1
|
Lathabhavan R, Hosseini Marznaki Z, Kaggwa MM, Darvishi M, Haghighi A, Yıldırım M. Exploring the relationship between peritraumatic dissociative experiences, post-traumatic stress disorder, stigma, and fear: A three-wave study during the COVID-19 pandemic. Arch Psychiatr Nurs 2024; 51:176-182. [PMID: 39034076 DOI: 10.1016/j.apnu.2024.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/09/2023] [Accepted: 06/30/2024] [Indexed: 07/23/2024]
Abstract
COVID-19 has emerged as a pervasive global challenge, giving rise to both significant public health concerns and a range of psychological experiences, such as fear, stigma, and post-traumatic stress disorder. Importantly, healthcare professionals have been subjected to immense mental health problems as they battle against this disease. This study aimed to investigate the mediating roles of perceived stigma, self-stigma related to COVID-19, and fear of COVID-19 in the associations between peritraumatic dissociative experiences and post-traumatic stress disorder during a three-wave COVID-19 pandemic (4th [T1], no wave [T2], and 5th [T3]) in Iran. Data were collected from healthcare professionals using the Peritraumatic Dissociative Experiences Questionnaire, Impact of Event Scale-6, Perceived Stigma Scale, Fear of COVID-19 Scale, and Self-Stigma Scale-Short. The results of structural equation modelling demonstrated positive associations between peritraumatic dissociative experiences, perceived stigma, self-stigma related to COVID-19, fear of COVID-19, and post-traumatic stress disorder across all survey waves. Moreover, the study revealed that perceived stigma, self-stigma related to COVID-19, and fear of COVID-19 acted as mediators in the association between peritraumatic dissociative experiences and post-traumatic stress disorder. The implications of these findings highlight the urgent need to address the mental health of healthcare professionals in the aftermath of a pandemic. Policy efforts should be directed towards providing adequate mental health resources and support to mitigate the psychological impact of pandemics on healthcare professionals.
Collapse
Affiliation(s)
- Remya Lathabhavan
- OB and HRM Area, Indian Institute of Management Bodh Gaya, Bihar, India
| | | | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioral Sciences, McMaster University, Ontario, Canada; Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mohammad Darvishi
- Infectious Diseases & Tropical Medicine Research Center (IDTMRC), School of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Abdullah Haghighi
- Imam Reza Hospital at Amol City, Mazandaran University of Medical Sciences, Sari, Iran
| | - Murat Yıldırım
- Department of Psychology, Agri Ibrahim Cecen University, Ağrı, Turkey; Department of Social and Educational Sciences, Lebanese American University, Beirut, Lebanon.
| |
Collapse
|
2
|
Negarandeh R, Shahmari M, Zare L. Stigmatization experiences of healthcare workers in the context of the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2024; 24:823. [PMID: 39020333 PMCID: PMC11253434 DOI: 10.1186/s12913-024-11300-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare workers face the stigmatization of those caring for COVID-19 patients, creating a significant social problem. Therefore, this study investigated the stigmatization of healthcare workers in the context of the COVID-19 pandemic. METHODS In this scoping review study, searches were conducted from December 2019 to August 2023 in Persian and English using various databases and search engines including PubMed (Medline), Embase, Scopus, ISI Web of Science, ProQuest, Science Direct, Springer, Cochrane Library, Google Scholar, and national databases. The study used English keywords such as Social Stigma, Health Personnel, Healthcare Worker, Medical Staff, Medical Personal, Physicians, doctors, Nurses, nursing staff, COVID-19, and coronavirus disease 2019, and their Persian equivalents, and their Persian equivalents to explore healthcare workers' experiences of COVID-19-related stigma. RESULTS From a total of 12,200 search results, 77 eligible studies were included in this study. stigmatization of healthcare workers caring for COVID-19 patients was evident from the literature because of fear, misinformation, and negative self-image. Manifestations were violence and deprivation of social rights, resulting in adverse biopsychosocial, occupational, and economic consequences. This condition can affect negatively health staff themselves, their families, and society as well. Anti-stigmatization measures include informing society about the realities faced by healthcare workers, presenting an accurate and empathetic image of health workers, providing psychosocial support to health workers, and encouraging them to turn to spirituality as a coping mechanism. There are notable research gaps in comprehending the phenomenon, exploring its variations across diverse healthcare roles and cultural contexts, examining its long-term effects, and monitoring shifts in stigma perceptions over time. CONCLUSION The COVID-19 pandemic has resulted in the stigmatization of healthcare workers, causing mistreatment and rights violations. This stigma persists even post-pandemic, posing a psychological dilemma for caregivers. Addressing this requires comprehensive strategies, including tailored stigma prevention programs and research to understand its psychological impact.
Collapse
Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Leily Zare
- Department of Medical Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Janoušková M, Pekara J, Kučera M, Kearns PB, Šeblová J, Wolfová K, Kuklová M, Šeblová D. Experiences of stigma, discrimination and violence and their impact on the mental health of health care workers during the COVID-19 pandemic. Sci Rep 2024; 14:10534. [PMID: 38720009 PMCID: PMC11078939 DOI: 10.1038/s41598-024-59700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.
Collapse
Affiliation(s)
- Miroslava Janoušková
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia.
- Division of Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czechia.
| | - Jaroslav Pekara
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia.
