Experiences of COVID-19-Related Stigma: A Qualitative Study on Nurses Caring for Patients With COVID-19

Abstract

BackgroundHealthcare workers caring for patients with Coronavirus Disease 2019 (COVID-19) have been a primary target of stigmatization and discrimination during the COVID-19 outbreak. Thus, there is an urgent need to develop a support system for Asian healthcare workers who care for patients with COVID-19.PurposeThis study was designed to understand the characteristics of COVID-19-related stigma experienced by nurses caring for patients with COVID-19.MethodsA qualitative content analysis methodology was used. This study was conducted between April 2020 and March 2021. The participants were 10 female registered nurses working at three medical facilities that accepted patients with COVID-19. The data included specific narratives on the instances of stigma experienced when caring for patients with COVID-19, including connected situations and ideas. The data were collected using focus group interviews with three or four participants in each group. Data analysis was conducted based on the inductive qualitative analysis approach of Krippendorff.ResultsThe content analysis identified two categories and seven subcategories of stigma experienced by clinical nurses. The category “directly experienced prejudice and discrimination” included the subcategories “being avoided,” “being treated as dirty,” “discrimination toward family members,” and “others prying.” The category “self-imposed coping behavior” included the subcategories “keeping oneself apart,” “feeling guilty,” and “nondisclosure.”Conclusions/Implications for PracticeThe participants internalized their experiences of stigma, as Japanese culture emphasizes keeping such things to oneself. Therefore, there is an urgent need to strengthen the support system for nurses who care for patients with COVID-19. This study addressed the problem of the stigmatization of these nurses and their families by others as well as their colleagues. The main findings were that stigma was directly experienced as discrimination and prejudice and often resulted in self-imposed coping behavior. The major implication of these findings is the need to establish systematic, active, and ongoing organizational support programs for nurses who are discriminated against because of COVID-19-related stigma.

Impact of the COVID‐19 pandemic on the primary lung cancer screening program in Akita Prefecture, a region with the fastest aging population in Japan

“…Therefore, older residents of Akita likely avoid chest X‐ray screening. Third, social stigma is reported to exist during the COVID‐19 pandemic, and people fear both COVID‐19 infection itself and social discrimination owing to infection 18–20 . Additionally, social discrimination tends to be stronger in areas with lower COVID‐19 prevalence, 19 suggesting that fear of social discrimination was strong in Akita Prefecture, where the COVID‐19 prevalence was lower 15 .…”

“…Third, social stigma is reported to exist during the COVID-19 pandemic, and people fear both COVID-19 infection itself and social discrimination owing to infection. [18][19][20] Additionally, social discrimination tends to be stronger in areas with lower COVID-19 prevalence, 19 suggesting that fear of social discrimination was strong in Akita Prefecture, where the COVID-19 prevalence was lower. 15 Therefore, aging, distance and social stigma are among the reasons for the large decrease in the rate of chest X-ray screening in Akita.…”

Factors Associated With HIV-Related Stigma Among Indonesian Healthcare Workers: A Cross-Sectional Online Survey

“…Likewise, a study conducted by Mahamboro and colleagues (2020) in Indonesia who studied HIV-positive patients among married men stated that irrational fear of HIV transmission among healthcare workers leads to discrimination in healthcare settings, as it contributes to unwillingness to provide treatment to PLWHA. A similar result was obtained in Tsukuda et al (2022), which was designed to understand the characteristics of COVID-19-related stigma experienced by nurses caring for patients with COVID-19. The content analysis identified two categories and seven subcategories of stigma experienced by clinical nurses.…”

The design and psychometric evaluation of a COVID-19 social stigma questionnaire in nurses

“…The COVID-19-related stigma, experienced at high levels by healthcare workers, causes fear, anxiety, negative attitudes, ignoring behavior and rejection, and psychological discomfort, which can negatively affect their performance (39). In a tool designed by Tsukuda et al (2022), healthcare workers expressed their worries and anxiety about disclosing their workplace. They felt guilty and lthy because of their close contact with patients (40).…”

“…However, no COVID-19 social stigma scale has been designed for nurses of COVID ICUs, who are in direct contact with patients. The studies conducted in this context only reported some stigma characteristics, such as discrimination of family members (22), and did not comprehensively investigate social stigma characteristics in nurses.…”