The Fear of COVID-19 Scale: Development and Initial Validation

COVID-19 pandemic and its impact on medical interns' mental health of public and private hospitals in Guadalajara

INTRODUCTION

Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated stress levels. Addressing this issue is crucial due to its impact on well-being and health-care quality.

MATERIALS AND METHODS

This cross-sectional survey study assessed fear of COVID-19 and burnout levels among medical student interns in hospitals in Guadalajara, Jalisco. The study used validated scales and collected data from September 2021 to September 2022. A snowball sampling method was employed and a minimum sample size of 198 participants was calculated.

RESULTS

This study included 311 medical students (62.1% female and 37.9% male with a mean age of 23.51 ± 2.21 years). The majority were in their second semester of internship (60.5%) and from public hospitals (89.1%). Most students believed that the COVID-19 pandemic affected the quality of their internship (82.6%). Female students had higher personal burnout scores, while male students had higher work-related burnout scores. The mean score for fear of COVID-19 was 13.71 ± 6.28, with higher scores among women (p = 0.004) and those from public hospitals (p = 0.009). A positive weak correlation was found between COVID-19 scores and burnout subscales.

CONCLUSION

Our study emphasizes the significant impact of various factors on burnout levels among medical students and health-care professionals during the COVID-19 pandemic. Prolonged exposure to COVID-19 patients, reduced staffing, and increased workload contributed to burnout, affecting well-being and quality of care. Targeted interventions and resilience-building strategies are needed to mitigate burnout and promote well-being in health-care settings.

Parental intention on getting children COVID-19 vaccinations: Invariance evaluation across parenting roles and COVID-19-like symptoms experiences among Iranians during the pandemic period

Countries worldwide are facing challenges with increasing the COVID-19 vaccination rates for children. This study examined associations between perceived knowledge, coping appraisal, threat appraisal, adaptive response, maladaptive response, and intention, and possible variance across parents (mother or father) and COVID-19-like symptoms experiences regarding parental intentions to vaccinate their children. A total of 836 Iranian parents with children between the ages of 6 and 12 y completed measures assessing perceived knowledge, coping appraisals, threat appraisals, intentions, adaptive responses, and maladaptive responses. Multigroup structural equation modeling revealed that perceived knowledge was positively associated with both coping and threat appraisals, coping appraisals positively associated with adaptive responses, maladaptive responses, and intentions to vaccinate, threat appraisals positively associated with adaptive and maladaptive responses, and adaptive responses positively associated with intentions to vaccinate. The invariance evaluation revealed no differences across parents or COVID-19-like symptoms experiences in parental intentions to get their children vaccinated. The findings suggest that cogent information regarding childhood COVID-19 vaccination may boost parents' knowledge influencing their appraisals, adaptive responses and intentions to vaccinate their children. Specifically, coping appraisals and adaptive responses appeared to be important mediators between knowledge and intentions to vaccinate. Furthermore, intentions to vaccinate children may not be strongly influenced by parental roles or COVID-19-like symptoms experiences. These findings may help multiple stakeholders promote COVID-19 vaccination rates among children, and countries should further examine ways of increasing rates based on their specific needs.

Psychological responses to the COVID-19 pandemic and situational impact: A network analysis in Hong Kong residents

BACKGROUND

The COVID-19 pandemic has had situational impacts and induced various psychological responses among residents. The present study aims to analyze the network structure of psychological responses to the pandemic and their relationships with situational impact, resilience, and well-being through a network approach.

METHODS

An online survey recruited 1122 residents (mean age = 32.5 years, 65.4 % female) in Hong Kong from October 2020 to October 2021. The participants completed the Mental Impact and Distress Scale: Psychological Response (MIDc-PR) and other validated measures. Gaussian graphical modeling was conducted in R to identify the central MIDc-PR symptoms and their bridge linkages with situational impact, resilience, and well-being.

RESULTS

In the MIDc-PR network, the central symptoms were 'Routine' and 'Images' for Anticipation and 'Tense' and 'Lonely' for Modulation, with 12 bridge edges between the two clusters. In the combined network, the MIDc-PR nodes showed 12 bridge edges with situational impact, particularly in the health domain. 'Concerned', 'Sleep', and 'Lonely' showed negative linkages with resilience; 'Unmotivated' and 'Trapped' showed negative linkages with well-being. The network models showed good levels of stability and did not differ significantly in network structure and global strength across gender and age groups.

LIMITATIONS

The cross-sectional study design only allowed undirected associations in the network and could not model the within-subject effects.

CONCLUSIONS

The study findings contributed to the literature by elucidating the network structure of psychological responses to the pandemic. The central and bridge symptoms have clinical implications as potential targets for future interventions.

COVID-19 Vaccination Uptake, Infection Rates, and Seropositivity Among Youth Experiencing Homelessness in the United States

BACKGROUND

People experiencing homelessness are at greater risk of exposure and poor health outcomes from COVID-19. However, little data exist on the prevalence and correlates of COVID-19 among homeless populations. To mitigate the spread and severity, uptake of the COVID-19 vaccine is needed. This can be challenging among youth experiencing homelessness who are more likely to be unvaccinated when compared to stably housed youth.