- Medical College, Prague, Czechia.
| | - Matěj Kučera
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
- National Institute of Mental Health, Klecany, Czechia
- Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pavla Brennan Kearns
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Jana Šeblová
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
- Paediatric Emergency Department, Motol University Hospital, Prague, Czechia
| | - Katrin Wolfová
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Marie Kuklová
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
- Faculty of Science, Charles University, Prague, Czechia
| | - Dominika Šeblová
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia
| |
Collapse
|
4
|
Bangalan SG. Mental health and protective strategies among community-based health workers in region 3, Philippines during COVID-19 pandemic. Behav Med 2023; 49:344-351. [PMID: 35532144 DOI: 10.1080/08964289.2022.2069666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 02/02/2022] [Accepted: 04/19/2022] [Indexed: 11/02/2022]
Abstract
The COVID-19 crisis in the Philippines posed both physical and psychological threats to health workers. It is vital to determine practices to protect them. This study determined the prevalence of mental health outcomes among community-based health workers during the COVID-19 pandemic and examined the association of protective strategies with symptoms of mental health outcomes. A cross-sectional study design was applied to the records of community-based health workers conducted through online psychological assessment by Department of Health - Central Luzon between September 1-30, 2020. Respondents' age, sex, mental health status, and protective strategies were extracted using Abstraction Form, and analyses were done using OpenEpi. A total of 324 records of community-based health workers were included in the analysis. Ten percent of the respondents present symptoms of stress, 26% anxiety symptoms, and 18% depressive symptoms. The majority of the respondents were using deep breathing techniques, having a constant social connection with family and friends, and engaging in their regular spiritual/religious activities as protective strategies during the pandemic. Engagement in regular spiritual/religious practices was found associated with symptoms of stress through Fisher's exact test. Participants who engaged in religious/spiritual practices were less likely to report symptoms of stress. Community-based health workers showed evident rates of symptoms of stress, anxiety, and depression. The majority of the participants engaged in various protective strategies but only engagement in regular religious/spiritual practices was found associated with symptoms of stress.
Collapse
|
5
|
Grover A, Venkatesh U, Kishore J, Chakma T, Thomas B, Menon G, Periyasamy M, Kulkarni R, Prusty RK, Venkateswaran C, Mishra B, Balu V, Viray M, Mathew G, Ketharam A, Balachandar R, Singh P, Jakhar K, Devi R, Saha K, Barde P, Moral R, Singh R, John D, Yadav J, Kohli S, Aggarwal S, Rao V, Panda S. Factors associated with stigma and manifestations experienced by Indian health care workers involved in COVID-19 management in India: A qualitative study. Glob Ment Health (Camb) 2023; 10:e46. [PMID: 37854432 PMCID: PMC10579676 DOI: 10.1017/gmh.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/02/2023] [Accepted: 07/20/2023] [Indexed: 10/20/2023] Open
Abstract
Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers.
Collapse
Affiliation(s)
- Ashoo Grover
- Division of Non-Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
| | - U Venkatesh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Jugal Kishore
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Tapas Chakma
- Division of Non-Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Beena Thomas
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Geetha Menon
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Murugesan Periyasamy
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ragini Kulkarni
- Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Chitra Venkateswaran
- Department of Psychiatry, Believers Church Medical College, Tiruvalla, Kerala, India
| | - Bijaya Mishra
- Department of Clinical Research, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Vinoth Balu
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Maribon Viray
- Department of Psychology, Department of Counselling Psychology Martin, Luther Christian University, Shillong, Meghalaya, India
| | - Geetu Mathew
- ICMR- Regional Occupational Health Centre -South, National Institute of Occupational Health, Bangalore, India
| | - Asha Ketharam
- Division of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Rakesh Balachandar
- Division of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, India
| | - Prashant Singh
- Division of Preventive Oncology and Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Kiran Jakhar
- Department of Psychaitry, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Rekha Devi
- ICMR-Regional Medical Research Centre, N. E. Region, Dibrugarh, India
| | - Kalyan Saha
- Social Sciences and Ethnomedicine, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Barde
- Division of Virology and Zoonotic Diseases, ICMR-National Institute of Research In Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rony Moral
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ravinder Singh
- Division of Non-Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Denny John
- Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Simran Kohli
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases, ICMR, New Delhi, India
| | - Vishnu Rao
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Samiran Panda
- Division of Epidemiology and Communicable Diseases, ICMR, New Delhi, India
| |
Collapse
|
6
|
Folayan MO, Zuñiga RAA, Virtanen JI, Ellakany P, Al-Tammemi AB, Quadri MFA, Jafer M, Ara E, Ayanore MA, Gaffar B, Aly NM, Idigbe I, Lusher J, Ezechi OC, Nguyen AL, Tantawi ME. A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic. BMC Public Health 2023; 23:1025. [PMID: 37254073 DOI: 10.1186/s12889-023-15933-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status. METHODS This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders. RESULTS There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS. CONCLUSION Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jorma I Virtanen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ala'a B Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Migration Health Division, International Organization for Migration, Amman, Jordan
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Oral Health Sciences, University of Washington, Washington, USA
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Dental Public Health Division, Faculty of Dentistry, Jazan University, Jizan, Saudi Arabia
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Psychology, Government College for Women, MA Road, Jizan, J&K, India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Nourhan M Aly
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Provosts Group, Regent's University London, London, UK
| | - Oliver C Ezechi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Centre for Reproductive and Population Health Studies, Nigerian Institute of Medical Research Yaba, Lagos, Nigeria
| | - Annie L Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
7
|
Olal E, Mukunya D, Oloya JN, Baguma S, Okot C, Alema NO, Acullu D, Ochula DO, Atim PO, Odong PO, Okot GS, Pebolo FP, Oyat FWD, Ikoona EN, Aloyo J, Kitara DL. Prevalence and Factors Associated With Compliance With COVID-19 Presidential Lockdown Measures: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231201258. [PMID: 37803931 PMCID: PMC10559722 DOI: 10.1177/00469580231201258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/31/2023] [Accepted: 08/29/2023] [Indexed: 10/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is one of the most severe global health uncertainties to date. Although significant global effort has been put into implementing COVID-19 pandemic control measures such as lockdowns, travel restrictions, and hygiene precautions, the transmission is expected to resurface once these efforts are discontinued. We aimed to determine the prevalence and factors associated with compliance with presidential 53-day lockdown measures in June-July 2021 in northern Uganda. In this cross-sectional study, 587 adult participants (≥18 years old) from northern Uganda were selected using a systematic sampling method. Data collection involved interviewer-administered questionnaires with an internal validity of Cronbach's α = .72. Socio-demographic characteristics of participants were described, and multivariable modified Poisson regressions were performed to assess prevalence ratios between dependent and selected independent variables, with respective P values at 95% confidence intervals. All analyses were conducted using Stata 17.0. Participants' compliance with the presidential lockdown directives was high at 88%(95% CI: 85%-90%). Compliance with the presidential directives was more likely among participants who agreed to the lockdown measures [adjusted Prevalence Ratio, aPR = 1.28 (95% CI: 1.10-1.49; P = .001)] compared to those who did not, and more likely among those who were afraid of death from COVID-19 [aPR = 1.08 (95% CI: 1.01-1.15; P = .023)] than those who did not. However, compliance was less likely among males [aPR = 0.91 (95% CI: 0.86-0.97; P = .002)] compared to females, those aged 35 to 44 years [aPR = 0.87 (95% CI: 0.79-0.97; P = .013)] compared to those less 25 years; and unmarried [aPR = 0.89 (95% CI: 0.82-0.97; P = .011)] compared to the married. Compliance with the COVID-19 presidential lockdown measures in northern Uganda was high. The factors associated with compliance were the fear of death and agreement with presidential lockdown measures. However, compliance was less likely among males, unmarried persons, and persons aged 35 to 44. The authors recommend more community engagements, participation, sensitization, mobilization, and simultaneous application of multiple public health approaches to improve compliance and control of COVID-19.
