Abstract

The stigma surrounding COVID-19 can have detrimental effects on individuals affected by the virus as well as those providing care and support. This study aimed to create and validate a scale for measuring COVID-19-related stigma on an 11-point scale. A cohort of 696 pregnant women, ranging from 12 to 15 weeks gestation, participated in an online survey, which included the newly developed COVID-19 stigma scale along with other relevant variables. The internal consistency of the scale was assessed using the omega index, while measurement invariance was also examined.

Exploratory factor analysis (EFA) was conducted on half of the sample (n = 350) to analyze the scale items, followed by confirmatory factor analysis (CFA) on the remaining half (n = 346). Various structural models, including single, two, three, and four-factor models derived from EFA, were compared in the CFA. The most suitable model comprised three factors: omnidirectional avoidance, attribution avoidance, and hostility, demonstrating good internal consistency (all omega indexes >0.70).

Furthermore, the three-factor structural model exhibited consistency in composition, measurement, and structure across different groups, including primiparas vs. multiparas and younger women (under 32 years) vs. older women (32 years and older). Notably, factors such as birth fear, maternal-fetal attachment, compulsive symptoms, depression, adult attachment styles, and borderline personality traits showed significant correlations with specific subscales of the COVID-19 stigma scale, underscoring its validity.

The findings highlight the robustness of the COVID-19 stigma scale in terms of its factor structure and compositional validity, shedding light on the psychological impact of infectious disease stigma. The study underscores the importance of addressing stigma associated with COVID-19, as it can hinder effective intervention efforts and exacerbate psychological distress among affected individuals and caregivers. Furthermore, it emphasizes the need to evolve societal attitudes towards infectious disease stigma in modern times, recognizing its potential to impede pandemic control efforts.