLUSION: These results emphasize a need for continuous education not only of teachers but also of the general population.
Authoritarianism ; Beneficence ; Cross-Sectional Studies ; Discrimination (Psychology) ; Humans ; Korea ; Mental Disorders ; Mental Health ; Prejudice ; Surveys and Questionnaires

Diagnostic errors can result in tangible harm to patients. Despite our advances in medicine, the mental processes required to make a diagnosis exhibits shortcomings, causing diagnostic errors. Cognitive factors are found to be an important cause of diagnostic errors. With new understanding from psychology and social sciences, clinical medicine is now beginning to appreciate that our clinical reasoning can take the form of analytical reasoning or heuristics. Different factors like cognitive biases and affective influences can also impel unwary clinicians to make diagnostic errors. Various strategies have been proposed to reduce the effect of cognitive biases and affective influences when clinicians make diagnoses; however evidence for the efficacy of these methods is still sparse. This paper aims to introduce the reader to the cognitive aspect of diagnostic errors, in the hope that clinicians can use this knowledge to improve diagnostic accuracy and patient outcomes.
Affect ; Attitude of Health Personnel ; Cognition ; Diagnosis, Differential ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Prejudice ; Thinking

OBJECTIVETo analyze partner attitude change and influencing factors on HIV infected pregnant women HIV disclosure.

METHODA multi-stage cross sectional method was used to collect information by questionnaires on 1164 HIV infected pregnant women in 6 counties including Ruili and Longchuan in Yunnan, Hezhou, Lingshan and Pingxiang in Guangxi and Yining in Xinjiang. Information on demographic characteristics and sexual behavior of the subjects and partner attitude toward HIV infected pregnant women were obtained. The influencing factors of partner's discrimination against HIV infected pregnant women were analyzed.

RESULTA total of 991(85.1%) HIV infected pregnant women have disclosed HIV status to partners among 1164 respondents and 39 (3.9%) reported they were discriminated against partners. Multivariate analysis showed that the 6.5% (15/231) of HIV infected pregnant women in urban had discrimination from their husbands while the ratio among rural pregnant women was lower(3.2% (24/760), OR = 0.40, 95%CI:0.12-0.77) . Compared with the ratio of discrimination among the women of first marriage(2.9%, 21/731), the discrimination ratio among women with remarriage and other status was higher (6.5% (15/232),OR = 2.45, 95%CI:1.61-5.25 and 10.7% (3/28),OR = 3.77, 95%CI:1.46-9.88) respectively. The discrimination ratio among pregnant women with multiple sexual partners was 5.9% (23/389), higher than women with single partner (2.6%, 15/580) (OR = 2.21, 95%CI:1.80-6.23).

CONCLUSIONThe discrimination toward HIV infected pregnant women from husbands was related to demographic characteristics and sexual behaviors.

Adolescent ; Adult ; Attitude ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; Humans ; Middle Aged ; Pregnancy ; Prejudice ; Risk-Taking ; Sexual Behavior ; Spouses ; psychology ; Surveys and Questionnaires ; Young Adult

PURPOSE: This study aimed to analyze the experience of female trainees who were trained in hospitals after graduating from medical school, focusing on methods of representing their gender in training courses. METHODS: We interviewed 8 trainees who had been trained in a hospital in Seoul and 4 faculties from June 2010 to October 2010. We analyzed their similarities and differences and developed a vocational identity formation process to represent gender. RESULTS: Gender was represented contradictorily in their training course, affecting their choice of specialties and interactions with patients. But, female trainees did not want to their being distinguished from their male counterparts with regard to being a good doctor to be influenced by meritocracy. It was difficult for them to bear children and balance work and family life due to aspects of the training system, including long work hours and the lack of replacement workers. Consequently, they asked their parents to help with child care, because hospitals are not interested in the maternity system. Female trainees did not consider being a doctor to be a male profession. Likely, they believed that their femininity influenced their professionalism positively. CONCLUSION: The methods of representing gender are influenced by the training system, based a male-dominated apprenticeship. Thus, we will research the mechanisms that influence gender-discriminated choices in specialties, hospitals, and medical schools and prepare a maternity care system for female trainees. Strategies that maximize recruitment and retention of women in medicine should include a consideration of alternative work schedules and optimization of maternity leave and child care opportunities.
Appointments and Schedules ; Child ; Child Care ; Female ; Femininity ; Humans ; Male ; Parental Leave ; Parents ; Physicians, Women ; Prejudice ; Retention (Psychology) ; Schools, Medical ; Ursidae

OBJECTIVES: In Korea, the term for schizophrenia has been changed from 'split-mind disorder' to 'attunement disorder'. This study compared the stigma of, and prejudice against, people with schizophrenia, according to use of the term 'split-mind disorder' or 'attunement disorder'. METHODS: We conducted a survey of 360 college students majoring in nursing science in order to assess their prejudice regarding the danger posed by schizophrenia and discrimination regarding relationships and privileges for patients with schizophrenia using the social stigma scale and the discrimination scale for patients with mental illness, respectively. Study subjects were randomly divided into two groups, and the same scales were assigned to each group using different instructions, beginning with either 'split-mind disorder' or 'attunement disorder'. RESULTS: In multivariate analysis, scores for prejudice with regard to the danger posed by, and discrimination against, patients with schizophrenia were significantly higher in the group assigned the term split-mind disorder, compared with the term attunement disorder. Scores for discrimination with regard to relationships and privileges were significantly lower for subjects with experience to contact the mentally ill, compared to those without such experience. CONCLUSION: Our findings suggest that renaming split-mind disorder as attunement disorder can result in reduced prejudice and discrimination against people with schizophrenia. In addition to renaming schizophrenia, implementation of anti-stigma campaigns, including contact with schizophrenia patients, may help to reduce discrimination against them.
Discrimination (Psychology) ; Humans ; Korea ; Mentally Ill Persons ; Multivariate Analysis ; Prejudice ; Schizophrenia ; Social Stigma ; Weights and Measures

OBJECTIVETo understand the self-discrimination experience of MSM and its relationship with sexual behavior and psychological factors.