Collapse
Affiliation(s)
- Emmanuel Olal
- Yotkom Medical Centre, Kitgum, Uganda
- Uganda Medical Association, Gulu City, Uganda
| | - David Mukunya
- Busitema University, Mbale, Uganda
- Nikao Medical Center, Kampala, Uganda
| | - Johnson Nyeko Oloya
- Uganda Medical Association, Gulu City, Uganda
- Moroto Regional Referral Hospital, Moroto, Uganda
| | - Steven Baguma
- Uganda Medical Association, Gulu City, Uganda
- Gulu Regional Referral Hospital, Gulu City, Uganda
| | - Christopher Okot
- Uganda Medical Association, Gulu City, Uganda
- Gulu Regional Referral Hospital, Gulu City, Uganda
| | | | - Denis Acullu
- Uganda Medical Association, Gulu City, Uganda
- Aga Khan Hospital, Mombasa, Kenya
| | - Denish Omoya Ochula
- Uganda Medical Association, Gulu City, Uganda
- Lamwo District Local Government, District Health Office, Padibe, Uganda
| | - Pamela Okot Atim
- Uganda Medical Association, Gulu City, Uganda
- St. Joseph’s Hospital, Kitgum District, Uganda
| | - Patrick Olwedo Odong
- Uganda Medical Association, Gulu City, Uganda
- Amuru District Local Government, District Health Office, Amuru, Uganda
| | - Godfrey Smart Okot
- Uganda Medical Association, Gulu City, Uganda
- Dr. Ambrosoli Memorial Hospital, Kalongo, Uganda
| | | | | | | | - Judith Aloyo
- Uganda Medical Association, Gulu City, Uganda
- Rhites-N, Acholi, Gulu City, Uganda
| | - David Lagoro Kitara
- Uganda Medical Association, Gulu City, Uganda
- Gulu University, Gulu City, Uganda
- Gulu Centre for Advanced Medical Diagnostics, Research, Trainings, and Innovations (GRUDI BIONTECH), Gulu, Uganda
| |
Collapse
|
8
|
Kraaijeveld SR, Jamrozik E. Moralization and Mismoralization in Public Health. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2022; 25:655-669. [PMID: 36045179 PMCID: PMC9432796 DOI: 10.1007/s11019-022-10103-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/09/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022]
Abstract
Moralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of 'mismoralization', which is when moralization is metaethically unjustified. In order to identify mismoralization, we argue that one must engage in metaethical analysis of moralization processes while paying close attention to the relevant facts. We briefly discuss one historical example (tuberculosis) and two contemporary cases related to COVID-19 (infection and vaccination status) that we contend to have been mismoralized in public health. We propose a remedy of de-moralization that begins by identifying mismoralization and that proceeds by neutralizing inapt moral content. De-moralization calls for epistemic and moral humility. It should lead us to pull away from our tendency to moralize-as individuals and as social groups-whenever and wherever moralization is unjustified.
Collapse
Affiliation(s)
| | - Euzebiusz Jamrozik
- Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, Johns Hopkins University, Baltimore, United States
- Ethox and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
9
|
Li S, Gu J. “We are pests, we have no future”: The prediction of anxiety by perceived discrimination in patients with coronavirus: Mediating role of psychological resilience. Front Psychol 2022; 13:979186. [DOI: 10.3389/fpsyg.2022.979186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
In a short amount of time, the COVID-19 pandemic has played havoc on social security, and people infected with coronavirus may have suffered from both physical and mental health issues requiring treatment. The purpose of our study was to examine the effect of perceived discrimination on anxiety in patients with coronavirus and to observe the role of psychological resilience as a mediator in this process. 376 patients with coronavirus were given a questionnaire, and 26 of them participated in in-depth interviews. Our results demonstrated that perceived discrimination in patients with coronavirus was predictive of anxiety and that strong perceptions of discrimination reduced patients’ psychological resilience levels, thereby triggering severe anxiety. Furthermore, psychological resilience was demonstrated to be a significant predictor of anxiety severity. Psychological resilience has been shown to act as a mediator between perceived discrimination and anxiety. As a response to COVID-19, the government, the media, and the general public should treat patients with coronavirus scientifically and rationally, minimize the secondary psychological damage caused by the perception of discrimination to the special groups of society represented by patients with coronavirus during the pandemic, correct the erroneous stigma generated by the traditional communication process, and prevent the spread of the psychosocial virus.
Collapse
|
10
|
A Mixed-Methods Study of Risk Factors and Experiences of Health Care Workers Tested for the Novel Coronavirus in Canada. J Occup Environ Med 2022; 64:e559-e566. [PMID: 35704778 PMCID: PMC9426315 DOI: 10.1097/jom.0000000000002614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A reappraisal of mitigation strategies against occupational hazards is required to ensure that all health workers – not just those in perceived “high-risk” work environments - are protected. This will mean reducing community-level risks and ensuring that the same level of IPC measures, PPE training and supply is available when needed. The aims of this study were to investigate occupational and non–work-related risk factors of coronavirus disease 2019 among health care workers (HCWs) in Vancouver Coastal Health, British Columbia, Canada, and to examine how HCWs described their experiences.
