Stress and Stigmatization in Health-Care Workers during the COVID-19 Pandemic

Abstract

Background: The health-care workers showed the highest risks of the adverse psychological reactions from the COVID-19 pandemic.

Aim: This study aimed to evaluate the structure and severity of psychological distress and stigmatization in different categories of health-care workers during the COVID-19 pandemic.

Materials and methods: This study included two phases of online survey in 1800 Russian-speaking health-care workers (March 30 - April 5 and May 4 - May 10, 2020). The Psychological Stress Scale (PSM-25) and modified Perceived Devaluation-Discrimination scale (Cronbach's α = 0.74) were used. Dispersion analysis was performed with P = 0.05, Cohen's d, and Cramer's V calculated (effect size [ES]).

Results: The psychological stress levels decreased in the second phase (ES = 0.13), while the stigma levels (ES = 0.33) increased. Physicians experienced more stress compared with nurses and paramedical personnel (ES = 0.34; 0.64), but were less likely to stigmatize SARS-CoV-2-infected individuals (ES = 0.43; 0.41). The increasing probability of contact with infected individuals was associated with higher levels of psychological stress (probable contact ES = 0.48; definite contact ES=0.97). The highest rates of contacts with COVID-19 patients were reported by physicians (χ² = 123.0; P = 0.00, Cramer's V = 0.2), the youngest (ES = 0.5), and less experienced medical workers (ES = 0.33).

Conclusion: Direct contact with coronavirus infection is associated with a significant increase in stress among medical personnel. The pandemic compromises the psychological well-being of the youngest and highly qualified specialists. However, the stigmatizing reactions are not directly associated with the risks of infection and are most prevalent among nurses and paramedical personnel.

Keywords: Anxiety; COVID-19; distress; health-care workers; stigma.

Figure 1

Marital status and number of practiced protection strategies in respondents according to their pandemic's concerns, % (χ² = 99.2, P ≤ 0.05). (1) Divorced, (2) constant partner, (3) widowed, (4) 2 strategies

Figure 2

Education, specialties, and probability of the contact with COVID-19 in respondents according to their number of practiced protective strategies % (χ² = 25.1; 23.4; 12.1, P ≤ 0.05). *<1%, **<2%, (1) incomplete primary education, (2) primary education, (3) incomplete higher, (4) anesthesiology/ICU, (5) epidemiology/infectious diseases, (6) internal medicine/pulmonology/general practitioners, (7) paramedical stuff, (8) contact with COVID-19. ICU – Intensive care unit

Figure 3

Marital status, specialties, probability of the contact with COVID-19, concerns about pandemic, and certain protective stages in respondents according to their tendency of stigmatization, % (χ² = 25.3; 71.9; 52.7; 22.2–34.1; 17–34.8, P ≤ 0.05). *≤1,5%, **≤2,5%, (1) widowed, (2) divorced, (3) constant partner, (4) anesthesiology/ICU, (5) epidemiology/infectious diseases, (6) internal medicine/pulmonology/general practitioners, (7) paramedical stuff, (8) contact with COVID-19. ICU – Intensive care unit

Figure 4

Marital status, specialties, employment, probability of the contact with COVID-19, and concerns about pandemic according to their distress, % (χ² = 29.8; 82.4; 34.3; 91.2; 36.1, P ≤ 0.05). *<1%, **<1,5%, (1) widowed, (2) divorced, (3) students/residents, (4) anesthesiology/ICU, (5) epidemiology/infectious diseases, (6) internal medicine/pulmonology/general practitioners, (7) paramedical stuff, (8) contact with COVID-19, (9) unemployment, (10) private organizations. ICU – Intensive care unit