Anxiety and coping strategies among nursing students during the covid-19 pandemic

Coronavirus Disease Stress Among Italian Healthcare Workers: The Role of Coping Humor

The study aimed to understand how coping strategies in general and humor-based coping strategies in particular modulate the perception of pandemic-related stress in a sample of Italian healthcare workers during the coronavirus disease (COVID-19) outbreak in Italy. A total of 625 healthcare workers anonymously and voluntarily completed a 10-min questionnaire, which included psychometrically valid measurements preceded by a set of questions aimed at determining workers' exposure to COVID-19. The Perceived Stress Scale was used to measure healthcare workers' stress levels, and the Brief COPE Scale and Coping Humor Scale were used to assess participants' avoidant or approach coping style and verify the degree to which they relied on humor to cope with stress. The results show that (1) levels of perceived stress were higher in healthcare workers who were more exposed to COVID-19 (i.e., who came into contact with COVID-19 patients or worked in wards dedicated to COVID-19) in comparison to less-exposed workers; (2) participants who reported a higher use of avoidant coping strategies perceived the situation as more stressful than those who used them less; and (3) healthcare workers who reported higher use of humor-based coping strategies perceived the situation as less stressful in comparison with those who reported less use of coping humor. Such findings expanded other research studies by including coping humor as a potential factor to mitigate the perceived stress related to COVID-19. The paper concludes with a discussion of implications for future research and limitations of the study.

Transition in learning during COVID-19: Student nurse anxiety, stress, and resource support

The purpose of this study was to explore anxiety and stress experienced by first‐semester nursing students and identify sources of support during a transition from a face‐to‐face to an online learning platform during the first months of the COVID‐19 pandemic. This descriptive study used a web‐based survey distributed to nursing students 2 months after the completion of their first semester. The survey questions were adapted from the Anxiety Symptoms Checklist and the College Student Stress Scale. The survey link was emailed to 79 students, with 56 consenting, and 50 completing the survey. The most commonly reported symptoms were difficulty concentrating (90%) and feeling anxious or overwhelmed (84%). Most respondents reported anxiety related to the pandemic, with 84% being concerned about a friend or relative contracting COVID‐19, and with 70% fearful of becoming infected themselves. The majority of respondents expressed concerns related to difficulty handling academic workload (62%), and the need to perform well in school (56%). To decrease anxiety and stress, the faculty should foster a structured learning environment; abide by the course schedule; communicate changes or updates in a timely fashion; adapt assignments to fit the learning environment; utilize campus, local, state, and national resources; practice self‐care; and extend grace.

Music Listening Predicted Improved Life Satisfaction in University Students During Early Stages of the COVID-19 Pandemic

Quarantine and spatial distancing measures associated with COVID-19 resulted in substantial changes to individuals’ everyday lives. Prominent among these lifestyle changes was the way in which people interacted with media—including music listening. In this repeated assessment study, we assessed Australian university students’ media use (i.e., listening to music, playing video/computer games, watching TV/movies/streaming videos, and using social media) throughout early stages of the COVID-19 pandemic in Australia, and determined whether media use was related to changes in life satisfaction. Participants (N = 127) were asked to complete six online questionnaires, capturing pre- and during-pandemic experiences. The results indicated that media use varied substantially throughout the study period, and at the within-person level, life satisfaction was positively associated with music listening and negatively associated with watching TV/videos/movies. The findings highlight the potential benefits of music listening during COVID-19 and other periods of social isolation.

Impacts of Coping Mechanisms on Nursing Students' Mental Health during COVID-19 Lockdown: A Cross-Sectional Survey

The COVID-19 pandemic and consequent lockdown have precipitated significant disruption in the educational system. Nursing students are known to have higher levels of stress and anxiety than other non-nursing students, but there is a dearth of evidence regarding the impacts of the COVID-19 lockdown on their mental health and coping mechanisms.

PURPOSE

The aim of this study was to explore the influence of coping mechanisms as predictors of stress, anxiety, and depression among nursing students during the COVID-19 lockdown.

METHODS

A cross-sectional online survey was conducted from 20 April to 10 May 2020 among 173 nursing students at a private university in Southern California, USA.

