Stigma perception of those who had COVID-19 in the first year of the pandemic (2020-2021): The case of Turkey

Yıl 2022, Cilt: 8 Sayı: 2, 165 - 183, 30.04.2022

Ömer Erdoğan , Mutluhan Ersoy

https://doi.org/10.24289/ijsser.1073759

Öz

The main purpose of the study is to investigate the experiences of stigma and its relationship with depression and anxiety in those with COVID-19 who recovered in the first year of the pandemic, when the vaccine was not developed yet. The study was carried out in two parts, and it was carried out with the quantitative method using the COVID-19 Stigma Scale and the Hospital Anxiety and Depression Scale to 1227 people with first stage COVID-19 disease and a recovery period of at least one month. The second stage was conducted with qualitative interviews with 50 participants in order to reveal the stigma with their life experiences. The results of the analysis of the data obtained showed that the perception of stigma was high among those who had COVID-19 disease. While the highest level of stigma perception was seen among the participants aged 60 and over, it was found that the perception of stigma decreased as the education increased, and the perception of stigma increased as the recovery time increased. In addition, as the level of stigma perception increases, both the depression and anxiety levels of the participants increase. In the qualitative interviews, themes related to the participants' feelings, thoughts and stigmatization perceptions regarding the disease were discussed before they contracted the COVID-19 disease, during the disease process and after recovery. While the most experienced emotions during and after the illness were feelings of fear and anxiety, it was stated that the participants experienced stigma in their immediate social environment after the illness and this shook them.

Anahtar Kelimeler

Stigma, COVID-19, Pandemic, Social exclusion, Infectious disease

Pandeminin birinci yılında (2020-2021) COVID-19 hastalığı geçirenlerin damgalanma algısı: Türkiye örneği

Öz

Çalışmanın temel amacı, COVID-19 hastalığı olan ve pandeminin henüz aşı geliştirilmediği ilk yılında iyileşenlerin damgalanma deneyimlerini ve bunun depresyon ve anksiyeteyle ilişkisini araştırmaktır. Çalışma iki bölüm halinde gerçekleştirilmiş olup, birinci aşama COVID-19 hastalığı olan ve iyileşme süresi en az bir ay olan 1227 kişiye COVID-19 Stigma Ölçeği ve Hastane Kaygı ve Depresyon Ölçeği kullanılarak nicel yöntemle gerçekleştirildi. İkinci aşama, yaşam deneyimleriyle damgalanmayı ortaya çıkarmak amacıyla 50 katılımcı ile nitel görüşmelerle gerçekleştirilmiştir. Elde edilen verilerin analiz sonuçları neticesinde COVID-19 hastalığı geçirenler arasında damgalanma algısının yüksek olduğu bulunmuştur. En yüksek düzeyde damgalanma 60 yaş ve üzerindeki katılımcılar arasında görülürken, eğitim düzeyi yükseldikçe damgalanma algısının düştüğü ve iyileşme süresi arttıkça damgalanma algısının da arttığı bulunmuştur. Ayrıca damgalanma düzeyi arttıkça katılımcıların depresyon ve kaygı düzeyleri artmaktadır. Nitel görüşmelerde katılımcıların COVID-19 hastalığı geçirmeden önce, hastalık sürecinde ve iyileştikten sonra hastalığa ilişkin duygu, düşünce ve damgalanma algılarına ilişkin temalar ele alınmıştır. Hastalık sürecinde ve sonrasında en çok yaşanan duygu korku ve kaygı duyguları olurken hastalık sonrasında katılımcıların yakın sosyal çevrelerine ilişkin damgalanma yaşadıkları ve bunun onları sarstığı ifade edilmiştir. 