OBJECTIVE

We conducted this study to determine the prevalence and correlates of COVID-19 among youth experiencing homelessness.

METHODS

We examined experiences of COVID-19 symptoms, self-report of infection, and rates of COVID-19 antibodies and distinguished between natural and vaccinated immunity among youth experiencing homelessness ( N = 265) recruited in one large metropolitan area in the south.

RESULTS

Based on self-report, very few participants experienced any symptoms, and 80% had never been diagnosed with COVID-19. Of those with COVID-19 antibodies (68%), the proportion with antibodies resulting from natural infection was 44%. The vaccination rate was 42%. Younger and vaccinated participants and those in shelters were likelier to have COVID-19 antibodies. Black and Hispanic youth were more likely than White youth to have had COVID-19. Those who adopted only one or two prevention behaviors were more likely to acquire a natural infection than those who adopted three or more prevention behaviors.

DISCUSSION

Youth experiencing homelessness report low vaccination rates, disrupted access to healthcare and social supports, and underlying chronic conditions, which may explain why they face poorer outcomes when infected with COVID-19. Vaccination and risk mitigation strategies to combat the high prevalence of COVID-19 are especially needed for sheltered youth who are at high risk yet are often asymptomatic.

Covid-19 Anxiety Scale (CAS): A Validity and Reliability Study

In this study, our aim was to develop a valid and reliable scale to determine the social anxiety level of people regarding COVID-19. A total of 420 people participated in the research. Explanatory and confirmatory factor analyses were used to test the validity and reliability of the scale. As a result of the explanatory factor analysis, it was determined that the scale consisted of 22 items and four sub-dimensions. These sub-dimensions were named "negative thinking", "sociability", "fear" and "vaccination". In examination of the fit indices obtained from the confirmatory factor analysis results, it was seen that the four-factor scale structure was high and acceptable. Based on these results, we concluded that the COVID-19 social anxiety scale (CAS) was valid and reliable for examining the level of social anxiety of people during the pandemic periods.

The relationship between social media dependency and psychological distress due to misunderstanding and fear of COVID-19 in medical students

Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P < 0.001, B = 0.19) but this relationship is not significant through fear and misperception related to COVID-19. Improper use of social media, identified as the strongest predictor, can directly increase psychological distress in medical students, without mediation through fear and misperception related to COVID-19. These findings should be taken into consideration when designing and evaluating interventions aimed at promoting mental health and fostering appropriate use of social media among students during disease outbreaks.

Emotions reflected in colours: experiences of nursing students during the COVID-19 period

BACKGROUND

The aim of this study was to identify nursing students' fears and emotions and to concretise the metaphors they used to describe their feelings towards the COVID-19 pandemic.

METHODS

This study was conducted with nursing students at a foundation university between December 2021 and February 2022 using a sequential mixed methods research design. In the quantitative part of the study, 323 nursing students answered the 'Positive and Negative Emotion Scale' and the 'COVID-19 Fear Scale'. In the qualitative part, students were asked to metaphorise COVID-19 with a colour and 21 in-depth interviews were conducted on the reasons for choosing this colour.

RESULTS

The average age of the students participating in the study was 21.41 ± 1.97 years and 78% of them were female. It was observed that 15.8 of the students had previously tested positive for COVID-19. Most of the participants (98.5%) were vaccinated against COVID-19 and 31.9% had a relative who died due to COVID-19. When the participants were asked which colour they compared COVID-19 to, it was observed that more than half of them chose red (51.4%) among bright colours and 13% chose black among dark colours. In this study, it was determined that students who chose dark colours to describe COVID-19 had higher COVID-19 Fear and Negative Emotion Scale scores. In in-depth interviews, it was observed that students who chose dark colours were more deeply affected by the COVID-19 process, while students who chose light colours associated this period with negative emotions.

CONCLUSION

In this study, it was observed that nursing students' feelings and thoughts about the COVID-19 period in line with their experiences affect the choice of colour in metaphorisation.

The relationship between fear of COVID-19 and adherence to personal protective measures in a sample of Iranian healthcare providers: a cross-sectional study

BACKGROUND

Studies have been conducted worldwide to investigate the level of adherence to personal protective measures or fear of COVID-19 among healthcare providers. However, few studies have examined the relationship between adherence to personal protective measures and fear of COVID-19. There is also a need for more information on this topic from Iran. This study investigated the relationship between adherence to personal protective measures against COVID-19 and fear of COVID-19 in the healthcare providers at Pastor Hospital of Bam, Iran, in 2022.

METHODS

This cross-sectional study was conducted in August and September 2022 with 199 healthcare providers of Pastor Hospital of Bam, Iran. The study included medical, nursing, and paramedical staff at Pastor Hospital at the time of the study. Incomplete responses and failure to return the questionnaire to the researcher were exclusion criteria. The fear of COVID-19 scale and a checklist of personal protective measures were used to collect data. Descriptive statistics, t-tests, analysis of variance, and Pearson's correlation coefficient were used to analyze the data.

