Exploring Stigma Communication About Urinary Tract Infections in the United States.

Urinary tract infections (UTIs) have steadily increased in prevalence and severity among women in the United States and can lead to serious complications if left untreated. Yet, women are often reluctant to discuss such infections due to potential stigmatization. Indeed, UTI treatment and prevention often involves communication with intimate partners and physicians, and this communication can require stigma management. Further, stigma communication can influence women's experiences with UTI symptoms and treatment. The theory of stigma management communication is well-suited to explore how stigma-related communication unfolds about the experience, diagnosis, and treatment of UTIs. The current study uses in-depth interviews conducted in 2022 to learn about experiences with stigma communication surrounding UTIs. Findings reveal that participants perceived UTIs as stigmatized due to associations between UTIs and female gender, sexual behavior, genital health, and hygiene. Participants described using stigma management strategies to accept, ignore, avoid, reduce responsibility for, and challenge stigmas related to UTIs. This analysis has implications for theorizing choice in stigma management research and for provider-patient interactions surrounding UTIs.

COVID-19 Courtesy Stigma among Healthcare Providers in India: A Study of Stigma Management Communication and its Impact.

In early 2020, the first wave of the COVID-19 pandemic hit India, generating one of the highest rates of infection and death in the world. Meanwhile, healthcare workers experienced stigma and discrimination due to their association with COVID-19 patients. This study analyzed healthcare workers' experience of courtesy stigma in India, the communication strategies they used to manage stigma, and the impact on their mental health. A cross-sectional survey of 150 healthcare workers in India showed that almost 50% experienced discrimination due to their association with COVID-19 patients. Using Confirmatory Factor Analysis and Structural Equation Modeling, this study found that experience of discrimination was associated with perceived courtesy stigma. Two stigma management strategies (reducing offensiveness and passive acceptance) mediated the relationship between perceived courtesy stigma and perceived stress and depression. Participants also reported engaging in stigma management strategies of bonding with other healthcare professionals and passive acceptance of the stigma more than reducing stigma and displaying/disclosing stigma. We conclude that perhaps due to depletion of cognitive and emotional resources, healthcare workers engaged more in social support (bonding) and passive stigma acceptance strategies to alleviate the stress associated with providing COVID-19 patient care. Practical and theoretical implications are further discussed.

Keeping patients safe in healthcare organizations: a structuration theory of safety culture.

AIM: This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. BACKGROUND: Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. DATA SOURCES: The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. DISCUSSION: When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. IMPLICATIONS FOR NURSING: Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. CONCLUSION: Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system.