1
|
Yirdaw BA, Moussallem M, Alkasaby M, Asmar MK, Alves V, Mamba DN, Tolba B, Kyalo CW, Hussain M, Dafwat J, Kagaayi G, Nkhoma D, Eaton J, Walker IF. Integrating mental health and psychosocial support (MHPSS) into infectious disease outbreak response: Results of an expert consensus study. IJID REGIONS 2024; 12:100396. [PMID: 39104379 PMCID: PMC11298854 DOI: 10.1016/j.ijregi.2024.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 08/07/2024]
Abstract
Objectives Outbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response. Methods A participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response. Results Systematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing. Conclusions Despite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.
Collapse
Affiliation(s)
- Biksegn Asrat Yirdaw
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Marianne Moussallem
- Higher Institute of Public Health, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Muhammad Alkasaby
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Vania Alves
- Child Protection in Humanitarian Action, UNICEF, New York, USA
| | | | - Basma Tolba
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | - Mujataba Hussain
- Child Psychiatry Unit, Institute of Mental Health and Neurosciences, Kashmir, India
| | - Jennifer Dafwat
- Global Mental Health Peer Network, Country Lead, Abuja, Nigeria
| | | | | | - Julian Eaton
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
- CBM Global, Cambridge, UK
| | - Ian F. Walker
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| |
Collapse
|
2
|
Barth SK, Monroe AK, Houston P, Benator D, Horberg M, Castel AD. COVID-19 Incidence, Risk Factors, Impact, and Related Stigma Among a Cohort of Persons With HIV in Washington, DC. J Acquir Immune Defic Syndr 2024; 96:429-438. [PMID: 38985440 DOI: 10.1097/qai.0000000000003447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/09/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Studies on the incidence of COVID-19 among persons with HIV (PWHs) present varied results. Few studies have investigated the impact of COVID-19 infection on health and socioeconomic factors or COVID-19 stigma. We sought to measure the incidence and severity of COVID-19 infection among a cohort of PWHs, characterize associated risk factors and impact, and document perceptions of COVID-19-related stigma. METHODS Data for this cross-sectional study come from the COVID-19 survey of participants in the DC Cohort longitudinal study from October 30, 2020, through December 31, 2022. Survey results were linked to electronic health records, including HIV laboratory test results and COVID test results. We conducted analyses comparing demographic, socioeconomic, HIV measures, and stigma among those with and without self-reported COVID-19. RESULTS Of 1972 survey respondents, 17% self-reported COVID-19 infection, with the greatest incidence in the Omicron wave of the pandemic. We found statistically significant differences by age, employment status, essential worker status, education, and household income. Longer duration of HIV diagnosis was associated with greater incidence of COVID-19. PWHs who were overweight or obese had a greater incidence of COVID-19 compared with those who were not. Over 40% of PWHs with COVID-19 reported experiencing at least 1 form of COVID-19-related stigma. CONCLUSION We observed a high incidence of COVID-19 infection among PWHs in DC. Furthermore, a substantial proportion of PWHs with COVID-19 reported experiencing COVID-19-related stigma. These findings add to the existing literature on COVID-19 coinfection among PWHs and highlight the need for awareness and support for those experiencing COVID-19 stigma.
Collapse
Affiliation(s)
- Shannon K Barth
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Anne K Monroe
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Patricia Houston
- Howard University Department of Pediatrics and Child Health, Washington, DC
| | - Debra Benator
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC
- Infectious Diseases Section, DC Veterans Administration Medical Center, Washington, DC; and
| | | | - Amanda D Castel
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC
| |
Collapse
|
3
|
Dang W, Li W, Liu H, Li C, Zhu T, Bai L, Yang R, Wang J, Liao X, Liu B, Zhang S, Yuan M, Zhang W. Psychosocial Factors Associated With Long-Term Cognitive Impairment Among COVID-19 Survivors: A Cross-Sectional Study. J Nerv Ment Dis 2024; 212:437-444. [PMID: 39008889 DOI: 10.1097/nmd.0000000000001792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
ABSTRACT COVID-19 survivors complained of the experience of cognitive impairments, which also called "brain fog" even recovered. The study aimed to describe long-term cognitive change and determine psychosocial factors in COVID-19 survivors. A cross-sectional study was recruited 285 participants from February 2020 to April 2020 in 17 hospitals in Sichuan Province. Cognitive function, variables indicative of the virus infection itself, and psychosocial variables were collected by telephone interview. Univariate logistic regression and Lasso logistic regression models were used for variable selection which plugged into a multiple logistics model. Overall prevalence of moderate or severe cognitive impairment was 6.3%. Logistic regression showed that sex, religion, smoking status, occupation, self-perceived severity of illness, sleep quality, perceived mental distress after COVID-19, perceived discrimination from relatives and friends, and suffered abuse were associated with cognitive impairment. The long-term consequences of cognitive function are related to multiple domains, in which psychosocial factors should be taken into consideration.
Collapse
Affiliation(s)
| | | | - Haotian Liu
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | | | | | - Lin Bai
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Runnan Yang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Jingyi Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao Liao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Liu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | | | | | | |
Collapse
|
4
|
Shiri I, Salimi Y, Sirjani N, Razeghi B, Bagherieh S, Pakbin M, Mansouri Z, Hajianfar G, Avval AH, Askari D, Ghasemian M, Sandoughdaran S, Sohrabi A, Sadati E, Livani S, Iranpour P, Kolahi S, Khosravi B, Bijari S, Sayfollahi S, Atashzar MR, Hasanian M, Shahhamzeh A, Teimouri A, Goharpey N, Shirzad-Aski H, Karimi J, Radmard AR, Rezaei-Kalantari K, Oghli MG, Oveisi M, Vafaei Sadr A, Voloshynovskiy S, Zaidi H. Differential privacy preserved federated learning for prognostic modeling in COVID-19 patients using large multi-institutional chest CT dataset. Med Phys 2024; 51:4736-4747. [PMID: 38335175 DOI: 10.1002/mp.16964] [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: 10/05/2023] [Revised: 01/10/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Notwithstanding the encouraging results of previous studies reporting on the efficiency of deep learning (DL) in COVID-19 prognostication, clinical adoption of the developed methodology still needs to be improved. To overcome this limitation, we set out to predict the prognosis of a large multi-institutional cohort of patients with COVID-19 using a DL-based model. PURPOSE This study aimed to evaluate the performance of deep privacy-preserving federated learning (DPFL) in predicting COVID-19 outcomes using chest CT images. METHODS After applying inclusion and exclusion criteria, 3055 patients from 19 centers, including 1599 alive and 1456 deceased, were enrolled in this study. Data from all centers were split (randomly with stratification respective to each center and class) into a training/validation set (70%/10%) and a hold-out test set (20%). For the DL model, feature extraction was performed on 2D slices, and averaging was performed at the final layer to construct a 3D model for each scan. The DensNet model was used for feature extraction. The model was developed using centralized and FL approaches. For FL, we employed DPFL approaches. Membership inference attack was also evaluated in the FL strategy. For model evaluation, different metrics were reported in the hold-out test sets. In addition, models trained in two scenarios, centralized and FL, were compared using the DeLong test for statistical differences. RESULTS The centralized model achieved an accuracy of 0.76, while the DPFL model had an accuracy of 0.75. Both the centralized and DPFL models achieved a specificity of 0.77. The centralized model achieved a sensitivity of 0.74, while the DPFL model had a sensitivity of 0.73. A mean AUC of 0.82 and 0.81 with 95% confidence intervals of (95% CI: 0.79-0.85) and (95% CI: 0.77-0.84) were achieved by the centralized model and the DPFL model, respectively. The DeLong test did not prove statistically significant differences between the two models (p-value = 0.98). The AUC values for the inference attacks fluctuate between 0.49 and 0.51, with an average of 0.50 ± 0.003 and 95% CI for the mean AUC of 0.500 to 0.501. CONCLUSION The performance of the proposed model was comparable to centralized models while operating on large and heterogeneous multi-institutional datasets. In addition, the model was resistant to inference attacks, ensuring the privacy of shared data during the training process.
