2019-nCoV epidemic: address mental health care to empower society

Factors Affecting Fatigue among Nurses during the COVID-19 Pandemic

This study identified clinical nurses' fatigue and related factors during the COVID-19 pandemic. This was a cross-sectional study. Data were collected from South Korean hospitals on 234 nurses' general characteristics, fatigue, depression, occupational stress, insomnia, and perceived daytime sleepiness using a structured questionnaire. The prevalence of fatigue was 62.0%, depression 52.1%, insomnia 20.7%, and daytime sleepiness 36.1%. Insomnia, sleepiness, depression, and occupational stress were significantly associated with fatigue. Ward nurses who cared for COVID-19 patients within the past month had significantly higher occupational stress related to organizational climate than those who had not provided care, and ICU nurses who cared for COVID-19 patients had significantly higher job insecurity-related occupational stress. Nurses have a high prevalence of fatigue and depression during the pandemic. Thus, insomnia, sleepiness, depression, and occupational stress must be reduced to lower nurses' fatigue. Caring for COVID-19 patients was not significantly associated with fatigue, but there were significant differences in occupational stress between nurses who provided such care and those who did not. Work environment-specific strategies are needed to reduce nurses' occupational stress during the pandemic.

Saúde Mental na Pandemia de Covid-19 em um Município Mineiro: Diálogos diante de uma Realidade Global

Introdução: O estudo buscou rastrear a presença de sintomas de ansiedade, depressão e estresse pós-traumático, além de descrever as principais mudanças comportamentais apresentadas por moradores de Juiz de Fora, MG, diante da covid-19. A coleta de dados foi on-line e, para o recrutamento, utilizou-se a técnica da “bola de neve”. Método: Participaram 897 sujeitos que responderam a um questionário sociodemográfico e comportamental; Escala Hospitalar de Ansiedade e Depressão; e Instrumento de Rastreio para Sintomas de Estresse Pós-Traumático (SPTSS). Resultados: indicaram mudanças comportamentais e de humor expressivas, como: percepção de estar infectado, mesmo estando saudável, maior uso de álcool que o habitual, medo, irritabilidade, ansiedade e tristeza. Os instrumentos de rastreamento evidenciaram também a presença de sintomas de ansiedade (53,4%), depressão (93,4%) e estresse pós-traumático (43,1%). Discussão/Conclusão: Apresenta-se um recorte local, contudo, os dados apresentam consonância com a comunidade científica quanto ao sofrimento psíquico na pandemia da covid-19.

Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

The COVID-19 pandemic is associated with an increased prevalence of mental health problems and addictive behaviors. There is a growing theoretical and empirical evidence that individual differences in interoceptive anxiety-related processes are a one set of vulnerability factors that are important in understanding the impact of pandemic-related mental health problems and addictive behavior. However, there has not been a comprehensive effort to explore this rapidly growing body of research and its implications for public health. In this paper, we discuss why interoceptive anxiety-related processes are relevant to understanding mental health and addictive behaviors during the COVID-19 pandemic. We then provide a narrative review of the available COVID-19 literature linking interoceptive fear and anxiety-related processes (e.g., anxiety sensitivity, health anxiety, and COVID-19 anxiety, fear, and worry) to mental health and addictive behaviors. We then propose a novel transdiagnostic theoretical model that highlights the role of interoceptive anxiety-related processes in mental health and addictive behavior in the context of the present and future pandemics. In the final section, we utilize this conceptualization to underscore clinical implications and provide guidance for future research initiatives in the management of COVID-19 mental health and addictive behaviors and inform the public health field for future pandemics.

Sleep Quality and Mental Health Consequences of COVID-19 Pandemic in the Aviation Community in Greece

OBJECTIVE

The aim of this study was to assess the mental health and sleep quality of aviation workers in Greece during the pandemic.

METHODS

A cross-sectional study of aviation workers in Greece was conducted.

RESULTS

Sleep disturbances were observed in 25.4% of our 548 participants, whereas 8.2% and 5.8% reported at least mild depressive and anxiety symptoms, respectively. The impact of the pandemic on their mental health was their primary concern, which increased for many active pilots according to their workload. Those infected mainly faced daily tiredness and fatigue. Smoking habits and high body mass index were a predisposition for more physical symptoms. Cabin crew and women generally yielded worse scores than the other groups.

CONCLUSION

Fear of infection could explain mental health issues, whereas physical symptoms of those infected could be attributed to long-COVID (coronavirus disease) syndrome. Flight attendants' lower ratings may be due to more occupational exposure.

Please Scream Inside Your Heart: Compounded Loss and Coping during the COVID-19 Pandemic

Individuals are experiencing unprecedented personal challenges as a result of the novel COVID-19 virus. Stay at home orders and social distancing guidelines were in place, which has had a direct effect on American lives: forcing the cancellation of events, ending in-person school or childcare, forcing remote work environments, and leading to drastic changes to recreational activities. All these life changes can be experienced as losses that lead to real grief. However, grieving in the time of COVID-19 is fraught with unique challenges. This study recruited 257 participants from across North America to participate in an online survey investigating the types of losses experienced due to COVID-19, feelings of guilt and delegitimization, communal coping, and general coping behaviors. Results indicate that people experienced various losses during the COVID-19 pandemic, many of which were compounded and varying in degrees of intensity (e.g., loss of a loved one, loss of a job, loss of physical activity routine). Because of these differences in intensity, people felt guilty for grieving over their losses, and subsequently were less likely to appraise the losses as communal and more likely to utilize avoidant coping mechanisms on their own. The theoretical and public health implications of the study are discussed.

Posttraumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic

BACKGROUND

Coronavirus disease 2019 (COVID-19) has taken a significant toll on people worldwide, and in particular, on the health care workers (HCWs) who have worked on the frontlines in the fight against the pandemic. The goal of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and related factors in HCWs in the era of COVID-19.

METHODS

This cross-sectional survey study was conducted between September 15, and October 15, 2020, among HCWs in Turkey. The survey consisted of self-administered questionnaires, which included questions about sociodemographic variables, experiences caring for patients with COVID-19, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a trauma screening tool. The online survey was completed by 1833 HCWs. Univariate and multivariate logistic regression analyses were used to identify independent predictors of PTSD.

RESULTS

The mean age of the participants was 32.7±7.0 years; 81.9% were physicians, and 56.5% were female. The rates of COVID-19 history in the respondents, a family member, or a coworker were 13.6%, 32.3%, and 12.6%, respectively. Among the HCWs who participated, 39.9% met the criteria for PTSD. Compared with the physicians, the nonphysician HCWs had a higher rate of PTSD (49.5% vs. 36%) (P<0.001) and higher PCL-5 scores (53.31±19.6 vs. 42.5±20.3) (P<0.001). In addition, 9.7% of the surveyed HCWs reported having suicidal ideation during the COVID-19 pandemic. Independent predictors of PTSD in HCWs were working on a COVID-19 unit, feeling isolated, suicidal ideation, being a nonphysician HCW, fear of spreading coronavirus to family, female sex, and a history of having COVID-19.

CONCLUSIONS

HCWs were at risk for impairment in mental well-being in the era of COVID-19, with a significant number experiencing PTSD as well as suicidal ideation. Therefore, HCWs, especially those who are working on a COVID-19 unit and are female, should be monitored regularly for PTSD.

Teachers' occupational well-being during the COVID-19 pandemic: The role of resources and demands

During the COVID-19 pandemic, teachers suddenly faced multiple challenges related to closed schools and remote teaching. This study investigated teachers' occupational well-being (stress, exhaustion, job satisfaction) and its relation to job resources (e.g., support from colleagues), job demands (e.g., technical difficulties), and personal resources (e.g., self-efficacy with digital media). 3250 teachers (82.8% female, M age = 40.16) throughout Germany answered an online survey on resources, demands, and occupational well-being. The resource support from colleagues was particularly positively related to job satisfaction and negatively to stress and exhaustion. The results pattern remained mostly stable after including personal resources in the model.

Perceived stress and its impact on the health behavior of Chinese residents during the COVID-19 epidemic: An Internet-based cross-sectional survey

Background and Aims

The novel coronavirus disease 2019 (COVID-19) causes severe respiratory illnesses, following exposure to air-borne droplets or direct contact, posing a great threat to human life. This study aimed to investigate perceived stress and its correlation with the health behaviors of Chinese residents during the COVID-19 epidemic.