Collapse
|
11
|
What about mental health after one year of COVID-19 pandemic? A comparison with the initial peak. J Psychiatr Res 2022; 153:104-108. [PMID: 35810599 PMCID: PMC9254135 DOI: 10.1016/j.jpsychires.2022.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 06/12/2022] [Accepted: 07/01/2022] [Indexed: 12/23/2022]
Abstract
A psychiatric epidemic has accompanied the COVID-19 pandemic and specific vulnerable populations have been identified. We aimed to explore the presence of anxiety, acute stress and depression among these vulnerable groups after a year of pandemic and relate them to our previous results obtained with the same methodology during the initial peak of the pandemic in Spain. A total of 2182 participants conducted a national survey, starting on March 2021. Sociodemographic information and clinical symptoms were assessed. The sample was divided into four groups in order to develop four substudies with these results: 1) Healthcare workers presented lower anxiety, acute stress, and depression than non-Healthcare workers (p < 0.001), being nurses the most affected. 2) People with mental disorders experienced higher anxiety, acute stress, and depression than people without (p < 0.001), as well as a higher rate of COVID cases (14% vs. 9.3%, p = 0.041). 3) People ≥60 years old presented lower anxiety and acute stress than people <60, (p < 0.05) and a weaker depressive syndrome (p = 0.003). 4) Males presented lower anxiety, acute stress and depression than females (p < 0.001). According to the results obtained during the initial peak, Healthcare workers have developed efficient coping strategies, while elders have managed to maintain their previously emotional balance. Notwithstanding, women and people with mental disorders continue to be vulnerable to emotional distress after a year of pandemic. Women and people with mental disorders continue to be especially vulnerable to emotional distress after a year of pandemic.
Collapse
|
12
|
Balton S, Vallabhjee AL, Pillay SC. When uncertainty becomes the norm: The Chris Hani Baragwanath Academic Hospital’s Speech Therapy and Audiology Department’s response to the COVID-19 pandemic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e11. [PMID: 36073072 PMCID: PMC9452927 DOI: 10.4102/sajcd.v69i2.913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Background In March 2020 the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. Management of this pandemic had significant implications for clinical departments across the world. Healthcare systems were urgently required to reorganise and redesign patient care as well as repurpose staff. Objectives We will share the lived experience of our response as speech therapy and audiology (STA) clinicians to the COVID-19 pandemic. Method This study adopted an autoethnographic approach within Bronfenbrenner’s bioecological model to describe STA clinicians’ response to the COVID-19 pandemic. Results Adaptations to practice were made to continue service provision whilst adhering to COVID-19 regulations. We assisted in other areas to meet the immediate needs of the hospital. Service delivery strategies consisted of a review of clinical and quality assurance protocols. We developed a telehealth service package which included a hybrid approach, within a context of digital poverty. We created resources to ensure continuity of care. Collaboration within our systems facilitated innovative solutions. Mental health and well-being of staff members were key to the response developed. Conclusion South African healthcare systems’ inequalities were highlighted by the pandemic. The response showed that the needs of vulnerable populations were not accounted for when developing this public health response. Lessons learnt included the importance of adaptability, becoming comfortable with uncertainty and maintaining open and transparent communication. Consultation and collaboration within various levels of our healthcare system were critical in responding to the needs of patients. Commitment to compassionate leadership and staff well-being were crucial.
Collapse
Affiliation(s)
- Sadna Balton
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg.
| | | | | |
Collapse
|
13
|
Medical avoidance among marginalized groups: the impact of the COVID-19 pandemic. J Behav Med 2022; 45:760-770. [PMID: 35688960 PMCID: PMC9186488 DOI: 10.1007/s10865-022-00332-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/12/2022] [Indexed: 11/16/2022]
Abstract
Medical avoidance is common among U.S. adults, and may be emphasized among members of marginalized communities due to discrimination concerns. In the current study, we investigated whether this disparity in avoidance was maintained or exacerbated during the onset of the COVID-19 pandemic. We assessed the likelihood of avoiding medical care due to general-, discrimination-, and COVID-19-related concerns in an online sample (N = 471). As hypothesized, marginalized groups (i.e., non-White race, Latinx/e ethnicity, non-heterosexual sexual orientation, high BMI) endorsed more general- and discrimination-related medical avoidance than majoritized groups. However, marginalized groups were equally likely to seek COVID-19 treatment as majoritized groups. Implications for reducing medical avoidance among marginalized groups are discussed.
Collapse
|
14
|
Tari Selçuk K, Avci D, Ataç M. Health professionals’ perception of social stigma and its relationship to compassion satisfaction, burnout, compassion fatigue, and intention to leave the profession during the COVID-19 pandemic. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2022. [DOI: 10.1080/15555240.2022.2078724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K. Tari Selçuk
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Bandırma Onyedi Eylül University, Bandırma, Balıkesir, Turkey
| | - D. Avci
- Faculty of Health Sciences, Nursing Department, Bandırma Onyedi Eylül University, Bandırma, Balıkesir, Turkey
| | - M. Ataç
- Çanakkale Onsekiz Mart University, Rectorate, Çanakkale, Turkey
| |
Collapse
|
15
|
Chandran N, Vinuprasad V G, Sreedevi C, Sathiadevan S, Deepak K S. COVID-19-related Stigma Among the Affected Individuals: A Cross-Sectional Study From Kerala, India. Indian J Psychol Med 2022; 44:279-284. [PMID: 35656434 PMCID: PMC9125476 DOI: 10.1177/02537176221086983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The studies and case reports from various parts of the world are showing discrimination and stigma associated with COVID-19. Stigma can directly worsen the mental health of people and also worsen physical health indirectly. This study is aimed to assess the anticipatory and experienced stigma associated with COVID-19 in affected individuals. METHODS This was a cross-sectional study conducted at Palakkad District in Kerala. Study participants were patients diagnosed with COVID-19. The sampling method was convenience sampling and snowball sampling. COVID-19 Related Stigma Survey Questionnaire was prepared by experts from the field of Psychiatry and Community Medicine. The responses were collected via an online survey and telephonic interview. RESULTS Among the total participants (N=303) 119 participants (39.3%) wanted to keep the illness a secret. Eighty-one participants (26.7%) had fear of discrimination from others. Eighty-nine participants (29.4%) had experienced stigma related to their COVID-19 infection. Seventy-five (24.8%) participants' family members had experienced stigma. Few stigma parameters were significantly higher among the younger people. The participants belonging to the below poverty line category and the participants with lesser education showed significantly more worry about rejoining society after the isolation. Below poverty line category also had significantly more worry about discrimination towards their family members. Participants with lower education had significantly more worry about affecting their job due to the illness. Health care workers had significantly high worry regarding others attitudes towards them. CONCLUSION There is a high level of stigma associated with COVID-19 in society. Definite measures need to be taken to reduce the stigma related to COVID-19 infection.
