Main Article Content
stigmatization healthcare professionals, COVID-19, professional identification, professional quality of life
Background and aim: Perceived COVID-19-related stigmatizations have a strong impact on healthcare workers’ wellbeing and quality of professional life, decreasing satisfaction and increasing fatigue. This work aims to investigate the role of professional identification in moderating the impact of COVID-19-related stigma on quality of professional life in a sample of healthcare professionals working in hospital.
Methods: A cross-sectional design in which a web-based questionnaire was sent to professionals was used to collect answers from 174 participants, most of whom women and nurses.
Results: Perceived stigma was negatively related with compassion satisfaction and positively related with an increase in both burnout and secondary traumatic stress. Professional identification had a positive correlation with satisfaction and a negative correlation with burnout, but this was not directly related with secondary traumatic stress. Importantly, stigma and identification interacted so that stigma decreased compassion satisfaction only when identification was low, and increased secondary traumatic stress only when identification was high. No interaction effect appeared with respect to burnout.
Conclusions: Experience of stigmatization has the potential to decrease the quality of professional life of healthcare professionals. Professional identification seems to help professional to maintain higher level of compassion satisfaction and reduced burnout. However, professional identification seems also be associated with vicarious trauma experienced following stigma. (www.actabiomedica.it)
2. He J, He L, Zhou W, Nie X, He M. Discrimination and social exclusion in the outbreak of COVID-19. Int J Environ Res Public Health. 2020;17(8). doi:10.3390/ijerph17082933
3. Bagcchi S. Stigma during the COVID-19 pandemic. Lancet Infect Dis. 2020;20(7):782. doi:10.1016/S1473-3099(20)30498-9
4. Bhanot D, Singh T, Verma SK, Sharad S. Stigma and Discrimination During COVID-19 Pandemic. Front Public Heal. 2021;8. doi:10.3389/fpubh.2020.577018
5. Devi S. COVID-19 exacerbates violence against health workers. Lancet (London, England). 2020;396(10252):658. doi:10.1016/S0140-6736(20)31858-4
6. Taylor S, Landry CA, Rachor GS, Paluszek MM, Asmundson GJG. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic. J Anxiety Disord. 2020;75. doi:10.1016/j.janxdis.2020.102289
7. Dye TD, Alcantara L, Siddiqi S, et al. Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: An analytical cross-sectional global study. BMJ Open. 2020;10(12). doi:10.1136/bmjopen-2020-046620
8. Ransing R, Ramalho R, de Filippis R, et al. Infectious disease outbreak related stigma and discrimination during the COVID-19 pandemic: Drivers, facilitators, manifestations, and outcomes across the world. Brain Behav Immun. 2020;89:555-558. doi:10.1016/j.bbi.2020.07.033
9. Teksin G, Uluyol OB, Onur OS, Teksin MG, Ozdemir HM. Stigma-related factors and their effects on health-care workers during COVID-19 pandemics in Turkey: a multicenter study. SiSli Etfal Hastan Tip Bul / Med Bull Sisli Hosp. 2020;54(3):281-290. doi:10.14744/semb.2020.02800
10. Ramaci T, Barattucci M, Ledda C, Rapisarda V. Social stigma during COVID-19 and its impact on HCWs outcomes. Sustain. 2020;12(9). doi:10.3390/su12093834
11. Haslam SA, Ellemers N. Identity Processes in Organizations. In: Handbook of Identity Theory and Research. Springer New York; 2011:715-744. doi:10.1007/978-1-4419-7988-9_30
12. Ashforth BE, Mael F. Social Identity Theory and the Organization. Acad Manag Rev. 1989;14(1):20-39. doi:10.5465/amr.1989.4278999
13. Tajfel H, Turner J. An integrative theory of inter-group conflict. In: Austin G, Worchel S, eds. The Social Psychology of Intergroup Relations. Monterey, CA: Brooks/Cole; 1979:33-47.
14. Turner JC, Hogg MA, Oakes PJ, Reicher SD, Wetherell MS. Rediscovering the Social Group: A Self-Categorization Theory. Oxford: Blackwell; 1987.