Methods

An Internet survey was conducted among 2449 residents in 20 provinces of China on residents' perceived stress, perception of COVID-19, and health behaviors. SAS 9.4 was used to analyze the relationship between health behaviors and perceived stress, and logistic regression was used to explore the factors influencing health risk stress.

Results

The participants' perceived stress score was 22.25 ± 7.2 (total 56), and the incidence of health risk stress was 39.89% (977/2449). Females, students, and medical staff were at high risk. Health risk stress refers to a level of stress that is hazardous to health (score over 25). Perceived stress increased, while the frequency of health behaviors decreased. Age, perception of susceptibility to COVID-19, life-threatening level of COVID-19, perception of the importance of home isolation, and perception of the difference between a common cold and COVID-19 were positively related to the occurrence of health risk stress.

Conclusions

A negative correlation was found between health behaviors and perceived stress. Therefore, it is of great significance to provide psychological interventions for those who are experiencing health risk stress and to promote their health behaviors.

Use of Digital Technologies in Home Office Work during the COVID-19 Pandemic

Background

Social distancing as a preventive measure to contain the spread of the COVID-19 pandemic has resulted in many people working from home, using online digital resources. Staying at home has led to the adaptation of many work activities to allow continuity of people´s jobs. It can also affect home routines and ways of working, thereby leading to changes in behavior, as the main interest of this study.

Objective

The study aimed to assess the impact on human behavior of working conditions in home office format due to social distancing.

Methods

Data collection was done online, using a specific computational tool (Google Forms) for this type of research, using the Home Office Work Scale (HOWS) validated and published in Mental Health and Addiction Research in 2021, with a total sample of 1,056 valid questionnaires. After the data collection, a database was created for statistical analysis of the results.

Results

More women than men volunteered to answer the questionnaire, although the results were similar between women and men. Home office work has impacts on human behavior and results in changes in routines and adaptations in people´s personal and professional lives.

Conclusion

Proportionally, more women participated, and there was low participation by young and elderly people. In general, people accepted home office work and the possibility of continuing to work in this format. Changes to routines and restrictive adaptations were necessary. The limitations reported for applying the scale did not compromise the results.

A Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19

BACKGROUND

The purpose of this study is to explore and categorize changes in depression, and investigate the relationship between suicidal ideations before and after the COVID-19 pandemic.

METHODS

In this study, data from the Korea Welfare Panel Study (KoWePS) was used and included 8692 adults, 19 years of age or older, who could estimate the change in depression from 2017 (12th) to 2021 (16th) for final analysis. Depression change was classified into two types, 'low-level ascending' type (n = 7809, 80.9%), and 'increasing after reduction' type (n = 883, 10.2%). The Firth Method was used to examine the relationship between depression change types and suicidal ideation.

RESULTS

The lower the equivalized annual income and the lower the educational level, and the likelihood of belonging to the 'increasing after reduction' type, compared to the 'low-level ascending' type, the greater the probability of having suicidal ideation.

CONCLUSION

The significant impact of socioeconomic status (income and educational background) on suicidal ideation indicates the need to consider how epidemics affect inequality in society. This study is expected to provide a deeper understanding of depression, as well as to establish a foundation for long-term prevention of the rapid increase in suicide rates after COVID-19.

Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight gain and increases in glycemia, ALT and intrahepatic fat content post lockdown. Participants with worsened liver status had low consumption of fibre, cheese, nuts and coffee, and high consumption of sweets and pastries. Participants who improved liver status ameliorated ALT values, waist circumference, and intrahepatic fat content, assessed by magnetic resonance imaging post-lockdown. Conclusions: The maintenance of healthy lifestyle habits is vital, especially for populations with NAFLD and MetS, to reduce unhealthy lifestyle patterns displayed during lockdown.

Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19

BACKGROUND

In the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact of sporadic cases of COVID-19 and isolation measures on mental health and sleep in different groups of people need to be analyzed.

AIM

To clarify the severity of psychological problems and insomnia of staff and community residents around a hospital with sporadic cases of COVID-19, and their relationship with quarantine location and long-term changes.

METHODS

A cross-sectional survey was conducted on community residents and medical staff. Many of these medical staff had been subjected to different places of quarantine. Community residents did not experience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale (ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acute stress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-year follow-up study on medical staff, with related scales measurement immediately after and one year after the 2-wk quarantine period.

RESULTS

We included 406 medical staff and 226 community residents. The total scores of ISI and subscale in HADS of community residents were significantly higher than that of medical staff. Further analysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels, 70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scores above normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logistic regression analysis found that subjects with higher total ASDS scores had a greater risk to develop anxiety and depression. The total ISI score for medical staff in hotel quarantine was significantly higher than those in home quarantine. Total 199 doctors and nurses who completed the 1-year follow-up study. Compared with baseline, HADS and ASDS scores decreased significantly one year after the end of quarantine, while ISI scores did not change significantly.

CONCLUSION

Sporadic COVID-19 cases had a greater psychological impact on residents in surrounding communities, mainly manifested as insomnia and depressive symptoms. Hotel quarantine aggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.

Cross-Sectional Study of Factors Influencing Perceived Threat and Stress among the Arab Minority in Israel during the COVID-19 Pandemic

This study aimed to examine the impact of the locus of control, coping strategies and loneliness on perceived threat and stress among the Arab minority in Israel during the first COVID-19 closure. This was a cross-sectional online study, with 486 participants who completed a questionnaire measuring the study variables during the period of 28-31 March 2020. Statistical analyses included t-tests and analyses of variance. Means, standard deviations and intercorrelations for the study variables were calculated. The results revealed a moderate-low level of stress and a moderate-high level of perceived threat. Higher stress was related to higher perceived threat, a greater external locus of control, lower problem-focused coping, higher emotion-focused coping and social support-seeking and higher loneliness. Perceived threat was positively related to both problem-focused coping and emotion-focused coping. The results show that the Arab population in Israel coped as a strong minority group. This study contributes to our understanding of how minority groups cope in the current epidemic and to the identification of effective strategies for reducing stress during this challenging period. The study's results may help devise intervention programs that foster more effective coping capabilities among this and other minority populations.

Development and Validation of a New COVID-19 Anxiety Scale (NCAS)

The study aimed to develop and validate a new coronavirus disease (COVID-19) anxiety scale. Three independent studies were done to achieve the stated aim of the research. Study 1 explored the factor structure of the scale. Study 2 aimed at confirming the factor structure and establishing test–retest reliability of NCAS. Study 3 aimed to test the incremental validity of the new scale over two most widely used scale (FCV-19S & CAS). EFA resulted in a three-dimensional factor structure with 4, 3, 5 items in ‘anxiety pertaining to threat posed by COVID-19’, ‘Anxiety pertained to public policies’ and ‘Anxiety pertaining to societal consequences’ respectively. CFA confirmed the findings of EFA and a higher order of ‘COVID-19 anxiety’ was also established. The test–retest reliability was found to be 0.91. NCAS shared 48% variance with FCV-19S (fear of COVID-19 scale) and 27% with CAS (Coronavirus anxiety scale). NCAS has significant incremental validity over FCV-19S and CAS in predicting self-reported mental health and life satisfaction. The scale would help in identifying people’s specific anxiety related to COVID-19, which would further help in their intervention/treatment.

Public health events emergency management supervision strategy considering citizens’ and new media’s different ways of participation

Public health events have done great harm. Emergency management requires the joint participation of multiple parties including government department, pharmaceutical enterprises, citizens and new media. Then, what are the effects of different strategy choices in participation of citizens and new media on emergency management? To answer the question, we construct a four-party evolutionary game model, considering the citizens' two participation ways consisted of true evaluation and false evaluation, and the new media's two participation ways consisted of report after verification and report without verification. This is of more practical significance than simply studying whether citizens and new media participate in emergency management or not because citizen and new media participation does not represent the completely positive behavior. Then, we conduct the evolutionary stability analysis, solve the stable equilibrium points using the Lyapunov first method and conduct the simulation analysis with MATLAB 2020b. The results show that, firstly, the greater the probability of citizens making true evaluation, the more inclined the government department is to strictly implement the emergency management system; secondly, when the probability of citizens making true evaluation decreases, new media are more inclined to report after verification, and when new media lose more pageview value or should be punished more for reporting without verification, the probability that they report without verification is smaller; thirdly, the greater the probability of citizens making false evaluation, the less enthusiasm of pharmaceutical enterprises to participate in emergency management, which indicates that false evaluation is detrimental to prompt pharmaceutical enterprises to participate; what's more, the greater the probability of new media reporting after verification, the greater the probability of pharmaceutical enterprises actively participating, which shows that new media's verification to citizens' evaluation is beneficial to emergency management.