Collapse
Affiliation(s)
- Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Nasim Sirjani
- Research and Development Department, Med Fanavarn Plus Co, Karaj, Iran
| | - Behrooz Razeghi
- Department of Computer Science, University of Geneva, Geneva, Switzerland
| | - Sara Bagherieh
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Pakbin
- Imaging Department, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Mansouri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | - Ghasem Hajianfar
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
| | | | - Dariush Askari
- Department of Radiology Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ghasemian
- Department of Radiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Saleh Sandoughdaran
- Department of Clinical Oncology, Royal Surrey County Hospital, Guildford, UK
| | - Ahmad Sohrabi
- Radin Makian Azma Mehr Ltd., Radinmehr Veterinary Laboratory, Iran University of Medical Sciences, Gorgan, Iran
| | - Elham Sadati
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Somayeh Livani
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Pooya Iranpour
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahriar Kolahi
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Salar Bijari
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sahar Sayfollahi
- Department of Neurosurgery, Faculty of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Atashzar
- Department of Immunology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Hasanian
- Department of Radiology, Arak University of Medical Sciences, Arak, Iran
| | - Alireza Shahhamzeh
- Clinical research development center, Qom University of Medical Sciences, Qom, Iran
| | - Arash Teimouri
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Goharpey
- Department of radiation oncology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Jalal Karimi
- Department of Infectious Disease, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiara Rezaei-Kalantari
- Rajaie Cardiovascular, Medical & Research Center, Iran University of Medical Science, Tehran, Iran
| | | | - Mehrdad Oveisi
- Department of Computer Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alireza Vafaei Sadr
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | | | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
- University Research and Innovation Center, Óbuda University, Budapest, Hungary
| |
Collapse
|
5
|
Huang PC, Lin CY, Huang RY, Chen JS, Griffiths MD, Strong C, Wang HW, Chen CY, Ko NY, Shieh SJ. The effect of social support and resource support on emotional exhaustion, insomnia, and suicidal ideation among allied health trainees and post-graduate year doctors in Taiwan. BMC Psychol 2024; 12:322. [PMID: 38824566 PMCID: PMC11144321 DOI: 10.1186/s40359-024-01811-9] [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: 07/27/2023] [Accepted: 05/22/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND COVID-19-related stigmatization refers to COVID-19-related judgements by others that devalue the individual. Such stigmatization towards healthcare workers may cause psychological burden and negative consequences. Such stigmatization may have particularly overwhelmed allied health trainees (AHTs) and post-graduate year doctors (PGYDs) because they just started their medical career. Social support and resource support have been reported to benefit psychological health and reduce stigmatization. Therefore, the present study used a cross-sectional study design to investigate the association between perceived stigma, self-stigma, psychological distress, and negative outcomes (including emotional exhaustion, insomnia and suicidal ideation) among AHTs and PGYDs in Taiwan. METHODS An online survey distributed between July and December, 2022 received 522 responses. Variables were assessed using the 21-item Depression, Anxiety and Stress Scale, Insomnia Severity Index and a series of self-designed questions to assess social support, resource support, perceived stigma, self-stigma, emotional exhaustion, and suicidal ideation. RESULTS Structural equation modeling showed that perceived stigma was associated with self-stigma (standardized coefficient [β] = 0.428, p < 0.001), and self-stigma was associated with psychological distress (β = 0.197, p < 0.001), as well as being associated with emotional exhaustion, insomnia, and suicidal ideation (β = 0.349, 0.556 and 0.212, all p-values < 0.001). While social support and resource support were negatively associated with perceived stigma (β= - 0.175 and - 0.152, p < 0.01), additional associations were found between social support and emotional exhaustion (β= - 0.093, p < 0.001), as well as between resource support and insomnia (β= - 0.120, p < 0.001). CONCLUSIONS The results showed that COVID-19 related stigmatization was correlated to the detrimental consequences of emotional exhaustion, insomnia and suicidal ideation. Clear paths regarding the associations of social support and resource support with the three negative associations were found as the possible solutions. Strategies to reduce the stigmatization and these negative outcomes, or improve the psychological health will benefit AHTs and PGYDs in maintaining a healthy mental status.
Collapse
Affiliation(s)
- Po-Ching Huang
- School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259, Wen-Hua 1st Rd., Taoyuan, 333323, Taiwan
| | - Chung-Ying Lin
- Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1, University Rd., Tainan, 701401, Taiwan.
| | - Ru-Yi Huang
- Division of Family Medicine Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine Tzu Chi University, No. 289, Jianguo Rd., Xindian Dist., New Taipei, 23142, Taiwan.
- Data Science Degree Program, National Taiwan University and Academia Sinica, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan.
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, No.1 Yida Rd., Yanchao Dist, Kaohsiung, 824005, Taiwan.
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare St, Nottingham, NG1 4FQ, UK
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
| | - Hsiao-Wen Wang
- Department of Hydraulic and Ocean Engineering, College of Engineering, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
| | - Chiung-Yu Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
| | - Shyh-Jou Shieh
- Department of Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
- Department of Surgery, College of Medicine, National Cheng Kung University, 1, University Rd., East Dist, Tainan, 701401, Taiwan
| |
Collapse
|
6
|
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
|
7
|
Karnik NS. Editorial: Pandemics Interact With and Amplify Child Mental Health Disparities: Further Lessons From COVID-19. J Am Acad Child Adolesc Psychiatry 2024; 63:505-506. [PMID: 38072243 DOI: 10.1016/j.jaac.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Abstract
Infectious diseases change our world. It is a simple understanding that history has consistently shown but it is a set of lessons that are routinely forgotten. From cholera1 to smallpox,2 pandemics amplify and run along societal fractures that form in the context of disparities. As of early September 2023, COVID-19 had caused nearly 7 million deaths worldwide, and there have been over 1.1 million deaths in the United States.3 The scale of this impact on children and families is only beginning to become clear.
Collapse
|
8
|
Sawamoto N, Okawara M, Muramatsu K, Odagami K, Mafune K, Tateishi S, Tsuji M, Ogami A, Fujino Y. Relationship Between Infection or Close Contact With COVID-19 and Workplace Mistreatment Among Japanese Workers: A Cross-sectional Study. J Occup Environ Med 2024; 66:339-343. [PMID: 38242539 DOI: 10.1097/jom.0000000000003055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
OBJECTIVE Discriminatory treatment against those with emerging infection is a long-standing problem. The present study investigates whether workers infected or in close contact with COVID-19 were susceptible to workplace mistreatment during the pandemic in Japan. METHODS This Internet-based cross-sectional study analyzed a total of 18,170 workers aged 20 to 60 years in Japan in December 2020. Odds ratios (ORs) for workplace mistreatment were estimated. RESULTS For workers with close contact or infection, ORs for workplace mistreatment in a model adjusted for socioeconomic factors were 7.64 (95% CI: 5.52-10.6, P < 0.001) and 10.7 (95% CI: 8.44-13.6, P < 0.001), respectively. CONCLUSIONS Workers with infection or close contact were significantly more likely to experience workplace mistreatment. Actions against workplace mistreatment for workers with emerging infection are still required.
Collapse
Affiliation(s)
- Naoya Sawamoto
- From the Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (N.S., M.O., Y.F.); Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan (K.M.); Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan (K.O.); Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan (K.M.); Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan (S.T.); Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan (M.T.); and Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan (A.O.)
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Shapiro E, Mekonent S, Tanami N. Mental Health and Care Utilization Among Ethiopian-Israeli Immigrants During the Period of COVID-19. J Racial Ethn Health Disparities 2024; 11:739-754. [PMID: 36930452 PMCID: PMC10022572 DOI: 10.1007/s40615-023-01557-x] [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: 10/06/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
As well as affecting physical health, COVID-19 can impact mental health. Despite this, Israelis may not be getting needed mental health care because of culture-related barriers such as stigma and lack of knowledge about mental health and appropriate care. This is especially likely among vulnerable populations, such as Ethiopian immigrants, yet the topic has been understudied. This study aimed to examine to what extent COVID-19-related mental health stressors and issues are found among Ethiopian-Israelis and the extent of stigma and mental health literacy among Ethiopian-Israelis during the COVID-19 period. It also examined differences between the 1.5th and 2nd generations and potential interventions to improve their mental health. Online surveys were filled out by a convenience sample of 225 Ethiopian-Israelis recruited from a variety of sources in the fall of 2020. Over 40% expressed greater mental distress since COVID-19 started. Stigma and lack of mental health-related knowledge were found among many in this population, serving as potentially important barriers to getting appropriate mental health care. For example, only 52% disagreed with the statement that people with mental illness should not be given any responsibility and only 66% felt confident they could identify having a mental health problem requiring treatment. Variations were found by types of stressors, stigma, and lack of knowledge, as well as by immigration generation, for at least some measures. COVID-19 can negatively impact mental health and appropriate mental health care utilization, especially for a racial/ethnic minority group of immigrants such as Ethiopian-Israelis. Interventions are needed, such as increased education about mental health from a variety of sources, which can help decrease stigma and improve mental health care utilization among this group, especially when appropriately tailored.
