A qualitative descriptive study of stigma and psychological burden among Japanese healthcare workers following COVID-19 infection or close contact

Healthcare workers (HCWs) experienced significant stigma and psychological burden during the COVID-19 pandemic, yet empirical studies exploring Japanese HCWs' experiences remain limited. This qualitative descriptive study examined stigma and psychological burden among HCWs who contracted COVID-19 or were identified as close contacts during the early pandemic period in Japan. Twenty-three paediatric intensive care unit (PICU) HCWs (9 infected and 14 close contacts) participated in semi-structured interviews conducted 6-12 months post-experience. Two categories emerged: (1) COVID-19-related stigma and collective blame in the Japanese context, manifested through blame, labelling, avoidance, and strong disclosure reluctance; (2) profound guilt and professional burden during COVID-19-related leave, including self-reproach, guilt about burdening colleagues and not contributing, transmission fear, and professional responsibility. Both infected and close contact groups experienced multifaceted stigma and guilt, with distinct patterns. Infected individuals faced indirect stigma and intense responsibility for disruption of healthcare provision, while close contacts encountered criticism for mandatory absences perceived as professional negligence and witnessed organisational shame. These manifestations reflected Japanese cultural values of collective responsibility and avoiding burden to others (meiwaku). Our findings illuminate how cultural contexts shape pandemic-related stigma, highlighting the need for culturally informed support strategies that address both universal healthcare challenges and culture-specific manifestations.