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The Relationship Between Stigma and Social Support to Quality of Life in Indonesia and the Philippines During the COVID-19 Pandemic

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International Perspectives in Psychology
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Rozel S. Balmores-Paulino
Rozel S. Balmores-Paulino
Rozel S. Balmores-Paulino
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Angela Oktavia Suryani
Angela Oktavia Suryani
Angela Oktavia Suryani
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May Zay Hta at Monash University Malaysia
May Zay Hta
Aron Harold G. Pamoso at Australian National University
Aron Harold G. Pamoso
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Abstract and Figures

The importance of quality of life (QoL) was magnified as countries faced the COVID-19 pandemic. This study aimed to determine the relationship between COVID-19-related stigma and preferred social support to QoL in two Southeast Asian countries. This paper examined (1) the differences in the physical and psychological dimensions of QoL (QoL-PSY, QoL-PHL), COVID-19 perceived stigma (PcS) and public stigma (PS), and preferred social support (PSS) between Indonesia (IDN) and the Philippines (PHP); (2) the associations between PS and PcS with QoL; (3) the associations between PSS and QoL; and (4) the role of the country as a moderator between the relationship of PcS and PSS to QoL. Data were collected from 992 participants (PHP = 564; IDN = 428) through an online survey (April–June 2022) and analyzed through multivariate analysis of covariance (MANCOVA), hierarchical multiple regression, and multiple-group path analysis. After controlling for potential covariates, we found significant country differences in QOL and PSS, where Indonesia's estimated means for these two measures were significantly higher than the Philippines. Both domains of PSS had significant positive associations with both QOL domains in the merged sample; similarly, PcS had significant negative associations with both domains of QOL. Path analysis also showed similar significant predictors (PSS and PcS) associated with QoL for both countries with minor coefficient variations, except PS and PSS-ST. The findings show a similar relationship pattern between perceived stigma and social support (strong ties) to the QoL in Indonesia and the Philippines. Cultural interventions to mitigate perceived stigma were suggested in healthcare settings.
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Special Section: Building an Equitable Global Psychology –Giving Voice to Indigenous
Psychology in Southeast Asia
Article
The Relationship Between Stigma
and Social Support to Quality of Life in
Indonesia and the Philippines During
the COVID-19 Pandemic
Rozel S. Balmores-Paulino
1
, Angela Oktavia Suryani
2
, May Kyi Zay Hta
3
,
Aron Harold G. Pamoso
4
, Andrian Liem
5
, and Rachel Sing-Kiat Ting
3
1
Department of Anthropology, Sociology, and Psychology, College of Social Sciences, University of the Philippines Baguio, Benguet,
Philippines
2
Indonesian Psychocultural Consortium, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
3
Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
4
Department of Psychology, School of Arts and Sciences, University of San Carlos, Cebu, Philippines
5
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
Abstract: The importance of quality of life (QoL) was magnified as countries faced the COVID-19 pandemic. This study aimed to determine the
relationship between COVID-19-related stigma and preferred social support to QoL in two S outheast Asian countries. This paper examined (1) the
differences in the physical and psychological dimensions of QoL (QoL-PSY, QoL-PHL), COVID-19 perceived stigma (PcS) and public stigma (PS),
and preferred social support (PSS) between Indonesia (IDN) and the Philippines (PHP); (2) the associations between PS and PcS with QoL; (3) the
associations between PSS and QoL; and (4) the role of the country as a moderator between the relationship of PcS and PSS to QoL. Data were
collected from 992 participants (PHP = 564; IDN = 428) through an online survey (April–June 2022) and analyzed through multivariate analysis of
covariance (MANCOVA), hierarchical multiple regression, and multiple-group path analysis. After controlling for potential covariates, we found
significant country differences in QOL and PSS, where Indonesia’s estimated means for these two measures were significantly higher than the
Philippines. Both domains of PSS had significant positive associations with both QOL domains in the merged sample; similarly, PcS had
significant negative associations with both domains of QOL. Path analysis also showed similar significant predictors (PSS and PcS) associated
with QoL for both countries with minor coefficient variations, except PS and PSS-ST. The findings show a similar relationship pattern between
perceived stigma and social support (strong ties) to the QoL in Indonesia and the Philippines. Cultural interventions to mitigate perceived stigma
were suggested in healthcare settings.