Collapse
Affiliation(s)
- Ephraim Shapiro
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Shimrit Mekonent
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Noi Tanami
- Department of Health Systems Management, Ariel University, Ariel, Israel
| |
Collapse
|
10
|
Facente SN, De Zuzuarregui M, Frank D, Gomez-Aladino S, Muñoz A, Williamson S, Wang E, Hunter LA, Packel L, Reingold A. Anticipated and Experienced Stigma After Testing Positive for SARS-CoV-2: A Qualitative Study. Health Promot Pract 2024; 25:235-243. [PMID: 35950699 PMCID: PMC10908201 DOI: 10.1177/15248399221115063] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Stigma has inhibited public health practitioners' influence during the COVID-19 pandemic. We explore the experienced and anticipated stigma of people affiliated with a large university in the United States, using the Health Stigma and Discrimination Framework. METHODS We conducted a qualitative secondary substudy of 20 people who tested SARS-CoV-2 positive and 10 who tested negative in the summer of 2020, selected from a study of 3,324 university students and employees. FINDINGS No participants reported anticipated stigmatization prior to testing positive. However, eight of 20 participants recounted stigma marking (being marked by COVID-19 diagnosis or membership in a "high-risk" group) or manifestations of stigma after testing positive, including feelings of guilt or shame, and concerns about being judged as selfish or irresponsible. Three described being denied services or social interactions as a result of having had COVID-19, long after their infectiousness ended. Participants noted that clear public health messaging must be paired with detailed scientific information, rather than leaving people to resort to non-experts to understand the science. DISCUSSION Public health messaging designed to mitigate spread of SARS-CoV-2 and protect the community may perpetuate stigma and exacerbate inequities. As a result, people may avoid testing or treatment, mistrust public health messaging, or even use risk-increasing behavior as coping mechanisms. IMPLICATIONS FOR PRACTICE Intentional use of language that promotes equity and deters discrimination must be high priority for any COVID-19-related public health messaging. Partnership with community leaders to co-create programs and disseminate messaging is a critical strategy for reducing stigma, especially for historically mistreated groups.
Collapse
Affiliation(s)
- Shelley N. Facente
- University of California, Berkeley, CA, USA
- Facente Consulting, Richmond, CA, USA
| | | | | | | | | | | | - Emily Wang
- University of California, Berkeley, CA, USA
| | | | | | | |
Collapse
|
11
|
Zammit T, Mancini VO, Reid C, Singer J, Staniland L, Breen LJ. Public stigma toward prolonged grief and COVID-19 bereavement: A vignette-based experiment. DEATH STUDIES 2024; 48:118-128. [PMID: 36976583 DOI: 10.1080/07481187.2023.2192010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We investigated the effects of cause of death and the presence of prolonged grief disorder (PGD) on eliciting public stigma toward the bereaved. Participants (N = 328, 76% female; Mage = 27.55 years) were randomly assigned to read one of four vignettes describing a bereaved man. Each vignette differed by his PGD status (PGD diagnosis or no PGD diagnosis) and his wife's cause of death (COVID-19 or brain hemorrhage). Participants completed public stigma measures assessing negative attributions, desired social distance, and emotional reactions. Bereavement with PGD (versus without PGD) elicited large and significantly stronger responses across all stigma measures. Both causes of death elicited public stigma. There was no interaction between cause of death and PGD on stigma. With increased PGD rates expected during the pandemic, the potential for public stigma and reduced social support for people bereaved via traumatic deaths and people with PGD requires mitigation.
Collapse
Affiliation(s)
- Tamara Zammit
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Vincent O Mancini
- Curtin School of Population Health, Curtin University, Perth, Australia
- UWA Medical School, Division of Paediatrics, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Nedlands, Perth, Western Australia
| | - Carly Reid
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Jonathan Singer
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Lexy Staniland
- Curtin School of Population Health, Curtin University, Perth, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lauren J Breen
- Curtin School of Population Health, Curtin University, Perth, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| |
Collapse
|
12
|
Cooper J, Theivendrampillai S, Lee T(T, Marquez C, Lau MWK, Straus SE, Fahim C. Exploring perceptions and experiences of stigma in Canada during the COVID-19 pandemic: a qualitative study. BMC GLOBAL AND PUBLIC HEALTH 2023; 1:26. [PMID: 38798820 PMCID: PMC11116254 DOI: 10.1186/s44263-023-00020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/13/2023] [Indexed: 05/29/2024]
Abstract
Background The COVID-19 pandemic fueled stigmatization and discrimination, particularly towards individuals of Chinese or East Asian ethnicity. We conducted interviews with members of the public in Canada in order to describe and understand stigma perceptions and experiences during the COVID-19 pandemic. Methods We used a phenomenological approach to describe stigma experiences of Canadian residents during the COVID-19 pandemic and compared the stigma perceptions and experiences of East Asian and non-East Asian individuals. Participants were invited to take part in a single, semi-structured interview. The interview guide was rooted in the Health Stigma and Discrimination Framework (HSDF). Interviews were conducted in English, Mandarin, and Cantonese. Following participant consent, interviews were audio recorded and transcribed verbatim. Data were double coded and analyzed using qualitative content analysis guided by a framework approach. Results A total of 55 interviews were conducted between May and December 2020. Fifty-five percent of the sample identified as East Asian, 67.3% identified as women, and mean age was 52 years (range 20-76). Fear of infection, fear of social and economic ramifications, and blame for COVID-19 were reported drivers of stigma. Participants described preexisting perceptions on cultural norms and media influence as facilitators of stigma that propagated harmful stereotypes, particularly against Chinese and East Asian individuals. Participants observed or experienced stigmatization towards place of residence, race/ethnicity, culture, language, occupation, and age. Stigma manifestations present in the public and media had direct negative impacts on East Asian, particularly Chinese, participants, regardless of whether or not they personally experienced discrimination. Conclusions We used the HSDF as a rooting framework to describe perceptions and impact of stigma, particularly as they related to race/ethnicity-based stigmatization in Canada. Participants reported a number of drivers and facilitators of stigma that impacted perceptions and experiences. These findings should be used to develop sustained strategies to mitigate stigma during public health emergencies or other major crises. Supplementary Information The online version contains supplementary material available at 10.1186/s44263-023-00020-7.
Collapse
Affiliation(s)
- Jeanette Cooper
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Suvabna Theivendrampillai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Taehoon (Tom) Lee
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Christine Marquez
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Michelle Wai Ki Lau
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | - Christine Fahim
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 209 Victoria Street, Toronto, M5B 1T8 Canada
| | | | | |
Collapse
|
13
|
Salmani B, Hasani J, Zanjani Z, Gholami-Fesharaki M. Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms. IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:429-442. [PMID: 37881416 PMCID: PMC10593991 DOI: 10.18502/ijps.v18i4.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/15/2022] [Accepted: 01/30/2023] [Indexed: 10/27/2023]
Abstract
Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM-) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs. Method : In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM- (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses. Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM-. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS. Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.
Collapse
Affiliation(s)
- Behzad Salmani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Jafar Hasani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Zahra Zanjani
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | | |
Collapse
|
14
|
Ramalho S, Martins-Mendes D, Macedo JM, Barros C, Luis C, Sá S, Gestoso Á, Pereira AC, Baylina P, Fernandes R. Unveiling the Path to Resilience: Prioritizing Mental Health, Sleep, and Nutrition in the Post-COVID Era. Healthcare (Basel) 2023; 11:2463. [PMID: 37685496 PMCID: PMC10487180 DOI: 10.3390/healthcare11172463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic has disrupted daily life, impacting relationships, work, and education. This has led to increased stress, anxiety, and depression, along with altered sleep patterns and eating behaviors. Quarantine and isolation have worsened mental health, especially in children and the elderly, due to the loss of activities and physical contact. Sleep disorders and negative dreams perpetuate poor sleep quality, increasing the risk of health issues. Sedentary lifestyles and emotional effects contribute to unhealthy eating patterns and obesity, exacerbated by disrupted routines and limited outdoor activities. Addressing these challenges requires prioritizing mental health, promoting healthy sleep habits, and addressing obesity factors. The pandemic has profoundly affected human well-being, but resilience, mental health, sleep, and nutrition can enhance overall well-being and adaptability in the post-COVID era. This comprehensive opinion aims to raise awareness of the wide-ranging impacts of this pandemic on various aspects of human well-being and to emphasize the importance of implementing strategies that prioritize mental health, improve sleep habits, address eating behaviors, and foster resilience to navigate and thrive in the face of future challenges.