METHODSBy respondent-driven sampling (RDS) method, a call-for action and anonymous self-administration questionnaire investigation was carried out in Mianyang city on experience of self-discriminations, sexual partners and behaviors and depression symptom, etc. The first 12 qualified people were designated as the "root" in the whole investigation from different MSM subgroups. Every "root" would get 3 recruit cards after their own investigation, then cards could be promoted to another 3 qualified people who were willing to accept questionnaires. And this process would go on till the sample size was accomplished. χ(2) test, rank correlation and contingency coefficient would be applied for the statistical analysis.

RESULTSIn total, 201 persons were investigated. Within the past 6 months, 59.2% (119/201) persons felt they did harm to their family or made the family down as gays, 79.6% (160/201) had to disguise their real sexual orientation in avoidance of being discriminated, 39.3% (79/201) were humiliated for having gay sex. It showed correlation between humiliation or harm to family and frequency to disco balls/night clubs (r = 0.196, χ(2) = 7.95, P < 0.05), concerts or theaters (r = 0.201, χ(2) = 8.423, P < 0.05) with MSM friends, HIV health consultancy (r = 0.231, χ(2) = 11.329, P < 0.05), experiences of one night stands (r(s) = 0.183, µ = 2.588, P < 0.05), detection of depression (r(s) = 0.241, µ = 15.717, P < 0.05) and stress-related perception (r(s) = -0.310, µ = 23.112, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 66.7% (11/33), 52.9% (18/34), 41.2% (14/34), 17.6% (6/34), 44.1% (15/34), 44.7% (10/24). Statistical significance was found between the relations of humiliation for gay sex and frequency into concerts or theaters (r = 0.195, χ(2) = 7.933, P < 0.05) with MSM friends, experiences of one night stands (r(s) = 0.145, µ = 2.051, P < 0.05), man-man anal sex (r = 0.165, χ(2) = 10.823, P < 0.05), numbers of female sexual partners (r = 0.265, χ(2) = 11.422, P < 0.05), protectiveness of female sexual behavior in the past 6 months (r = 0.513, χ(2) = 7.442, P < 0.05), detection of depression (r(s) = 0.152, µ = 13.034, P < 0.05) and stress-related perception (r(s) = -0.259, µ = 21.190, P < 0.05), the corresponding behavior report rates of who experienced 3-4 times were 22.7% (5/22), 9.1% (2/22), 13.6% (3/22), 91.6% (2/22), 66.7% (2/3), 57.1% (4/7), 33.3% (19/57). It has statistical significance between the relations of disguising their real sexual orientation in avoidance of being discriminated and the frequency of show up in the cybercafé (r = 0.272, χ(2) = 15.932, P < 0.05), involvement of HIV test (r = 0.232, χ(2) = 11.446, P < 0.05), and stress-related perception (r(s) = -0.373, µ = 28.868, P < 0.05). It was found that increasing of discrimination was connected to entrance into gay-welcome places, acceptance of HIV consultancy and tests, posting gay information among MSM friends and hold of many sexual partners. Meanwhile, the pressure was rising when depression was checked out.

CONCLUSIONSelf-discrimination was prevalent among MSM, which had brought critical influence on the individual behavior, MSM psychological health and prevalence of AIDS.

Adolescent ; Adult ; Homosexuality, Male ; psychology ; Humans ; Male ; Middle Aged ; Prejudice ; Self Concept ; Sexual Behavior ; Social Control, Informal ; Surveys and Questionnaires ; Young Adult

On April 28, the National Assembly passed 3 bills revising the Medical Act, Pharmaceutical Affairs Act, and Medical Instruments Act which are related to the so-called 'dual punishment system' at its 9th plenary session of the 289th provisional meeting. According to the government timetable, beginning November of this year (2010), doctors will be subject to imprisonment for up to two years or face fines of up to 30 million won when found to have taken financial or non-financial benefits from drug companies. Their license could also be suspended for one year. Interactions between industry and physicians are vital to public health. However, they must be principled partnerships effectively managed to sustain public trust in both partners' commitment to patient welfare and the improvement of health care. Mounting scientific evidence indicates that gifts, favors, and other marketing activities, both explicit and implicit, prejudice independent judgment in unconscious ways. Physicians who receive free gifts from the pharmaceutical industry must consider the ethical dilemmas posed by this practice. These dilemmas are conflict of interest, impairment of objectivity, and the impact of these free gifts on the cost of health care. In order to minimize the likelihood of biased decisions by physicians, pharmaceutical companies should comply with their code of ethics for fair competition, while medical societies should establish an influence-free culture for physicians and optimize the benefits inherent in the principled relationships between medical society and industry.
Bias (Epidemiology) ; Codes of Ethics ; Conflict of Interest ; Delivery of Health Care ; Drug Industry ; Gift Giving ; Humans ; Judgment ; Licensure ; Marketing ; Prejudice ; Public Health ; Punishment ; Societies, Medical ; Unconscious (Psychology)