Keywords: COVID-19 pandemic, quality of life, culture, stigma, social support, Southeast Asia
Impact and Implications: Our research findings bridge the gaps in mental health and well-being in two Southeast Asian countries by exploring
how the COVID-19 pandemic and stigma impacted the QoL among Indonesians and Filipinos. These are in line with United Nations Sustainable
Development Goals 3 (good health and well-being) and 10 (reducing inequality). With the provided evidence that Indonesia and the Philippines
have significant differences in their QoL, cultural ecologies should be considered in planning and implementing psychosocial interventions
during a pandemic and beyond.
This paper puts a premium on the cultural context in the
quality of life (Hofstede, 1984), as many studies have
established that culture plays an important role in health
and well-being (Almanza-Munoz & Raplin, 1998). In the
Southeast Asia region, Indonesia and the Philippines are
the two countries with big population sizes and ranked top
on COVID-19 infection and mortality (Center for Strategic
& International Studies, 2021). As of November 2022,
Indonesia recorded 6.6 million cumulative cases and
158,253 cumulative deaths, while the Philippines docu-
mented four million and 64,420 total cases and deaths,
respectively (World Health Organization, 2022). Hence,
our study prioritized these two countries as our target
populations for studying the impact of pandemic stigma.
International Perspectives in Psychology (2023), 12(3), 175–188
https://doi.org/10.1027/2157-3891/a000078
© 2023 Hogrefe Publishing
... This issue concludes with two special section articles. These complete the special issue on Building an Equitable Global Psychology -Giving Voice to Indigenous Psychology in Southeast Asia (issue 2/2023), guest edited bySing-Kiat Ting et al. (2023). Both relate to experiences during the Covid-19 pandemic.Balmores- Paulino et al. (2023) present their work on the relationship between stigma and social support with quality of life in Indonesia and the Philippines, whileUmil et al. (2023) provide an interpretative phenomenological analysis of the mental health of Filipino rural doctors. ...
... ing commonalities despite varying contexts. This issue concludes with two special section articles. These complete the special issue on Building an Equitable Global Psychology -Giving Voice to Indigenous Psychology in Southeast Asia (issue 2/2023), guest edited bySing-Kiat Ting et al. (2023). Both relate to experiences during the Covid-19 pandemic.Balmores- Paulino et al. (2023) present their work on the relationship between stigma and social support with quality of life in Indonesia and the Philippines, whileUmil et al. (2023) provide an interpretative phenomenological analysis of the mental health of Filipino rural doctors. ...
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... Dampak stigma sosial terhadap kesehatan mental para penyintas perempuan sangat mengkhawatirkan. Studi longitudinal yang dilakukan oleh Balmores-Paulino et al. (2023) menunjukkan korelasi yang kuat antara stigma sosial dengan peningkatan tingkat depresi dan kecemasan pada perempuan dengan kanker. Hal ini menciptakan siklus negatif di mana tekanan psikologis yang dialami dapat mempengaruhi kepatuhan terhadap pengobatan dan kualitas hidup secara keseluruhan. ...
Pengaruh stigma sosial terhadap perempuan dengan kanker di Indonesia
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Kanker merupakan salah satu tantangan kesehatan yang signifikan di Indonesia, dengan beban ganda yang dihadapi oleh para penyintas khususnya perempuan yang tidak hanya menghadapi aspek medis tetapi stigma sosial yang melekat padanya. Stigma sosial terhadap perempuan dengan kanker di Indonesia merupakan fenomena kompleks yang berakar pada interseksi antara konstruksi sosial-budaya, nilai-nilai tradisional, dan keterbatasan literasi kesehatan di masyarakat. Manifestasi stigma seringkali muncul dalam berbagai bentuk, mulai dari diskriminasi sosial, isolasi komunitas, hingga internalisasi rasa malu yang dialami oleh para penyintas. Stigma dapat dikategorikan dalam tiga bentuk utama meliputi stigma struktural, stigma publik, stigma internalisasi dan secara global dalam stigma sosial.