RESULTS

Of the 199 participants, 67.3% were female, and their mean age was 31 ± 4.55 years. The mean score for adherence to personal protective measures was 14.46 ± 3.39 (out of 23), and the mean score for fear of COVID-19 was 17.04 ± 4.58 (out of 35). Adherence to personal protective measures was higher among females than males (14.96 ± 2.99 vs. 13.43 ± 3.92, p = 0.003), in individuals who had attended infection control courses than in those who had not (15.57 ± 2.88 vs. 13.30 ± 3.50, p < 0.001), and in those working in intensive care units than those in other wards (p = 0.009). A positive correlation was found between fear of COVID-19 and adherence to personal protective measures (r = 0.16, p = 0.03).

CONCLUSIONS

Healthcare providers demonstrated average levels of adherence to the personal protective measures and fear of COVID-19. Fear scores were also positively correlated with adherence scores. Specific workshops are necessary to familiarize all healthcare workers with personal protective measures against COVID-19 and universal precautions.

A Comparative Study of Cognitive and Motor Performance in Liver Recipients

Introduction: Neurocognitive and motor impairments are often observed both before and after liver transplantation, resulting in inefficiencies in dual-task performance. Specific aim: The aim of this study was to evaluate the motor-cognitive dual-task performance in liver recipients, with a particular emphasis on cognition, performance status, and the impact of the COVID-19 pandemic. Design: A prospective, cross-sectional, web-based design with a control group was used. The study included 22 liver transplant recipients and 23 controls. Participants completed a motor-cognitive dual-task test (timed up and go test, TUG), a cognitive assessment (mini mental state examination), and a physical performance test (5-repetition sit-to-stand test). The study also used a functional performance status scale (The Karnofsky performance status) and assessed fear of coronavirus disease (fear of COVID-19 scale). Dual-task interference was assessed and the rate of correct responses per second was calculated to assess cognitive performance. Results: The results indicated no statistically significant difference in TUG time and TUG correct responses per second between the groups (group × condition interactions; P > 0.05). There was no significant difference in cognitive and motor dual-task interference during the TUG test between the two groups (P > 0.05). The Karnofsky Performance Status score was significantly correlated with TUG motor dual-task interference (r = -0.424 and P = 0.049). Conclusion: This study suggests that dual-task performance does not differ in cognitive or motor performance between liver recipients and healthy controls under the same dual-task condition. However, further controlled studies are needed to improve the generalizability of these findings.

Students for others: Correlates of adherence to COVID-19 guidelines

Objective: The present study aimed to determine correlates of adherence to COVID-19 health precautions among college students. Drawing from the literature, the following constructs were considered: self-efficacy, conscientiousness, social support, collectivism, empathy, and fear of COVID. Participants: Undergraduate students (N = 92) recruited from psychology classes and social media, living on and off-campus, served as participants during fall 2020. Methods: Participants completed a short self-report survey, delivered online, measuring adherence to COVID-19 health precautions and its possible correlates. Results: After preliminary comparisons showing no differences in adherence between students living on and off-campus, linear regression analyses of the complete sample revealed that the significant predictors of adherence were conscientiousness, collectivism, empathy, and fear of COVID. Conclusions: College student adherence was largely driven by interpersonal motivators coupled with a modest level of fear, rather than more general constructs. These findings offer implications for considering targets in public health campaigns delivered to college students.

Workplace Deceptions During the Pandemic: Differences in Conspiracy Beliefs, Psychological Functioning, and Covid-19 Experiences

The global pandemic has disrupted virtually all countries on health, psychological functioning, and economies, to name a few. Accurate information has also fallen victim to the pandemic, which has been rife with misinformation and conspiracy theories. The current study investigated Covid-19 deceptions related to employment. With complete anonymity via MTurk, 389 participants from the United States rated their likelihood of deception regarding hypothetical four workplace scenarios. The first set of analyses examined differences between high and low risk of deceptions for each scenario based on participants' self-appraisals. The largest differences were found for general conspiracy beliefs and affective disorders, specifically major depression and generalized anxiety. The second set of analyses focused across the workplace scenarios on two operationalized groups with Likely-Deceptive (n = 189) vastly outnumbering Likely-Genuine (n = 55). Personal experiences with Covid-19 dramatically increased deceptions. Testing positive for Covid-19 increased the odds of being in the Likely-Deceptive by twelve-fold. Two discriminant models examined cognitive misbeliefs and psychological functioning. When both were combined, depression and Covid-19 misinformation produced the strongest structure coefficients followed closely by general conspiracy beliefs and generalized anxiety. The far-ranging implications of these findings are discussed.

A Bayesian approach to reveal the role of psychological factors on turnover intention among nurses during the COVID-19 pandemic

BACKGROUND

Turnover intention is considered a significant challenge for healthcare and treatment organizations. The challenging conditions of treating COVID-19 patients and the physical and mental stress imposed on nurses during the pandemic may lead them to leave their jobs. The present study aimed to determine the role of psychological factors (general health, mental workload, work-family conflicts, and resilience) on turnover intention using a Bayesian approach during the COVID-19 pandemic.

