Human immunodeficiency virus (HIV) infection remains a growing public health concern in the Philippines, where new infections rose by about 550% between 2010 and 2024 and diagnosis gaps persist in CALABARZON. Nurses are often the first and most sustained point of contact in HIV testing and care, yet knowledge gaps, stigmatizing attitudes, and procedure-focused training may limit their ability to provide compassionate, person-centered counseling. This study aims to develop and validate a Caring-Based HIV Counseling Training Program for Nurses in Laguna, Philippines, using a methodological research design and a modified Delphi technique. Registered nurses from selected government and private healthcare facilities in Laguna will complete a researcher-developed training-needs assessment questionnaire covering six competency domains: HIV-related knowledge; counseling and therapeutic communication; caring behaviors and person-centered practice; ethical and legal responsibilities; cultural sensitivity and stigma reduction; and linkage to prevention, treatment, care, and support. The questionnaire will undergo expert review, pilot testing, and reliability testing using Cronbach’s alpha. The needs-assessment findings, together with a review of current literature and guidelines, will inform a preliminary training program, which a multidisciplinary panel of approximately 15 to 20 experts will evaluate over successive anonymous Delphi rounds for relevance, clarity, comprehensiveness, cultural appropriateness, feasibility, and applicability. Consensus is defined in advance as at least 80% expert agreement, a median rating of at least 3.00, and an interquartile range of no more than 1.00. Content validity will be established through an Item-Level Content Validity Index of at least .78 and a Scale-Level Content Validity Index (average) of at least .90, overall agreement will be measured with Kendall’s coefficient of concordance, and the experts’ qualitative comments will undergo directed content analysis. The study is expected to produce an expert-validated, contextually relevant training program that strengthens nurses’ capacity to deliver compassionate, stigma-free HIV counseling, with its effectiveness to be tested in a future pilot or quasi-experimental study.
Objective: The study aimed to evaluate the internalised stigma and self-esteem in adult outpatients with major depressive disorder (MDD) attending a psychiatric outpatient clinic in Iraq, and to explore the relationship between these variables. Methods: A cross-sectional correlational study among 120 adults with MDD who attended psychiatric outpatient clinics of Azadi Teaching Hospital in Kirkuk, Iraq. All participants filled out a sociodemographic and clinical questionnaire, the Internalised Stigma of Mental Illness Scale (ISMI), and the Rosenberg Self-Esteem Scale (RSES). Data were analysed using descriptive statistics, Pearson's correlation coefficient and simple linear regression. Results: The overall mean ISMI score was 2.90 (SD = 0.42), with the highest scores for stereotype endorsement (M = 3.16) and alienation (M = 3.14) and the lowest for stigma resistance (M = 2.19). The overall mean RSES score was 2.29 (SD = 0.38). There was a negative correlation between internalised stigma and self-esteem (r = −0.338, p < 0.001). Self-esteem was statistically associated with internalised stigma (β = −0.338, t = −3.897, p < 0.001), explaining 11.4% of the variance (R² = 0.114) in simple linear regression. Conclusions: In this single-centre sample of adults with MDD, internalised stigma and self-esteem were inversely related. Since the study is a cross-sectional design, the association observed cannot be considered a causal relationship. The results provide a basis for consideration of the psychosocial aspects of routine psychiatric care (stigma and self-esteem) and for further longitudinal and multicentre research to establish temporal relationships and to determine potentially modifiable factors.
Although knowledge and stigma about suicide are important factors in suicide prevention, there are no validated instruments available in Hungary. Our goal was to validate the Literacy of Suicide Scale—Short Form (LOSS-SF) and the Stigma of Suicide Scale—Short Form (SOSS-SF) in Hungarian. An anonymous online survey was administered to a self-selected online convenience sample of 954 participants of 38.0 years (SD: 14.8) of age. Our study used a descriptive, correlational, cross-sectional design. Confirmatory factor analysis results indicate a good model fit for a three-factor structure of the SOSS-SF scale. Invariance testing revealed that the scale is valid across gender, age and former suicide ideation. LOSS-SF had an acceptable unidimensional model fit as a two-parameter logistic (2PL) IRT (Item Response Theory) based survey, and results showed good infit–outfit with appropriate item discrimination and difficulty measures. The results show that the two instruments show sound psychometric properties and construct validity within this sample. While the Hungarian versions of the SOSS-SF and the LOSS-SF provide useful tools for assessing suicide stigma and suicide literacy in research settings, further validation on nationally representative samples may be required in case population-level norms are needed to inform national policy-makers.
The discussion on third gender rights today highlights a significant socio-legal transformation, tracing a path from historical respect through colonial criminalisation to current constitutional acknowledgement. This evolution signifies a growing recognition and validation of third gender identities within legal frameworks, demonstrating a societal shift towards inclusivity and acceptance, as well as addressing long-standing discrimination and marginalisation faced by these individuals. Despite constitutional promises, systemic discrimination, social exclusion and inadequate legal protections continue to deprive transgender persons of civil rights such as voting, marriage, property ownership and access to justice. The article concludes that genuine recognition of gender identity, beyond token legislation, is essential to secure equality and dignity for transgender communities in the contemporary era.