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... However, Zay Hta et al. (2023) concluded that there has been limited research on culture and pandemic stigma in Asian countries, especially Southeast Asian regions. The majority of the studies in Asian countries have also focused on the negative impact of COVID-19 perceived stigma, such as the mental health and wellbeing of the individuals (e.g., Balmores-Paulino et al., 2023;Taib et al., 2023;Zhou, 2022). While these studies give an insight into the impact of the COVID-19 stigma, it is also important to understand first how stigma is being perceived and how it originates in different relational contexts. ...
An ecological model of experienced stigma during the COVID-19 pandemic: A qualitative study in Malaysia
Article
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  • CULT PSYCHOL
In this paper, we adopted an ecological model and relational cognition framework to decolonize pandemic stigma in a non-WEIRD society. We reconstructed the concept of pandemic stigma in an ex-colonized and multicultural society of Southeast Asia region, by conducting a qualitative study in Malaysia to explore their lived experiences of differential treatment during the COVID-19 Pandemic from 2020 to 2022. We interviewed 30 Malaysians aged 18–64 of diverse ethnicities (Malays, Chinese, Indians, and other minorities) through online semi-structured sessions and coded the transcripts through consensus thematic analysis. Results showed that the interviewees’ lived experiences of stigma could be conceptualized as negative interactions with multiple systems: (1) Kinship, (2) Companionship, (3) Organizations, (4) Societal (5) Political, as well as (6) Internal systems. We found that interviewees attributed their experiences of stigma to (1) Individual (self) reasons, (2) Impact of close relationships, (3) Impact of casual social interactions, and (4) Impact of cultural-political context. Our findings could be translated into culturally responsive and context-specific interventions, which addressed systemic injustice that exacerbated the global polarization during the pandemic.
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Factors associated with child marriage during the COVID-19 pandemic in Indonesia
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The aim of this study is to investigate factors associated with the applications of child marriage dispensation submitted to the Religious Courts during the COVID-19 pandemic in Indonesia, particularly in 2019–2021. The number of child marriage dispensation cases was analyzed together with other socioeconomic variables, including poverty and jobless rates, junior and senior high school completion rates, number of cerai talak (a divorce initiated by the husband) and cerai gugat (a divorce initiated by the wife) applications, number of COVID-19 positive cases, and number of deaths by COVID-19. The differences between 2021 and 2019 were analyzed using the paired t-test and repeated measures analysis of variance (ANOVA). The relationship between variables was analyzed using the Pearson product-moment correlation coefficient. Hierarchical multiple regression with the entering method was used to determine the predictors of the number of child marriage dispensation cases in the years 2019, 2020, and 2021 and the change from 2019 to 2021. New dispensation underage marriage applications in 2019, 2020, and 2021 were 24,457 (M =843, SD =1519), 63,391 (M = 2186, SD = 4085), and 62,167 (M = 2144, SD = 4058), which were significantly different (F(1.0, 28.6) = 7.63, p = .01) and positively correlated with poverty rate, jobless rate, cerai talak, cerai gugat, COVID-19 positive cases, and COVID-19 death cases. The multiple regression analysis for the change of dispensation underage marriage applications in the pandemic and before (years 2021–2019) was statistically significant, (F(6,22) = 117.62, p < .001), which the final model was able to account for 97% of the variance in new dispensation underage marriage applications. Collaborative multi-sector works are needed to decrease the skyrocketing child marriage numbers, especially in a crisis situation like the COVID-19 pandemic.
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Cross-cultural psychology has come of age as a scientific discipline, but how has it developed? The field has moved from exploratory studies, in which researchers were mainly interested in finding differences in psychological functioning without any clear expectation, to detailed hypothesis tests of theories of cross-cultural differences. This book takes stock of the large number of empirical studies conducted over the last decades to evaluate the current state of the field. Specialists from various domains provide an overview of their area, linking it to the fundamental questions of cross-cultural psychology such as how individuals and their cultures are linked, how the link evolves during development, and what the methodological challenges of the field are. This book will appeal to academic researchers and post-graduates interested in cross-cultural research.
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