Collapse
Affiliation(s)
- Nimmy Chandran
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Vinuprasad V G
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Sreedevi C
- Dept. of Community Medicine, Government Medical College, Palakkad, Kerala, India
| | - Sajal Sathiadevan
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Deepak K S
- Dept. of Community Medicine, Government Medical College, Palakkad, Kerala, India
| |
Collapse
|
16
|
COVID-19-Related Workplace Bullying and Customer Harassment Among Healthcare Workers Over the Time of the COVID-19 Outbreak. J Occup Environ Med 2022; 64:e300-e305. [DOI: 10.1097/jom.0000000000002511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
17
|
Ahmadi S, Irandoost SF, Ahmadi A, Yoosefi Lebni J, Mohammadi Gharehghani MA, Baba Safari N. Explaining Experiences, Challenges and Adaptation Strategies in COVID-19 Patients: A Qualitative Study in Iran. Front Public Health 2022; 9:778026. [PMID: 35186867 PMCID: PMC8850373 DOI: 10.3389/fpubh.2021.778026] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/27/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Getting COVID-19 makes a person confront numerous individual, physical, psychological, family and social challenges. Therefore, the present study was conducted to explain the experiences, challenges and adaptation strategies in patients with COVID-19 in Tehran, Iran. METHODS The present study was performed with a qualitative approach and phenomenological method among 33 patients with COVID-19. From July 20 to September 21, access to participants and data collection were done in person (15 people) and by phone (18 people) through targeted sampling and snowball and semi-structured interviews. Data management was carried out using MAXQDA-2018 software and its analysis was done by the Colaizzi analysis method. Guba and Lincoln's criteria were also observed to improve the quality of results. RESULTS After analyzing the data, two main categories and 17 subcategories were obtained, including (1) experiences and challenges (ignoring the disease, blaming, physical health disorders, mental problems, guilt, and remorse, being blamed, living a life of disappointment and ambiguity, emotional challenges, frustrating reactions from others, helplessness and limitation) and (2) disease adaptation strategies (spirituality, learning about COVID-19, doing valuable and fun activities, participating in treatment, strengthening one's spirit and hope, trying to make up for past mistakes and virtual communication). CONCLUSIONS Based on the results, interventions and policies such as increasing people's health knowledge and literacy to get acquainted with the symptoms of the disease and prompt referral for diagnosis and treatment, teaching stress and psychological pressure management techniques, instructing families to continue emotional and social support for patients and strengthening and reproducing the strategies patients use, along with teaching disease coping skills, harnessing the potential of cyberspace and the media can make it easier to tolerate illness and get back to life.
Collapse
Affiliation(s)
- Sina Ahmadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Fahim Irandoost
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Ahmad Ahmadi
- PhD in Educational Technology, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Javad Yoosefi Lebni
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nafe Baba Safari
- PhD in Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
| |
Collapse
|
18
|
Yoosefi Lebni J, Irandoost SF, Safari H, Xosravi T, Ahmadi S, Soofizad G, Ebadi Fard Azar F, Hoseini AS, Mehedi N. Lived Experiences and Challenges of the Families of COVID-19 Victims: A Qualitative Phenomenological Study in Tehran, Iran. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221081405. [PMID: 35225048 PMCID: PMC8886310 DOI: 10.1177/00469580221081405] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Being COVID-19 positive and then dying causes a slew of personal, familial, and social issues for family members. Therefore, the current study was carried out to analyze the lived experiences and issues of COVID-19 victims' families in Tehran, Iran. The phenomenological approach was used in the qualitative analysis of 21 first-degree relatives of COVID-19 victims. From August 22 to October 21, 2020, data was gathered by phone (4 people) and in-person (17 people) using semi-structured interviews. The subjects were chosen through purposeful and snowball sampling. The MAXQDA-2018 program was used to organize the data, and the Colaizzi analytical technique was used to analyze it. Guba and Lincoln's criteria were also used to assess the findings' quality. After analyzing the data, 2 main categories and 14 subcategories were extracted, including (1) challenges in caring for a COVID-19 patient (being rejected, limited access to medical facilities, dissatisfaction with the behavior of medical staff, disruption of family life, the challenge of managing family members' behavior with the patient, and living with doubts and worries (2) challenges after a COVID-19 patient's death (incomplete farewell to the corpse, unbelievability of the death, ambiguity and tension in the burial process, lonely burial, the twinge of conscience, worry about not respecting the deceased, incomplete condolences, and abandonment). The troubles of victims' families can be ameliorated by developing the skills of caring for COVID-19 patients at home, providing medical and psychological services to families before and after the patient's death, appropriately informing the families to guarantee them about dignity and respect and respect of the deceased at the interment, and developing a culture of virtual condolence to provide emotional support to survivors.