Anahtar Kelimeler

Damgalanma, COVD-19, Pandemi, Sosyal dışlanma, Enfeksiyon hastalığı

Kaynakça

• Abuhammad, S, Alzoubi, KH, Khabour, O. (2020). Fear of COVID‐19 and stigmatization towards infected people among Jordanian people. Int J Clin Pract. 00:e13899. https://doi.org/10.1111/ijcp.13899
• Almutairi, A. F., Adlan, A. A., Balkhy, H. H., Abbas, O. A., & Clark, A. M. (2018). “It feels like I'm the dirtiest person in the World”: Exploring the experiences of healthcare providers who survived MERS-CoV in Saudi Arabia. Journal of Infection and Public Health, 11(2), 187–191.
• Arwady MA, Garcia EL, Wollor B, Mabande LG, Reaves EJ, Montgomery JM. Reintegration of ebola survivors into their communities - Firestone District, Liberia, 2014. MMWR Morb Mortal Wkly Rep. 63(50): 1207–1209.
• Aydemir, Ö., Guvenir, T., Kuey, L., & Kultur, S. (1997). Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Dergisi, 8(4), 280-287.
• Bagcchi S. (2020). Stigma during the COVID-19 pandemic. Lancet Infect Dis.20(7):782. https://doi.org/10.1016/S1473 -3099(20)30498 -9. PMID: 32592670, PMCID: PMC7314449
• Banerjee, D., (2020). The COVID-19 outbreak: crucial role the psychiatrists can play. Asian J. Psychiatry, 50, 102014. https://doi.org/10.1016/j.ajp.2020.102014.
• Banerjee, D., & Rai, M. (2020). Social isolation in COVİD-19: The impact of loneliness. International Journal of Social Psychiatry, 66(6), 525-527. doi:10.1177/0020764020922269
• Batey DS, Whitfield S, Mulla M, Stringer KL, Durojaiye M, McCormick L, et al. (2016). Adaptation and implementation of an intervention to reduce HIV-related stigma among healthcare workers in the United States: piloting of the FRESH workshop. AIDS Patient Care STDs. 30(11):519–27.
• Chopra KK, Arora VK. (2020). Covid-19 and social stigma: role of scientific community. Indian J Tuberc. 67(3):284-285.
• Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. T. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (Vol. 2, 4th ed., pp. 504-553). Boston, MA: McGraw-Hill.
• Des Jarlais DC, Galea S, Tracy M, et al. (2006). Stigmatization of newly emerging infectious diseases: AIDS and SARS. Am J Public Health, 96: 561–567.
• Duan, W., Bu, H., & Chen, Z. (2020). COVİD-19-related stigma profiles and risk factors among people who are at high risk of contagion. Soc Sci Med, 266, 113425. doi:10.1016/j.socscimed.2020.113425
• Erdoğan, Ö., Ersoy, M. (2022). Development and psychometrıc evaluatıon of a covıd-19 stıgma scale: a factor analysıs ınvestıgatıon ın a Turkısh populatıon. Akademik Sosyal Bilimler Dergisi, 9, 25, 86-101. DOİ: 10.34189/asbd.9.25.006
• Gardner PJ, Moallef P. (2015).Psychological impact on SARS survivors: critical review of the English language literature. Can Psychol. 56(1): 123.
• Gilbert, D.T., Fiske, S.T., Lindzey, G., (1998). The Handbook of Social Psychology. Oxford University Press, New York.
• Goffman, I. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice Hall.
• Guetiya Wadoum RE, Samin A, Mafopa NG et al. (2017). Mobile health clinic for the medical management of clinical sequelae experienced by survivors of the 2013–2016 Ebola virüs disease outbreak in Sierra Leone, West Africa. Eur J Clin Microbiol Infect Dis. 36(11): 2193–2200.
• Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103, 813-821.
