| dc.description.abstract | The purpose of this study was to examine the effect of stigmatisation on the self-concept
among clients recovering from substance use in Kiambu County, Kenya. The first
objective was examine the prevalence of stigmatisation among clients recovering from
substance use in selected rehabilitation centres in Kiambu County. The second
objective was explore how stigmatisation influences self-concept of clients in selected
rehabilitation centres in Kiambu County. Thirdly, the study sought to analyse the
relationship between perceived stigmatisation and self-concept among clients in the
selected rehabilitation centres in Kiambu County. The final objective was to assess the
influence of stigmatisation on self-concept and treatment outcomes. A cross-sectional
research design, incorporating mixed methods, guided the collection of data from 113
participants, including individuals in treatment and 12 professionals from accredited
rehabilitation centres in Kiambu County. Purposive and random sampling approaches
formed the basis for the selection of individuals for the inclusion into the sample.
Different validated data collection instruments, including the PSAS - Perceived Stigma
of Substance Abuse Scale (PSAS), Recovery Assessment Scale (RAS), and Substance
Use Stigma Mechanisms Scale (SU-SMS) provided a foundation for the development
and operationalisation of the data collection instrument. A semi-structured interview
guide was included to collect qualitative data. Quantitative data was analysed using
SPSS version 26 and presented using tables, graphs, and texts. Thematic analysis
formed the basis for the processing of identifying recurring themes in the qualitative
data. Word clouds and text narratives formed the basis for presenting the qualitative
data showing frequency of key themes and verbatim quotes from the participants and
interpretations. Pretesting through a pilot study in Mathari Hospital helped assess the
validity and reliability of the data collection instruments. To ensure ethical conduct
during the research process, it was first important to obtain approval from Nazarene
University. Additionally, the researcher obtained informed consent and voluntary
participation from the participants. Further, implementing various security measures
ensured that all the data was private and confidential. The study found a high prevalence
of perceived stigmatisation among clients in rehabilitation. Most of the participants
reported feeling judged (66.0%), experiencing negative societal views (79.4%), and
facing stigma in personal relationships (65.0%), while 59.8% reported discrimination
related to substance use. Despite this, fewer felt ashamed to share their recovery journey
(32.9%), with 44.3% feeling comfortable sharing. Perceived stigma showed significant
associations with self-concept indicators, including confidence in maintaining recovery
(τ = .303, p = .001) and belief in goal potential (τ = .344, p < .001), while perceived
treatment support demonstrated protective effects by reducing stigma-related barriers
to help seeking (τ = −.279, p = .001). There was a consensus that reducing stigma can
potentially lower relapse risk (Mdn=5). However, stigma is common and can harm self-
concept, self-worth, and recovery outcomes. As such, it is critical for all stakeholders,
including professionals and policymakers to provide a support environment, social
support systems, and empowerment to foster the development of a positive identity,
which could result in better engagement and outcomes. Rehabilitation efforts should be
stigma-sensitive, and more particularly, supportive treatment, which could improve
engagement and reduces relapse. | en_US |