Collapse
Affiliation(s)
- Javad Yoosefi Lebni
- Health Promotion Research Center, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Fahim Irandoost
- Social Determinants of Health Research Center, Clinical Research Institute, 37555Urmia University of Medical Sciences, Urmia, Iran
| | - Hossein Safari
- Health Promotion Research Center, 440827Iran University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, 113106Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tareq Xosravi
- 201574Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Sina Ahmadi
- Social Welfare Management Research Centre, Department of Social Welfare Management, 48533University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Goli Soofizad
- School of Public Health and Safety, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farbod Ebadi Fard Azar
- Health Promotion Research Center, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Ava Sadat Hoseini
- Department of Health Education and Health Promotion, School of Health, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Nafiul Mehedi
- Department of Social Work, 113074Shahjalal University of Science and Technology, Sylhet, Bangladesh
| |
Collapse
|
19
|
Public Stigma of COVID-19 and Its Correlates in the General Population of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111718. [PMID: 34770234 PMCID: PMC8582727 DOI: 10.3390/ijerph182111718] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 12/12/2022]
Abstract
This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the general population completed the survey measuring their stigmatizing attitudes towards COVID-19, as well as knowledge and causal attributions of COVID-19. Univariate and multivariate analyses were performed to examine the correlates of COVID-19-related public stigma. A total of 31.8% of participants endorsed stigmatization towards people with COVID-19. Those who were of older age (t = -3.97, p < 0.001), married (F = 3.04, p < 0.05), had a lower level of education (F = 8.11, p < 0.001), and a serious psychological response (F = 3.76, p < 0.05) reported significantly higher scores of public stigma. Dangerousness (B = 0.047, p < 0.001), fear (B = 0.059, p < 0.001), anger (B = 0.038, p < 0.01), and responsibility (B = 0.041, p < 0.001) were positively associated with public stigma. This study shows that public stigma related to COVID-19 is prevalent in the general population of China. Actions against public stigma need to contain the spread of misinformation about COVID-19, alter inappropriate attributions, alleviate unfavorable reactions, and provide psychosocial support for the public.
Collapse
|
20
|
Haddad C, Bou Malhab S, Malaeb D, Sacre H, Saadeh D, Mourtada V, Salameh P. Stigma toward people with COVID-19 among the Lebanese population: a cross-sectional study of correlates and mediating effects. BMC Psychol 2021; 9:164. [PMID: 34686218 PMCID: PMC8532089 DOI: 10.1186/s40359-021-00646-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/04/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Stigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma. METHODS A cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19. RESULTS More than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta = -.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score. CONCLUSION Our main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.
Collapse
Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
| | - Sandrella Bou Malhab
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Diana Malaeb
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Vanessa Mourtada
- Faculty of Letters and Human Sciences, Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| |
Collapse
|
21
|
Grover S, Sahoo S, Mishra E, Gill KS, Mehra A, Nehra R, Suman A, Bhalla A, Puri GD. Fatigue, perceived stigma, self-reported cognitive deficits and psychological morbidity in patients recovered from COVID-19 infection. Asian J Psychiatr 2021; 64:102815. [PMID: 34455354 PMCID: PMC8379818 DOI: 10.1016/j.ajp.2021.102815] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Few studies have highlighted multiple psychosocial and physical outcomes in patients with COVID-19 infection after recovery. However, the data from developing countries is limited. AIM To evaluate psychological morbidity, post-traumatic stress disorder (PTSD), fatigue, and perceived stigma among patients with COVID-19 after recovery from the acute phase of COVID-19 infection. METHODS In a cross-sectional online survey, 206 adult patients (age>18 years), recovered from COVID-19 infection completed the Patient Health Questionnaire-4 (PHQ-4), the Impact of Events Scale-Revised (IES-R), Fatigue Severity Scale (FSS), 4 items self-designed questionnaire evaluating cognitive deficits and self-designed questionnaire to evaluate perceived stigma. Additionally, they completed the information about demographic and clinical information. RESULTS The prevalence of anxiety, depressive symptoms, and PTSD in the study sample was 24.8 %, 23.8 %, and 30 % respectively. About three-fifths of the participants (61.2 %) had at least one fatigue symptom as per the FSS with the mean FSS score being 32.10 ± 15.28. About one-fourth of the participants (23.7 %) reported "feeling confused and always feeling mentally foggy", and 38 % of patients reported experiencing at least one cognitive problem. The level of felt stigma related to self was seen in 31.1 %, 20 % reported stigma related to family, and 50 % reported stigma in relation to neighbors and society. Those reporting higher PTSD scores had higher anxiety and depressive scores, reported more fatigue and stigma, and had a higher level of cognitive deficits. A higher fatigue score was also associated with higher anxiety, depression, and cognitive deficits. CONCLUSIONS Our study reveals that a significant proportion of patients after recovery from COVID-19 experience psychological morbidities, fatigue, cognitive problems, and stigma. Efforts should be made to take care of these issues in routine post-COVID follow-up care.
