ABSTRACT
BACKGROUND: Stigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatizing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals. METHODS: We used a qualitative exploratory research design to contrast the differences and similarities regarding stigmatizing attitudes towards people with SMD in primary healthcare centers (PHC) from the perspective of two groups: (i) people diagnosed with a severe mental disorder, and (ii) healthcare professionals. Data was collected through semi-structured interviews and discussion groups and subsequently analyzed using Atlas.ti software. RESULTS: Our results indicate that both service users and healthcare professionals manifest stereotypes, prejudices, and discriminatory behavior in health care. In addition, structural aspects of the health system and organizational culture appear to contribute to stigmatization. Both groups agreed that there is a need for healthcare professionals to have more education, specialization, and skill development related to mental health issues. CONCLUSIONS: Interventions to reduce the stigma towards people with SMD in PHC must consider delivery of information about mental disorders, development of skills in the healthcare professionals, and modifications in the culture of the health centers.
ABSTRACT
A determinant of particular relevance in human development is the socioeconomic status (SES) and, specifically, low SES and poverty. Likewise, family environment is essential in the development of children and a potential mediator or moderator of the effect of broader social conditions. OBJECTIVE: To analyze the role of parenting stress as a mediating variable of the relationship between SES and both externalized and internalized behaviors in preschool children. SUBJECTS AND METHOD: Descriptive secondary base study based on the Longitudinal Survey of Chilean First Infancy that selected a stratified sample, representative by clusters, of 9.996 children from 3 to 5 years old and their caregivers, that completed a battery of instruments for measuring SES variables, parenting stress and externalized and internalized behaviors. The analysis used a linear model with least square estimate. As hypothesis testing, the Dm (an adaptation of the F-test for multiple imputation method) was used. RESULTS: The mediation model of parenting stress in the relationship between SES and both externalized and internalized behaviors was confirmed for the latter; regarding externalized behaviors a model of moderation was observed, being the stress influence lower on the low SES. CONCLUSIONS: Parental stress showed a clear relationship with the presence of externalized and internalized behaviors, stronger than the SES. The relationship between SES and parenting stress is very important to understand the processes that affect childrens development.
Subject(s)
Child Behavior/psychology , Parenting/psychology , Poverty/psychology , Social Class , Stress, Psychological/psychology , Child , Child Development , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Models, Psychological , Stress, Psychological/economicsABSTRACT
Un determinante de particular relevancia en el desarrollo humano es el nivel socioeconómico y, en específico, el nivel socioeconómico (NSE) bajo y la pobreza. El entorno familiar es asimismo fundamental en el desarrollo de niños y niñas, y un potencial mediador o moderador del efecto de condiciones sociales más amplias. Objetivo: Analizar el rol del estrés parental como variable mediadora de la relación del NSE con conductas externalizadas e internalizadas en niños y niñas preescolares. Sujetos y Método: Estudio descriptivo de base secundaria basado en la Encuesta Longitudinal de Primera Infancia Chilena que seleccionó una muestra estratificada, representativa por clusters, de 9.996 niños y niñas de 3 a 5 años y sus cuidadoras(es), los(as) que completaron una batería de instrumentos para la medida de las variables de NSE, estrés parental y conductas externalizadas e internalizadas. El análisis utilizó un modelo lineal con estimación por mínimos cuadrados. Como prueba de hipótesis, se usó la Dm, una adaptación de la prueba F para imputación múltiple. Resultados: El modelo de mediación del estrés parental en la relación entre NSE y conductas externalizadas e internalizadas se corroboró para las segundas; respecto de las conductas externalizadas se observó un modelo de moderación, siendo menor la influencia del estrés en el NSE bajo. Conclusiones: El estrés parental mostró una clara relación con la presencia de conductas externalizadas e internalizadas, más fuerte que el NSE; la relación entre NSE y estrés parental resulta de importancia para comprender los procesos que afectan el desarrollo de niños y niñas.
A determinant of particular relevance in human development is the socioeconomic status (SES) and, specifically, low SES and poverty. Likewise, family environment is essential in the development of children and a potential mediator or moderator of the effect of broader social conditions. Objective: To analyze the role of parenting stress as a mediating variable of the relationship between SES and both externalized and internalized behaviors in preschool children. Subjects and Method: Descriptive secondary base study based on the Longitudinal Survey of Chilean First Infancy that selected a stratified sample, representative by clusters, of 9.996 children from 3 to 5 years old and their caregivers, that completed a battery of instruments for measuring SES variables, parenting stress and externalized and internalized behaviors. The analysis used a linear model with least square estimate. As hypothesis testing, the Dm (an adaptation of the F-test for multiple imputation method) was used. Results: The mediation model of parenting stress in the relationship between SES and both externalized and internalized behaviors was confirmed for the latter; regarding externalized behaviors a model of moderation was observed, being the stress influence lower on the low SES. Conclusions: Parental stress showed a clear relationship with the presence of externalized and internalized behaviors, stronger than the SES. The relationship between SES and parenting stress is very important to understand the processes that affect childrens development.
