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.
ABSTRACT
AIM: To identify groups of nurses engaging in coronavirus disease (COVID-19) care who are most in need of organizational support. BACKGROUND: Overwhelming stress and susceptibility to burnout have been reported in nurses during the COVID-19 pandemic. METHODS: Nurses working at five hospitals that accepted COVID-19 patients answered the questionnaire. The Tokyo Metropolitan Distress Scale for Pandemic, Self-Diagnosis Check List for Assessment of Workers' Accumulated Fatigue and Japanese Burnout Scale were evaluated. Multiple regression analysis was performed to examine the relationship between engaging in COVID-19 care and psychosocial/physical burden. RESULTS: In total, 895 questionnaires were analysed. With experience in caring for COVID-19 patients as the independent variable, nurses caring for suspected cases had significantly higher standardized Tokyo Metropolitan Distress Scale for Pandemic scores for 'concerns for infection' (standardized partial regression coefficient ß = .921, P = .004), Assessment of Workers' Accumulated Fatigue (ß = .445, P = .022) and Japanese Burnout Scale 'emotional exhaustion' (ß = .136, P = .021) than those caring for confirmed cases. CONCLUSIONS: Nurses caring for suspected COVID-19 patients have the highest psychological/physical burden and propensity for burnout. IMPLICATIONS FOR NURSING MANAGEMENT: Extensive support systems are required for nurses caring for confirmed and suspected COVID-19 cases.