Background: Around 30% of people with mental disorders consider that stigma related to mental illness is a barrier to seeking help for mental disorders. A well-designed theoretical framework may provide insight into processes that lead to stigmatization and discrimination of people with mental illness and subsequently yield effective interventions that could prevent the stigmatizing process and improve patient outcomes. However, a recent literature review revealed that nursing research lacks a theoretical framework about stigma of mental illness. The purpose of this study was to evaluate two existing stigma theories from two sciences adjacent to nursing: sociology and social psychology.
Methods: Two researchers performed a detailed analysis and evaluation of each theory using the Fawcett and DeSanto-Madeya theoretical framework. The analysis of a theory requires a non-judgmental and detailed examination of its scope, context, and content. Evaluation of a theory requires judgmental examination based on the results of the analysis and previously published research. Throughout the evaluation process, the reviewer assesses whether the theory meets the following criteria: significance to nursing, internal consistency, parsimony, testability, empirical adequacy, and pragmatic adequacy.
Results: Our final evaluation reveled that MLT and SCM are similar in scope, since both are concrete, middle range, relational theories that can be tested with appropriate empirical indicators. They were both developed in sciences relevant to nursing: sociology for MLT and social psychology for the SCM. Both theories partially met the criterion of significance to nursing, and fully met the criteria of internal consistency, parsimony, and testability. Neither theory met the pragmatic adequacy criterion since neither has been applied in nursing research. The major difference between the two theories was that the MLT fully met the empirical adequacy criterion, given that it was tested by many researchers and used with diverse populations, while the SCM was only tested with college students and only used by its original authors.
Conclusion & Implications: MLT was found to be superior in quality over the SCM. The MLT can contribute to nursing knowledge, education, training and practice by offering new insights into the experiences of people with mental illness. The MLT can inform nursing education and guide nursing practice. Having insight into processes that might lead to stigmatizing attitudes toward people with mental illness can help nurses provide appropriate interventions to their patients. Since the MLT has not been used in nursing research, it is recommended to test the MLT in nursing research studies.