• Self-stigma, loneliness and culture among older adults with mental illness residing in nursing homes

      Tzouvara, Vasiliki (University of BedfordshireUniversity of Bedfordshire, 2015-08)
      This study aimed to investigate the inter-relationships between self-stigma, loneliness, and culture among older adults with mental illness residing in nursing homes. This study also explored how this population experiences self-stigma and loneliness within the context of their cultural backgrounds. A mixed-methods approach was utilised. The first phase involved a quantitative face-to-face questionnaire survey (n=16). More than half of the study participants reported low levels of self-stigma (56.3%), yet a substantial number of them scored high on the self-stigma scale (43.8%). The analysis identified a statistical relationship between stereotype endorsement and marital status (sig. =.010). No relationship was identified between Internalised Stigma of Mental illness constructs (ISMI) and age, gender, religiousness, and educational level. Loneliness was identified to be prevalent among more than half of the sample (68.8%). There was also a positive correlation between loneliness, age (sig.=.062) and religiosity (sig.=.044). The second phase involved a qualitative hermeneutic phenomenological approach involving one-to-one semi-structured interviews (n=10). Seven themes emerged: ‘social loneliness’, ‘emotional loneliness’, ‘emotional reactions’, ‘coping mechanisms’, ‘insight into illness’, ‘understanding and view towards mental illness’, and ‘behavioural reactions’. Overall, the qualitative findings supported the quantitative results but also revealed additional theoretical and conceptual insight. Most participants were collectivistic-oriented, and most experienced both social and emotional loneliness. The degree of insight into mental illness played a key role in how self-stigma was experienced, while gender and culture were found to influence how loneliness was experienced. Based on the results of both phases, a new theoretical framework is posited that explains the relationships between the concepts of loneliness and self-stigma among this population. The study also evidences and discusses a wide range of methodological issues associated with the successful recruitment of nursing homes in older adult research.