Psychiatric rehabilitation is a crucial aspect of recovery-oriented mental healthcare, yet it remains underdeveloped in Oman. This paper reviews the current state of rehabilitation services, identifying systemic gaps in in-patient, day care and community-based provisions. Services are fragmented, lacking adequate multidisciplinary integration, sufficient community rehabilitation and supported housing, which leads to prolonged hospital stays. Additionally, broader challenges such as stigma and limited intersectoral collaboration hinder service development. The paper suggests practical strategies to enhance rehabilitation services, including the establishment of multidisciplinary teams, expansion of community programmes, provision of supported accommodation and workforce training, all aligned with Oman Vision 2040 and the principles of recovery-oriented mental health care.
Introduction This study examines sympathy as a socially organized emotion in Arabic-language digital discourse about suicide. Drawing on the sociology of emotions, suicide stigma, and digital death studies, it investigates how public Facebook comment cultures distribute compassion, blame, and moral worth after suicide. Methods A quantitative content analysis was conducted on 2,132 publicly visible comments responding to three highly discussed suicide cases. Comments were coded for inferred public gender presentation, emotional orientation, reported case context, and dominant interpretive frame. Pearson chi-square tests were calculated from raw counts; Cramer’s V , 95% Wilson confidence intervals, and sensitivity analyses are reported. Results Comments from accounts inferred as female were more often sympathetic than comments from accounts inferred as male (60.0% vs. 40.5%; V = 0.15), and commenter composition differed across the three cases ( V = 0.29). Religious framing was the most common interpretive repertoire (48.6%) and could accompany both mercy and condemnation. Discussion The study develops the concept of a moral economy of sympathy to describe the social rules through which digital publics allocate compassion after suicide. Because each case combines a particular person, national setting, reported circumstance, and media framing, the findings are case-specific and should not be generalized to Arab publics.
BACKGROUND: Israel's 2015 mental health reform transferred responsibility for mental health services from the government to community health maintenance organisations (HMOs), aiming to improve accessibility and equity and reduce stigma. However, its implications for different populations remain significantly underresearched. AIMS: To examine trends in mental health service utilisation and psychiatric medication issue rates among Arab and Ultra-Orthodox Jewish populations before and after the 2015 mental health reform. METHOD: = 2 847 184). Participants were classified as either general (non-Ultra-Orthodox Jewish), Ultra-Orthodox Jewish or Arab. The study analysed annual community visits to mental health professionals and dispensed psychiatric prescriptions. RESULTS: Between 2012 and 2019 the number of mental health service users increased across all populations, most prominently among Ultra-Orthodox Jewish and Arab populations (1.94- and 1.91-fold, respectively), compared with 1.55-fold in the general population. Annual community visits increased 2.4-fold in the general population, 2.2-fold in the Ultra-Orthodox Jewish population and 3.7-fold among Arabs, who had the lowest baseline utilisation. Psychiatric medication issue rates increased most in the Ultra-Orthodox Jewish population (2.5-fold), compared with 1.7-fold in the Arab and 1.5-fold in the general population. Women consistently used more services than men, with the greatest relative increase among Arab women. CONCLUSIONS: The findings suggest improved access to mental health services over the study period spanning the 2015 mental health reform, particularly in previously underserved populations. Continued progress requires culturally sensitive, community-tailored interventions for Arab and Ultra-Orthodox Jewish populations.
Gender inequality in higher education remains a concern in rural Pakistan, where women’s education opportunities are shaped by social expectations concerning mobility, family responsibilities, and appropriate gender roles. This study examined how social stigmatization associated with staying at home and performing domestic roles is experienced by rural females and how public and self-stigma relate to their participation in higher education. A qualitative descriptive phenomenological design was employed. Data were collected by semi-structured interviews from 30 participants in rural Pakistan, including eight female students and nine female family members, and 13 male family and community members. Thematic analysis identified four interrelated themes: restricted mobility and chaperonage, conditional educational and career aspirations, internalized domestic identity, and protectionist concerns surrounding coeducation. The findings indicate that female education was generally valued, but support was often conditional on family approval, proximity to home, supervision, and conformity with socially accepted roles as daughters, wives, and mothers. Public stigma was reflected in shared expectations that restricted women’s mobility, educational location, and career choices. While self-stigma through self-censorship became apparent when some female students anticipated these judgments and adjusted their educational aspirations accordingly. These findings suggest that educational inequality in the setting examined is associated not only with material and institutional barriers but also with social judgments and their internalization. By applying a stigma perspective, the study provides a context-specific account of how public stigma, self-stigma, and self-censorship may interact with gendered expectations to narrow higher education opportunities for rural females.
The exclusion and bullying targeting minority groups--including sexual minorities, individuals with disabilities, and orphans--have become observable social phenomena in Chinese campus settings. This review examines, from a social psychological perspective, how the herd effect operates within physical campus environments to trigger, amplify, and consolidate prejudice and discrimination held by majority groups toward minority students. Adopting a literature review methodology, this paper synthesizes Asch's conformity experiments, behaviorist theory, Freudian individual unconscious, Jungian collective unconscious, and empirical studies on school bullying and peer conformity published over the past two decades. The central argument proposes a "three-tiered ladder" through which the herd effect function: first, linguistic stigmatization transforms neutral identity labels such as "gay" and" Tang"(a colloquial abbreviation for Down Syndrome in Chinese, used similarly to offensive slurs like "mong" in English) into tools of humiliation; second, social isolation dismantles the victim's support network; and third, peer pressure escalates into physical violence and property damage. This mechanism is significantly amplified within the Chinese collectivist educational context, where the physical inseparability of fixed-class systems extends conformity pressure from temporary behavior into chronic survival anxiety.