Collapse
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Eepsita Mishra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Kanwarbir Singh Gill
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Aseem Mehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Ritu Nehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Aarzoo Suman
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Ashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Goverdhan Dutt Puri
- Department of Anaesthesia & Critical Care, Post Graduate Institute of Medical, Education and Research, Chandigarh, 160012, India
| |
Collapse
|
22
|
Zhao L, Wang Z, Guan J, Shen P, Zhao W, Zuo G. Coronavirus Disease 2019-Related Stigma in China: A Descriptive Study. Front Psychol 2021; 12:694988. [PMID: 34456809 PMCID: PMC8385269 DOI: 10.3389/fpsyg.2021.694988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) tremendously impacts the physical and mental health of humans worldwide. Consequently, studies on COVID-19 remain extensive. However, most of them were mainly focused on the pathological mechanisms and treatment methods from medical perspectives. Various reports have indicated that COVID-19 is closely related to stigma and discrimination, but little statistical information has been integrated quantitatively to describe the situation in China. Thus, this study investigated the COVID-19-related stigma of individuals. We collected the online survey data from 1,920 Chinese participants from October to December 2020. Findings showed that 306 (15.94%), 285 (14.84%), 265 (13.80%), and 100 (5.21%) participants endorsed stigma toward individuals in high-risk areas, recovered patients with COVID-19, families of recovered patients with COVID-19, and frontline healthcare providers, respectively. To understand the possible factors that could impact the COVID-19-related stigma, knowledge about COVID-19 was investigated. Generally, knowledge about COVID-19 was negatively associated with COVID-19-related stigma in general, while no significant relationship existed between the knowledge about COVID-19 and the COVID-19-related stigma in the groups who had held COVID-19-related stigma. Ultimately, individuals showed COVID-19-related stigma toward recovered patients and their families, individuals in high-risk areas, and frontline healthcare providers to some extent. The results of this study can provide reference to nations, governments, and organizations in addressing the stigma issues raised by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Li Zhao
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Zhen Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Jian Guan
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - Panyan Shen
- Department of Applied Psychology, School of Law, Southwest University of Science and Technology, Sichuan, China
| | - Wen Zhao
- Department of Applied Psychology, School of Law, Southwest University of Science and Technology, Sichuan, China
| | - Guoguo Zuo
- Department of Applied Psychology, School of Law, Southwest University of Science and Technology, Sichuan, China
| |
Collapse
|
23
|
Kamada K, Konno S, Kaneko T, Fukunaga K, Hasegawa Y, Yokoyama A. The effect of the outbreak of COVID-19 on respiratory physicians and healthcare in Japan: Serial nationwide surveys by the Japanese Respiratory Society. Respir Investig 2021; 59:792-798. [PMID: 34446400 PMCID: PMC8324411 DOI: 10.1016/j.resinv.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/20/2021] [Accepted: 07/04/2021] [Indexed: 12/23/2022]
Abstract
Background The impact of the outbreak of COVID-19 on the work of respiratory physicians in Japan has not yet been evaluated. The study investigates the impact of the outbreak on respiratory physicians’ work over time and identifies problems to be addressed in the future. Methods We conducted a web-based survey of respiratory physicians in 848 institutions. The survey comprised 32 questions and four sections: Survey 1 (April 20, 2020), Survey 2 (May 27, 2020), Survey 3 (August 31, 2020), and Survey 4 (December 4, 2020). Results The mean survey response rate was 24.9%, and 502 facilities (59.2%) participated in at least one survey. The proportion of facilities that could perform PCR tests for diagnosis and more than 20 tests per day gradually increased. The percentage capable of managing extracorporeal membrane oxygenation (ECMO) or more than five ventilators did not increase over time. The proportion that reported work overload of 150% or more, stress associated with lack of personal protective equipment (PPE), and harassment or stigma in the surrounding community did not sufficiently improve. Conclusion While there was an improvement in expanding the examination system and medical cooperation in the community, there was no indication of enhancement of the critical care management system. The overwork of respiratory physicians, lack of PPE, and harassment and stigma related to COVID-19 did not sufficiently improve and need to be addressed urgently.
Collapse
Affiliation(s)
- Keisuke Kamada
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan; Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan.
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
| | | | - Akihito Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Japan
| |
Collapse
|
24
|
Mayer CH, Vanderheiden E. Transforming Shame in the Pandemic: An International Study. Front Psychol 2021; 12:641076. [PMID: 34220612 PMCID: PMC8244785 DOI: 10.3389/fpsyg.2021.641076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/15/2021] [Indexed: 01/07/2023] Open
Abstract
Shame is an unconscious, somehow unattended and neglected emotion and occurs when individual and socio-cultural norms are violated. It often impacts negatively on the self and others across cultures. During the Covid-19 crises, shame has become an important emotion with a powerful effect, depending on how it is experienced within the socio-cultural context. This article explores shame in international perspectives in the context of Covid-19 and addresses the question how shame is transformed from an existential positive psychology (PP2.0) perspective. The study uses a qualitative research paradigm and explores shame and its transformation during Covid-19. Purposeful and snowball sampling was used. The sample consisted of 24 individuals (16 female, 8 male), of 13 different nationalities. Data were collected from written interviews and analyzed through thematic analysis. Ethical considerations were followed; ethical approval was given by a university. Findings show that participants become very worried, anxious, scared, sad, and shocked when they or individuals in their close relationships contracted Covid-19. Shame plays an important role during the Covid-19 pandemic. However, the meaning and experience of shame during Covid-19 is strongly dependent on the socio-cultural background of the individual who is experiencing the disease. Individuals use different strategies and mechanisms to deal with and transform shame in the context of Covid-19.
Collapse
Affiliation(s)
- Claude-Hélène Mayer
- Department of Industrial Psychology and People Management, University of Johannesburg, Johannesburg, South Africa
- Kulturwissenschaftliche Fakultät, Europa Universität Viadrina, Frankfurt, Germany
| | | |
Collapse
|
25
|
Liu R, Nicholas S, Leng A, Qian D, Maitland E, Wang J. The influencing factors of discrimination against recovered Coronavirus disease 2019 (COVID-19) patients in China: a national study. Hum Vaccin Immunother 2021; 18:1913966. [PMID: 34085898 PMCID: PMC8920212 DOI: 10.1080/21645515.2021.1913966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Over 26 million recovered COVID-19 patients will suffer from discrimination in work, education and social interactions. We analyzed the determinants of discrimination against recovered COVID-19 patients and suggest policy recommendations to reduce such discrimination. Methods Twenty-seven Chinese cities were selected randomly based on their geographical location and GDP rank. One hundred adults were interviewed in each city with an equal number of men and women and three urban residents for every two rural residents. A multiple ordered logistic regression model was used to assess the associations between potential determinants and the COVID-19 discrimination level. Results Of 2377 participants, 79.76% displayed discrimination toward recovered COVID-19 patients. The female discrimination level was 1.25 times that of males; the discrimination level increased with age; and was occupation-specific, with physicians’ (OR = 0.352) and students’ (OR = 0.553) discrimination level lower than that of farmers. The discrimination level of participants from the central regions was 1.828 times, and the eastern region 1.504 times, that of participants from western region. The participants’ discrimination level was lower when they scored higher in transmission knowledge, prevention knowledge and other COVID-19 knowledge, treatment methods and quarantine time. Conclusion Sex, age, occupation, infections of relatives and friends, regions and scores on COVID-19 knowledge were determinants of discrimination level against recovered COVID-19 patients. In contrast with qualitative studies, our quantitative study recommends targeted education campaigns, focusing on physicians, women, older people and certain occupations. Only the COVID-19 vaccination program for the whole population will resolve the COVID-19 discrimination problem.