• Honey M, Wang WY. (2013).New Zealand nurses perceptions of caringfor patients with influenza A (H1N1). Nurs Crit Care. 18:63–69.. Hunter M. Keys, Bonnie N. Kaiser, Jenny W. Foster, Matthew C. Freeman, Rob Stephenson, Andrea J. Lund & Brandon A. Kohrt, (2019). Cholera control and anti-Haitian stigma in the Dominican Republic: from migration policy to lived experience, Anthropology & Medicine, 26:2, 123-141, DOI: 10.1080/13648470.2017.1368829
• Jones, E. E., Farina, A., Hastorf, A. H., Markus, H., Miller, D. T., & Scott, R. A. (1984). Social stigma: The psychology of marked relationships. New York: W.H. Freeman and Company.
• Kandil, C. Y. (2020, March 26). Asian American report over 650 racist acts over last week, new data says. NBA News.com. https://www.nbcnews.com/news/asian-america/asian-americansreport-nearly-500-racist-acts-over-last-week-n1169821.
• Katherine J. Roberto, Andrew F. Johnson & Beth M. Rauhaus (2020) Stigmatization and prejudice during the COVID-19 pandemic, Administrative Theory & Praxis, 42:3, 364-378, DOI: 10.1080/10841806.2020.1782128
• Kurohi, R. (2020, February 7). MHA investigating religious teacher for xenophobic, racists posts. The Straits Times. https://www.straitstimes.com/singapore/coronavirus-mha-investigating-religious-teacher-for-xenophobic-racist-posts.
• Lau JT, Yang X, Wong E, Tsui H. (2006). Prevalence and factors associated with social avoidance of recovered SARS patients in the Hong Kong general population. Health Educ Res. 21(5): 662–673.
• Lotsch F, Schnyder J, Goorhuis A, Grobusch MP. (2017). Neuropsychological long-term sequelae of Ebola virus disease survivors - A systematic review. Travel Med Infect Dis. 18: 18–23.
• Lin, C.Y. (2020). Social reaction toward the 2019 novel coronavirus (COVID-19). Social Health and Behavior, 3(1), 1–2. https://doi.org/10.4103/SHB.SHB_11_20.
• Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment. American Sociological Review, 54(3), 400–423. https://doi.org/10.2307/2095613
• Link, B., and Phelan, J. (1995). Social conditions as fundamental causes of disease. Health Soc Behav, (special issue) 80-94
• Locsin R.C. & Matua A.G. (2002) The lived experience of waiting-to-know: Ebola at Mbarara, Uganda–hoping for life, anticipating death. Journal of Advanced Nursing 37(2), 173–81.
• Mohammed A, Sheikh TL, Gidado S et al.(2015). An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study 2014. BMC Public Health, 15(1): 1–8.
• Overholt, L.; Wohl, D.A.; Fischer, W.A.; Westreich, D.; Tozay, S.; Reeves, E.; Pewu, K.; Adjasso, D.; Hoover, D.; Merenbloom, C.; et al. (2018). Stigma and Ebola survivorship in Liberia: Results from a longitudinal cohort study. PLoS ONE, 13, e0206595
• Pappas, G., Kiriaze, I. J., Giannakis, P., & Falagas, M. E. (2009). Psychosocial consequences of infectious diseases. Clinical Microbiology and Infection, 15(8), 743–747. https://doi.org/10.1111/j.1469-0691.2009.02947.x.
• Pellecchia, U., Crestani, R., Decroo, T., Van den Bergh, R., & Al-Kourdi, Y. (2015). Social consequences of Ebola containment measures in Liberia. PLOS ONE, 10 (12), e0143036. https://doi.org/10.1371/journal.pone.0143036
• Person, B., Sy, F., Holton, K., Govert, B., Liang, A., & Garza, B. (2004). Fear and stigma: The epidemic within the SARS outbreak. Emerging Infectious Diseases, 10(2), 358-363. Doi: 10.3201/eid1002.030750
• Pescosolido, B.A., Martin, J.K., Lang, A., Olafsdottir, S. (2008). Rethinking theoretical approaches to stigma: a Framework integrating normative influences on stigma (FINIS). Soc. Sci. Med. 67 (3), 431–440. https://doi.org/10.1016/j. socscimed.2008.03.018.
