Breaking Down Barriers: How Stigma Silences Patient Voices

To clarify the concept of anticipated stigma and examine its relevance to cannabis use disclosure in nursing using an evolutionary concept analysis approach. Concept analysis guided by Rodgers and Knafl's evolutionary method. An interdisciplinary purposive literature review was conducted using empirical and theoretical sources drawn from nursing, public health, psychology and sociology. Literature published between 1963 and 2024 was included, with specific emphasis on health-related stigma, disclosure and cannabis use. Rodgers and Knafl's evolutionary method was used to identify the defining attributes, antecedents, consequences, related concepts and contextual variations of anticipated stigma. Empirical and conceptual literature were synthesised to reflect cross-disciplinary themes. A model case was constructed to illustrate the concept's application in a nursing context, followed by a critical synthesis of implications for nursing theory, research and practice. Anticipated stigma is a future-oriented expectation of devaluation or discrimination associated with disclosing a stigmatised identity or behaviour. Five core attributes were identified. Antecedents include individual identity salience, sociocultural norms and structural factors. Consequences include psychological distress, concealment and reduced healthcare engagement. Anticipated stigma is a dynamic and under-theorised concept that hinders therapeutic communication and person-centred care in nursing settings. This analysis offers conceptual clarity and supports stigma-informed approaches to assessment and communication in nursing education and practice, especially when addressing cannabis use and other stigmatised health behaviours. No patient or public contribution.