Exploring Nurses' Perception of Stigma in Intensive Care Units: A Qualitative Study.

BACKGROUND

Stigma is a sociological concept that is important in healthcare settings because it threatens health as much as the disease itself. The consequences of stigma are profound, as those who are stagmatised often face systematic exclusion from healthcare and endure social isolation, diminished self-esteem, depresssion, self-harm, and deteriorating physical and mental health. Limited information is available on nurses' perception of stigma in ICUs and how it affects their attitudes, behaviours and overall well-being when caring for patients with a broader range of stigmatised conditions.

AIM: This study explored the perception of associative stigma and public stigma among nurses caring for ICU-stigmatised patients and their engagement in avoidance thoughts and behaviours.

STUDY

DESIGN

A descriptive phenomenological research study design was used to conduct this study. Analysis of interview data was guided by inductive content analysis. We explored the perception of 15 ICU nurses towards stigma and avoidance behaviours and thoughts in Egypt.

RESULTS

Four themes were revealed: (1) perception of ICU nurses caring for patients with stigmatised diseases; initially, some of the participants were uncertain about experiencing stigma while caring for ICU patients with certain conditions. (2) Emotional reactions to stigma and its effect on nurses' professional conduct; despite most of the participants focusing mainly on their perception of stigma on infectious diseases such as COVID-19, others perceive stigmatisation while caring for other patients, for example, patients with tattoos on their bodies, patients with TB, patients with HIV and patients in prison. (3) Impact of stigma on professional identity and disclosure: The ICU nurse described the challenges of fulfilling their professional and social roles when caring for patients with certain disease labels. (4) Coping strategies of ICU nurses caring for stigmatised patients; ICU nurses briefed that they need training on handling such cases and increasing their resilience.

CONCLUSION

This study has achieved a deep understanding of the perception of ICU nurses towards stigma and avoidance behaviours and thoughts in Egypt. This understanding is a prerequisite for developing appropriate interventions that address this phenomenon and thereby for the development of healthcare services in Egypt.

RELEVANCE TO CLINICAL PRACTICE: Understanding ICU nurses' perceptions of stigma is essential for developing interventions that reduce bias and improve patient care. Enhancing nurses' awareness, emotional resilience, communication skills and fostering inclusive practices can lead to better health outcomes and a more supportive work environment.