RESULTS

Self-reported stress, anxiety, and depression were significantly higher during the lockdown compared to the pre-lockdown period (p < 0.001). Almost a quarter of participants reported high stress, while more than half reported moderate-to-severe symptoms of anxiety and depression. High resilience was negatively associated with high stress (Odds Ratio (OR) = 0.46; 95% Confidence Interval (CI) = 0.22-0.98; p = 0.045), moderate-to-severe anxiety (OR = 0.47; 95%CI = 0.25-0.90; p = 0.022), and moderate-to-severe depression (OR = 0.50; 95%CI = 0.26-0.95; p = 0.036). Similarly, high family functioning was negatively associated with high stress (OR = 0.41; 95%CI = 0.20-0.86; p = 0.018), moderate-to-severe anxiety (OR = 0.41; 95%CI = 0.21-0.80; p = 0.009), and moderate-to-severe depression (OR = 0.41; 95%CI = 0.20-0.81; p = 0.011). High spiritual support was negatively associated with moderate-to-severe depression (OR = 0.48; 95%CI = 0.24-0.95; p = 0.035).

CONCLUSIONS

During the COVID-19 lockdown, nursing students experienced remarkable levels of poor mental health. High levels of resilience and family functioning were associated with 2- to 2.4-fold lower risk of stress, anxiety, and depression, whereas high spiritual support was associated with 2-fold lower risk of depression. As the pandemic evolves, fostering these coping mechanisms may help students to maintain their psychological wellbeing.

COVID-19–induced anxiety and protective behaviour among nursing students: A survey from western India

Introduction:

The COVID-19 Pandemic has caused anxiety and stress among people. Nursing students, being an important link in the delivery of health care services, are always exposed to stressful situations which in turn put a great toll on their mental health. Moreover, the perceived risk of pandemics motivates people to embrace different protective measures so as to reduce any potential threats of an emerging health concern.

Objective:

The aim of this study was to assess the COVID-induced anxiety and protective behaviors among nursing students.

Methods:

Nursing students studying at 02 nursing institutes of Jodhpur, Rajasthan, India were enrolled for the study. The data were collected using COVID-induced anxiety scale and protective behaviors towards COVID-19 Scale. These scales were converted to online google forms, and the link was circulated among 370 nursing students through emails and WhatsApp. A total of 229 students submitted their responses within stipulated time and were included in the final data analysis.

Results:

The response rate of the survey was 62%. Evidently, nursing students had a moderate level of anxiety (mean score 31.28 ± 5.29) due to the COVID-19 outbreak. Overall protective behavior mean score was 56.63 ± 6.4 which reflects that students were following higher quality of protective behaviors. There is a negative linear correlation between anxiety score and protective behavior score.

Conclusion:

The nursing students exhibited a moderate level of anxiety, and routing protective behaviors were frequently performed by these students. There is a timely need to plan and implement interventions for nursing students so as to make them self-capable to resolve psychosocial issues, especially during disease outbreaks.

Conocimientos, actitudes, prácticas, temor y estrés ante el Covid-19 en estudiantes y recién egresados de Enfermería en Colombia

Introducción: La pandemia por Covid-19 ha tenido una afectación de la salud emocional del recurso humano en salud, a pesar de contar con conocimientos sobre el virus y su manejo, el personal sanitario entre el que está Enfermería, presenta estrés y temor ante el Covid-19. Objetivo. Describir y correlacionar el nivel de temor, estrés, conocimientos, actitudes y prácticas frente al Covid-19 en estudiantes y recién egresados de Enfermería en Colombia. Método. Se realizó un estudio observacional de carácter transversal y analítico en Colombia entre octubre y noviembre de 2020. Los instrumentos de temor, estrés y conocimientos, actitudes y prácticas ante el Covid-19 fueron respondidos en línea por 1621 estudiantes y recién egresados de Enfermería. Resultados. Se observó una media de temor de 20.69 ± 6.1 puntos, una media de estrés de 89.15 ± 29.5 puntos y frecuencias relativas superiores al 80% para los conocimientos actitudes y prácticas ante el Covid-19. Correlaciones directas fueron observadas entre los conocimientos y actitudes y a su vez, las actitudes con las prácticas. El temor se correlacionó de forma inversa con los conocimientos y de forma directa con el estrés ante el Covid-19. Conclusión. Se observa un adecuado nivel cognitivo en los estudiantes y recién egresados de enfermería, pero una deficiencia emocional frente al Covid-19, en términos de estrés y temor. Es necesario establecer estrategias de soporte en salud mental para esta población clave en el control actual y futuro de situaciones de crisis en salud.