METHODS

The present cross-sectional study was carried out during the winter of 2021 at three hospitals in Khuzestan Province, Iran. To collect data for this investigation, 300 nurses were chosen based on Cochran's formula and random sampling technique. Seven questionnaires, including General Health, Mental Workload, Work-Family Conflict, Resilience, Job Stress, Fear of COVID-19, and Turnover Intention Questionnaires. Bayesian Networks (BNs) were used to draw probabilistic and graphical models. A sensitivity analysis also was performed to study the effects of the variables. The GeNIe academic software, version 2.3, facilitated the examination of the Bayesian network.

RESULTS

The statistically significant associations occurred between the variables of fear of COVID-19 and job stress (0.313), job stress and turnover intention (0.302), and resilience and job stress (0.298), respectively. Job stress had the highest association with the fear of COVID-19 (0.313), and resilience had the greatest association with the work-family conflict (0.296). Also, the association between turnover intention and job stress (0.302) was higher than the association between this variable and resilience (0.219). At the low resilience and high job stress with the probability of 100%, the turnover intention variable increased by 20%, while at high resilience and low job stress with the probability of 100%, turnover intention was found to decrease by 32%.

CONCLUSION

In general, the results showed that four psychological factors affect job turnover intention. However, the greatest impact was related to job stress and resilience. These results can be used to manage job turnover intention in medical environments, especially in critical situations such as COVID-19.

The 100 most-cited articles in COVID-19: a bibliometric analysis

Corona virus disease 2019 (COVID-19) pandemic, sparked by the emergence of a novel coronavirus in early 2020, has prompted a surge in published articles. This study aims to systematically analyse the characteristics and trends of impactful research in the field. The 100 most-cited publications associated with COVID-19 were identified by two independent reviewers using the 'Web of Science' database across all available journals up to the year 2023. Data collected include country, citation count, subject, level of evidence (using Oxford Centre for Evidence-Based Medicine System 2011), impact factor, funding, and study design. We identified 394 038 publications, and the 100 most-cited publications were ranked. These were cited by a total of 283 034 articles (median citation = 767), median impact factor of 66.9 and 72 articles with fundings. China (n = 44), USA (n = 19), and UK (n = 13) were the three highest contributors (n = 220 505). Most articles were level 5 evidence (n = 48), followed by level 3 (n = 28), 4 (n = 14), 2 (n = 7), and 1 (n = 3). The main subjects were mechanism of action and structures of SARS-CoV-2 virus (n = 18) and impact of COVID-19 on public health (n = 18). Publications in 2022 and 2023 predominantly focused on the impact of COVID-19. Majority of the highly cited studies were of low-to-moderate quality, with only 10 consisting of randomized controlled trials or systematic reviews with or without meta-analysis. These findings reflect a growing interest in understanding the impact of COVID-19 pandemic on public and mental health. This analysis found the potential for future double-blinded randomized controlled trials to validate existing findings.

The Long COVID Symptoms and Severity Score: Development, Validation, and Application

OBJECTIVES

The primary focus of this research is the proposition of a methodological framework for the clinical application of the long COVID symptoms and severity score (LC-SSS). This tool is not just a self-reported assessment instrument developed and validated but serves as a standardized, quantifiable means to monitor the diverse and persistent symptoms frequently observed in individuals with long COVID.

METHODS

A 3-stage process was used to develop, validate, and establish scoring standards for the LC-SSS. Validation measures included correlations with other patient-reported measures, confirmatory factor analysis, Cronbach's α for internal consistency, and test-retest reliability. Scoring standards were determined using K-means clustering, with comparative assessments made against hierarchical clustering and the Gaussian Mixture Model.

RESULTS

The LC-SSS showed correlations with EuroQol 5-Dimension 5-Level (rs = -0.55), EuroQol visual analog scale (rs = -0.368), Patient Health Questionnaire-9 (rs = 0.538), Beck Anxiety Inventory (rs = 0.689), and Insomnia Severity Index (rs = 0.516), confirming its construct validity. Structural validity was good with a comparative fit index of 0.969, with Cronbach's α of 0.93 indicating excellent internal consistency. Test-retest reliability was also satisfactory (intraclass correlation coefficient 0.732). K-means clustering identified 3 distinct severity categories in individuals living with long COVID, providing a basis for personalized treatment strategies.

CONCLUSIONS

The LC-SSS provides a robust and valid tool for assessing long COVID. The severity categories established via K-means clustering demonstrate significant variation in symptom severity, informing personalized treatment and improving care quality for patients with long COVID.

Mental health among Hispanic college students during the COVID-19 pandemic: Concurrent and predictive effects of negative and positive COVID-19 changes

Objective: We generated items to assess COVID-19 changes among Hispanic college students and examined the concurrent and predictive effects of these changes vis-à-vis mental health. Participants: The sample consisted of 559 Hispanic first-year (69% women; age range 18-22; 88.1% U.S.-born; 84% Mexican/Mexican American) attending a public university in Texas. Methods: Students participated in a three-wave longitudinal online survey assessing stressors, COVID-19 changes, anxious and depressive symptoms, hope, and self-esteem. Results: Students experienced negative changes across six life domains as a result of the pandemic-related lockdowns: education; health; relationships; finances; social issues; death/loss. They also reported positive changes during the lockdowns. Negative changes were positively correlated with higher, and positive changes with lower, acculturative and perceived stress. Negative COVID-19 changes predicted lower mental health. Conclusions: Hispanic students experienced both negative and positive COVID-19 changes, which were related to their mental health. Results can guide research and decision-making during future pandemics.

