Hope and stigma in early stage dementia

Chapman, David George

Clinical psychology
June 2011

Thesis or dissertation

© 2011 David George Chapman. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

This portfolio thesis consists of three parts:

Part one is a systematic review of the literature relating to perceived stigma and support amongst family caregivers of people with dementia. Numerous studies have suggested stigma is associated with negative outcomes in various mental and physical health difficulties. Older people with dementia and their family caregivers could be especially vulnerable to experiencing stigma and this could have a negative impact on their engagement with services. Out of an initial literature search resulting in 101 articles, 15 articles met the inclusion criteria for the present review and their methodological quality was assessed. The 15 articles were critically analysed and four main themes from the articles were extracted. The themes were sociocultural aspects, services use and diagnosis, stigma and aging and managing stigma. A proposed model of perceived stigma that explained the potential origins of stigma, the difficulties it may bring and possible links to service engagement was developed from the results of this review. The clinical implications of this and possible further research areas was discussed.

Part two is an empirical paper consisting of two aims. The first aim investigated levels and types of hope experienced by older people with and without dementia. The second aim focused on potential relationships between stigma, hope and quality of life in older people with dementia. Many studies have indicated that hope is positively associated with quality of life in chronic health conditions and there are two contrasting theories of hope, multi-dimensional hope and goal directed hope. Preliminary studies suggested that older people with dementia may predominantly experience multi-dimensional hope and that stigma may be a barrier towards hope. A group of 60 older people without dementia completed two different questionnaires on hope and a group of 40 older people with dementia completed two additional questionnaires on their experiences of stigma and their quality of life. The results supported the hypothesis that older people with dementia experienced higher levels of multi-dimensional hope but stigma was not a statistically significant barrier towards this. Implications for services, including the development of psychosocial interventions and possible further research were discussed.

Part three are the appendixes including a reflective statement on the designing, planning and implementation of the research.

Department of Clinical Psychology and Psychological Therapies, The University of Hull
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