COVID-19 Courtesy Stigma among Healthcare Providers in India: A Study of Stigma Management Communication and its Impact

In early 2020, the first wave of the COVID-19 pandemic hit India, generating one of the highest rates of infection and death in the world. Meanwhile, healthcare workers experienced stigma and discrimination due to their association with COVID-19 patients. This study analyzed healthcare workers' experience of courtesy stigma in India, the communication strategies they used to manage stigma, and the impact on their mental health. A cross-sectional survey of 150 healthcare workers in India showed that almost 50% experienced discrimination due to their association with COVID-19 patients. Using Confirmatory Factor Analysis and Structural Equation Modeling, this study found that experience of discrimination was associated with perceived courtesy stigma. Two stigma management strategies (reducing offensiveness and passive acceptance) mediated the relationship between perceived courtesy stigma and perceived stress and depression. Participants also reported engaging in stigma management strategies of bonding with other healthcare professionals and passive acceptance of the stigma more than reducing stigma and displaying/disclosing stigma. We conclude that perhaps due to depletion of cognitive and emotional resources, healthcare workers engaged more in social support (bonding) and passive stigma acceptance strategies to alleviate the stress associated with providing COVID-19 patient care. Practical and theoretical implications are further discussed.

Automated summary

This study analyzed the experience of healthcare workers in India who were stigmatized due to their association with COVID-19 patients, their communication strategies to manage stigma, and the impact on their mental health. The findings showed that almost 50% of healthcare workers in India faced discrimination because of their association with COVID-19 patients. The study also found that perceived courtesy stigma was associated with experience of discrimination and that stigma management strategies of reducing offensiveness and passive acceptance mediated the relationship between perceived courtesy stigma and perceived stress and depression. Healthcare workers reported engaging more in strategies of bonding with other healthcare professionals and passive acceptance of the stigma to alleviate stress.