Stigmatization profiles and psychological distress in people at high risk of infection with COVID-19 -A study conducted in Germany from March to August 2021.

COVID-19-related stigmatization of affected people or people at risk of infection has been shown to enhance the reluctance of affected individuals to use health services and reduce their mental health. It is thus highly important to gain a thorough understanding of COVID-19-related stigmatization. The present study's first aim was to explore stigmatization profiles of experienced stigmatization (anticipated stigmatization, internalized stigmatization, enacted stigmatization, disclosure concerns) and stigmatization practices in 371 German people at high risk of infection using latent class analyses. The second aim was to investigate the relationship between stigmatization profiles and psychological distress via multiple regression analysis taking into account other possible negative and positive risk factors. Our results showed two stigmatization profiles: "high stigmatization group" and "low stigmatization group". Belonging to the "high stigmatization group" was significantly correlated with higher levels of psychological distress. Other risk factors significantly related to psychological distress were mental health disorders in the past, exposure to COVID-19, fear related to COVID-19, perceived risk of being infected, lower perceived self-efficacy, and lower subjective knowledge about COVID-19.

Factors associated with pre-loss grief and preparedness in relatives of people with cancer during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVES: Before the loss of a loved one to cancer, relatives have time to adapt to the impending death. However, due to the current COVID-19 pandemic, adjustment to an imminent death may be more difficult. This study investigates factors related to pre-loss grief and preparedness during the COVID-19 pandemic and their relationship with COVID-19 related fears. METHODS: Data of 299 participants from a cross-sectional study was used. Participants were included if they were relatives of people with cancer, spoke German and were at least 18 years. Multivariate linear regression analyses were conducted to measure the relationship between predictors (dysfunctional coping, emotion-focused coping, problem-focused coping, attachment anxiety, attachment avoidance, COVID-19 related fears, prognosis, perceived depth of the relationship, perceived conflict in the relationship, health status) and pre-loss grief, preparedness for caregiving and preparedness for death as the dependent variables. RESULTS: Perceived depth (ß = .365, p < .001), COVID-19 related fears (ß = .141, p = .002), prognosis for death (ß = .241, p < .001), dysfunctional coping strategies (ß = .281, p < .001) and emotion-focused coping strategies (ß = -.320, p < .001) significantly predicted pre-loss grief. Prognosis for death (ß = .347, p < .001), dysfunctional coping strategies (ß = -.229, p < .001), emotion-focused coping strategies (ß = .242, p < .001), COVID-19 related fears (ß = -.112, p = .037) and health status (ß = .123, p = .025) significantly predicted preparedness for death. Dysfunctional coping (ß = -.147, p = .009), problem-focused coping (ß = .162, p = .009), emotion-focused coping (ß = .148, p = .017), COVID-19 related fears (ß = -.151, p = .006), attachment anxiety (ß = -.169, p = .003), perceived conflict in the relationship with the patient with cancer (ß = -.164, p = .004), perceived depth in the relationship (ß = .116, p = .048) and health status (ß = .157, p = .003) significantly predicted preparedness for caregiving. CONCLUSIONS: This study shows COVID-19 pandemic impacts on the grieving process of relatives of patients with cancer. Consequently, screening for pre-loss grief, preparedness and their associated factors may help provide early support for relatives of people with cancer at need. However, further research is needed to help understand the stability of pre-loss grief and preparedness.