Predictors of fear of COVID-19 in a low-income country: health literacy is important

Introduction

Excessive fear of a threatening condition or situation can result in individuals engaging in unhealthy behaviors, especially during the COVID-19 pandemic. Identifying the influential factors of fear can be effective in designing and implementing health-center interventions to control and reduce the COVID-19 pandemic.

Methods

This study was a cross-sectional design implemented in Iran in 2022. Participants were adults 18-65 years of age recruited randomly from primary Health Care Services Centers (HCSCs) by medical records (n = 380, 64.7% female, mean (SD) age 32.14 ± 10.98 years) in urban and rural areas of the county. The data collection included a demographic form, Fear of COVID-19 questionnaire, Perceived Barriers of COVID-19 preventive behaviors, Self-efficacy, and Health Literacy for Iranian Adults (HELIA) questionnaire.

Results

It was determined that the fear of COVID-19 showed statistically significant differences according to gender (p-value = 0.013), education level (p-value = 0.001), and job status (p-value = 0.001). According to the hierarchical linear regression, educational level (p-value = 0.001; β = 0.665), job (β = 0.126; p-value = 0.018), self-efficacy (p-value = 0.015; β = 0.103), and Health Literacy (HL) (p-value = 0.001; β = 0.446) were significant predictors of fear of COVID-19. Also, among variables, educational level (p-value = 0.001; β = 0.665) and HL (p-value = 0.001; β = 0.446) were the most important predictors for fear of COVID-19.

Discussion

This research shows that HL has a potential and determinative role in controlling fear of COVID-19. The findings can help healthy policymakers and healthcare providers design HL-based programs in similar epidemics and pandemic situations.

Grandiose narcissism, unfounded beliefs, and behavioral reactions during the COVID-19 pandemic

A theoretical perspective on grandiose narcissism suggests four forms of it (sanctity, admiration, heroism, rivalry) and states that these forms conduce to different ways of thinking and acting. Guided by this perspective, we examined in a multinational and multicultural study (61 countries; N = 15,039) how narcissism forms are linked to cognitions and behaviors prompted by the COVID-19 pandemic. As expected, differences in cognitions and behaviors across narcissism forms emerged. For example, higher narcissistic rivalry predicted lower likelihood of enactment of COVID-19 prevention behaviors, but higher narcissistic sanctity predicted higher likelihood of enactment of COVID-19 prevention behaviors. Further, whereas the heroism, admiration, and rivalry narcissism forms acted in a typically antisocial manner, with high narcissism predicting greater endorsement of unfounded health beliefs, the sanctity form acted in a prosocial manner, with higher narcissism being linked to lower endorsement of unfounded COVID-19 health beliefs. Thus, the findings (a) support the idea of four narcissism forms acting differently, and (b) show that these differences reflect a double-edged sword, sometimes linking to an anti-social orientation, and sometimes linking to a pro-social orientation.

Effects of perceived risk of COVID-19 on fear among visiting workers: Mediating role of perceived stress

With the creation of a social distancing policy due to coronavirus disease 2019 (COVID-19), home visit workers are under mental stress as they are treated as the source of infection for COVID-19. Since door-to-door rental equipment examiners and gas inspectors must perform their duties even in the COVID-19 situation, they are being discriminated against so severely. The purpose of study was to examine the mediating role of perceived stress on the relationship between risk perception and fear. Data was collected data through labor unions among 275 home visiting workers who examine rental home appliance equipment or inspecting gas. On-line survey was conducted to assess COVID-19 risk perception, fear, perceived stress, and demographic characteristics. The data was analyzed using PROCESS Macro (Model 4). The results of the study showed that stress plays an important role in increasing COVID-19 fears when COVID-19 risk perception increases. Meanwhile, it was found that COVID-19 fear decreased when the level of perceived stress decreased. To reduce the impact of COVID-19 risk perception on COVID-19 fears, appropriate educational programs to reduce stress should be developed for home visit workers. Policymakers need to develop online or mobile Infectious disease education programs for COVID-19 risk at work and establish policies to apply legal education.

Negative impact of nurses' fear of COVID-19: the moderating role of implementation of knowledge management

Background

During the COVID-19 pandemic, nurses encountered substantial infection risks and psychological strain, which severely affected their emotional well-being, professional attitudes, and job performance. This study investigated the impact of nurses' fear of COVID-19 on their intention to leave the occupation and emotional labor as well as the moderating role of the implementation of knowledge management on these primary variables.

Methods

To mitigate common method bias, this research adopted a two-phase questionnaire approach, targeting nurses at a medical center in central Taiwan. In the first phase, 300 copies of questionnaire were distributed for participants to complete self-assessment surveys covering fear of COVID-19, knowledge management implementation, and demographic information. After 1 month, the participants were invited to complete a follow-up questionnaire, focusing on the intention to leave the occupation and emotional labor. The questionnaire was conducted from June to July 2022. Through this two-phase distribution method, after exclusion of invalid responses, a total of 288 valid responses were collected, resulting in a response rate of 96%. The proposed hypotheses were verified using hierarchical regression conducted with SPSS version 25.0.