Collapse
Affiliation(s)
- Rugang Liu
- School of Health Policy & Management, Nanjing Medical University, Nanjing, PRC.,Center for Global Health, Nanjing Medical University, Nanjing, PRC
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, 1 Central Avenue Australian Technology Park, Sydney, Australia.,Research Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, PRC.,School of Economics and School of Management, Tianjin Normal University, Tianjin, PRC.,Newcastle Business School, University of Newcastle, University Drive, Newcastle, Australia
| | - Anli Leng
- School of Political Science and Public Administration, Institute of Governance, Shandong University, Shandong, PRC
| | - Dongfu Qian
- School of Health Policy & Management, Nanjing Medical University, Nanjing, PRC.,Center for Global Health, Nanjing Medical University, Nanjing, PRC
| | | | - Jian Wang
- Dong Fureng Economic and Social Development School, Wuhan University, Beijing, China.,Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan, China
| |
Collapse
|
26
|
Li L, Wang J, Leng A, Nicholas S, Maitland E, Liu R. Will COVID-19 Vaccinations End Discrimination against COVID-19 Patients in China? New Evidence on Recovered COVID-19 Patients. Vaccines (Basel) 2021; 9:vaccines9050490. [PMID: 34064737 PMCID: PMC8150813 DOI: 10.3390/vaccines9050490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/01/2021] [Accepted: 05/09/2021] [Indexed: 12/16/2022] Open
Abstract
(1) Background: By April 2021, over 160 million Chinese have been vaccinated against coronavirus disease 2019 (COVID-19). This study analyzed the impact of vaccination on discrimination against recovered COVID-19 patients and the determinants of discrimination among intended vaccinated people. (2) Methods: A self-designed questionnaire was used to collect data on COVID-19 associated discrimination from nine provinces in China. Pearson chi-square tests and a multivariate ordered logistic regression analyzed the determinants of COVID-19-related discrimination. (3) Results: People who intended to be COVID-19 vaccinated displayed a high level of discrimination against recovered COVID-19 patients, with only 37.74% of the intended vaccinated without any prejudice and 34.11% displaying severe discrimination. However, vaccinations reduced COVID-19-related discrimination against recovered COVID-19 patients from 79.76% to 62.26%. Sex, age, education level, occupation, geographical region, respondents' awareness of vaccine effectiveness and infection risk, and COVID-19 knowledge score had a significant influence on the COVID-19 related discrimination (p < 0.05). (4) Conclusions: Vaccination significantly reduced COVID-19 associated discrimination, but discrimination rates remained high. Among the intended vaccinated respondents, females, the older aged, people with high school and above education level, retirees, migrant workers, and residents in central China were identified as key targets for information campaigns to reduce COVID-19 related discrimination.
Collapse
Affiliation(s)
- Lu Li
- School of Business Administration, Jiangsu Vocational Institute of Commerce, Nanjing 211168, China;
| | - Jian Wang
- Dong Fureng Economic and Social Development School, Wuhan University, Beijing 100010, China;
- Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan 430072, China
| | - Anli Leng
- School of Political Science and Public Administration, Institute of Governance, Shandong University, Qingdao 266237, China;
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Eveleigh, Sydney, NSW 2015, Australia;
- Research Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou 510420, China
- School of Economics, Tianjin Normal University, Tianjin 300074, China
- School of Management, Tianjin Normal University, Tianjin 300074, China
- Newcastle Business School, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Chatham Building, Chatham Street, Liverpool L69 7ZH, UK;
| | - Rugang Liu
- School of Health Policy & Management, Nanjing Medical University, Nanjing 211166, China
- Center for Global Health, Nanjing Medical University, Nanjing 211166, China
- Correspondence:
| |
Collapse
|
27
|
Yuan Y, Zhao YJ, Zhang QE, Zhang L, Cheung T, Jackson T, Jiang GQ, Xiang YT. COVID-19-related stigma and its sociodemographic correlates: a comparative study. Global Health 2021; 17:54. [PMID: 33962651 PMCID: PMC8103123 DOI: 10.1186/s12992-021-00705-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is closely associated with physical and mental health problems; however, little is known about the severity of stigma caused by COVID-19 among its survivors. Thus, the aim of this study was to compare differences in stigma experiences of COVID-19 survivors versus healthy controls after the COVID-19 outbreak peak in China. METHODS This cross-sectional study comprised 154 COVID-19 survivors and 194 healthy controls recruited through consecutive and convenience sampling methods, respectively. COVID-19 related stigma was measured by the Social Impact Scale (SIS). Stigma differences between the two groups were compared with analysis of covariance (ANCOVA) and a generalized linear model (GLM) was used to identify independent correlates of COVID-19-related stigma in this study. RESULTS Compared with healthy controls, COVID-19 survivors reported more overall stigma (F(1,347) = 60.82, p < 0.001), and stigma in domains of social rejection (F(1,347) = 56.54, p < 0.001), financial insecurity (F(1,347) = 19.96, p < 0.001), internalized shame (F(1,347) = 71.40, p < 0.001) and social isolation (F(1,347) = 34.73, p < 0.001). Status as a COVID-19 survivor, having family members infected with COVID-19, being married, economic loss during the COVID-19 pandemic, and depressive symptoms were positively associated with higher overall stigma levels (all p values < 0.05). CONCLUSION COVID-19-related stigma is commonly experienced among COVID-19 survivors even though the outbreak has been well-contained in China. Routine assessment of stigma experiences should be conducted on COVID-19 survivors and appropriate psychological assistance, public education, and anti-stigma campaigns and policies should be enforced to reduce stigma within this vulnerable subpopulation.
Collapse
Affiliation(s)
- Yuan Yuan
- Chongqing Mental Health Center, Chongqing, China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Qing-E Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, Macau SAR, China
| | | | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
| |
Collapse
|