The Higher the CKD Stage, the Higher the Psychological Stress in Patients with CKD during COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic is related to psychological distress. Such distress depends on various factors. We previously reported that hemodialysis patients have more psychological distress than peritoneal dialysis patients among patients on dialysis in the COVID-19 pandemic era. However, no study has reported how psychological distress related to the COVID-19 pandemic depends on renal function in the entire group of chronic kidney disease (CKD) patients. Therefore, the objective of this study was to investigate psychological distress and concerns related to COVID-19 according to CKD stage. This was a cross-sectional study that included 397 CKD patients who visited a hospital from August 2020 to November 2020. Patients responded to questionnaires covering depression (9-item Patient Health Questionnaire, PHQ-9), anxiety (7-item Generalized Anxiety Disorder, GAD-7), psychological impact of event (22-item Impact of Event Scale-Revised, IES-R), insomnia (7-item Insomnia severity Index, ISI), concerns, and precautionary measures about COVID-19. According to eGFR and dialysis status, patients were divided into three groups: (1) patients with CKD stage 1~2, (2) patients with CKD stage 3~5 without dialysis, and (3) dialysis patients. The higher the CKD stage, the higher the GAD-7 (p = 0.009) and the ISI score (p = 0.001). When patients with CKD stage 1~2 and CKD stage 3~5 (with or without dialysis) were compared, PHQ-9 (p = 0.026), GAD-7 (p = 0.010), and ISI score (p = 0.002) were higher in the CKD stage 3~5 group. However, when comparing those with and without dialysis, only the ISI score (p = 0.008) showed a significant difference. More severe kidney dysfunction in CKD patients was associated with more psychological distress during the COVID-19 pandemic. Therefore, as CKD stage increases, more attention should be paid to the mental care of these patients.

Association between Sleep Quality and Depression Symptoms in Chinese College Students during the COVID-19 Lockdown Period

Background: The outbreak of COVID-19 has seriously threatened the health of people around the world. To prevent the spread of the epidemic, Chinese universities have implemented closed management of campuses. The implementation of restrictive measures has gradually caused changes in the quality of sleep and the psychological state of college students. In addition, college students are faced with the dual pressure of employment and study, and the psychological pressure is huge. Therefore, it is necessary to investigate sleep and depressive symptoms among college students. Methods: Using the method of stratified cluster sampling, 6695 college students were selected from three universities in Jiangxi, Anhui, and Xinjiang provinces from April to May 2022. The Chinese version of the Pittsburgh sleep quality index (PSQI) and the self-rating depression scale (SDS) were used for the survey. Hierarchical logistic regression analysis was used to analyze the relationship between the PSQI and the SDS. Results: Overall, during the outbreak of COVID-19, 69.0% of males and 73.5% of females had poor sleep quality among Chinese college students and the detection rate of depressive symptoms was 43.6% for males and 47.8% for females, respectively. Taking students with good sleep quality as references, after controlling for covariates, hierarchical logistic regression shows that Chinese college students with poor sleep quality have a higher OR value (OR = 12.0, 95%CI: 10.2~14.1, p < 0.001), especially in males (OR = 43.8, 95%CI:30.2~63.6, p < 0.001). For both males and females, the OR value of college students with the following characteristics was higher: rural college students (males, OR = 50.32, 95%CI: 32.50−77.93; females, OR = 8.03, 95%CI: 6.45−9.99), overweight college students (males, OR = 62.17, 95%CI: 19.47−198.53; females, OR = 16.67, 95%CI: 6.48−42.88), and college students drinking sugar-sweetened beverages (males, OR = 59.00, 95%CI: 36.96−94.18; females, OR = 8.16, 95%CI: 6.63−10.05) (p < 0.001). Conclusions: Poor sleep quality is associated with depressive symptoms among Chinese college students, especially college males. Our research suggests that it is necessary to consider the improvement of sleep quality and depressive symptoms among college students during the COVID-19 epidemic.

Psychological Distress among Hospitalized COVID-19 Patients in Denmark during the First 12 Months of the Pandemic

This study aimed to investigate psychological distress among patients hospitalized with a COVID-19 diagnosis in Denmark during the first 12 months of the pandemic and to assess changes in psychological distress in the three months following discharge. A single-center prospective observational survey study among patients hospitalized with a COVID-19 diagnosis between May 2020 and May 2021 was conducted. Participants completed a survey at three time points: at admission, and 1 and 3 months after discharge. Psychological distress was assessed by validated scales measuring symptoms related to depression, anxiety, stress, insomnia, post-traumatic stress disorder (PTSD), and health-related quality of life (HRQoL). In total, 95 patients were included. At admission, the proportion of patients with symptoms of depression was 43%, symptoms of anxiety 32%, moderate/high level of stress 39%, insomnia 52%, and probable/positive PTSD 19%. The burden of symptoms related to depression and anxiety decreased significantly over time, while there was no significant change over time in stress, insomnia, or PTSD. Suboptimal levels of physical and mental HRQoL were detected at admission but improved over time. Patients hospitalized due to COVID-19 during the first year of the pandemic experienced considerable levels of psychological distress at admission, with some improvements within 3 months after discharge.

Psychological effects and associated factors among vaccinated and unvaccinated general population against COVID-19 infection in Bangladesh

Background

The global effort to develop herd immunity in the general public against the COVID-19 pandemic is currently ongoing. However, to the best of our knowledge, there have been no studies on how the COVID-19 vaccine affects mental health in the context of the COVID-19 pandemic in Bangladesh. The present study investigated the psychological effects and associated factors among vaccinated and unvaccinated general populations against COVID-19 infection in Bangladesh.

Methods

A nationwide online cross-sectional survey was conducted in Bangladesh from June 23 to December 25, 2021. The frequency of symptoms of psychological distress, depression, anxiety, stress, post-traumatic stress disorder (PTSD), insomnia, and fear was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and FCV-19S scales, respectively.

Results

The study included 3,013 persons from all eight divisions of Bangladesh, with 1,272 (42.2%) being vaccinated and 1,741 (57.8%) being unvaccinated. Compared with unvaccinated populations, vaccinated populations had significantly lower prevalence rates of psychological distress (36.4 vs. 51.5%), depression (21.1 vs. 37.9%), anxiety (25.1 vs. 44.9%), stress (19.4 vs. 30.4%), PTSD (29.4 vs. 38.3%), insomnia (18.7 vs. 39.4%), and fear symptoms (16.1 vs. 27.5%). Among vaccinated populations, respondents who lived in nuclear families were significantly associated with higher risk of psychological distress (AOR, 1.38; 95% CI, 1.09-1.78), depression (AOR, 1.49; 95% CI, 1.11-1.98), anxiety (AOR, 1.77; 95% CI, 1.21-1.98), and fear (AOR, 1.43; 95% CI, 1.11-1.83) symptoms. Participants who lost family members, friends, or colleagues due to the COVID-19 pandemic had significantly higher risk of symptoms of psychological distress (AOR, 1.35; 95% CI, 1.02-1.79), anxiety (AOR, 1.41; 95% CI, 1.11-1.87), and PTSD (AOR, 1.76; 95% CI, 1.24-2.19). On the other hand, unvaccinated populations who lived in the Dhaka division were significantly associated with an increased risk of depression (AOR, 2.06; 95% CI, 1.40-2.52), anxiety (AOR, 1.86; 95% CI, 1.15-2.47), stress (AOR, 1.92; 95% CI, 1.12-2.88), and insomnia (AOR, 1.88; 95% CI, 1.20-2.94) symptoms. Except for PTSD and fear symptoms, unemployed participants had considerably higher rates of psychological distress, depression, anxiety, stress, and insomnia symptoms (e.g., psychological distress: AOR, 1.83; 95% CI, 1.10-2.62; depression: AOR, 1.74; 95% CI, 1.37-2.19).