Results

The findings indicated that nurses' fear of COVID-19 was significantly and positively associated with their intention to leave the occupation and surface acting, but negatively associated with their deep acting. Moreover, the implementation of knowledge management significantly moderated the positive relationship among fear of COVID-19, intention to leave the occupation, and surface acting. A robust knowledge management system weakened the positive association among fear of COVID-19, intention to leave the occupation, and surface acting.

Conclusion

In summary, nurses' fear of COVID-19 may increase their tendency to leave the nursing profession and engage in more surface acting and less deep acting. However, effective knowledge management practices can mitigate these adverse effects. Hospitals can thus establish and employ comprehensive knowledge management systems to enhance nurses' resilience and help alleviate their fear of future pandemics and their potential negative repercussions.

Trends and factors influencing the mental health of college students in the post-pandemic: four consecutive cross-sectional surveys

Background

The long-term impact of COVID-19 on the mental health and well-being of college students, specifically trends over time after full removal of COVID-19 restrictions, has not been well-studied.

Methods

Four consecutive cross-sectional surveys were conducted in December 2022 (N = 689), March 2023 (N = 456), June 2023 (N = 300), and November 2023 (N = 601) at a university in Sichuan Province, China.

Results

The proportion of students with COVID-19 panic decreased from 95.1 to 77.3% (p < 0.001). The prevalence of moderate anxiety and above decreased from 18 to 13.6% (p < 0.001), and the prevalence of moderate and above depression decreased from 33.1 to 28.1% (p < 0.001), while the prevalence of post-traumatic stress disorder (PTSD) increased from 21.5 to 29.6% (p < 0.005). Further, the proportion of suicidal thoughts increased from 7.7 to 14.8% (p < 0.001). Suicidal thoughts and self-injuries were significantly associated with COVID-19 panic, depression, anxiety, and PTSD. Students who reported being in close contact with COVID-19 patients in the past were more likely to develop PTSD. Further, COVID-19-induced panic was a risk factor for self-injury.

Conclusion

One year after the COVID-19 pandemic, the overall mental health of college students was not optimal. Hence, we can conclude that the long-term impacts of COVID-19 on the mental health of college students may have already occurred. To mitigate this impact and prepare for the next major public health event, strengthening college students' mental health curricula and promoting healthy behaviors among college students should be a priority for universities and education authorities.

Longitudinal experiences of Canadians receiving compassionate access to psilocybin-assisted psychotherapy

Recent clinical trials have found that the serotonergic psychedelic psilocybin effectively alleviates anxiodepressive symptoms in patients with life-threatening illnesses when given in a supportive environment. These outcomes prompted Canada to establish legal pathways for therapeutic access to psilocybin, coupled with psychological support. Despite over one-hundred Canadians receiving compassionate access since 2020, there has been little examination of these 'real-world' patients. We conducted a prospective longitudinal survey which focused on Canadians who were granted Section 56 exemptions for legal psilocybin-assisted psychotherapy. Surveys assessing various symptom dimensions were conducted at baseline, two weeks following the session (endpoint), and optionally one day post-session. Participant characteristics were examined using descriptive statistics, and paired sample t-tests were used to quantify changes from baseline to the two-week post-treatment endpoint. Eight participants with Section 56 exemptions (four females, Mage = 52.3 years), all with cancer diagnoses, fully completed baseline and endpoint surveys. Significant improvements in anxiety and depression symptoms, pain, fear of COVID-19, quality of life, and spiritual well-being were observed. Attitudes towards death, medical assistance in dying, and desire for hastened death remained unchanged. While most participants found the psilocybin sessions highly meaningful, if challenging, one reported a substantial decrease in well-being due to the experience. These preliminary data are amongst the first to suggest that psilocybin-assisted psychotherapy can produce psychiatric benefits in real-world patients akin to those observed in clinical trials. Limited enrollment and individual reports of negative experiences indicate the need for formal real-world evaluation programs to surveil the ongoing expansion of legal access to psychedelics.

COVID-19 memories young adults may share: exploring event properties and motivations for transmission

The COVID-19 pandemic has left an enduring mark on human history. This study investigates the intergenerational transmission of COVID-19 memories through a unique approach involving 49 participants aged 18-30. Specifically, participants were prompted to share a COVID-19 memory they would choose to transmit to their future children. Furthermore, participants provided reasons for selecting that particular memory, utilising a memory functions scale and open-ended responses. Applying Transition Theory, we examined the transitional impact, event importance, previous rehearsal, and valence of reported memories. Results revealed that 88% of memories revolve around distinctive events inducing psychological and material changes. Perceived as significant, negative, and transitional, these memories are predominantly public in nature. Predictors of event importance include previous rehearsal and psychological change. Participants share memories primarily for directive purposes, intending to inform future generations. The results imply that transitions not only organise personal memories but may also direct and shape memories for public events.

