Challenging aged care stigma through communication: discursive responses to stigmatising discourses about aged care work and implications for workers' mental health

Occupational stigma can negatively impact aged care workers' (ACWs) mental health. This mixed-methods study investigates whether ACWs who challenge stigmatising discourses, through communication, experience reduced psychological costs of aged care stigma. We screened 184 ACWs' discursive responses and tested for differences in ACWs' mental health between those who challenge stigma and those who do not. A discourse approach was further employed to examine recurring language patterns in 'challenge' discursive responses. ACWs (n = 95) who discursively challenged stigmatising discourses reported lower internalised occupational stigma and psychological distress than those who did not challenge stigma (n = 89). These workers chose to infuse positive value into negative evaluations about ACWs and aged care work. Overall, findings suggest that ACWs may spontaneously challenge occupational stigma, through their discursive responses, which may proactively protect their mental health. We offer practical implications for challenging stigma, including developing guidelines, training, and language-based interventions.

Navigating marginalized identities in diverse organizations

People with marginalized identities must often manage the diversity dynamics that are activated by their presence in organizations. Due to underrepresentation and stigmatization, they cope with a range of identity threats while navigating diverse settings. A host of studies over the past twenty-five years have examined the wide range of verbal and nonverbal tactics that people use to suppress and express their devalued versus valued social identities at work. Recent research has begun to specify the conditions under which different identity management tactics positively or negatively impact individual well-being, interpersonal relationships across difference, and important evaluations and outcomes (e.g., admissions, hiring). Less attention has been devoted to how members of marginalized groups directly and indirectly shape others' perceptions of them through emotional expressions and status signals. This review illuminates how people proactively affirm others' identities in order to bolster or protect their own, using a wide range of identity management tactics. As featured in this article, global studies of marginalized identity management tactics include nuanced portrayals of intersectionality, as people cope with threats to multiple identity group memberships.

The "dirty work" of last responders: Occupational stigma risk and protective factors

Last responders constitute an occupational category that includes all those who are involved in the postmortem care of deceased persons and their families. The work of last responders is often considered "dirty work" and, as a result, stigmatized. Last responders are aware of this stigma, and stigma consciousness has been associated with negative health outcomes. Despite the wide acknowledgment of stigma among last responders, specific risk, or protective factors for experiencing stigma have not been investigated. This paper aims to identify determinants of stigma among last responders in the United States. The data for this study were obtained from a national cross-sectional survey of last responders. The survey included a measure of stigma and multiple sociodemographic characteristics. A hurdle model was used to assess the association between the characteristics of last responders and their perceived stigma. Respondents were predominantly male (55.1%), White non-Hispanic (90.2%), and employed full-time (96%). Seventy-seven percent reported having experienced at least one form of occupation-related stigma. There was no significant association between the experience of stigma and any socio-demographic variables. The experience of stigma is nearly ubiquitous among last responders->75% of last responders in the sample experienced at least one form of stigma. Another aspect of its ubiquitous nature is the lack of evidence that stigma was experienced differentially across sex, race/ethnicity, employment type, and length of years as a last responder. Interventions are needed to decrease stigma among last responders and to support last responders in managing the consequences of the stigma they experience.

Epilepsy in Asian countries

Epilepsy affects 50 million people worldwide. Nearly 80% of people with epilepsy live in resource-constrained low-income and middle-income countries. In Asia, which has a population of over 4 billion or has 50% of the world's population, about 23 million people have epilepsy. In this review, we discuss the difficulties in managing epilepsy in Asia due to the limited resources. The medical expense, limited access to treatment, premature mortality, health transitions from pediatric care to adult care, and the huge population size make it challenging for epilepsy management. Even though certain countries have access to highly innovative treatments, up to 90% of patients with epilepsy do not receive proper care due to limited resources. The insufficiency of research on epilepsy in most countries makes it difficult to obtain accurate data to analyze the progress of epilepsy management. However, the current influx of research studies, acceptance of the latest international practices, and funding will contribute a long way to closing treatment gaps in communities.

Psychiatrists' occupational stigma conceptualization, measurement, and intervention: A literature review

Psychiatrists require frequent contact with and treatment of patients with mental illnesses. Due to the influence of associative stigma, psychiatrists may also be targets of stigma. Occupational stigma warrants special consideration because it significantly affects psychiatrists' career advancement, well-being, and their patients' health. Given that there is no complete summary of this issue, this study reviewed the existing literature on psychiatrists' occupational stigma to clearly synthesize its concepts, measurement tools, and intervention strategies. Herein, we emphasize that psychiatrists' occupational stigma is a multifaceted concept that simultaneously encompasses physically, socially, and morally tainted aspects. Currently, standardized methods to specifically measure psychiatrists' occupational stigma are lacking. Interventions for psychiatrists' occupational stigma may consider the use of protest, contact, education, comprehensive and systematic methods, as well as the use of psychotherapeutic approaches. This review provides a theoretical basis for the development of relevant measurement tools and intervention practices. Overall, this review seeks to raise public awareness of psychiatrists' occupational stigma, thereby promoting psychiatric professionalism and reducing its stigma.

