Stigma of visible and invisible chronic conditions

Nurses deliver care to people with various forms of chronic illnesses and c onditions. Some chronic conditions, such as paraplegia, are visible while o thers, such as diabetes, are invisible. Still others, such as multiple scle rosis, are both visible and invisible. Having a chronic illness or conditio n and being different from the general population subjects a person to poss ible stigmatization by those who do not have the illness. Coping with stigm a involves a variety of strategies including the decision about whether to disclose the condition and suffer further stigma, or attempt to conceal the condition or aspects of the condition and pass for normal. We present a be ginning framework that describes the relationship between the elements of s tigma and the decision to disclose or hide a chronic condition based on its visibility or invisibility. The specific aims were to combine the results from a meta-study on qualitative research with a review of the quantitative literature, then develop a theoretical framework. Although an understandin g of how patients cope with stigmatizing conditions is essential for nurses who aim to deliver comprehensive individualized patient care, there is lit tle current literature on this subject. The relationship between visibility and invisibility and disclosure and non-disclosure remains poorly understo od. A framework to facilitate a deeper understanding of the dynamics of chr onic illnesses and conditions may prove useful for practice.