Collapse
Affiliation(s)
- Susana Ramalho
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Daniela Martins-Mendes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - José Mário Macedo
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Carla Barros
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- Faculdade de Ciências Humanas e Sociais, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Carla Luis
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sara Sá
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Álvaro Gestoso
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Ana Cláudia Pereira
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Pilar Baylina
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Escola S. Saúde, Instituto Politécnico do Porto, 4200-465 Porto, Portugal
| | - Rúben Fernandes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| |
Collapse
|
15
|
Techapoonpon K, Wonglertwisawakorn C, Kerdchareon N, Pruttithavorn W, Srikhamdokkhae O. Can a brief session of the online coronavirus disease 2019 destigmatization program reduce stigma among survivors? A randomized controlled trial. Front Psychiatry 2023; 14:1234038. [PMID: 37680453 PMCID: PMC10482106 DOI: 10.3389/fpsyt.2023.1234038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023] Open
Abstract
Background Stigmatization has taken a heavy toll on the mental health and quality of life of the survivors of coronavirus disease 2019 (COVID-19). To address this issue, we proposed a brief, self-directed, reflective, and practical destigmatization intervention. The current study aimed to investigate the efficacy of the online COVID-19 destigmatization program (OCDP) in mitigating stigma among the survivors of COVID-19. Methods This study was conducted on 142 survivors of COVID-19 before their discharge from Vajra Hospital from July 2022 to November 2022. The participants were randomly assigned between the intervention group (n = 71), who attended the 40-min OCDP, and the control group (n = 71), who received standard mental health care. The primary outcome was the efficacy of OCDP in reducing stigmatization. A COVID-19 stigma questionnaire was administered to assess stigmatization in the intervention and control groups immediately before and after the program during follow-up on days 7, 14, and 28. The secondary outcome was the efficacy of the program in alleviating negative emotions according to the Depression Anxiety Stress Scale 21 questionnaire. Results Compared with the control group, the intervention group had a more prominent reduction in the overall stigma score on day 7 (p = 0.002) and day 14 (p = 0.028). The intervention group had a more evident reduction in enacted stigma (day 7, p = 0.04), internalized stigma (day 7, p = 0.008; day 14, p < 0.028), and perceived external stigma (day 7, p = 0.002) than the control group. However, there was no significant difference in terms of disclosure concern between the intervention and control groups. Furthermore, the reduction in depression, anxiety, and stress between the two groups did not significantly differ. Conclusion Online COVID-19 destigmatization program provided prior to hospital discharge is an effective tool in reducing stigmatization, particularly within the first 2 weeks after reintegration into society, among the survivors of COVID-19.
Collapse
|
16
|
Vera San Juan N, Martin S, Badley A, Maio L, Gronholm PC, Buck C, Flores EC, Vanderslott S, Syversen A, Symmons SM, Uddin I, Karia A, Iqbal S, Vindrola-Padros C. Frontline Health Care Workers' Mental Health and Well-Being During the First Year of the COVID-19 Pandemic: Analysis of Interviews and Social Media Data. J Med Internet Res 2023; 25:e43000. [PMID: 37402283 PMCID: PMC10426381 DOI: 10.2196/43000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shed light on fractures in health care systems worldwide and continues to have a significant impact, particularly in relation to the health care workforce. Frontline staff have been exposed to unprecedented strain, and delivering care during the pandemic has affected their safety, mental health, and well-being. OBJECTIVE This study aimed to explore the experiences of health care workers (HCWs) delivering care in the United Kingdom during the COVID-19 pandemic to understand their well-being needs, experiences, and strategies used to maintain well-being (at individual and organizational levels). METHODS We analyzed 94 telephone interviews with HCWs and 2000 tweets about HCWs' mental health during the first year of the COVID-19 pandemic. RESULTS The results were grouped under 6 themes: redeployment, clinical work, and sense of duty; well-being support and HCW's coping strategies; negative mental health effects; organizational support; social network and support; and public and government support. CONCLUSIONS These findings demonstrate the need for open conversations, where staff's well-being needs and the strategies they adopted can be shared and encouraged, rather than implementing top-down psychological interventions alone. At the macro level, the findings also highlighted the impact on HCW's well-being of public and government support as well as the need to ensure protection through personal protective equipment, testing, and vaccines for frontline workers.
Collapse
Affiliation(s)
- Norha Vera San Juan
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sam Martin
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Ethox Centre, Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Anna Badley
- Academy Research and Improvement, Solent Trust, Southampton, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Laura Maio
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
| | - Petra C Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Elaine C Flores
- Centre on Climate Change & Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Stanford Center for Innovation in Global Health, Stanford Woods Institute for the Environment,, Stanford University, Stanford, CA, United States
| | - Samantha Vanderslott
- Oxford Vaccine Group, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Aron Syversen
- Institute of Epidemiology and Healthcare, University College London, London, United Kingdom
| | - Sophie Mulcahy Symmons
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Inayah Uddin
- Division of Psychiatry, Marie Curie Palliative Care Research Department, University College London, London, United Kingdom
| | - Amelia Karia
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
| | - Syka Iqbal
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Department of Psychology, University of Bradford, Bradford, United Kingdom
| | - Cecilia Vindrola-Padros
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
| |
Collapse
|
17
|
Reibling N, Linden P, Schneider T. [COVID-19-related self-stigma: association with vulnerability and trust in institutions]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03742-z. [PMID: 37395753 PMCID: PMC10372126 DOI: 10.1007/s00103-023-03742-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Self-stigmatization in the context of infectious diseases can be a psychosocial burden and reduce the cooperation with infection control measures. This study investigates for the first time the level of self-stigmatization among individuals with different social and medical vulnerabilities in Germany. METHODS Data are derived from an online survey (CAWI: Computer Assisted Web Interview) conducted during the COVID-19 pandemic in winter 2020/21. The quota sample (N = 2536) is representative for the key variables gender, age, education, and place of residence for the German adult population. For operationalizing COVID-19 related self-stigmatization, we developed a new scale. We also collected information on medical and social vulnerabilities as well as trust in institutions. Data analysis was based on descriptive statistics and multiple ordinary least squares (OLS) regression. RESULTS Overall, we find a level of self-stigmatization slightly over the scale mean. While socially vulnerable groups do not have higher levels of self-stigmatization - with the exception of women - individuals with medical vulnerabilities (higher infection risks, poor health status, risk group) show higher levels of self-stigma. Higher trust in institutions is associated with higher levels of self-stigmatization. DISCUSSION Stigmatization should be regularly monitored during pandemics and considered in communication measures. Thus, it is important to pay attention to less stigmatizing formulations and to point out risks without defining risk groups.
Collapse
Affiliation(s)
- Nadine Reibling
- Fachbereich Gesundheitswissenschaften, Hochschule Fulda, Fulda, Deutschland
| | - Philipp Linden
- Fachbereich Gesundheitswissenschaften, Hochschule Fulda, Fulda, Deutschland
| | - Torsten Schneider
- Seminar für Sozialwissenschaften, Universität Siegen, Adolf-Reichwein-Str. 2, 57068, Siegen, Deutschland.
| |
Collapse
|
18
|
Wong NCW, Paat YF. Understanding the Link between COVID-19 and HIV/AIDS Stigmas. JOURNAL OF APPLIED SOCIAL SCIENCE 2023; 17:272-290. [PMID: 38602905 PMCID: PMC10028685 DOI: 10.1177/19367244231159609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
While the HIV/AIDS epidemic has informed the responses to the COVID-19 pandemic, there is a lack of understanding of the empirical links between stigmas associated with COVID-19 and HIV/AIDS. Surveying 247 adults in the United States online, this study aims to examine the relationships between COVID-19 and HIV/AIDS stigmas in order to understand how they are similar and different from each other, taking into consideration the context relevant to the COVID-19 pandemic. Four scales of stigmas conveying different attitudes (i.e., rejection, despise, accusation, and caution) were used to examine the relationships between the stigmas of these two infectious diseases. Findings based on the mean comparisons from paired t tests showed the mean difference in scores between respondents who supported the exclusion of COVID-19-infected individuals versus HIV-infected individuals was statistically significant. In addition, the mean difference in scores between respondents who were wary of their need to protect their rights around COVID-19-infected persons versus HIV-infected persons was statistically significant. Controlling for the respondents' sociodemographics and factors that were relevant to the COVID-19 pandemic, multiple regression analyses showed that all four types of COVID-19 stigmas were positively associated with their corresponding types of HIV/AIDS stigmas. The preliminary findings between COVID-19 and HIV/AIDS stigmas suggested that HIV/AIDS stigma mitigation strategies may present a fruitful approach to inform stigma mitigation of COVID-19.