Approach Coping Mitigates Distress of COVID-19 Isolation for Young Men With Low Well-Being in a Sample of 1,749 Youth From Australia and the USA

The unprecedented COVID-19 pandemic has led to lockdowns across the world with people being separated from their loved ones including partners, family, and friends. Here, using a large sample of 1,749 Australians and Americans, we investigated the impact of COVID-19 isolation on younger populations (13-25 years), and the influence of coping strategies and mental well-being on this impact. Overall, COVID-19 isolation had a more negative impact on adolescence (13-17 years) than young adulthood (18-25 years), but with no difference apparent between men and women, or between Australian and American residents. However, a deeper analysis revealed a gender-specific effect: the type of coping strategies differentially influenced the negative impact of COVID-19 isolation on men with various levels of well-being, an interaction effect not apparent in women. For men with lower levels of mental well-being, COVID-19 isolation appeared to have a less negative impact on them if they used more approach-oriented coping strategies (e.g., actively focusing on the problem). Our results provide cross-sectional evidence for a differential impact on young men at low levels of wellbeing by pandemic isolation. In sum, young men and adolescent boys with lower well-being coped better with COVID-19 isolation when they used more approach coping strategies.

Ser estudante de enfermagem em tempos de COVID-19

Resumo Objetivo Compreender como a pandemia afetou os estudantes de enfermagem nos contextos de Ensino Clínico. Método Este é um estudo de abordagem qualitativa, exploratória, transversal e descritiva. Os participantes foram 5 enfermeiros recém-licenciados que realizaram o último estágio clínico da sua licenciatura durante a pandemia de COVID-19. A análise de conteúdo ocorreu por meio da técnica para a análise dos achados das narrativas. Resultados Emergiram 5 categorias: Dificuldades sentidas na integração; Dificuldades na concretização do ensino clínico; Influência da pandemia nas expectativas dos estudantes ante o ensino clínico de integração à vida profissional; Receios, relacionadas com a COVID 19; e Sugestões para a formação dos licenciados em enfermagem, com vista a capacitá-los para a gestão de situações de pandemia. Conclusões e implicações para a prática O ensino clínico, cujo objetivo é atingir as competências exigidas para o exercício profissional, foi vivenciado com ansiedade, medo e pressão, porém com o suporte possível por parte dos supervisores clínicos, eles próprios também sob pressão, dado o aumento da sobrecarga de trabalho provocada pela pandemia. O estudo permite fazer recomendações para a educação e investigação em enfermagem.

Online Teaching Experience during the COVID-19 in Pakistan: Pedagogy–Technology Balance and Student Engagement

This study aimed to explore the lived experiences of university teachers who participated in online teaching for the first time during the COVID-19 pandemic. A qualitative method of data collection and inductive thematic analysis were used. The data were collected through a semistructured interview from 11 faculty members who teach in various universities in Pakistan. The analysis presented five themes of the online teaching experience: culture and gender-related issues, teaching effectiveness, challenges in online teaching, coping strategies, and faculty’s’ post-COVID-19 perceptions. The findings reflect that the faculty prioritized to focus on immediate online instructional matters in the wake of the pandemic with a lack of emphasis on global practices for online learning. Experienced and young faculty reported disparities in striking a balance between pedagogy and technology. Moreover, despite the limitations, the experience itself prepared the faculty for a blended learning approach and increased their awareness of global and future challenges. The implications were reported based on the findings.

How anxious did you feel during lockdown? The roles resilience, living environment, and gender play on the level of anxiety state during pandemic isolation

In the unique context of the coronavirus disease 2019 (COVID-19) pandemic, researchers and clinicians alike drew attention to the risks involved by physical and social isolation for mental health. Factors like resilience, gender, urban/rural environment, or preexisting anxiety can impact anxious states produced by home forced isolation. Based on these, we assumed that: i) there are significant differences in the level of anxiety (state) during the pandemic, depending on the living area of the subjects; ii) gender plays a moderating role in the relationship between resilience and anxiety; and iii) anxiety (trait), experiential avoidance, resilience, and family connectedness, determine the level of anxiety (state). The MemoryLab team conducted the present study on 495 subjects (n=411 women, age between 18 and 65). Of these, 350 live in large and medium urban areas, 63 in small urban areas, and 82 in rural areas. As instruments, we used The State-Trait Anxiety Inventory (STAI 2.0), The Acceptance and Action Questionnaire 2 (AAQ-2), The Aggression Questionnaire (AQ), The Family Connectedness Questionnaire, and Connor-Davidson Resilience Scale 10 (CD-RISC-10), as well as the standard division of living areas according to community size. Data collection took place online during the spring peak of the pandemic. According to ANOVA analysis, people living in small urban areas have a higher level of anxiety. The difference is significant compared to those living in large and medium cities and villages. Gender has no moderating role in the relationship between resilience and the anxiety state. Also, experiential avoidance, anxiety (trait), and resilience play a significant role on the level of anxiety (state), measured during social isolation. The results could be an important indicator for understanding psychological mechanisms guiding interventions to support the communities effectively.

