Badrfam Rahim, Qorbani Mostafa, Zandifar Atefeh
Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Front Psychiatry. 2022 Nov 3;13:1045683. doi: 10.3389/fpsyt.2022.1045683. eCollection 2022.
Stigma can be seen as a mark of disgrace that can lead to the separation of one person from another. In this qualitative study, we assess the status of stigma among in front-line health care workers (HCWs) during the first wave of the COVID-19 pandemic in Iran.
The participants were selected from frontline HCWs related to COVID-19 in Imam Ali and Imam Hossein referral hospitals in Alborz province, Iran. Study was conducted between May and June 2020. The 32-item checklist Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this qualitative study. Interview questions were prepared based on the grounded theory method. The thematic approach was used to analyze the data content. Data analysis was based on open and axial coding and after implementing the codes in MAXQDA software.
The results of this study included 4 themes, 8 categories and 33 sub-categories. Themes included extrinsic and intrinsic elements of stigma, perplexity and stigma removal requirements. Extrinsic elements included "creating blame and shame" and "discrimination" categories. Intrinsic elements included "the desire to be avoidance," "feeling depressed and frustrated" and "feeling anxious and scared" categories. Perplexity included "feeling loss" category. Stigma removal requirements included "factors causing stigma" and "protective agents against stigma" categories.
Low public awareness on COVID-19 and inadequate public care, limited personal protective equipment and inadequate facilities for HCWs along with lack of appreciation for their efforts, lack of proper psychiatric/psychological counseling to identify and treat symptoms associated with mental health and the limitations of training to maintain mental health skills are considered to be factors in the formation of stigma among HCWs related to COVID-19. Health policymakers should implement coherent strategies related to increasing public awareness and providing personal protection needs and counseling care for HCWs in relation to COVID-19.
耻辱感可被视为一种耻辱的标记，它会导致人与人之间的隔离。在这项定性研究中，我们评估了伊朗新冠疫情第一波期间一线医护人员的耻辱感状况。
参与者选自伊朗阿尔伯兹省伊玛目·阿里和伊玛目·侯赛因转诊医院中与新冠疫情相关的一线医护人员。研究于2020年5月至6月进行。本定性研究采用32项条目的《定性研究报告统一标准》（COREQ）清单进行报告。访谈问题基于扎根理论方法编制。采用主题分析法分析数据内容。数据分析基于开放编码和轴心编码，并在MAXQDA软件中实施编码后进行。
本研究结果包括4个主题、8个类别和33个子类别。主题包括耻辱感的外在和内在因素、困惑以及消除耻辱感的要求。外在因素包括“制造指责和羞耻”和“歧视”类别。内在因素包括“想要回避”、“感到沮丧和挫败”以及“感到焦虑和恐惧”类别。困惑包括“感到失落”类别。消除耻辱感的要求包括“造成耻辱感的因素”和“抵御耻辱感的保护因素”类别。
公众对新冠疫情的认知度低、公共关怀不足、医护人员个人防护装备有限以及设施不足，同时对他们的努力缺乏认可，缺乏识别和治疗心理健康相关症状的适当精神科/心理辅导，以及维持心理健康技能培训的局限性，被认为是与新冠疫情相关的医护人员中形成耻辱感的因素。卫生政策制定者应实施相关连贯策略，以提高公众认知度，并为医护人员提供与新冠疫情相关的个人防护需求和辅导护理。