Conclusions

This study recommends immunizing unvaccinated populations as soon as possible to prevent infection and boost mental health. Vulnerable people needed special care, health-related education, and psychological assistance.

Activity system, schizotypal personality, and mentalization: A study between halted activity and COVID-19 conducted in Henan, China

The pandemic-related lifestyle has potentially imposed crucial disturbances on daily and long-term activities, which, in turn, were associated with thought disturbance. This study investigates how the characteristics of the activity system during pandemic-related restrictions are associated with other psychomental aspects. By focusing on PTSD, mentalization, and schizotypal personality, and by inquiring about the main components of the activity system of 852 college students (Zhengzhou, Henan, China)- including the goals orienting their activity, goals' terms and types, the motivation levels and sources, the activity type and engagement time, the flow of the activity, and how due to pandemic lifestyle-results revealed that the activity system's components have significant associations with PTSD, reflective function, and schizotypal traits. Additionally, some of the activity system's elements have a significant predictive role regarding schizotypal traits. The study considered that the life narrative during the pandemic has been disturbed; hence, this may have a crucial effect on mind coherence. Additionally, the outcomes from the pandemic context will support mental health interventions in other similar contexts where the life narrative is severely affected.

Influence of information attributes on information dissemination in public health emergencies

When public health emergencies occur, relevant information containing different topics, sentiments, and emotions spread rapidly on social media. From the cognitive and emotional dimensions, this paper explores the relationship between information attributes and information dissemination behavior. At the same time, the moderating role of the media factor (user influence) and the time factor (life cycle) in information attributes and information transmission is also discussed. The results confirm differences in the spread of posts under different topic types, sentiment types, and emotion types on social media. At the same time, the study also found that posts published by users with a high number of followers and users of a media type are more likely to spread on social media. In addition, the study also found that posts with different information attributes are easier to spread on social media during the outbreak and recurrence periods. The driving effect of life cycles is more obvious, especially for topics of prayer and fact, negative sentiment, emotions of fear, and anger. Relevant findings have specific contributions to the information governance of public opinion, the development of social media theory, and the maintenance of network order, which can further weaken the negative impact of information epidemic in the occurrence of public health emergencies, maintain normal social order, and thus create favorable conditions for the further promotion of global recovery.

The “Mask Effect” of the Emotional Factor in Nurses’ Adaptability to Change: Mental Health in a COVID-19 Setting

During healthcare catastrophes, such as the current COVID-19 pandemic, nurses are exposed to highly stressful situations derived from their work and personal activity. Development of coping strategies for such situations can improve nurses’ physical and mental health. This study analyzed nurses’ adaptability to change, with attention to socio-demographic variables in a COVID-19 setting, and identified the repercussions on their health. This quantitative, observational and cross-sectional study had a sample of 351 nurses aged 22 to 64 with a mean age of 40.91 (SD = 10.98). The instruments used for the study were the ADAPTA-10 questionnaire and the General Health Questionnaire (GHQ-28). It was observed that age, sex, and having a stable partner significantly influenced scores on the emotional, cognitive–behavioral, and adaptation to change factors. Finally, the emotional factor mediated between positive COVID-19 in someone close and the presence of health problems. Understanding the elements that help adapt better to change and adversity enable effective interventions to be developed for improving emotional health of nurses, especially for those in whom there are positive cases of COVID-19 in their personal or work environment.

Cross-cultural validity of the Death Reflection Scale during the COVID-19 pandemic

Background

The global COVID-19 pandemic confronts people with their fragility, vulnerability, and mortality. To date, scales to measure death awareness mainly focus on the anxiety-provoking aspect of mortality cues. This study aims to cross-culturally adapt and validate the Death Reflection Scale (DRS), a scale for measuring positive, growth-oriented cognitions of life reflection and prosocial behavior following confrontation with the finiteness of life.

Materials and Methods

The Death Reflection Scale was translated and adapted in a multi-step process to the German language. In this anonymous, cross-sectional, online survey at a large university in Germany, students, healthcare professionals (HCP) and other staff completed the DRS alongside comparison measures. Multi-group confirmatory factor analysis was used to assess configural, metric, and scalar measurement equivalence across four age and occupational groups. Convergent/divergent validity testing was done via Spearman correlations.

Results

1,703 participants provided data for a response rate of ∼5%. 24% of respondents were HCP, 22% students. Confirmatory factor analysis showed a higher-order structure of the DRS with a strong general factor and the originally proposed five subscales (CFI 0.945, SRMR 0.045, RMSEA 0.055). Multi-group CFA showed partial metric equivalence across age groups and partial scalar invariance across occupational groups. Non-invariant scales were the Motivation to live, Putting life into perspective, and Legacy subscales. In the convergent validity testing, two hypotheses were fully confirmed, two partially and four were not confirmed. Experiencing a propensity for increased contemplation and life reflection during the pandemic together with spirituality showed correlations of moderate to large size to the DRS and its subscales (Spearman’s rho ranging from 0.31 to 0.52).

Conclusion

Further conceptual work for death awareness to explore the construct’s stability in different population groups needs to be undertaken. However, the DRS can be mostly used to assess positive and growth-oriented aspects of death awareness and death reflection which may be an important avenue when developing counseling and support interventions for groups experiencing a high burden during the pandemic.

Exposure to COVID-19-related media content and mental health during the initial outbreak of COVID-19 in China

Exposure to disaster-related media content is closely related to mental health. This study aimed to explore the patterns of COVID-19-related media exposure and examine whether these patterns were associated with mental health. In total, 917 participants in this study completed the Media Exposure Questionnaire (MEQ), the Positive and Negative Affect Scale (PANAS), and the Depression Anxiety Stress Scale (DASS-21). Then latent class analysis and discriminant analysis were conducted to identify the patterns of media exposure. Finally, we tested how mental health was associated with such patterns. Four subtypes of media exposure were identified: the slightly exposed group, the lower-moderately exposed group, the higher-moderately exposed group, and the heavily exposed group. And there were significant differences in individuals' levels of positive and negative affect among different subtypes, but no difference in depression, anxiety, and stress. The results of the current study indicated that more COVID-19-related media exposure was related to increased positive and negative affect. And the current findings would help people to better understand the relationships between media exposure and mental health during a pandemic.

Psychological impacts of COVID-19 pandemic in cancer patients on active treatment

Introduction

Although cancer patients have a high risk of exposing COVID-19 and developing severe complications, they have to receive active treatment. We aimed to determine the psychological conditions of cancer patients and shed light on the establishment of early psychological intervention and intervention policies by making specific recommendations.

Method

We consecutively evaluated 385 cancer patients under treatment. Post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, stress, and associated sociodemographic/clinical characteristics were investigated. In addition, we applied depression-anxiety-stress-scale-21 (DASS-21) for the mental states of patients and Impact of Event-Scale-Revised (IES-R) for the psychological effects of Covid-19.

Results

The mean age was 58 (18-88). 47.2% were psychologically distressful per DASS-21, and 39.3% were traumatic per IES-R scores. 71.9% stated the risk of getting COVID-19 was high since they had cancer, and 82% stated serious complications would develop if they had COVID-19 infection. Patients diagnosed for more than one year were more stressed, anxious, and depressive (p-value = 0.001,0.003,0.049, respectively). Singles were more stressed, depressed, and traumatized than couples (p-value = 0.001, 0.011, 0.001). In multivariate analysis, a significant correlation with being under psychiatric treatment before the pandemic was found for depression (OR: 3.743, 95 %CI: 1.790-7.827) anxiety (OR: 3.776-95 %CI: 1.945-7.332) and stress levels (OR: 4.129, 95 %CI: 1.728-9.866). Having relatives who died or received treatment for COVID-19(OR: 0.515,0.296-0.895) and being unmarried (OR: 2.445-95% CI: 1.260-4.747) predicts PTSD development.

Conclusions

When the psychological effects of the COVID-19 pandemic are manifesting strongly, cancer patients' anxiety and exposure levels are high. It is of great importance that clinicians understand needs, recognize psychological distress, and direct them to relevant departments for supportive care.

