Associations between COVID-19 related stigma and sleep quality among COVID-19 survivors six months after hospital discharge

Leiwen FU, Bingyi WANG, Paul Shing Fong CHAN, Dan LUO, Weiran ZHENG, Niu JU, Yuqing HU, Xin XIAO, Hui XU, Xue YANG, Yuan FANG, Zhijie XU, Ping CHEN, Jiaoling HE, Hongqiong ZHU, Huiwen TANG, Dixi HUANG, Zhongsi HONG, Xiaojun MA, Yanrong HAOLianying CAI, Jianrong YANG, Jianhui YUAN, Yao-Qing CHEN, Fei XIAO, Zixin WANG, Shupei YE, Huachun ZOU

Research output: Contribution to journalArticlespeer-review

1 Citation (Scopus)

Abstract

Background: Many COVID-19 survivors reported stigmatization after recovery. This study investigated the association between stigma (discrimination experiences, self-stigma and perceived affiliate stigma) and sleep quality among COVID-19 survivors six months after hospital discharge. 

Methods: Participants were recovered adult COVID-19 survivors discharged between February 1 and April 30, 2020. Medical staff of five participating hospitals approached all discharged COVID-19 period during this period. A total of 199 participants completed the telephone interview during July to September, 2020. Structural equation modeling was performed to test the hypothesize that resilience and social support would mediate the associations between stigma and sleep quality. 

Results: The results showed that 10.1% of the participants reported terrible/poor sleep quality, 26.1% reported worse sleep quality in the past week when comparing their current status versus the time before COVID-19. After adjusting for significant background characteristics, participants who had higher number of discrimination experience, perceived stronger self-stigma and stronger perceived affiliate stigma reported poorer sleep quality. Resilience and social support were positively and significantly associated with sleep quality. The indirect effect of self-stigma on sleep quality through social support and resilience was significant and negative. Perceived affiliate stigma also had a significant and negative indirect effect on sleep quality through social support and resilience. 

Conclusions: Various types of stigma after recovery were associated with poor sleep quality among COVID-19 survivors, while social support and resilience were protective factors. Resilience and social support mediated the associations between self-stigma/perceived affiliate stigma and sleep quality. Copyright © 2021 Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)273-281
JournalSleep Medicine
Volume91
Early online dateOct 2021
DOIs
Publication statusPublished - Mar 2022

Citation

Fu, L., Wang, B., Chan, P. S. F., Luo, D., Zheng, W., Ju, N., . . . Zou, H. (2022). Associations between COVID-19 related stigma and sleep quality among COVID-19 survivors six months after hospital discharge. Sleep Medicine, 91, 273-281. doi: 10.1016/j.sleep.2021.10.020

Keywords

  • COVID-19 survivors
  • Sleep quality
  • Stigma
  • Resilience
  • Social support
  • China

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