Disabled at Work: Body-Centric Cycles of Meaning-Making

A 22-month longitudinal study of (self)employed disabled workers (Following the preference of the lead author who identifies as disabled, the linguistic self-presentation by our participants, the precedent of (Hein and Ansari, Academy of Management Journal 65:749-783, 2022), and the clarification note included in Jammaers & Zanoni's recent review of ableism (Jammaers and Zanoni, Organization Studies 42:429-452, 2021), we chose, and consistently use, the term "disabled employees" throughout the paper. We do so to underscore the premise of the social model of disability, which explains that "people are disabled first and foremost by society, not by their individual, biological impairment. To us this term most clearly highlights that it is society (and possibly organizations) that disable and oppress people with impairments, by preventing their access, integration and inclusion to all walks of life, making them 'disabled'." (Jammaers and Zanoni, Organization Studies 42:429-452, 2021: 448)) models the growing centrality of the body in meaning-making. We inductively explain how body dramas of suffering or thriving initially instigate cycles of meaning deflation and inflation at work. Our disjunctive process model shows that, at the beginning of the pandemic, disabled workers performed either dramas of suffering or on dramas of thriving. However, as the global pandemic unfolded, disabled workers begun crafting composite dramas that deliberately juxtaposed thriving and suffering. This conjunctive process model stabilized meaning-making at work by acknowledging the duality of the disabled body, as both anomaly and asset. Our findings elaborate, and bridge, emerging theories of body work and recursive meaning-making to explain how disabled workers explicitly enroll their bodies to make meaning at work during periods of societal upheaval.

How would you respond to stereotype pressure? The effects of perceived occupational stigma on social workers’ proactive behavior in China

Purpose

The purpose of this study is to explore a balanced understanding of the relationship between perceived occupational stigma and social workers’ proactive behaviors in China. Drawing on cognitive appraisal theory, this study explored the mediating role of threat and challenge appraisals, as well as the moderating role of trait resilience.

Design/methodology/approach

Data were collected using a time-lagged research design. The hypotheses were examined using a sample of 338 social workers in China.

Findings

Perceived occupational stigma is appraised as both a challenge and a threat simultaneously. Challenge appraisal positively mediated perceived occupational stigma and proactive behavior, whereas threat appraisal negatively mediated this relationship. Trait resilience moderated the effect of threat appraisal, suggesting that perceived occupational stigma was appraised as a threat when trait resilience was lower (rather than higher), which then reduced social workers’ proactive behaviors.

Originality/value

This study enriches the literature on perceived occupational stigma by identifying the relationship and mechanism of perceived occupational stigma-proactive behaviors and a boundary condition from the theoretical perspective of cognitive appraisals. It demonstrates both the positive and negative aspects of perceived occupational stigma as appraised by social workers in relation to an important workplace outcome of proactive behaviors. In addition, it offers a fresh approach by exploring perceived occupational stigma from the perspective of social workers.

Bridgework: A Model of Brokering Relationships Across Social Boundaries in Organizations

Relationships are central to organizing, work, and organizations. Yet, in many instances, relationships do not build themselves, and third-party actors are often needed to intervene in situations, persuade individuals, and facilitate connections across disconnected actors in organizations. Little is known about the strategies through which third-party actors can broker relationships across what are considered to be intractable social boundaries—membership in stigmatized or nonstigmatized social identity-based groups. We build a process theory of what we call “bridgework,” the strategy used by third-party agents, intermediaries, and allies to bridge by shifting value-related perceptions about actors on the other side of social identity-based divides. More specifically, we focus on a stigmatizing social identity that can create boundaries that are often reinforced through informal network ties. Based on interviews, participatory observation, and archival data with job coaches for adults with autism spectrum disorders and related developmental disabilities, we showcase a model of bridgework—a combination of internal and external strategies across three stages (adding, stabilizing, and maintaining perceptions of value) to facilitate relationships between stigmatized and nonstigmatized members of organizations. We discuss how our grounded model contributes to the rich traditions of research on stigma, brokerage, disability studies, positive relationships, and compassion in organizations.

The Consequences of not Being Me: Longitudinal Examination of the Relations Among Anticipated Discrimination, Authenticity, and Counterproductive Work Behaviors

The current study examines the relations among anticipated discrimination, authenticity, and counterproductive work behaviors (CWBs) in an employee population that is vulnerable to mistreatment—namely, employees with depression and bipolar disorder. Using a longitudinal research design, we collected data at 3 points in time from 279 individuals diagnosed with depression and/or bipolar disorder. We tested the extent to which authenticity mediated the relationship between anticipated discrimination and counterproductive work behaviors. Our results provided support for our research model. Thus, when individuals perceived that they were likely to be targets of discrimination due to their mental illness, it resulted in increased counterproductive work behaviors, and this effect was transmitted through decreased perceptions of authenticity. In addition, we tested stigma centrality and symptom severity moderators of the mediated relationships. We found support for symptom severity (but not stigma centrality) as a moderator in which the mediated relationship between anticipated discrimination and CWBs through authenticity was stronger for those with more severe symptoms.

My Work Is Meaningless: The Consequences of Perceived Occupational Stigma for Employees in High-Prestige Occupations

Occupational stigma is pervasive, but there is a lack of understanding about how it impacts the behaviors of employees in relatively high-prestige occupations. We draw on the job characteristics model and social information processing theory to establish hypotheses about the effects of occupational stigma on the withdrawal behavior of employees in a relatively high-prestige occupation (preschool teacher). We suggest that perceptions of skill variety and task significance among high-prestige employees may be negatively influenced due to occupational stigma perception. In addition, occupational stigma conveys information to employees that the work they do is not appreciated by beneficiaries. For those reasons, making it difficult for them to perceive the meaningfulness of their work. This lack of meaningful experience is in turn positively associated with employees’ withdrawal behavior. Furthermore, we propose that these indirect effects are moderated by perceived job embeddedness of employees. Based on data collected at two time points from 466 preschool teachers in China, we find that occupational stigma is positively related to employees’ withdrawal behavior through meaningfulness. In addition, the negative relationship between perceived occupational stigma and experienced meaningfulness is stronger for employees with high job embeddedness than for employees with low job embeddedness.