Stress and perceived discrimination among the Arab population in Israel: the mediation role of the perceived COVID-19 threat and trust in the healthcare system

During pandemics, minorities may experience high stress levels, which could harm their mental and physical health. However, to the best of our knowledge, this has not been examined among minorities in Israel during the COVID-19 pandemic. This study, therefore, explores stress among the Arab minority in Israel during the first wave of the COVID-19 outbreak, and its association with the population's perceived COVID-19 threat, trust in the healthcare system, adherence to preventative guidelines, and perceived discrimination.The study analyzed a cross-sectional online survey of 626 Israeli Arabs. Most participants (65%) reported moderate levels of stress, and 10% reported severe levels. The Bedouin population reported significantly higher levels of stress compared to other minority groups. The participants also reported a high degree of perceived threat, a moderate-to-high level of discrimination, a moderate level of trust in the healthcare system, and very high adherence to guidelines.Hierarchical regression analysis showed that age, religion, trust in the healthcare system, perceived threat, and adherence to guidelines were all significant predictors of stress [F(11,600), p < .001]. The model explained 24% of the variance in stress. Structural equation modeling (SEM) revealed that the participants' perceived threat and trust mediated the association between their perceived discrimination and stress [indirect effect = 0.13, SE = 0.03 CI = (0.08, 0.18)], whereby discrimination was negatively associated with trust (β = -0.52), which, in turn, was negatively associated with stress (β = -0.10). Furthermore, discrimination was positively associated with perceived threat (β = 0.21), which, in turn, was positively associated with stress (β = 0.35). Discrimination is an important social determinant of health - especially during health emergencies when trust in healthcare systems and perceived threats are crucial. As such, our findings could assist policymakers in developing fair policies that are tailored to various population groups and that may reduce stress levels among minorities, thereby improving both their mental and physical health.

The effect of the COVID-19 social distancing measures on Turkish women's mental well-being and burnout levels: A cross-sectional study

Lockdown and social distancing measures during the COVID-19 pandemic increase women's responsibilities and influence their mental health. This study aimed to assess the effect of COVID-19 social distancing measures on mental well-being and burnout levels of women using an online cross-sectional survey in Turkey. The Warwick-Edinburgh Mental Well-being Scale, The Burnout Measure, and Sociodemographic form were used in this study. All analyses were performed on a sample of 438 women aged between 18 and 65. The mean score of mental well-being was 47.86 (SD = 10.04) and the mean score of burnout was 3.86 (SD = 1.16). Being younger than 30 years old (t = 2.14, P = 0.033), having undergraduate education or above (F = 5.09, P = 0.007), part-time working (F = 5.39, P = 0.005), attending to school (t = 2.68, P = 0.008), having COVID-19 symptoms (t = 6.01, P < 0.001), and perceiving spousal emotional support (F = 3.47, P = 0.016) were the factors associated with high burnout. Being older than 30 years old (z = -3.11, P = 0.002), full time working (H = 11.96, P = 0.003), not attending to school (z = -2.09, P = 0.036), perceiving spousal emotional (H = 13.22, P = 0.004), or social (H = 13.11, P = 0.004) support were the factors associated with higher mental well-being. Age (β = -0.03, P = 0.001), having two or more children (β = 0.42, P = 0.015), and perceiving COVID-19 symptoms (β = -0.73, P < 0.001) were the predictors of women's burnout. This study shows that mental well-being and burnout levels of women in Turkey have been considerably affected as a result of social distancing measures taken with the first wave of the pandemic. Findings signal the immediate need for targeted mental health nursing interventions. Therefore, technology-based mental health support programmes are recommended to be designed and utilized by mental health nurses.

Female sexual function before and during the severe acute respiratory syndrome coronavirus-2 pandemic: a systematic review and Meta-analysis of longitudinal studies

PurposeTo compare the female sexual function before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Female Sexual Function Index (FSFI).MethodsRelevant studies were retrieved by online databases and manual searching reporting FSFI scores before and during the SARS-CoV-2 pandemic. The methodological quality of reviewed articles was evaluated using the Newcastle-Ottawa Scale, and heterogeneity with the I² statistic. The standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were calculated by random-effect meta-analyses.ResultsFour studies met the inclusion criteria reporting 1002 sexually active non-pregnant women comparing results of the 19-item FSFI. The meta-analysis of the overall FSFI score showed an SMD (95% CI) of -1.16 (-1.97 to -0.35), comparing the pandemic with the pre-pandemic scores. In addition, SMD scores for the FSFI domains were also significantly lower during the pandemic for arousal -0.80 (-1.13 to -0.48), orgasm -0.66 (-1.07 to -0.25), satisfaction -0.59 (-0.97 to -0.22), and pain -0.35 (-0.54 to -0.16), whereas there were not significant differences for desire and lubrication domains. There was a low risk of bias and the sensitivity analysis suggests that results are robust.ConclusionThe available studies showed a lower overall FSFI score during the pandemic, suggesting an increased risk of female sexual dysfunction compared to prepandemic results. Also, there were increased risks of sexual arousal, orgasm, satisfaction, and pain disorders. However, there were no alterations in the desire and the lubrication domains. Limitations are related to the heterogeneity populations, and pandemic confounding and aggravating factors.

The effects of family-centered empowerment model on depression, anxiety, and stress of the family caregivers of patients with COVID-19: a randomized clinical trial

BACKGROUND

Taking care of patients with Covid-19 is regarded as a challenging task for family caregivers. Hence, a Family-Centered Empowerment Model (FCEM) should help them achieve greater psychological strength throughout the home healthcare process.

METHODS

This study is a randomized clinical trial with two groups; besides, pre-test and post-test designs were conducted based on the CONSORT checklist from April to July 2020, in Iran. Seventy family caregivers were randomly assigned to FCEM (n = 35) and control (n = 35) groups. Then, four stages of FCEM in four online sessions were provided to the participants of the intervention group via WhatsApp messenger. The procedure started at the patient's discharge and continued for two weeks. The demographic information questionnaire and Depression Anxiety Stress Scale (DASS-21) were employed before and five days after the FCEM sessions to gather the required data.

RESULTS

The sample was made up of 55.8% women and 44.2% men caregivers, with a mean age of 42.5 years. The results demonstrated a substantial difference in the average score of stress (p = 0.023), anxiety (p = 0.003), and depression (p = 0.012).

CONCLUSIONS

The combination of a face-to-face orientation session and online methods of FCEM is likely to lower stress, anxiety, and depression in family caregivers, which can be contributed to the practicability, simplicity, and effectiveness of this home health intervention.

TRIAL REGISTRATION

This study (no. IRCT20180429039463N2 ) was registered in the Iranian Registry of Clinical Trials on 10/04/2020.

Factors Predicting the Quality of Life of University Students in Japan Amidst COVID-19: A Cross-Sectional Study

Owing to the COVID-19 pandemic, classes and club activities in Japanese universities have been canceled; this may increase students' perceived stress and adversely affect their quality of life. This study investigated the factors that influence Japanese university students' quality of life during the pandemic. An online questionnaire collating data related to demographic characteristics, the perceived stress scale (PSS), sense of coherence (SOC), number of social supports, and quality of life (Short Form Health Survey; SF-8) was distributed to university students. Participants were divided into two groups: those who entered university before (seniors) and after (juniors) the onset of the pandemic. Their scores on the two sub-domains (physical and mental) of the SF-8 were evaluated. Multiple regression analysis was performed to identify factors associated with the composite mental summary of the SF-8. Regression analysis indicated that the predictor model of the composite mental summary differed between juniors and seniors. Among seniors, the composite mental summary was significantly indicated by the composite physical summary (β = 0.549, p < 0.0001) and PSS (β = 0.422, p < 0.0001). Among juniors, it was significantly indicated by the composite physical summary (β = 0.531, p < 0.0001), PSS (β = 0.390, p < 0.0001), and number of social supports (β = -0.148, p = 0.006). The factors associated with quality of life differed between seniors and juniors. Universities must provide opportunities for students to find more friends, especially for juniors who have limited socialization opportunities owing to the pandemic.

Factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic

Introduction

Sanitary control mechanisms differ greatly from country to country. Therefore, it is important to know citizens' perception of different realities. We aimed to determine the factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic.

Methods

This is an analytical cross-sectional study. We asked about six perceptions in regard to different situations experienced by inhabitants of 12 Latin American countries during the pandemic. Frequencies according to country were described and associations vs. other important variables were obtained.