Exploring Perceived Stress among Students in Turkey during the COVID-19 Pandemic

Students have been highly vulnerable to mental health issues during the COVID-19 pandemic, and researchers have shown that perceived stress and mental health problems have increased during the pandemic. The aim of this study was to reveal the prevalence of perceived stress and mental health among students during the pandemic and to explore predictors of stress levels. A cross-sectional study was conducted on a sample of 358 undergraduates from 14 universities in Turkey, including 200 female students (56%). The measurements used in the study were the Generalized Anxiety Disorder 7-item (GAD-7) scale, Patient Health Questionnaire (PHQ-8), Satisfaction with Life Scale (SWLS), Perception of COVID Impact on Student Well-Being (CI), Perceived Stress Scale (PSS-10), Physical Activity Scale (PA), and a sociodemographic survey. Students reported high perceived stress, mild generalized anxiety, and low satisfaction with life. More than half of the students met the diagnostic criteria of GAD (52%) and depression (63%). Female and physically inactive students had higher PSS-10 levels. A hierarchical linear regression model showed that after controlling for gender and negative CI, anxiety and physical inactivity significantly predicted high perceived stress. The study shows that students’ mental health during the pandemic is at high risk.

Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates

Introduction

The COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups. Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students.

Methods and Materials

We surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE. We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale. The GAD-7 score was measured at three time points: during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students.

Results

The majority of students demonstrated high levels of knowledge and utilized reliable sources of information. Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene. Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2.02, 95% CI, 1.41 to 2.91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0.61, 95% CI, 0.45 to 0.84). Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students’ anxiety levels increased with online learning.

Conclusion

This study provides important information on the initial response and anxiety levels in university students across the UAE during the COVID-19 pandemic. The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future.

Recovery from the COVID-19 pandemic: Distress and resilience

The current study analyzed repeated responses to the coronavirus. Data for the first phase was gathered during the peak of the COVID-19 pandemic crisis in Israel (T1), which included the overall lock-down of the Israeli society. The repeated measurement was conducted approximately two months later, on the initial phase of lifting the lock-down (T2). The sample size was 300 people. Results indicated four significant differences between the first and the second measurements: Sense of danger, distress symptoms, and national resilience significantly decreased, while perceived well-being increased at T2. No significant differences were noted between the two measurements regarding individual and community resilience and economic difficulties. The data indicated that the highest decrease in national resilience was accounted for by low respondent trust in governmental decisions during the COVID-19 crisis. The negative impact of the COVID-19 pandemic on the participants was determined by two indicators: level of distress symptoms and sense of danger. Path analyses showed that five variables significantly predicted these two indicators. Their best predictor at T1 and T2 was well-being followed by individual resilience, economic difficulties due to the pandemic crisis, community resilience, and gender. It was concluded that psychological attributes may help in decreasing the impact of the threats of the COVID-19 pandemic.

Recovery from the COVID-19 pandemic: Distress and resilience

The current study analyzed repeated responses to the coronavirus. Data for the first phase was gathered during the peak of the COVID-19 pandemic crisis in Israel (T1), which included the overall lock-down of the Israeli society. The repeated measurement was conducted approximately two months later, on the initial phase of lifting the lock-down (T2). The sample size was 300 people. Results indicated four significant differences between the first and the second measurements: Sense of danger, distress symptoms, and national resilience significantly decreased, while perceived well-being increased at T2. No significant differences were noted between the two measurements regarding individual and community resilience and economic difficulties. The data indicated that the highest decrease in national resilience was accounted for by low respondent trust in governmental decisions during the COVID-19 crisis. The negative impact of the COVID-19 pandemic on the participants was determined by two indicators: level of distress symptoms and sense of danger. Path analyses showed that five variables significantly predicted these two indicators. Their best predictor at T1 and T2 was well-being followed by individual resilience, economic difficulties due to the pandemic crisis, community resilience, and gender. It was concluded that psychological attributes may help in decreasing the impact of the threats of the COVID-19 pandemic.