• Poudel, A., (2020). Stigma Against Health Workers, Patients and Area Locals Continues in Covid-19 Hotspots. https://kathmandupost.com/national/2020/05/01/stigmaagainst-health-workers-patients-and-area-locals-continues-in-covid-19-hotspots.
• Ramaci T, Barattucci M, Ledda C, Rapisarda V. (2020). Social stigma during COVID-19 and ITS IMPACT on HCWs outcomes. Sustainability.12(9):3834.
• Rabelo, I.; Lee, V.; Fallah, M.P.; Massaquoi, M.; Evlampidou, I.; Crestani, R.; Severy, N. (2016) Psychological Distress among ebola survivors Discharged from an ebola Treatment Unit in Monrovia, liberia—A Qualitative study. Front. Public Health, 4, 142.
• Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. (2020). Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatry.8:102083.
• Sahoo, S., Mehra, A., Suri, V., Malhotra, P., Yaddanapudi, N., Puri, G. and Grover, S. (2020). Lived experiences of the corona survivors (patients admitted in COVID wards): a narrative reallife documented summaries of internalized guilt, shame, stigma, anger. Asian Journal of Psychiatry, Vol. 53, pp. 1-3.
• Scheff TJ. (1966). Being Mentally Ill: A Sociological Theory. Chicago, IL: Aldine de Gruyter Scheimer, D., & Chakrabarti, M. (2020). Asian American discrimination and the coronavirus crisis. On Point.org. https://www.wbur.org/onpoint/2020/04/14/george-takei-asianamerican-discrimination-coronavirus.
• See LC, Shen YM, Chen CL, et al. (2011). Professional attitude of health care workers toward serving HIV/AIDS patients and drug users: Questionnaire design and evaluation of reliability and validity. AIDS Care.23:1448-1455.
• Siu, J. Y. M. (2008). The SARS-associated stigma of SARS victims in the post-SARS era of Hong Kong. Qualitative Health Research, 18(6), 729–738.
• Stets, J. E. , & Burke, P. J. (2000). Identity theory and social identity theory. Social Psychology Quarterly, 63, 224-237
• Tian, S., Hu, N., Lou, J., Chen, K., Kang, X., Xiang, Z., et al., (2020). Characteristics of COVID-19 infection in Beijing. Journal of Infection, 80 (4), 401–406. https://doi.org/10.1016/j. jinf.2020.02.018.
• Turner, J. C., Hogg, M. A., Oakes, P. J., Reicher, S. D., & Wetherell, M. S. (1987). Rediscovering the social group: A self-categorization theory. Basil Blackwell.
• Xiong, Y., Peng, L., (2020). Focusing on health-care providers’ experiences in the COVID-19 crisis. Lancet Glob. Health 8 (6), e740–741. https://doi.org/10.1016/S2214-109X (20)30214-X.
• World Health Organization WHO, (2020). Positive Tests for Recovered Virus Patients are not Reinfections, WHO Says. https://www.sciencealert.com/those-positive-resultsfrom-recovered-covid-19-patients-weren-t-reinfections-after-all.
• Venables E. ‘Atomic bombs’ in Monrovia, Liberia: the identity and stigmatisation of Ebola survivors. Anthropol Action, 24(2): 36–43.
• Vetter P, Kaiser L, Schibler M, Ciglenecki I, Bausch DG. (2016). Sequelae of Ebola virus disease: the emergency within the emergency. Lancet Infect Dis. 16(6): e82–e91.
• Villa, S., Jaramillo, E., Mangioni, D., Bandera, A., Gori, A., & Raviglione, M. C. (2020). Stigma at the time of the COVİD-19 pandemic. Clin Microbiol Infect, 26(11), 1450-1452. doi:10.1016/j.cmi.2020.08.001
• Yang, L., F. Chen, K. Sia, J. Lam, K. Lam, H. Ngo, S. Lee, A. Kleinman, and B. Good. (2014). What Matters Most:’ A Cultural Mechanism Moderating Structural Vulnerability and Moral Experience of Mental Illness Stigma. Social Science and Medicine 103: 84–93.
• Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatr Scand, 67(6), 361-370. doi:10.1111/j.1600-0447.1983.tb09716.x