Results

Out of 8,489 participants, 68% stated that there were moments of collective hysteria. Honduras was the country that most perceived inadequate control mechanisms established by the government. Multivariate analysis showed that there were statistically significant differences among many of the countries according to the six evaluated items. The higher the level of education, the greater the perception of poor control in five of the aspects. Additionally, men had a lower perception of inadequate control. The older the age, the lower the perception of inadequate control regarding whether there was collective hysteria and shortages of basic essentials. Those with COVID-19 had a lower perception of medicine shortages.

Conclusion

The population of multiple realities in Latin America have perceived a bad management of the pandemic. Citizens' perception is an important indicator of the performance of each government during the COVID-19 pandemic. This study may provide valuable information on the relationship between the effectiveness of government sanitary control and people's mental health, which ultimately helps to create objective prevention programs against post-traumatic stress disorder, depression, fear of contagion, and collective hysteria. In addition, governments could use this information to design effective mitigation plans for future unavoidable pandemic events based on the six criteria discussed here.

Difference between Impacts of COVID-19 on Women and Men's Psychological, Social, Vulnerable Work Situations, and Economic Well-Being

The SARS-CoV-2 virus changed social reality worldwide, affecting people's health and work life, particularly their anxiety levels. The purpose of this study is to verify the situation of women in terms of anxiety and social determinants in Spain during the pandemic. The sample consisted of 4686 people (3500 women and 1186 men). The tools used were the State-Trait Anxiety Inventory (STAI) and an ad hoc questionnaire to assess the work and mental situation of the participants. The results indicate a higher rate of anxiety among women than among men and reveal a relationship between higher levels of anxiety and more vulnerable work situations in terms of higher unemployment rates, contract changes, etc. Furthermore, there was a higher percentage of women than men in the sectors where the health crisis has had a greater impact and presence, with repercussions on the physical, mental, and social health of the entire population and especially on women. It is necessary to take into account the social determinants of health, not only at the structural level, in terms of the socio-economic and political contexts, to avoid and limit the axes of inequality such as gender.

Predictors of COVID-19-related health anxiety among health care workers: a cross-sectional study

Background

One of the psychological issues that may affect health care workers (HCWs) during the outbreak of COVID-19 is health anxiety. Health anxiety disorder goes beyond normal health concerns and can seriously affect occupational and interpersonal performance. The present study was designed to determine the level of COVID-19-related health anxiety and its predictors in Iranian HCWs.

Methods

This is a cross-sectional study. Data were collected online through a demographic information questionnaire and the short version of the Health Anxiety Questionnaire. The online questionnaires were created via Google Form and the URL link was sent to HCWs via email or social networking applications. In total, questionnaires were sent to more than 1,500 HCWs throughout Iran. Data were analyzed with SPSS software version 23.

Results

Five hundred and fifty-two HCWs completed and sent the questionnaires. The mean scores of health anxiety of HCWs were higher than the cutoff point of health anxiety (17.28 ± 8.84) and 58.1% of HCWs had health anxiety. There was a significant inverse relationship between health anxiety score and age (r = − 0.13; P = 0.002), work experience (r = − 0.16; P < 0.001) and income level (r = − 0.097; P = 0.03). The rate of health anxiety was significantly higher in females (P = 0.03). Based on regression results, age and hospital category were significant risk factors for health anxiety.

Conclusion

Based on the results of this study, employees working in health centers in Iran had high health anxiety. Due to the high level of health anxiety in HCWs, it is important to consider strategies to reduce their health anxiety in the current situation.

Change of Residents’ Attitudes and Behaviors toward Urban Green Space Pre- and Post- COVID-19 Pandemic

The COVID-19 pandemic has changed and influenced people’s attitudes and behaviors toward visiting green spaces. This paper aims to explore the association between residents’ health and urban green spaces (UGS) through an in-depth study of changes in residents’ use of UGS under the influence of the COVID-19 pandemic. The Wuhan East Lake Greenway Park was selected as the location for the field survey and in-depth interviews. At the same time, an online survey was also conducted (total number = 302) regarding participants’ physical and mental health and their attitude and behavior toward the UGS. A paired sample t-test and binary logistic regression were performed to investigate the association between participants’ health and UGS during COVID-19. The results show that: (1) the COVID-19 pandemic has primarily changed the leisure patterns of parks, with potential impacts on the physical and mental health of participants; (2) the purpose, frequency, timing, and preferred areas of participants’ park visits have changed to varying degrees after the pandemic, highlighting the important role and benefits of UGSs; (3) the physical and mental health of participants and urban development issues reflected by UGS use are prominent. This study reveals that awareness of the construction and protection of UGSs is an important prerequisite for ensuring the health of urban residents.

Latent profiles of multi-dimensionality of self-compassion predict youth psychological adjustment outcomes during the COVID-19: A longitudinal mixture regression analysis

The multi-dimensionality of self-compassion and its influence on college students' adjustments have not been widely examined during the COVID-19 pandemic. The current study aims to explore profiles of self-compassion dimensions in Chinese college students and examine the predictive effects of different profiles on students' adjustment outcomes. A longitudinal online survey of college students was conducted in mainland China. In May of 2020, college students (N = 1361) completed Neff's Self-Compassion Scale-Short Form during the home quarantine period. Six months after the baseline assessment, students (N = 717) reported their level of anxiety symptoms, depression symptoms, insomnia symptoms, complex post-traumatic stress (CPTSD) symptoms, post-traumatic growth (PTG), and positive youth development (PYD). A latent profile analysis was adopted to identify profiles of self-compassion dimensions. A longitudinal regression mixture model was used to examine the predictive effects of different self-compassion profiles on college students' adjustment outcomes. Three classes best characterized the self-compassion dimensions of college students: the compassionate group (54.1%), the uncompassionate group (38.6%), and the extremely uncompassionate group (7.3%). College students in the compassionate group scored significantly higher on positive adjustment indicators (PTG and PYD), and significantly lower on negative adjustment indicators (anxiety, depression, insomnia, and CPTSD symptoms) than students in the other two groups. College students in the uncompassionate group scored significantly lower on negative indicators, and higher on PYD scores than students in the extremely uncompassionate group, but did not differ in PTG levels from students in the extremely uncompassionate group. College students in the compassionate group adjusted best across groups. The limitations that using a composite score to represent the relative balance of self-compassion dimensions were highlighted. Intervention programs need to focus on improving the level of positive self-responses in college students.

Changes in lifestyles and depressive symptom among patients with chronic diseases during COVID-19 lockdown

This study aims to investigate the impact of COVID-19 lockdown on lifestyle behaviors and depressive symptom among patients with NCDs (noncommunicable diseases). We incorporated a COVID-19 survey to the WELL China cohort, a prospective cohort study with the baseline survey conducted 8–16 months before the COVID-19 outbreak in Hangzhou, China. The COVID-19 survey was carried out to collect information on lifestyle and depressive symptom during lockdown. A total of 3327 participants were included in the COVID-19 survey, including 2098 (63.1%) reported having NCDs at baseline and 1457 (44%) without NCDs. The prevalence of current drinkers decreased from 42.9% before COVID-19 lockdown to 23.7% during lockdown, current smokers from 15.9 to 13.5%, and poor sleepers from 23.9 to 15.3%, while low physical activity increased from 13.4 to 25.2%, among participants with NCDs (P < 0.05 for all comparisons using McNemar's test). Participants with NCDs were more likely than those without to have depressive symptom (OR, 1.30; 95% CI 1.05–1.61), especially among those who need to refill their medication during the COVID-19 lockdown (OR, 1.52; 95% CI 1.15–2.02). Our findings provide insight into the development of targeted interventions to better prepare patients with NCDs and healthcare system to meet the challenge of future pandemic and lockdown.

How to boost the boosters? A survey-experiment on the effectiveness of different policies aimed at enhancing acceptance of a "Seasonal" vaccination against COVID-19

BACKGROUND

Evidence suggests a gradual decrease in the effectiveness of the anti-COVID-19 vaccines, stressing the potential need for periodical booster shots. However, it is hard to tell whether previously applied policies for enhancing vaccine acceptance will be as effective for repeated periodical booster shots during a pandemic. Hence, this study aims to explore the effectiveness of different health policies on periodical vaccination acceptance amidst an ongoing pandemic.

