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BMC Health Services Research
Published in: BMC Health Services Research 1/2022

Open Access 01-12-2022 | COVID-19 | Research

The development and validation of a novel COVID19 stigma scale among healthcare workers (COVISS-HCWs)

Authors: Hasan Nabil Al Houri, Abdullah Alhouri, Rand T. Akasheh, Christine E. S. Jovanovic, Heba Al-tarcheh, Douaa Mohammad Nazir Arrouk, Ahmad Nabil Alhouri, Marah Marrawi, Malik E. Juweid, Youssef Latifeh

Published in: BMC Health Services Research | Issue 1/2022

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Abstract

Background and aim

Fear of coronavirus disease 2019 (COVID-19) and its complications may result in stigmatization of individuals who may carry the virus. This is of special concern to healthcare workers who tolerate additional physical and emotional stress at times of pandemic. The aims of this study are to (1) develop and validate the COVID-19 Stigma Scale (COVISS-HCWs) survey; and (2) investigate the experience of stigma among healthcare workers possibly dealing with COVID-19 patients in five major public hospitals in Damascus, Syria.

Methods

We divided the sample into two parts and then underwent EFA on the first 350 participants, dividing the 14 questions into two dimensions. Furthermore, CFA was conducted on the other 350 participants to confirm how correctly a hypothesized model matched the factor structure by EFA, as described above. Moreover, the coefficient of determination (R2) and item–scale correlations (standardized factor loading) were estimated to establish the acceptability of the final structure of the COVISS-HCWs. Through a cross-sectional study, a convenience sample of 700 healthcare workers participated in a self-administered questionnaire containing a section for demographic variables and another for newly designed COVISS-HCWs. The scale comprises 14 adapted and novel items that measure two subscales: feelings of perceived harm and inferiority, and avoidance. Descriptive statistics, reliability, and validity were evaluated.

Results

The 14 COVISS-HCWs items were reduced to 11 items with a high Cronbach’s α of 0.909. A significant correlation was observed between the responses to each COVISS-HCWs item and the corresponding subscale, and between each subscale and the overall scale. Feeling stigmatized was reported by 9.86% of the participants. Younger age, low socioeconomic status, and higher intensity of contact with COVID-19 patients significantly correlated with higher stigmatization.