Does Physical Activity Matter for the Mental Health of University Students during the COVID-19 Pandemic?

Research indicates that university and college students are at higher risk of experiencing mental health problems than other populations. This study aims to examine the relationship between Physical Activity (PA) and the mental health of Ukrainian university students during the Corona Virus Disease 2019 (COVID-19) pandemic lockdown. The conventional sample consisted of 1512 students from 11 Ukrainian universities, with a mean age of 20 years (M = 20.06, SD = 3.05) and 69% of whom were female. The cross-sectional online survey was disseminated through the most popular social media channels in Ukraine (i.e., Facebook, Viber, Telegram) and included the Generalized Anxiety Disorder (GAD-7) scale to measure anxiety and the Patient Health Questionnaire (PHQ-9) to assess depression. Data were collected from 14 May to 4 June 2020 during the COVID-19 pandemic outbreak in Ukraine. Among university students, 43% were engaged in PA ≥ 150 min weekly, 24% met the criteria of GAD, and 32% met the criteria of depression. More students were involved in PA before the COVID-19 outbreak than during the national lockdown. Students with anxiety and depression were almost two times less likely to engage in PA than their counterparts without mental health disorders. The inactive group had higher scores of anxiety and depression than the physically active group. The relationship of PA with anxiety and depression was statistically significant but weak during the COVID-19 pandemic.

Personnel Well-Being in the Helsinki University Hospital during the COVID-19 Pandemic-A Prospective Cohort Study

In March 2020, strict measures took place in Finland to limit the COVID-19 pandemic. Majority of Finnish COVID-19 patients have been located in southern Finland and consequently cared for at the Hospital District of Helsinki and Uusimaa (HUS) Helsinki University Hospital. During the pandemic, HUS personnel’s psychological symptoms are followed via an electronic survey, which also delivers information on psychosocial support services. In June 2020, the baseline survey was sent to 25,494 HUS employees, 4804 (19%) of whom answered; altogether, 62.4% of the respondents were nursing staff and 8.9% were medical doctors. While the follow-up continues for a year and a half, this report shares the sociodemographic characteristics of the respondents and the first results of psychological symptoms from our baseline survey. Out of those who were directly involved in the pandemic patient care, 43.4% reported potentially traumatic COVID-19 pandemic-related events (PTEs) vs. 21.8% among the others (p < 0.001). While over a half of the personnel were asymptomatic, a group of respondents reported PTEs and concurrent depression, insomnia, and anxiety symptoms. This highlights the need to ensure appropriate psychosocial support services to all traumatized personnel; especially, nursing staff may require attention.

Impacts of the COVID-19 Pandemic on Life of Higher Education Students: A Global Perspective

The paper presents the most comprehensive and large-scale study to date on how students perceive the impacts of the first wave of COVID-19 crisis in early 2020 on various aspects of their lives on a global level. With a sample of 30,383 students from 62 countries, the study reveals that amid the worldwide lockdown and transition to online learning students were most satisfied with the support provided by teaching staff and their universities’ public relations. Still, deficient computer skills and the perception of a higher workload prevented them from perceiving their own improved performance in the new teaching environment. Students were mainly concerned about issues to do with their future professional career and studies, and experienced boredom, anxiety, and frustration. The pandemic has led to the adoption of particular hygienic behaviours (e.g., wearing masks, washing hands) and discouraged certain daily practices (e.g., leaving home, shaking hands). Students were also more satisfied with the role played by hospitals and universities during the epidemic compared to the governments and banks. The findings also show that students with certain socio-demographic characteristics (male, part-time, first-level, applied sciences, a lower living standard, from Africa or Asia) were significantly less satisfied with their academic work/life during the crisis, whereas female, full-time, first-level students and students faced with financial problems were generally affected more by the pandemic in terms of their emotional life and personal circumstances. Key factors influencing students’ satisfaction with the role of their university are also identified. Policymakers and higher education institutions around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey

The purpose of this study was to investigate the prevalence of depression and anxiety among Bangladeshi university students during the COVID-19 pandemic. It also aimed at identifying the determinants of depression and anxiety. A total of 476 university students living in Bangladesh participated in this cross-sectional web-based survey. A standardized e-questionnaire was generated using the Google Form, and the link was shared through social media-Facebook. The information was analyzed in three consecutive levels, such as univariate, bivariate, and multivariate analysis. Students were experiencing heightened depression and anxiety. Around 15% of the students reportedly had moderately severe depression, whereas 18.1% were severely suffering from anxiety. The binary logistic regression suggests that older students have greater depression (OR = 2.886, 95% CI = 0.961-8.669). It is also evident that students who provided private tuition in the pre-pandemic period had depression (OR = 1.199, 95% CI = 0.736-1.952). It is expected that both the government and universities could work together to fix the academic delays and financial problems to reduce depression and anxiety among university students.

Impacts of CoVID-19 Pandemic on the Psychological Well Being of Students in a Nigerian University

The novel Covid-19 pandemic has caused disruption of several activities globally. It has resulted in lockdown of economic activities in most countries including Nigeria. The effects of the pandemic and the associated lockdown on the mental health status of Nigerian students have not taken into perspective in the control efforts. This study was conducted to assess the burden of the psychological problems associated with COVID-19 pandemic and coping strategies among students at Bowen University, Iwo (BUI), Nigeria. A cross-sectional survey was conducted, and multi-stage sampling technique employed to recruit 433 eligible respondents. Validated online self-administered, semi-structured questionnaire was used to collect relevant information from respondents. Appropriate summary statistics were carried out, and Binary logistic regression model was developed to examine protective/risk-factors of decreased mental wellbeing among the respondents. Mean age of the respondents was 20.11 ± 2.9 years, almost three-quarter (72.7%) of them were females. In all, 55.0% of the respondents had decreased psychological wellbeing because of the lockdown. Protective factors against decreased mental wellbeing included online catting with friends/watching films (OR=0.22, 95%CI=1.37-3.59), and participating in online vocational training (OR=0.25, 95%CI=0.25-0.61). The odds of decreased mental wellbeing was significantly higher in students who indicated a need for substance use as coping strategy(OR=1.50, 95%CI=0.55-4.05), and those who were not satisfied with online teaching method (OR=5.34, 95%CI=4.13-9.18).The mental health impacts of COVID-19 on the Nigerian students is huge. Thus, psychological wellbeing of the Nigerian students should be taken into cognizance and prioritized in the post-COVID-19 national rebuilding strategies. Keywords: Covid-19, Determinants, Depression, Mental wellbeing, Mental disorders, Suicide

The Role of Resilience and Gender in Relation to Infectious-Disease-Specific Health Literacy and Anxiety During the COVID-19 Pandemic

BACKGROUND

Anxiety is one of the psychological problems being experienced by the general population during the current coronavirus disease 2019 (COVID-19) pandemic. Health literacy, such as infectious-disease-specific health literacy, is associated with anxiety, but the mechanism of such association is not clear. This study explored the relationship between infectious-disease-specific health literacy and anxiety.

METHODS

We conducted an online survey in Hubei province, the early epicenter of the COVID-19 pandemic. A total of 1038 COVID-19-negative participants accomplished a battery of online survey tools determining their sociodemographic characteristics, perceived risk of acquiring COVID-19, infectious-disease-specific health literacy, resilience, and anxiety symptoms. We examined the moderated mediation models, in which the mediator was resilience and the moderator was gender.

RESULTS

Most (63%) of the study participants experienced at least mild anxiety. The indirect effect of infectious-disease-specific health literacy on anxiety through resilience was -0.282 (95% confidence interval [CI] = [-0.511, -0.083]), contributing to 32.7% of the total effect of health literacy on anxiety. Resilience fully mediated the association. The mediation effect of resilience tended to be stronger for the male participants than for the female participants as the moderation effect of gender remained until we included perceived risk of acquiring COVID-19 in the model.

CONCLUSION

Resilience was found to mediate the association between infectious-disease-specific health literacy and anxiety. Individuals with good infectious-disease-specific health literacy are more likely to acquire higher resilience, which may in turn decrease their anxiety level. Males may benefit more from the mediation effect of resilience during the current pandemic. Infectious-disease-specific health literacy programs may help reduce the anxiety of the program participants by enhancing their resilience during a pandemic.