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Development of a Scale of COVID-19 Stigma and its Psychometric Properties: A Study of Pregnant Japanese Women

Malik Babikir Badri

The stigma surrounding COVID-19 can adversely affect those who suffer from COVID-19 and those who support and treat COVID-19. To develop and validate a scale for assessing 11-point COVID-19-related stigma. A total of 696 pregnant women with gestational ages of 12 to 15 weeks were interviewed using an online survey using a newly developed scale for COVID-19 stigma and other variables. The internal consistency of the scale was calculated using the omega index. We also examined the measurement invariance of the scale. Exploratory factor analysis (EFA) of scale items was performed using half the sample (n = 350). Confirmatory factor analysis (CFA) of the other half of the samples (n = 346) compared single, two, three, and four-factor structural models derived from EFA. The best model included the following three-factor structure (χ2 / df = 2.718, CFI = 0.960, RMSEA = 0.071) omnidirectional avoidance, attribution avoidance, and hostility. Its internal integrity was excellent (all omega indexes> 0.70). A threefactor structural model revealed composition, measurement, and structural invariance between primiparas and prolific women, and between young women (under 32 years) and older women (32 years and older). Birth fear, maternal-fetal attachment, compulsive symptoms, depression, self-modelling of adult attachment, and borderline personality traits were not significantly correlated with the omnidirectional avoidance subscale, but attribution avoidance. And correlated with hostility subscales (p <0.001). Conclusion: The results suggest that our COVID-19 stigma scale was robust in both its factor structure and the validity of its composition.

Infections can lead to a stigma among the general public. Historically, patients have experienced stigma as a result of being infected with the disease. Currently, researchers and practitioners share concerns about the stigma associated with COVID-19 [1-3]. The stigma of an infectious disease represents an additional burden on the affected patient. In addition, stigmatized people often develop self-stigma, the internalization of external stigma, which leads to reduced self-efficacy and self-esteem of the stigmatized person. Bagcchi reported that people infected with COVID-19 face stigma such as being abandoned by their families and the general public and healthcare professionals face social expulsion and even attacks. This is a phenomenon seen all over the world. Such stigma can confuse effective intervention and even lead to a loss of control over the pandemic. Stigma attitudes can also cause psychological distress to those infected with COVID-19 and those who care for and support them. From an evolutionary psychological point of view, infectious disease stigma has been shown to be adaptable to community survival and protection, but in modern society stigma no longer has such a function [4, 5].