Concepts of stigma and candidacy
| (A) Concept of stigma | |
| Concept/stage | Definition |
| Self-stigma | the social and psychological impacts of having a stigma and encompasses both the experience and anticipation of encountering stigmatising behaviour (felt stigma) and the diminished self-worth and feelings of shame that often accompany a stigmatising condition (internalised stigma) |
| Public stigma | the social and psychological reactions towards individuals with a stigmatised condition or attribute. |
| Structural/institutional stigma | Legitimisation and perpetuation of a stigmatised status by society’s institutions and ideological systems.38 |
| (B) Candidacy concept | |
| Stage | Description |
| (1) Identification of candidacy | How individuals decide their symptoms require medical attention. |
| (2) Navigation | Individuals knowledge of and ability to gain entry to appropriate services. |
| (3) Permeability of services | Ease of entry into the health system determined by system's internal factors, such as cultural alignment or the availability of care pathways for specific conditions. |
| (4) Appearances at health services | The process of asserting candidacy during interactions with health professionals. |
| (5) Adjudications | Professional judgements about an individual’s candidacy, influencing subsequent treatment. |
| (6) Offers and resistance | How follow-up services may be accepted or rejected by the patient depending on their appropriateness. |
| (7) Operating conditions and the local production of candidacy | Locally specific factors that influence interactions between patientd and healthcare professionals and develop over time. |
Sources: References 33–40.