Collapse
Affiliation(s)
| | - Yok-Fong Paat
- The University of Texas at El Paso, El
Paso, TX, USA
| |
Collapse
|
19
|
Farrell D, Moran J, Zat Z, Miller PW, Knibbs L, Papanikolopoulos P, Prattos T, McGowan I, McLaughlin D, Barron I, Mattheß C, Kiernan MD. Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury—An RCT study. Front Psychol 2023; 14:1129912. [PMID: 37063579 PMCID: PMC10100089 DOI: 10.3389/fpsyg.2023.1129912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
ObjectiveFrontline mental health, emergency, law enforcement, and social workers have faced unprecedented psychological distress in responding to the COVID-19 pandemic. The purpose of the RCT (Randomized Controls Trial) study was to investigate the effectiveness of a Group EMDR (Eye Movement Desensitization and Reprocessing) therapy (Group Traumatic Episode Protocol—GTEP) in the treatment of Post-Traumatic Stress Disorder (PTSD) and Moral Injury. The treatment focus is an early intervention, group trauma treatment, delivered remotely as video-conference psychotherapy (VCP). This early intervention used an intensive treatment delivery of 4x2h sessions over 1-week. Additionally, the group EMDR intervention utilized therapist rotation in treatment delivery.MethodsThe study’s design comprised a delayed (1-month) treatment intervention (control) versus an active group. Measurements included the International Trauma Questionnaire (ITQ), Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Moral Injury Events Scale (MIES), and a Quality-of-Life psychometric (EQ-5D), tested at T0, T1: pre—treatment, T2: post-treatment, T3: 1-month follow-up (FU), T4: 3-month FU, and T5: 6-month FU. The Adverse Childhood Experiences – International version (ACEs), Benevolent Childhood Experience (BCEs) was ascertained at pre-treatment only. N = 85 completed the study.ResultsResults highlight a significant treatment effect within both active and control groups. Post Hoc comparisons of the ITQ demonstrated a significant difference between T1 pre (mean 36.8, SD 14.8) and T2 post (21.2, 15.1) (t11.58) = 15.68, p < 0.001). Further changes were also seen related to co-morbid factors. Post Hoc comparisons of the GAD-7 demonstrated significant difference between T1 pre (11.2, 4.91) and T2 post (6.49, 4.73) (t = 6.22) = 4.41, p < 0.001; with significant difference also with the PHQ-9 between T1 pre (11.7, 5.68) and T2 post (6.64, 5.79) (t = 6.30) = 3.95, p < 0.001, d = 0.71. The treatment effect occurred irrespective of either ACEs/BCEs during childhood. However, regarding Moral Injury, the MIES demonstrated no treatment effect between T1 pre and T5 6-month FU. The study’s findings discuss the impact of Group EMDR therapy delivered remotely as video-conference psychotherapy (VCP) and the benefits of including a therapist/rotation model as a means of treatment delivery. However, despite promising results suggesting a large treatment effect in the treatment of trauma and adverse memories, including co-morbid symptoms, research results yielded no treatment effect in frontline/emergency workers in addressing moral injury related to the COVID-19 pandemic.ConclusionThe NICE (2018) guidance on PTSD highlighted the paucity of EMDR therapy research used as an early intervention. The primary rationale for this study was to address this critical issue. In summary, treatment results for group EMDR, delivered virtually, intensively, using therapist rotation are tentatively promising, however, the moral dimensions of trauma need consideration for future research, intervention development, and potential for further scalability. The data contributes to the emerging literature on early trauma interventions.Clinical Trial Registration:Clinicaltrials.gov, ISRCTN16933691.
Collapse
Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
- *Correspondence: Derek Farrell,
| | - Johnny Moran
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul W. Miller
- School of Nursing, Magee Campus, Ulster University, Northern Ireland, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Penny Papanikolopoulos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Tessa Prattos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Iain McGowan
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Derek McLaughlin
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Cordula Mattheß
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Matthew D. Kiernan
- Northern Hub for Veteran and Military Families’ Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
20
|
Owens C, Hubach RD. An Exploratory Study of the Mpox Media Consumption, Attitudes, and Preferences of Sexual and Gender Minority People Assigned Male at Birth in the United States. LGBT Health 2023. [PMID: 36735618 DOI: 10.1089/lgbt.2022.0251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Purpose: This study examined the consumption of, attitudes toward, and preferences for mpox media among U.S. sexual and gender minority (SGM) people assigned male at birth (AMAB). Methods: A total of 496 SGM people AMAB completed an online cross-sectional survey between August 6 and 15, 2022. Data were analyzed with descriptive statistics and logistic regressions. Results: Approximately two-thirds of participants overall agreed that media-related content about mpox targeted (66.3%) and stigmatized gay, bisexual, and other men who have sex with men (69.2%). The three most preferred mpox content were the destigmatization of SGM people (44.2%), mpox vaccine accessibility (25.2%), and mpox transmission and prevention (19.2%). Rural participants had a lower likelihood of consuming mpox-related media than urban participants. Conclusion: SGM people AMAB prefer mpox messaging campaigns to be grounded in stigma-reduction to ensure that messages do not perpetrate stigma against them. Stigmatizing content might foster SGM people AMAB to distrust mpox interventions.
Collapse
Affiliation(s)
- Christopher Owens
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| |
Collapse
|
21
|
Sawamoto N, Okawara M, Matsugaki R, Odagami K, Mafune K, Tateishi S, Tsuji M, Ogami A, Fujino Y. Relationship between financial distress and mistreatment of workers regarding the COVID-19 prevention measures: A 1-year prospective cohort study. J Occup Health 2023; 65:e12403. [PMID: 37165744 PMCID: PMC10172736 DOI: 10.1002/1348-9585.12403] [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: 03/06/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE A substantial number of workers' experience mistreatment in the workplace, impacting workers' health and companies' functioning. Vulnerability of those with lower income has been reported, yet little is known about mistreatment during COVID-19. This study aims to examine whether workers in financial distress are particularly prone to mistreatment at the workplace with reference to pandemic-related infection prevention measures. METHODS An internet-based, year-long prospective cohort study was conducted from 2020 to 2021. Participants were recruited from workers aged 20 and 65 years and currently employed at baseline. In total, 27 036 were included in the analysis and 18 170 responded to the follow-up survey. The odds ratio (OR) of mistreatment at the workplace regarding COVID-19 associated with the financial condition at baseline was estimated using multilevel logistic regression analysis nested by participant residence. RESULTS Compared with workers in a comfortable financial condition, those under financial stress showed significantly higher ORs of mistreatment (age- and sex-adjusted model: 2.08, 95% confidence interval [CI] 1.75-2.47, P < .001, model adjusted for socioeconomic factors: 2.14, 95% CI 1.79-2.55, P < .001). CONCLUSION Workers in financial distress were shown to be vulnerable to mistreatment at work regarding infection prevention measures in the COVID-19 pandemic, underscoring a double burden of poverty and mistreatment. The perspective of vulnerable groups needs to be taken into account when implementing countermeasures against emerging infectious diseases, such as COVID-19. As unfair treatment in the workplace might distort vulnerable employees' reactions to infection control (e.g., hiding infection), financial deprivation should be considered a public health issue.
Collapse
Affiliation(s)
- Naoya Sawamoto
- Department of Environmental Epidemiology, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Makoto Okawara
- Department of Environmental Epidemiology, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Ryutaro Matsugaki
- Department of Preventive Medicine and Community Health, School of MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Kiminori Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Kosuke Mafune
- Department of Mental Health, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Mayumi Tsuji
- Department of Environmental Health, School of MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Akira Ogami
- Department of Work Systems and Health, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | | |
Collapse
|
22
|
Sierra M, Franco-Paredes C, Agudelo Higuita NI. Health inequities in the global response to the COVID-19 pandemic. Ther Adv Infect Dis 2023; 10:20499361231162726. [PMID: 37051438 PMCID: PMC10085731 DOI: 10.1177/20499361231162726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/17/2023] [Indexed: 04/14/2023] Open
Affiliation(s)
| | - Carlos Franco-Paredes
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
- Hospital Infantil de México, Federico Gómez, México City, México
| | - Nelson Iván Agudelo Higuita
- Section of Infectious Diseases, Department of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
- Instituto de Enfermedades Tropicales y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| |
Collapse
|
23
|
Zhou X, Chen C, Yao Y, Xia J, Cao L, Qin X. The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes. Front Psychol 2022; 13:1026712. [PMID: 36533056 PMCID: PMC9752089 DOI: 10.3389/fpsyg.2022.1026712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/14/2022] [Indexed: 09/19/2023] Open
Abstract
COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.