COVID-19 Symptoms and Mental Health Outcomes among Italian Healthcare Workers: A Latent Class Analysis

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.

Rates of Vaccination against COVID-19 in Psychiatric Outpatients

BACKGROUND

The aim of this study was to compare the rates of vaccination against COVID-19 infection in psychiatric outpatients and the general population, as well as rates of infected patients. In addition, the level and type of anxiety due to the pandemic were observed in patients with psychotic, anxiety, and depressive disorders.

MATERIALS AND METHODS

In the present study, 171 patients with pre-existing mental disorders completed the questionnaire about the doses and types of vaccination against COVID-19. During 2021-2023, patients with different mental disorders, aged from 18 to 80, were included. All patients filled in a self-reported questionnaire including general information (age, sex, marriage, education, working status, comorbid conditions) as well as questions about mental health, receiving vaccination, and the course of COVID-19 infection if it was present. All patients gave informed consent for the interview.

RESULTS

Patients with pre-existing mental disorders were more likely to be vaccinated against COVID-19 compared with the general population. The Sinopharm vaccine was most frequently applied. In the observed patients, 46.8% were infected, but just 7% had a medium or serious form of infection and were not vaccinated.

CONCLUSIONS

In our study, the percentage of vaccinated psychiatric patients was greater than that in the general population, except in psychotic patients, who were mostly limited by fear. Such results can be explained by the high percentage of somatic comorbidities in this population and perhaps insufficient information about the positive effects of vaccination.

Sleep quality and related factors among healthcare workers in designated quarantine hospital site in post-pandemic based on the health ecological model: a cross-sectional study in Nanjing, China

Aims

This study aims to assess the status and related factors among healthcare workers (HCWs) in designated quarantine-hospital-site (DQHS) based on the model of health ecology.

Methods

The cross-sectional study was conducted from April to May, 2022, which included 351 valid samples. We measured sleep quality using the Pittsburgh Sleep Quality Index, which encompasses seven dimensions: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each dimension is scored individually, contributing to an overall sleep quality score. Factors associated with the sleep quality of HCWs in DQHS were divided into individual, behavioral, interpersonal and social dimensions. Hierarchical linear regressions were conducted to identify the potential factors associated with sleep quality among HCWs in DQHS.

Results

HCWs in DQHS had a statistically higher sleep quality than the Chinese national norm. HCWs who were female, afraid of Coronavirus disease, had more negative emotions, frequently worked overtime, were married, and had a higher income were more likely to experience worse sleep quality (p < 0.05), while those who worked between 51 and 70 h weekly, treated over 10 patients daily, and engaged in more health behaviors may have better sleep quality (p < 0.05).

Conclusion

This study revealed a worrying level of sleep quality among HCWs in DQHS. The government, hospital managers, and families should collaborate to ensure the sleep quality of HCWs in DQHS.

Direct Losses and Media Exposure to Death: The Long-Term Effect of Mourning during the COVID-19 Pandemic

Background: The social distancing policies adopted during the COVID-19 pandemic forced many individuals to confront their mortality and worry about losing loved ones, making it impossible to say goodbye to them properly. Those not directly experiencing loss were inundated with information about COVID-19-related deaths throughout social media, leading to vicarious grief. This study delved into the long-term effects of direct and vicarious mourning on people's mental health during the COVID-19 pandemic. Method: A sample of 171 adults (65% female) aged 19-66 years (Mage = 25.8, SD = 8.57) voluntarily participated in an online survey assessing self-reported psychological measures of complicated grief, stress, depression, dispositional neuroticism, trait anxiety, and situational anxiety. Results: MANOVAs revealed that direct mourning experiences had an extremely severe impact on anxiety, stress, and fear of COVID-19, and a moderate effect on those without personal losses. Indeed, participants reporting high media exposure showed higher scores of depression and stress. Conclusions: Findings from the current study displayed that during the COVID-19 pandemic, people engaged more in proximal defenses than distal ones, taking health-protective measures, experiencing increased anxiety levels toward virus infection, and feeling distressed. Additionally, vicarious mourning was more strongly associated with depression due to emotional empathy with others.

Investigation of the psychiatric factors that determine the fear of COVID-19 in healthcare workers and hospital staff in a university hospital in Turkey

To examine the association of health and hospital workers' fears of coronavirus disease 2019 (COVID-19) with anxiety, anxiety sensitivity, depression, and sociodemographic variables during the COVID-19 pandemic. A total of 527 participants (237 men/289 women) were included, 222 of the participants were doctors, 99 nurses, 22 assistant health personnel, and 182 hospital personnel without health education. Participants filled in the sociodemographic data form, Beck Depression Inventory, Beck Anxiety Inventory, Anxiety Sensitivity Index-3, and Fear of COVID-19 Inventory. In linear regression analysis, independent predictors of the fear of COVID-19 were determined as Beck Anxiety Inventory (p < 0.001), Beck Depression Inventory (p = 0.001), and Anxiety Sensitivity Index-3 Physical subscale (p = 0.001). The fear of COVID-19 is associated with the physical subscale of anxiety, depression, and anxiety sensitivity.