METHODS

A cross sectional online experiment was performed in a representative sample of 929 Israeli citizens. Participants were randomly allocated to 4 groups simulating different hypothetical periodical-vaccination-promoting policy scenarios: (1) Mandate (N = 229); (2) a negative monetary incentive (N = 244); (3) a positive monetary incentive (N = 228) and (4) information provision (N = 228). Compliance intentions and vaccine-acceptance-related variables were measured. Analysis included multivariate hierarchic logistic and linear regressions.

RESULTS

Compliance intentions levels were medium (M = 3.13 on a 1-5 scale). Only 20.2% of the sample demonstrated strong acceptance of periodical vaccination, which is lower than the acceptance rate of the seasonal flu shot in the country in the year preceding the pandemic. Type of policy was related to the extent to which a respondent strongly agreed to be periodically vaccinated or not. Specifically, strong acceptance was more likely when positive or negative incentives were presented in comparison to the mandate or information provision conditions. However, when examining the extent of compliance among respondents who were less decisive, the type of policy did not predict the extent to which these respondents intended to comply. In addition, compliance intentions were related with the perceived benefits and barriers of the vaccine, the perceived efficacy of getting vaccinated and social norms. Hesitator's intentions were additionally associated with anti-COVID-19 vaccination history, perceived severity of the disease and trust in government.

CONCLUSIONS

Pandemic-containing vaccines may be perceived as less effective and beneficial than pandemic-preventing vaccines. Individuals with different levels of motivation for periodical vaccination during a pandemic may be affected by different factors. While strongly opinionated individuals are affected by the type of vaccination-promoting policy, hesitators are affected by a larger number of factors, which provide policy makers with greater opportunities to enhance their vaccination intentions.

Comparison of Mental Health among Japanese Healthcare Workers at Two Points during the COVID-19 Pandemic

BACKGROUND

The prolonged pandemic of coronavirus disease 2019 (COVID-19) has resulted in mental burden among healthcare workers (HCWs). This study aimed to conduct a repeated study to assess changes in psychological concerns among Japanese HCWs.

METHODS

This study is the second survey involving HCWs at the Japanese Red Cross Medical Center conducted between November 20, 2020 and December 4, 2020. The degree of symptoms of anxiety, depression, and resilience was assessed using the Japanese versions of the 7-item Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale, and 10-item Connor-Davidson Resilience Scale, respectively.

RESULTS

The survey included 594 HCWs, comprising 95 physicians, 261 nurses, 150 other co-medical staff, and 88 office workers. Among them, 46 (7.7%) and 152 (25.6%) developed moderate-to-severe symptoms of anxiety and depression, respectively. Compared with those in the initial survey conducted 6 months earlier, the resilience score did not change, whereas the anxiety and depression scores improved significantly (P < 0.001, P = 0.033, respectively). However, the frequency of HCWs developing moderate-to-severe symptoms of anxiety or depression did not significantly improve. Multivariable logistic regression analysis showed that having higher anxiety symptoms was a risk factor for depression symptoms, while older HCWs and those with higher resilience were less likely to develop depression symptoms.

CONCLUSIONS

Many HCWs still suffer from psychological concerns during the COVID-19 pandemic.

Psychological status of mass people in the capital city of Bangladesh during COVID-19: Do home quarantine challenges matter?

This study aimed to identify the impact of home quarantine challenges on the psychological status of mass people during Coronavirus Disease (COVID-19) in the capital city (Dhaka) of Bangladesh. A highly organized questionnaire was created in "Google Form" and given to respondents at random via multiple social media sites, including WhatsApp, LinkedIn, and Messenger. However, a sample size of 208 people was taken and analysis was carried out using Statistical Package for the Social Sciences and Analysis of a Moment Structures software. Analysis showed that home quarantine challenges are positively related to the psychological status and home quarantine challenges have a significant impact on psychological status during COVID-19. In Bangladesh, the major challenges to home quarantine are lack of consciousness, lack of medical support, and the possibility of losing their current jobs. This study provides insight into the challenges of home quarantine and the psychological status of Bangladeshi people. The findings may be helpful for policymakers in identifying necessary measures to overcome these challenges. Only Dhaka division was taken out of seven divisions in Bangladesh to conduct this study, which might be difficult to generalize the findings of this study. Thus, in the future, it is suggested that more respondents from other divisions need to be covered.

Young Adults' Loneliness and Depression During the COVID-19 Pandemic: A Moderated Mediation Model

Since the outbreak of the COVID-19 pandemic in December 2019, millions of people have been infected with the disease. The COVID-19 pandemic also produced severe mental health problems, such as loneliness and depression. The present study aimed to examine the mediating role of cognitive reappraisal and moderating role of resilience in the relationship between young adults’ loneliness and depression during the pandemic by adopting a cross-sectional research approach. In March 2020, 654 young adults (18–29 years old) were recruited to complete the measures for loneliness, depression, emotion regulation, and resilience. Results found that loneliness was positively and moderately associated with depression (r = 0.531, p < 0.001), and that both loneliness and depression were separately negatively associated with cognitive reappraisal (r = −0.348, p < 0.001; r = −0.424, p < 0.001) and resilience (r = −0.436, p < 0.001; r = −0.419, p < 0.001). The results indicated that both loneliness and depression were not associated with expressive suppression (r = 0.067, p = 0.087; r = −0.002, p = 0.961). The moderated mediation model results revealed that only cognitive reappraisal partially mediated the relationship between loneliness and depression (b = −0.301; Boot 95% CI = −0.388, −0.215). In addition, the results of the moderated mediation model indicated that resilience moderated the association between loneliness and depression (b = 0.035, p < 0.001, Boot 95% CI = 0.014, 0.055), while also moderated the impact of cognitive reappraisal on depression (b = −0.031, p < 0.001, Boot 95% CI = −0.058, −0.005). These findings have practical implications that broaden our understanding of depression in young adults and shed light on how to enhance cognitive reappraisal and resilience as a means of combating depression in this age group during the COVID-19 pandemic.

Long Coronavirus Infection is Associated with Significant Sleep Disturbances as Detected by Wearable Health Devices

Background

Patients with COVID-19 have increased sleep disturbances and decreased sleep quality during and after the infection. The current published literature focuses mainly on qualitative analyses based on surveys and subjective measurements rather than quantitative data.

Objective

In this paper, we assessed the long-term effects of COVID-19 through sleep patterns from continuous signals collected via wearable wristbands.

Methods

Patients with a history of COVID-19 were compared to a control arm of individuals who never had COVID-19. Baseline demographics were collected for each subject. Linear correlations among the mean duration of each sleep phase and the mean daily biometrics were performed. The average duration for each subject’s total sleep time and sleep phases per night was calculated and compared between the 2 groups.

Results

This study includes 122 patients with COVID-19 and 588 controls (N=710). Total sleep time was positively correlated with respiratory rate (RR) and oxygen saturation (SpO₂). Increased awake sleep phase was correlated with increased heart rate, decreased RR, heart rate variability (HRV), and SpO₂. Increased light sleep time was correlated with increased RR and SpO₂ in the group with COVID-19. Deep sleep duration was correlated with decreased heart rate as well as increased RR and SpO₂. When comparing different sleep phases, patients with long COVID-19 had decreased light sleep (244, SD 67 vs 258, SD 67; P=.003) and decreased deep sleep time (123, SD 66 vs 128, SD 58; P=.02).

Conclusions

Regardless of the demographic background and symptom levels, patients with a history of COVID-19 infection demonstrated altered sleep architecture when compared to matched controls. The sleep of patients with COVID-19 was characterized by decreased total sleep and deep sleep.

Social Media as Online Shelter: Psychological Relief in COVID-19 Pandemic Diaries

The pandemic diary on social media is a special form of online communication. Studying individual narratives in social networks during the pandemic and post-pandemic periods can help us generate valuable knowledge about the behaviors of media users and the function of social media in a public health crisis. This research focuses on psychological relief in virtual public spaces and explores how social media individual narratives affect people's psychological health in a state of emergency from the perspective of narrative theory. Based on 19 in-depth interviews with Chinese diary writers, it has been found that the narrative genres of the pandemic diary were mainly Restitution and Quest narrative, while a few were categorized as "Restrained chaos" narrative. The purpose of editing pandemic diaries is to communicate both inwardly and outwardly. The pandemic diary can promote self-relief, public communication, emotional drive, meaning connection, and identity construction in public spaces, thus helping shape a sense of unity and belonging, and facilitating the psychological reconstruction of people who are vulnerable to potential mental health crises.

