Premium
Same clinic, different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care
Author(s) -
Salamat Samantha,
Hegarty Peter,
Patton Robert
Publication year - 2019
Publication title -
journal of applied social psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 111
eISSN - 1559-1816
pISSN - 0021-9029
DOI - 10.1111/jasp.12602
Subject(s) - vignette , attribution , psychology , anticipation (artificial intelligence) , situational ethics , stigma (botany) , health care , health professionals , disengagement theory , perception , social psychology , medicine , psychiatry , gerontology , artificial intelligence , neuroscience , computer science , economics , economic growth
Stigma experienced by drug users by their healthcare professionals can be a barrier to treatment engagement, which in turn affects mortality and morbidity rates. Attribution theory suggests that stigma will be greatest whenever drug use is attributed to factors within personal control. Here, clients ( n = 76) and healthcare professionals ( n = 62) identified features that characterize good and bad clinical interactions, and responded to a vignette about a drug user who attributed his use to personal control or situational factors. Healthcare professionals completed the vignette and drug users gave their best guess of how healthcare professionals would react to this vignette. Clients and professionals held overlapping prototypes of clinical interactions. Clients overestimated both how negative healthcare professionals’ reactions would be, and the extent to which healthcare professionals’ reactions would accord with attribution theory. Despite healthcare professionals’ believing they are acting in nonstigmatizing ways, they may engender stigma in clinical situations more than they realize. Discrepancies between professionals’ hypothetical responses and clients’ anticipation of these responses are discussed in terms of the influence of self‐stigma and societal understandings of drug use and control. Attribution theory only offers a limited explanation for these discrepancies, because professionals’ beliefs about drug users are complex. Implications for theories of stigma and engagement with services are discussed, and the importance of clients’ anticipation of stigma is highlighted as a primary target for addressing treatment disengagement. Anti‐stigma campaigns may also benefit from changing their focus from individuals’ attributions to holistically addressing discrepant conceptions of treatment.