Collapse
Affiliation(s)
- Xiang Zhou
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Chen Chen
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Yuewei Yao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Jingtian Xia
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Limei Cao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Xin Qin
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
24
|
du Toit RE, de Klerk W. Guidelines for conducting rapid reviews in psychology research. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2121468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Ryan Evan du Toit
- School of Psychosocial Health, Community Psychosocial Research (COMPRES), North-West University, Potchefstroom, South Africa
| | - Werner de Klerk
- School of Psychosocial Health, Community Psychosocial Research (COMPRES), North-West University, Potchefstroom, South Africa
| |
Collapse
|
25
|
Sawaguchi E, Nakamura S, Watanabe K, Tsuno K, Ikegami H, Shinmura N, Saito Y, Narimatsu H. COVID-19-related stigma and its relationship with mental wellbeing: A cross-sectional analysis of a cohort study in Japan. Front Public Health 2022; 10:1010720. [PMID: 36249227 PMCID: PMC9558281 DOI: 10.3389/fpubh.2022.1010720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/07/2022] [Indexed: 01/27/2023] Open
Abstract
Objective Social stigma related to coronavirus disease (COVID-19), i. e., COVID-19 stigma, forms a burden on people socially, economically, and mentally. This study assessed COVID-19 stigma using a scale to identify a population likely to exhibit higher prejudice against COVID-19 itself as well as those infected with COVID-19. Methods We adapted and modified the Cancer Stigma Scale to assess COVID-19 stigma and used it as the baseline survey of a cohort study in Japan. The questionnaire was disseminated to 1,573 participants (51.7% men) between December 2020 and March 2021. The questionnaire items included the infection status of individuals close to the respondent and their preventive behaviors related to COVID-19, quality of life (QOL; using the EuroQoL 5-Dimension 5-Level [EQ-5D-5L]), and psychological distress (using the 6-item Kessler Psychological Distress Scale [K6]). Exploratory and confirmatory factor analyses were performed to validate the COVID-19 stigma scale, and we further used the structural equation modeling (SEM) to assess the relationship with QOL and psychological distress. Results COVID-19 stigma was calculated for the 257 (16.3%) participants who responded to the questionnaire. The mean age (standard deviation) was 54.5 (14.4) years, and 50.2% were men. Factor analysis revealed a five-factor model: Awkwardness (feeling uncomfortable being with a person infected before), Severity (fear of not being able to return to normal after infection), Avoidance (attitude of avoiding infected persons), Policy Opposition (expecting more public funding investment), and Personal Responsibility (believing that infected persons themselves are responsible for their infection). Participants > 70 years had the highest scores among other age groups considering all factors except for Policy Opposition. Standardized coefficients in SEM for COVID-19 stigma (latent variable) was highest for Severity (beta = 0.86). Regression coefficients of COVID-19 stigma on K6 and QOL were 0.21 (95% confidence interval [CI] 0.074-0.342) and -0.159 (95% CI -0.295-0.022), respectively. Conclusion People aged ≥ 70 years are more likely to exhibit COVID-19 stigma. Additionally, the results indicate that COVID-19 stigma impacts QOL and psychological distress.
Collapse
Affiliation(s)
- Emiko Sawaguchi
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Sho Nakamura
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan,Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,*Correspondence: Sho Nakamura
| | - Kaname Watanabe
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,Department of Genetic Medicine, Kanagawa Cancer Center, Yokohama, Japan
| | - Kanami Tsuno
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Hiromi Ikegami
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,Hygeia Communication General Incorporated Association, Kawasaki, Japan
| | - Naoko Shinmura
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,Hygeia Communication General Incorporated Association, Kawasaki, Japan
| | - Yoshinobu Saito
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,Faculty of Sport Management, Nippon Sport Science University, Yokohama, Japan
| | - Hiroto Narimatsu
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan,Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan,Department of Genetic Medicine, Kanagawa Cancer Center, Yokohama, Japan
| |
Collapse
|
26
|
The effects of social isolation stress and discrimination on mental health. Transl Psychiatry 2022; 12:398. [PMID: 36130935 PMCID: PMC9490697 DOI: 10.1038/s41398-022-02178-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Social isolation and discrimination are growing public health concerns associated with poor physical and mental health. They are risk factors for increased morbidity and mortality and reduced quality of life. Despite their detrimental effects on health, there is a lack of knowledge regarding translation across the domains of experimental research, clinical studies, and real-life applications. Here, we review and synthesize evidence from basic research in animals and humans to clinical translation and interventions. Animal models indicate that social separation stress, particularly in early life, activates the hypothalamic-pituitary-adrenal axis and interacts with monoaminergic, glutamatergic, and GABAergic neurotransmitter systems, inducing long-lasting reductions in serotonin turnover and alterations in dopamine receptor sensitivity. These findings are of particular importance for human social isolation stress, as effects of social isolation stress on the same neurotransmitter systems have been implicated in addictive, psychotic, and affective disorders. Children may be particularly vulnerable due to lasting effects of social isolation and discrimination stress on the developing brain. The effects of social isolation and loneliness are pronounced in the context of social exclusion due to discrimination and racism, during widespread infectious disease related containment strategies such as quarantine, and in older persons due to sociodemographic changes. This highlights the importance of new strategies for social inclusion and outreach, including gender, culture, and socially sensitive telemedicine and digital interventions for mental health care.
Collapse
|
27
|
Paul AM, Lee C, Fesshaye B, Gur-Arie R, Zavala E, Singh P, Karron RA, Limaye RJ. Conceptualizing the COVID-19 Pandemic: Perspectives of Pregnant and Lactating Women, Male Community Members, and Health Workers in Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10784. [PMID: 36078503 PMCID: PMC9518350 DOI: 10.3390/ijerph191710784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Pregnant women are at greater risk of adverse outcomes from SARS-CoV-2 infection. There are several factors which can influence the ways in which pregnant women perceive COVID-19 disease and behaviorally respond to the pandemic. This study seeks to understand how three key audiences-pregnant and lactating women (PLW), male community members, and health workers-in Kenya conceptualize COVID-19 to better understand determinants of COVID-19 related behaviors. This study used qualitative methods to conduct 84 in-depth interviews in three counties in Kenya. Data were analyzed using a grounded theory approach. Emerging themes were organized based on common behavioral constructs thought to influence COVID-19 related behaviors and included myths, risk perception, economic implications, stigma, and self-efficacy. Results suggest that risk perception and behavioral attitudes substantially influence the experiences of PLW, male community members, and health workers in Kenya during the COVID-19 pandemic. Public health prevention and communication responses targeting these groups should address potential barriers to preventive health behaviors, such as the spread of misinformation, financial constraints, and fear of social ostracization.
Collapse
Affiliation(s)
- Alicia M. Paul
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Clarice Lee
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Berhaun Fesshaye
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rachel Gur-Arie
- Berman Institute of Bioethics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Eleonor Zavala
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Prachi Singh
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Ruth A. Karron
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rupali J. Limaye
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| |
Collapse
|
28
|
Tsukuda M, Ito Y, Nojima K, Kayano T, Honda J. Development and Validation of the COVID-19-Related Stigma Scale for Healthcare Workers (CSS-HCWs). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9641. [PMID: 35954996 PMCID: PMC9368494 DOI: 10.3390/ijerph19159641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Stigma among healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic is an issue that requires immediate attention, as it may otherwise lead to the collapse of healthcare systems. In this study, we developed the COVID-19-related stigma scale for healthcare workers (CSS-HCWs) and assessed its reliability and validity. Data were collected online from 500 participants, including physicians and nurses involved in COVID-19 care. The first item of the draft scale was developed based on a literature review and qualitative study. The draft scale consisted of 24 items, which were rated on a six-point Likert scale. Descriptive statistics were calculated and the data distribution was analyzed. To assess the scale's validity and reliability, structural validity was evaluated through an exploratory factor analysis. Criterion-related validity was examined through a correlation analysis using the E16-COVID19-S, a COVID-19 scale developed for physicians in Egypt. Reliability was evaluated by examining the scale's stability and internal consistency. The findings revealed that the stigma scale was a valid and reliable instrument. The final scale consisted of 18 items across three domains: personal stigma, concerns of disclosure and others, and family stigma. In conclusion, the scale is a valid and reliable instrument that can measure COVID-19-related stigma among healthcare workers.
Collapse
Affiliation(s)
- Makoto Tsukuda
- College of Nursing Art and Science, University of Hyogo, Kobe 673-0021, Japan
| | - Yoshiyasu Ito
- College of Nursing Art and Science, University of Hyogo, Kobe 673-0021, Japan
| | - Keisuke Nojima
- Faculty of Nursing, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Tomonori Kayano
- Department of Human Nursing, Sonoda Women’s University, Amagasaki 661-8520, Japan
| | - Junko Honda
- College of Nursing Art and Science, University of Hyogo, Kobe 673-0021, Japan
| |
Collapse
|
29
|
Mental Health Consequences of COVID-19 Pandemic Period in the European Population: An Institutional Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159347. [PMID: 35954706 PMCID: PMC9367746 DOI: 10.3390/ijerph19159347] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.
Collapse
|
30
|
Association between Social Engagements and Stigmatization of COVID-19 Infection among Community Population in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159050. [PMID: 35897433 PMCID: PMC9329772 DOI: 10.3390/ijerph19159050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022]
Abstract
In the face of unknown risks, including the coronavirus disease 2019 (COVID-19) pandemic, we tend to have stigmatized perceptions. The current study aimed to examine the association of social engagements with the level of stigmatization of COVID-19 infection among the general population. The data of 429 participants of the Utsunomiya COVID-19 seroprevalence neighborhood association (U-CORONA) study, a population-based cohort study conducted in Utsunomiya City, Japan, were analyzed. Their stigmatized perception of people with COVID-19 infection was evaluated via a questionnaire for the situation if they or others in their community were to get infected. The association between social engagements (community social capital, social network diversity, and social network size) and stigmatization were analyzed by a multiple linear regression model with generalized estimating equations. Overall, females reported a higher stigmatized perception of people with COVID-19 than males. Lower education and depressive symptoms were also positively associated with higher stigmatization, while age, household income, and comorbidities were not. People with higher community social capital reported lower stigmatization (B = −0.69, 95% CI = −1.23 to −0.16), while social network diversity and social network size did not show an association with stigmatization. We found an association between community social capital and stigmatization, suggesting that enhancing their community social capital, but not social network diversity and size, has the potential to mitigate the levels of stigmatization.