Influencing Factors of Students Aged 10–20 Non-participating in Home Physical Exercise During the COVID-19 Isolation Policy Period: A Cross-Sectional Study From China

Background

A number of public health measures are required during the COVID-19 pandemic. To stop the spread of COVID-19, the Chinese government has adopted isolation policies, including closing non-essential businesses, public transportation and schools, moving students' face-to-face learning to online, and recommending the cancellation of all non-essential activities and outdoor activities. However, while this isolation strategy has reduced human-to-human transmission of COVID-19, it has led to dramatic changes in students' daily lives and learning styles, including reduced physical activity and increased sedentary time. Considering the potentially harmful effects of physical inactivity, this study hoped to explore the incidence and influencing factors of non-participation in home physical exercise among Chinese students aged 10–20 during the implementation of the COVID-19 isolation policy.

Methods

Through an online questionnaire platform, this study created an open-ended questionnaire (from March 1, 2020 to March 10, 2020) and distributed it to students in areas where isolation policies were enforced. The questionnaire was initially distributed by 10 recruited volunteers, and then the questionnaire was voluntarily forwarded and shared by the subjects or others, in a “snowball” way, to expand distribution. Finally, the survey data of 4,532 Chinese students aged 10–20 were collected. The incidence of respondents non-participating in home physical activity was determined using univariate analysis. Using odds ratios and 95% confidence intervals of a multivariate binary logistic regression model, factors influencing non-participation in home physical exercise were estimated.

Results

Among the sample students, the incidence rate of non-participating in home physical exercise was 25.86% (24.06–27.15%). Exercise intentions, exercise habits, self-assessed health, beliefs in physical health, family exercise, family exercise recommendations, home exercise conditions, school exercise guidance, and health education programs had a negative impact on students non-participating in home physical exercise. Academic performance and electronic product use had a positive effect on non-participating in home physical exercise.

Conclusions

A variety of forward leaning factors, enabling factors and demand factors have affected the occurrence of students” non-participating in home physical exercise. Future health isolation policies should take into account these influencing factors to reduce the occurrence of students” non-participating in home physical exercise and to promote students' independent participation in physical exercise.

Work from home issues due to COVID-19 lockdown in Indian higher education sector and its impact on employee productivity

Purpose

This study focuses on work from home (WFH) issues faced by faculty members of higher education institutes in India during the coronavirus infection (COVID-19) pandemic. The study aims to understand the impact of these issues on faculty productivity. The study also analyzes the moderating effect of information technology (IT) training on the relationship between work- from-home issues and faculty productivity.

Design/methodology/approach

This study is quantitative. Data were collected from 215 faculty members working in higher education institutes in India. Correlation and hierarchical regression analysis have been used to analyze the data.

Findings

The analysis revealed that online teaching, lack of technology acceptance, poor working environment and work–life conflict negatively impacts faculty productivity. Thus, IT training work as a moderator plays an important role in reducing the WFH issues mainly Online Teaching, Lack of Technology acceptance & Poor Working Enviornment by increasing faculty productivity. IT training work does not moderate the relationship between work–life conflict and faculty productivity.

Research limitations/implications

This research is limited to the higher education sector; the research limits the generalization of the higher education sector's finding to other sectors.

Practical implications

The findings would help policymakers and educational institutes to explore the use of digital technology to break boundaries of workplace and education institutes to disseminate knowledge to a global level. The findings also help to understand how the workplace is essential for the smooth functioning of tasks of the institute.

Social implications

The study will also help management, institute, organization, society and individuals to change their mindset that education can be imparted through online mode in a better way with the help of digital technology.

Originality/value

There is a scarcity of research work examining WFH issues in conducting mandatory online classes due to COVID-19 pandemic and COVID-19's relation to faculty productivity in the higher education sector. This study contributes to the knowledge regarding the impact of COVID-19 on faculty productivity in the education sector.

Sociodemographic and Psychological Predictors of Resilience Among Frontline Nurses Fighting the COVID-19 Pandemic

OBJECTIVE

According to a WHO report, the number of patients with coronavirus disease 2019 (COVID-19) has reached 456,797,217 worldwide as of 15 March, 2022. In Wuhan, China, large teams of health-care personnel were dispatched to respond to the COVID-19 emergency. This study aimed to determine the sociodemographic and psychological predictors of resilience among frontline nurses fighting the current pandemic.

METHODS

A total of 143 nurses were recruited from February 15 to February 20, 2020, to participate in this study. The 10-item Connor-Davidson Resilience Scale and the 21-item Depression Anxiety Stress Scale were used to estimate the participants' resilience and mental wellbeing.

RESULTS

Results showed that the nurses displayed a moderate resilience level. Their median depression, anxiety, and stress scores were 1, 2, and 3, respectively, which were negatively correlated with resilience. Female gender, being dispatched to Wuhan, and depression levels were the significant predictors of resilience.

CONCLUSIONS

The results suggest that particular attention should be given to nurses who were dispatched to Wuhan and who exhibited depression symptoms, and appropriate measures should be taken to boost their resilience.

Longitudinal trajectories of insomnia symptoms among college students during the COVID-19 lockdown in China

PURPOSE

This study aimed to examine the patterns and predictors of the trajectories of college students' insomnia symptoms across different stages of the COVID-19 pandemic.

METHODS

A total of 35,516 college students completed three online surveys during the COVID-19 outbreak period (3-10 February 2020), initial remission period (24 March-3 April 2020), and effective control period (1-15 June 2020), respectively. These surveys measured the participants' socio-demographic and pandemic related factors, insomnia symptoms, mental health status, and psychosocial factors. Multivariate logistic regressions were used to examine predictors for trajectory membership.

RESULTS

The prevalence of insomnia symptoms increases during home quarantine. Five insomnia symptoms trajectories were observed: resistance (82.8% of the sample), recovery (5.0%), delayed-dysfunction (5.8%), chronic-dysfunction (1.8%), and relapsing/remitting (4.6%). Female gender, residence location in urban, has history of sleep problems, smoking, alcohol use, community or village has confirmed COVID-19 cases, current poor mental health, higher negative coping were related to higher risk of developing insomnia symptoms in at least one time point, whereas better family function increased the possibility of recovery relative to chronic dysfunction. Lower social support and positive coping could also cause insomnia chronicity.

CONCLUSION

Adolescents have different trajectories of insomnia symptoms during pandemic lockdown. Although most adolescents did not experience insomnia or recovered over time, some adolescents, especially those with the risk factors noted above, exhibit delayed or chronic symptoms. These findings could inform mental health professionals regarding how to provide individualized and appropriate intervention for college students after their return to school.

Lessons learned from psychosocial support and mental health surveys during the 10 years since the Great East Japan Earthquake: Establishing evidence-based disaster psychiatry

Post-disaster mental health and psychosocial support have drawn attention in Japan after the 1995 Great Hanshin-Awaji Earthquake, with mental health care centers for the affected communities being organized. After the catastrophe, a reconstruction budget was allocated to organize mental health care centers to provide psychosocial support for communities affected by the 2007 Chūetsu offshore earthquake, the 2011 Great East Japan Earthquake, and the 2016 Kumamoto Earthquake. There were several major improvements in post-disaster mental health measures after the Great East Japan Earthquake. The Disaster Psychiatric Assistance Team system was organized after the earthquake to orchestrate disaster response related to the psychiatric health system and mental health of the affected communities. Special mental health care efforts were drawn to the communities affected by the nuclear power plant accident through Chemical, Biological, Radiological, Nuclear, and high yield Explosives, being succeeded by measures against the coronavirus pandemic. As another new movement after the Great East Japan Earthquake, the number of surveys involving communities affected by disasters has soared. More than 10 times the number of scientific publications were made in English during the decade following the Great East Japan Earthquake, compared with the previous decades. In this review, we examined the results and issues acquired in the 10 years since the Great East Japan Earthquake, proposing evidence-based disaster psychiatry as the direction of future mental health measures related to emergency preparedness and response.