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Understanding stigma in chronic health conditions: Implications for nursing



Joan Engebretson, DrPH, AHN-BC, RN, Department of Family Nursing, School of Nursing, University of Texas Health Science Center at Houston, 6901 Bertner #764, Houston, TX 77030. Tel: 713-500-2045; Fax: 713-500-2073; E-mail:



This article explores the social processes in stigmatization and the theoretical background on the impact in chronic illness.

Data sources

Review of literature from social sciences and applications to health issues.


Understanding the social utility of stigmatization in preserving social cohesion and protecting the social order is an important function. However, this process can be harmful when applied to persons with chronic illness, such as HIV-AIDS, and psychiatric illness. These individuals often become shamed, ostracized, isolated, discredited, and socially and economically marginalized. Recent theoretical work on stigma has identified several issues and patient responses that may have implications in many other chronic conditions. Stigma is based on visible or nonvisible health conditions and can be both externally imposed or perceived in a process of self-stigma.

Implications for practice

Understanding stigma can aid clinicians in providing supportive help for patients with chronic illness. Stigma has been well researched in a few chronic illnesses; however, future studies in other conditions are much needed. Recognizing the underlying social factors has potential use in health-promoting behaviors. Sensitivity to stigma allows health professionals to critically reflect on ways the healthcare environment may add to stigma for their patients.