Collapse
|
31
|
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
|
32
|
Development and psychometric validation of new questionnaires assessing experienced discrimination and internalised stigma among people with Covid-19. Epidemiol Psychiatr Sci 2022; 31:e37. [PMID: 35616053 PMCID: PMC9158394 DOI: 10.1017/s204579602200021x] [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
AIMS To develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or had developed coronavirus disease 2019 (Covid-19) disease. METHODS Both the CEDISC and the COINS were developed in Italian and tested for ease of use, comprehension, acceptability, the relevance of items and response options within a focus group session. Online cross-sectional validation survey was conducted among adults infected with SARS-CoV-2 or who developed Covid-19 disease, members of a closed Facebook discussion group in Italy. Exploratory factor analysis (EFA) with Promax oblique rotation; the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient. RESULTS Overall, 579 participants completed the CEDISC, 519 also completed the COINS, 155 completed the retest for both scales after two weeks. The 12 items of the CEDISC converged over a 2-factor solution ('social life' and 'close relations') accounting for 49.2% of the variance (KMO = 0.894; Bartlett's test p < 0.001); the 13 items of the COINS converged over a 3-factor solution ('self-perception', 'close relations' and 'social life') accounting for 67.7% (KMO = 0.827; Bartlett's test p < 0.001). Cronbach's α was 0.848 for the CEDISC, and 0.837 for the COINS. The CEDISC showed three items (25%) with kappa between 0.61 and 0.80 and seven (58.4%) between 0.41 and 0.60, with only two items scoring 0.21 and 0.40; the COINS had ten items (76.9%) with kappa ranging from 0.41 to 0.60, and three items below 0.31. ICC was 0.906 (95% CI, 0.871-0.932) for the, CEDISC and 0.860 (95% CI, 0.808-0.898) for the COINS. Kendall's tau-b ranged from 0.360 to 0.556 (p < 0.001) for the CEDISC and from 0.290 to 0.606 (p < 0.001) for the COINS. CONCLUSIONS Both the CEDISC and the COINS are two valid and reliable scales to be used in studies examining the role of stigma and discrimination of people infected with SARS-CoV-2 and Covid-19 patients, and in research evaluating interventions designed to mitigate stigma in this population.
Collapse
|
33
|
Zhu J, Yan L, Mu Y. Comparisons Between COVID-19 Stigma and Other Stigmas: Distinct in Explicit Attitudes and Similar in Implicit Process. Front Psychol 2022; 13:848993. [PMID: 35558720 PMCID: PMC9087195 DOI: 10.3389/fpsyg.2022.848993] [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] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/18/2022] [Indexed: 01/09/2023] Open
Abstract
Since the outbreak of COVID-19, the public stigma associated with COVID-19 has emerged. To better understand the COVID-19 stigma, the present research conducted three studies on 1,493 Chinese participants from the outbreak to the recovery period of the COVID-19 pandemic to examine the psychological mechanisms of COVID-19 stigma by comparing it with other disease-related stigmas in terms of their explicit and implicit processes. Study 1 and Study 2 jointly demonstrated that the public endorsed more stigma toward the COVID-19 related people (i.e., the COVID-19 patients) relative to the other disease-related people (i.e., the SARS patients, people with flu) in multiple explicit aspects, including emotional, motivational, cognitive, and social processing. Using the implicit association test (IAT), Study 3 found no significant difference in the implicit measures of the COVID-19 vs. the SARS groups, which further revealed that the pandemic stigmas (i.e., COVID-19 and SARS) were similar at the implicit level. These findings suggest common (implicit level) but distinct (explicit level) psychological processes of the pandemic-related stigmas, which provide reference to policymakers in formulating suitable interventions to deal with COVID-19 stigma and a newly generated potential stigma and provide psychological support for the public in the future.
Collapse
Affiliation(s)
- Jiajia Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lihua Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Yan Mu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,*Correspondence: Yan Mu,
| |
Collapse
|
34
|
Schiavi M, Fugazzaro S, Bertolini A, Denti M, Mainini C, Accogli MA, Bedogni G, Ghizzoni D, Esseroukh O, Gualdi C, Costi S. “Like before, but not exactly”: the Qualy-REACT qualitative inquiry into the lived experience of long COVID. BMC Public Health 2022; 22:599. [PMID: 35346138 PMCID: PMC8960224 DOI: 10.1186/s12889-022-13035-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/18/2022] [Indexed: 01/08/2023] Open
Abstract
Abstract
Background
Post-acute sequelae of SARS-CoV-2 infection (PASC) affect millions of individuals worldwide. Rehabilitation interventions could support individuals during the recovery phase of COVID-19, but a comprehensive understanding of this new disease and its associated needs is crucial. This qualitative study investigated the experience of individuals who had been hospitalized for COVID-19, focusing on those needs and difficulties they perceived as most urgent.
Methods
This naturalistic qualitative study was part of a single-center mix-method cross-sectional study (REACT) conducted in Italy during the first peak of the SARS-CoV-2 pandemic. The qualitative data collection took place through a telephone interview conducted 3 months after hospital discharge. The experience of individuals discharged after hospitalization for COVID-19 was investigated through the main research question – “Tell me, how has it been going since you were discharged?”. Two secondary questions investigated symptoms, activities, and participation. Data were recorded and transcribed verbatim within 48 h. An empirical phenomenological approach was used by the researchers, who independently analyzed the data and, through consensus, developed an interpretative model to answer the research question. Translation occurred after data was analyzed.
Results
During the first peak of the COVID-19 pandemic, 784 individuals with COVID-19 were discharged from the hospitals of the Local Health Authority of the Province of Reggio Emilia (Italy); 446 were excluded due to the presence of acute or chronic conditions causing disability other than COVID-19 (n. 339), inability to participate in the study procedures (n. 56), insufficient medical documentation to allow for screening (n. 21), discharge to residential facilities (n. 25), and pregnancy (n. 5). Overall, 150 individuals consented to participate in the REACT study, and 56 individuals (60.7% male, average age 62.8 years ±11.8) were interviewed in June–July 2020, up to data saturation.
Persistent symptoms, feelings of isolation, fear and stigma, emotional distress, a fatalistic attitude, and return to (adapted) life course were the key themes that characterized the participants’ experience after hospital discharge.
Conclusions
The experience as narrated by the participants in this study confirms the persistence of symptoms described in PASC and highlights the sense of isolation and psychological distress. These phenomena may trigger a vicious circle, but the participants also reported adaptation processes that allowed them to gradually return to their life course. Whether all individuals are able to rapidly activate these mechanisms and whether rehabilitation can help to break this vicious circle by improving residual symptoms remain to be seen.
Trial registration
ClinicalTrials.com NCT04438239.
Collapse
|
35
|
Campion J, Javed A, Lund C, Sartorius N, Saxena S, Marmot M, Allan J, Udomratn P. Public mental health: required actions to address implementation failure in the context of COVID-19. Lancet Psychiatry 2022; 9:169-182. [PMID: 35065723 PMCID: PMC8776278 DOI: 10.1016/s2215-0366(21)00199-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/19/2021] [Accepted: 05/14/2021] [Indexed: 12/13/2022]
Abstract
Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery.