15. Haslam C, Jetten J, Cruwys T, Dingle GA, Haslam SA. The New Psychology of Health: Unlocking the Social Cure. London & New York: Routledge; 2018. doi:10.4324/9781315648569
16. Haslam SA, McMahon C, Cruwys T, Haslam C, Jetten J, Steffens NK. Social cure, what social cure? The propensity to underestimate the importance of social factors for health. Soc Sci Med. 2018;198:14-21. doi:10.1016/j.socscimed.2017.12.020
17. Nie S, Sun C, Wang L, Wang X. The Professional Identity of Nursing Students and Their Intention to Leave the Nursing Profession During the Coronavirus Disease (COVID-19) Pandemic. J Nurs Res. 2021. doi:10.1097/jnr.0000000000000424
18. Elias RZ. The impact of professional commitment and anticipatory socialization on accounting students’ ethical orientation. J Bus Ethics. 2006;68(1):83-90. doi:10.1007/s10551-006-9041-5
19. Caricati L, La Sala R, Marletta G, et al. Work climate, work values and professional commitment as predictors of job satisfaction in nurses. J Nurs Manag. 2014;22(8):984-994. doi:10.1111/jonm.12079
20. Lu H, While AE, Barriball KL. Job satisfaction and its related factors: A questionnaire survey of hospital nurses in Mainland China. Int J Nurs Stud. 2007;44(4):574-588. doi:10.1016/j.ijnurstu.2006.07.007
21. Cruwys T, South EI, Greenaway KH, Haslam SA. Social Identity Reduces Depression by Fostering Positive Attributions. Soc Psychol Personal Sci. 2015;6(1):65-74. doi:10.1177/1948550614543309
22. DeMarco TC, Newheiser AK. When groups do not cure: Group esteem moderates the social cure effect. Eur J Soc Psychol. 2019;49(7):1421-1438. doi:10.1002/ejsp.2594
23. Jetten J, Haslam C, Haslam SA, Dingle G, Jones JM. How groups affect our health and well-being: The path from theory to policy. Soc Issues Policy Rev. 2014;8(1):103-130. doi:10.1111/sipr.12003
24. Leach CW, Mosquera PMR, Vliek MLW, Hirt E. Group Devaluation and Group Identification. J Soc Issues. 2010;66(3):535-552. doi:10.1111/j.1540-4560.2010.01661.x
25. Avanzi L, Schuh SC, Fraccaroli F, van Dick R. Why does organizational identification relate to reduced employee burnout? The mediating influence of social support and collective efficacy. Work Stress. 2015. doi:10.1080/02678373.2015.1004225
26. Caricati L, Panari C, Melleri M. Group identification and self-efficacy associated with quality of life in emergency medical services volunteers: A cross-sectional investigation. J Appl Soc Psychol. 2020;50(8):476-488. doi:10.1111/jasp.12675
27. Major B, Schmader T. Stigma, Social Identity Threat, and Health. In: Major B, Dovidio JF, Link BG, eds. The Oxford Handbook of Stigma, Discrimination, and Health. Oxford: Oxford University Press; 2018:85–103.
28. Eliezer D, Major B, Mendes WB. The costs of caring: Gender identification increases threat following exposure to sexism. J Exp Soc Psychol. 2010. doi:10.1016/j.jesp.2009.09.015
29. Haslam SA, O’Brien A, Jetten J, Vormedal K, Penna S. Taking the strain: Social identity, social support, and the experience of stress. Br J Soc Psychol. 2005;44(3):355-370. doi:10.1348/014466605X37468
30. Stamm BH. The Concise ProQOL Manual (Second Edition).; 2010. http://www.proqol.or.
31. Shoji K, Cieslak R, Smoktunowicz E, Rogala A, Benight CC, Luszczynska A. Associations between job burnout and self-efficacy: A meta-analysis. Anxiety, Stress Coping. 2016;29(4):367-386. doi:10.1080/10615806.2015.1058369
32. Stamm BH. Measuring compassion satisfaction as well as fatigue: Developmental history of the Compassion Satisfaction and Fatigue Test. In: Figley CR, ed. Treating Compassion Fatigue. Psychosocial Stress Series, No. 24. New York, NY, US: Brunner-Routledge; 2002:107-119.
33. Mostafa A, Sabry W, Mostafa NS. COVID-19-related stigmatization among a sample of Egyptian healthcare workers. PLoS One. 2020;15(12 December). doi:10.1371/journal.pone.0244172
34. Prati G, Catufi V, Pietrantoni L. Una verifica del modello dello stress basato sull’identificazione e categorizzazione sociale nei soccorritori. A test of the social identity/self- categorization model of stress among rescue workers. G Ital di Psicol dell’Orientamento. 2014;(14):59-71.
35. Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.
36. Rosseel Y. Lavaan: An R package for structural equation modeling. J Stat Softw. 2012;48. doi:10.18637/jss.v048.i02
37. R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2020.
38. Häusser JA, Junker NM, van Dick R. The how and the when of the social cure: A conceptual model of group- and individual-level mechanisms linking social identity to health and well-being. Eur J Soc Psychol. 2020;50(4):721-732. doi:10.1002/ejsp.2668
39. Sangal RB, Wrzesniewski A, Dibenigno J, et al. Work team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic. BMJ Lead. 2020;0:1-4. doi:10.1136/leader-2020-000331
40. Jetten J, Haslam SA, Cruwys T, Greenaway KH, Haslam C, Steffens NK. Advancing the social identity approach to health and well-being: Progressing the social cure research agenda. Eur J Soc Psychol. 2017;47(7):789-802. doi:10.1002/ejsp.2333
41. Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88(5):879-903. doi:10.1037/0021-9010.88.5.879