Conclusions

The novel COVISS-HCWs is a reliable and valid tool to evaluate stigma among healthcare workers during the COVID-19 pandemic. The Stigma prevalence among healthcare workers was 9.86%. Therefore, this must be addressed to prevent possible psychosocial and public health repercussions.
Literature
1.
2.
Turner-Musa J, Ajayi O, Kemp L. Examining social determinants of health, stigma, and COVID-19 Disparities. Healthcare (Basel). 2020;8(2):168.CrossRefPubMed
3.
4.
Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations. Psychiatry Res. 2020;293:113429.CrossRefPubMedPubMedCentral
5.
6.
Earnshaw VA, Quinn DM. The impact of stigma in healthcare on people living with chronic illnesses. J Health Psychol. 2012;17(2):157–68.CrossRefPubMed
7.
Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatr. 2020;51: 102083.CrossRefPubMedPubMedCentral
8.
Tsukuda M, Ito Y, Nojima K, Kayano T, Honda J, Health P. Development and Validation of the COVID-19-Related Stigma Scale for Healthcare Workers (CSS-HCWs). Int J Environ Res Public Health. 2022;19(15):9641.CrossRefPubMedPubMedCentral
9.
Mostafa A, Mostafa NS, Ismail N. Validity and reliability of a COVID-19 stigma scale using exploratory and confirmatory factor analysis in a sample of Egyptian Physicians: E16-COVID19-S. Int J Environ Res Public Health. 2021;18(10):5451.CrossRefPubMedPubMedCentral
10.
Tabachnick B, Fidell LJUMS, 4th ed. Allyn, Bacon B, MA. Using Multivariate Statistics, Allyn and Bacon, Boston, MA. 2001:-.
11.
Nyblade L, Jain A, Benkirane M, Li L, Lohiniva AL, McLean R, et al. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis. Journal of the International AIDS Society. 2013;16(3 Suppl 2):18718.
12.
Craig G, Meershoek A, Zwerling A, Daftary A, Citro B, Smyth C, et al. TB STIGMA–MEASUREMENT GUIDANCE. 2018.
13.
Jones ACJJoC, RD-CMR MR. Stigma and shame: Conceptualisations and views concerning service use and health care provision: A literature review and commentary. 2019;10012.
14.
Link BG, Phelan JC, Sullivan G. Mental and physical health consequences of the stigma associated with mental illnesses. The Oxford handbook of stigma, discrimination, and health2018.
15.
Abiri S, Oakley LD, Hitchcock ME, Hall A. Stigma related avoidance in people living with severe mental illness (SMI): findings of an integrative review. Community Ment Health J. 2016;52(3):251–61.CrossRefPubMed
16.
Ben-Zeev D, Young MA, Corrigan PW. DSM-V and the stigma of mental illness. J Ment Health (Abingdon, England). 2010;19(4):318–27.CrossRef
17.
Norris M, Lecavalier L. Evaluating the use of exploratory factor analysis in developmental disability psychological research. J Autism Dev Disord. 2010;40(1):8–20.CrossRefPubMed
18.
Roberson RB, Elliott TR, Chang JE, Hill JN. Exploratory factor analysis in Rehabilitation Psychology: a content analysis. Rehabil Psychol. 2014;59(4):429–38.CrossRefPubMed
19.
Nunnally JC. Psychometric theory 3E: Tata McGraw-hill education; 1994.
20.
Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003;168(10):1245–51.PubMedPubMedCentral
21.
Siegel J, Yassi A, Rau A, Buxton JA, Wouters E, Engelbrecht MC, et al. Workplace interventions to reduce HIV and TB stigma among health care workers–where do we go from here? Glob Public Health. 2015;10(8):995–1007.CrossRefPubMed
22.
23.
24.
Korte K, Denckla C, Ametaj A, Koenen K. Viruses don't discriminate and neither should we. Retrieved from Harvard University at. harvard. edu/student-life; 2020.
25.
Yufika A, Pratama R, Anwar S, Winardi W, Librianty N, Prashanti NAP, et al. Stigma Associated with COVID-19 Among Health Care Workers in Indonesia. Disaster medicine and public health preparedness. 2021:1–5.
26.
27.
Assefa N, Soura A, Hemler EC, Korte ML, Wang D, Abdullahi YY, et al. COVID-19 knowledge, perception, preventive measures, stigma, and mental health among healthcare workers in Three Sub-Saharan African Countries: a phone survey. Am J Trop Med Hyg. 2021;105(2):342–50.CrossRefPubMedPubMedCentral
28.
Campo-Arias A, Álvarez-Solorza I, Tirado-Otálvaro AF, Cassiani-Miranda CA. Proposal of a scale for COVID-19 stigma-discrimination toward health workers. J Investig Med. 2021;69(1):100–1.CrossRefPubMed
29.
Nochaiwong S, Ruengorn C, Awiphan R, Kanjanarat P, Ruanta Y, Phosuya C, et al. COVID-19 public stigma scale (COVID-PSS): development, validation, psychometric analysis and interpretation. BMJ Open. 2021;11(11): e048241.CrossRefPubMed
30.
Al-Zamel LA, Al-Thunayan SF, Al-Rasheed AA, Alkathiri MA, Alamri F, Alqahtani F, et al. Validation and cultural adaptation of explanatory model interview catalogue (EMIC) in Assessing stigma among recovered patients with COVID-19 in Saudi Arabia. Int J Environ Res Public Health. 2021;18(16):8261.CrossRefPubMedPubMedCentral
31.
32.
Do Duy C, Nong VM, Van Ngo A, Doan Thu T, Do Thu N, Nguyen QT. COVID-19-related stigma and its association with mental health of health-care workers after quarantine in Vietnam. Psychiatry Clin Neurosci. 2020;74(10):566–8.CrossRefPubMedPubMedCentral
33.
Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singapore. 2004;33(6):743–8.PubMed
34.
Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.CrossRefPubMed
35.
Mehmetoglu M. CONDISC: Stata module to perform convergent and discriminant validity assessment in CFA. Statistical Software Components S458003. Boston College Department of Economics.: Stata; 2015.
36.
Yuan K, Huang XL, Yan W, Zhang YX, Gong YM, Su SZ, et al. A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action. Mol Psychiatry. 2022;27(1):19–33.CrossRefPubMed
37.
Chew QH, Chia FL-A, Ng WK, Lee WCI, Tan PLL, Wong CS, et al. Psychological and coping responses to COVID-19 amongst residents in training across ACGME-I accredited specialties in Singapore. Psychiatry Res. 2020;290:113146-.
38.
Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559–65.CrossRefPubMedPubMedCentral
39.
Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Ann Intern Med. 2020;173(4):317–20.CrossRefPubMed
40.
Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet (London, England). 2020;395(10224):e37–8.CrossRefPubMed
41.
Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The lancet Psychiatry. 2020;7(6):547–60.CrossRefPubMedPubMedCentral
42.
Metadata
Title
The development and validation of a novel COVID19 stigma scale among healthcare workers (COVISS-HCWs)
Authors
Hasan Nabil Al Houri
Abdullah Alhouri
Rand T. Akasheh
Christine E. S. Jovanovic
Heba Al-tarcheh
Douaa Mohammad Nazir Arrouk
Ahmad Nabil Alhouri
Marah Marrawi
Malik E. Juweid
Youssef Latifeh
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
COVID-19
Published in
BMC Health Services Research / Issue 1/2022
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-022-08911-5

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