Collapse
Affiliation(s)
- Jonathan Campion
- South London and Maudsley NHS Foundation Trust, London, UK; Public Mental Health Implementation Centre, Royal College of Psychiatrists, London, UK.
| | - Afzal Javed
- Department of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Shekhar Saxena
- Department of Global Health and Population at the Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Michael Marmot
- Institute of Health Equity, Department of Epidemiology and Public Health, UCL, London, UK
| | - John Allan
- Office of the President, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia; Mental Health, Alcohol and Other Drugs Branch, Clinical Excellence Queensland, Queensland Health, Brisbane, QLD, Australia; Mayne Academy of Psychiatry, University of Queensland Medical School, University of Queensland, Brisbane, QLD, Australia
| | - Pichet Udomratn
- Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| |
Collapse
|
36
|
Syamsun A, Kadriyan H, Lestari NPS, Lestarini IA, Rivarti AW, Bukhari A, Haikal Z. The role of the rapid molecular test (RMT) and the provision of a negative pressure mortuary room in reducing COVID-19 corpse handling protocol rejection: experiences with religious conservative groups. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022; 12:4. [PMID: 35070456 PMCID: PMC8761831 DOI: 10.1186/s41935-022-00267-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/12/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study explores the difference in COVID-19 corpse handling protocol rejection before and after the innovation in rapid molecular test (RMT) postmortem examination and providing negative pressure mortuary rooms. This study is a retrospective observational study. Each of the corpse's immediate family was explained the procedure for handling the body based on the fatwa of the religious institution and the hospital's standard operating system. The acceptance or rejection of the protocol, general characteristics of the corpse, and the reasons for refusal are documented. RESULTS From March to May 2020, there were 16 probable COVID-19 corpses and 3 confirmed COVID-19 corpses. Rejection of the COVID-19 corpse protocol occurred six times. The main reason for rejection is that the death might not necessarily be caused by COVID-19, the body's handling in the hospital is not following religious law, and the negative stigma of COVID-19. From June to August 2020, there were 42 probable COVID-19 corpses and 49 confirmed COVID-19 corpses. Rejection of the COVID-19 corpse protocol occurred eight times. The most rejection reason is that the deceased families do not believe the deceased died because of COVID-19. CONCLUSIONS The decline in the COVID-19 corpse protocol rejection has occurred after applying RMT and providing a negative pressure mortuary room. This decline proves that religious conservative groups can accept this innovation to reduce rejection on religious grounds.
Collapse
Affiliation(s)
- Arfi Syamsun
- Faculty of Medicine, University of Mataram, Jalan Pendidikan 37, Mataram, 83125 Indonesia
| | - Hamsu Kadriyan
- Faculty of Medicine, University of Mataram, Jalan Pendidikan 37, Mataram, 83125 Indonesia
| | | | - Ima Arum Lestarini
- Faculty of Medicine, University of Mataram, Jalan Pendidikan 37, Mataram, 83125 Indonesia
| | - Arina Windri Rivarti
- Faculty of Medicine, University of Mataram, Jalan Pendidikan 37, Mataram, 83125 Indonesia
| | | | - Zikrul Haikal
- Faculty of Medicine, University of Mataram, Jalan Pendidikan 37, Mataram, 83125 Indonesia
| |
Collapse
|
37
|
Oo MM, Liabsuetrakul T, Boonathapat N, Aung HKK, Pungrassami P. Association of Health Insurance and Documentation with Stigma and Social Support Among Myanmar Migrants with Tuberculosis Before and During Thailand's Policy on Border Closure Due to COVID-19: a Cross-Sectional Study. J Racial Ethn Health Disparities 2022; 9:2495-2507. [PMID: 34811647 PMCID: PMC8608234 DOI: 10.1007/s40615-021-01185-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The objective of this study was to assess the effect of health insurance and documentation status on tuberculosis (TB)-related stigma and social support before and during Thailand's policy on border closure. METHODS A cross-sectional study was conducted in two TB clinics in Mae Sot district, a border area of Thailand. Myanmar migrants with new TB were interviewed before (between September 2019 and March 2020) and during Thailand's policy (between April 2020 and January 2021). We used multiple linear regression models to assess the association of health insurance and documentation status with stigma and social support before and during the policy on border closure. RESULTS Of 229 migrants diagnosed new TB recruited, 117 and 112 were interviewed before and during Thailand's policy on border closure. The relationship of stigma with health insurance and documentation status was modified by the policy. Migrants with health insurance reported significantly lower stigma during the policy compared to those without health insurance, whereas documented migrants had lower stigma before the policy compared to undocumented migrants. No significant association of health insurance and documentation status with social support was observed. Ethnicity, perceived TB severity and education level were also independently associated with TB-related stigma. CONCLUSION The relationships between health insurance, documentation status and TB-related stigma were modified by Thailand's policy on border closure among Myanmar migrants with TB in a border area of Myanmar and Thailand. Promotion of health insurance and well-planned documentation for migrants should be more discussed and strengthened among stakeholders and policymakers.
Collapse
Affiliation(s)
- Myo Minn Oo
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Thailand
| | - Tippawan Liabsuetrakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Thailand
| | | | - Htet Ko Ko Aung
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
38
|
Chua MWJ. The Invisible and Insidious Enemy. Obes Surg 2021; 31:5460-5461. [PMID: 34215974 PMCID: PMC8253466 DOI: 10.1007/s11695-021-05550-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Marvin Wei Jie Chua
- Endocrinology Service, Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
| |
Collapse
|
39
|
Di Y, Li A, Li H, Wu P, Yang S, Zhu M, Zhu T, Liu X. Stigma toward Wuhan people during the COVID-19 epidemic: an exploratory study based on social media. BMC Public Health 2021; 21:1958. [PMID: 34715825 PMCID: PMC8554505 DOI: 10.1186/s12889-021-12001-2] [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] [Received: 09/17/2020] [Accepted: 10/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Stigma associated with infectious diseases is common and causes various negative effects on stigmatized people. With Wuhan as the center of the COVID-19 outbreak in China, its people were likely to be the target of stigmatization. To evaluate the severity of stigmatization toward Wuhan people and provide necessary information for stigma mitigation, this study aimed to identify the stigmatizing attitudes toward Wuhan people and trace their changes as COVID-19 progresses in China by analyzing related posts on social media. Methods We collected 19,780 Weibo posts containing the keyword ‘Wuhan people’ and performed a content analysis to identify stigmatizing attitudes in the posts. Then, we divided our observation time into three periods and performed repeated-measures ANOVA to compare the differences in attitudes during the three periods. Results The results showed that stigma was mild, with 2.46% of related posts being stigmatizing. The percentages of stigmatizing posts differed significantly during the three periods. The percentages of ‘Infectious’ posts and ‘Stupid’ posts were significantly different for the three periods. The percentage of ‘Irresponsible’ posts was not significantly different for the three periods. After government interventions, stigma did not decrease significantly, and stigma with the ‘Infectious’ attitude even increased. It was not until the government interventions took effect that stigma significantly reduced. Conclusions This study found that stigma toward Wuhan people included diverse attitudes and changed at different periods. After government interventions but before they took effect, stigma with the ‘Infectious’ attitude increased. After government interventions took effect, general stigma and stigmas with ‘Infectious’ and ‘Stupid’ attitudes decreased. This study constituted an important endeavor to understand the stigma toward Wuhan people in China during the COVID-19 epidemic. Implications for stigma reduction and improvement of the public’s perception during different periods of epidemic control are discussed.
Collapse
Affiliation(s)
- Yazheng Di
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, 100083, China
| | - He Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Peijing Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Simin Yang
- Department of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Meng Zhu
- Hubei University of Economics, Wuhan, 430205, China
| | - Tingshao Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiaoqian Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| |
Collapse
|
40
|
Valeri L, Amsalem D, Jankowski S, Susser E, Dixon L. Effectiveness of a Video-Based Intervention on Reducing Perceptions of Fear, Loneliness, and Public Stigma Related to COVID-19: A Randomized Controlled Trial. Int J Public Health 2021; 66:1604164. [PMID: 34475811 PMCID: PMC8407346 DOI: 10.3389/ijph.2021.1604164] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/26/2021] [Indexed: 01/27/2023] Open
Abstract
Objectives: During the first peak of the COVID-19 outbreak in the United States, we investigated the impact of digital interventions to reduce COVID-19 related fear, loneliness, and public stigma. Methods: We recruited and randomly assigned 988 United States residents to: 1) no intervention 2) informational sheet to learn about COVID-19, 3) (2) AND video encouraging digital social activity, 4) (2) AND video sensitizing to COVID-19 related stigma (registered in Clinicaltrials.gov). Surveys were conducted between April 2-16, 2020. We employed generalized linear mixed models to investigate intervention effects. Results: 10% of the participants reported not being afraid of people COVID-19+ and 32% reported not feeling lonely. Stigma and fear items reflected acute worries about the outbreak. Relative to the informational sheet only group, video groups led to greater reduction in perceptions of fear towards COVID-19+ (ORvideo.solo = 0.78, p-val<0.001; ORvideo.friend = 0.79, p-val<0.001) and of stigma (BETAvideo.solo = -0.50, p-val<0.001; BETAvideo.friend = -0.69, p-val<0.001). Conclusion: Video-based interventions lead to reductions in COVID-19-related fear and stigma. No difference in social activity among groups was found, potentially explaining lack of efficacy on loneliness.
Collapse
Affiliation(s)
- Linda Valeri
- Department of Biostatistics, Columbia University, New York, NY, United States
| | - Doron Amsalem
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
| | - Samantha Jankowski
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
| | - Ezra Susser
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Lisa Dixon
- New York State Psychiatric Institute (NYSPI), New York, NY, United States
| |
Collapse
|