The validation of the Arabic version of the Coronavirus-2019 Phobia Scale (C19P-SA) and individual differences in coronaphobia experiences among an Arabic population

The current study adapted the Coronavirus 19 Phobia Scale into Arabic and tested the psychometric properties of the adapted version on 469 Arabic-speaking individuals (mean age = 29.57 years old; SD = 10.39; range = 9-71 years old). After confirmatory analysis found supporting evidence for the four-factor structure, consequent analysis on convergent and discriminant validity and reliability of the Arabic version are also supported. A 2 × 2 between-groups factorial multivariate analysis of variance was used to investigate individual differences in coronaphobia. Results show that there is no significant interaction effect between gender and marital status, λ = 0.973, F (8,460) = 1600, p = 0.121, partial η2 = 0. 014; however, the main effect for gender is statistically significant, λ = 0.925, F (4,464) = 9.367, p < 0.001, partial η2 = 0.075, power = 1.000, where women score higher than men on all coronaphobia factors. In addition, the main effect for marital status is also significant, λ = 0.923, F (4,464) = 4.701, p < 0.001, partial η2 = 0.039, power = 0.998, where singles score higher than married couples on only two coronaphobia factors: Psychological and economic. Based on the findings, we conclude that the effects of coronaphobia have similarities across nations as well as differences unique to the Arabic populations.

Managing Fear During Pandemics: Risks and Opportunities

Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics.

The Japanese adaptation and validation of the COVID-19 Phobia Scale (C19P-S)

There exists a significant need of screening, measuring, and assessing phobic reactions to the negative effects and consequences of coronavirus disease 2019 (COVID-19) across the world. For this purpose, the C19P-S has b een developed and adapted to several languages and cultures including Turkish, Russian, Arabic, English, Korean, and soforth. This study aimed to adapt the scale into Japanese. Convenience sampling was used in the recruitment of the participants. The sample involved 310 Japanese-speaking natives from different prefectures of the country (MeanAGE = 49.97; SD = 13.07). The scale is a self-report instrument, which includes 20, 5-point Likert-type items. The scale assesses the levels of COVID-19 phobia in four areas: Psychological, Somatic, Economic, and Social. The validity (content, construct, convergent, and discriminant) and reliability (internal consistency) analyses were conducted. Multivariate analysis of variance (MANOVA) was used for group comparisons. MANOVA results show that women scored statistically higher in the psychological area. Furthermore, the participants with a lower educational level scored higher than those with a higher level in the somatic area. Among other scales measuring fear and anxiety, the C19P-S Japanese (C19P-SJ) is the first measurement tool specifically designed and adapted for evaluating coronaphobia. It is suggested that the individuals with psychiatric diagnoses be included to measure and support the construct validity of the scale.

Evaluation of fear, willingness to seek care, and healthcare delivery preferences for patients with nephrolithiasis during the COVID-19 pandemic

Background

Although minimal is known about coronavirus disease 2019 (COVID-19)'s impact on patient healthcare perceptions, improved understanding can guide healthcare providers to adequately address patient concerns. This cross-sectional study investigated how fear induced by COVID-19 impacted nephrolithiasis patients' perceptions, decision-making, and preferences for care delivery.

Methods

Utilizing the validated Fear of COVID-19 Scale (FCV-19S), patients were surveyed at a single stone clinic during part of the COVID-19 pandemic, 03/2021-04/2022. One-way analysis of variance (ANOVA), Chi-square tests, and multinomial logistic regression evaluated the effect of sociodemographics on responses.

Results

Two hundred and four surveys were completed. Mean age was 58±16 years, and 112 (54.9%) were women. Mean FCV-19S was 14.8±5.8 points (range, 7-33). Women and non-Caucasian races were associated with higher fear scores (P<0.01 and P=0.01 respectively). Stone prevention effort was not associated with fear (P=0.38). Poorer self-assessed health status was associated with increased stone prevention efforts (P=0.04). Preference for in-person care was reported in 89% of patients. Willingness to seek care varied by age and education, with decreased likelihood to seek care for middle-aged patients (P=0.04) and increased education (P=0.01).

Conclusions

Perceived fear during the COVID-19 pandemic was highly variable in nephrolithiasis patients, with higher fear scores in women and non-Caucasians. Willingness to seek care during the pandemic varied with age, education level, symptom severity, COVID-19 fear, current stone status, and health status. Stone patients greatly preferred in-person medical care over telemedicine during COVID-19. Future studies are needed to further evaluate these health disparities, discrepancies in fear, and comfort in seeking stone-related healthcare to help us better inform health policymakers and provide patient-centered care.

Changes in experienced quality of oncological cancer care during the COVID-19 pandemic based on patient reported outcomes - a cross-sectional study

AIM

The study aims to investigate the impact of the COVID-19 pandemic on cancer patients' perceptions of the quality of their oncological treatment and care.

BACKGROUND

The COVID-19 pandemic disrupted healthcare delivery and oncological resources were repurposed, potentially leading to prolonged treatment and reduced access to innovative therapies and clinical trials. Still, little is known about how patients perceived the quality of their treatment.

METHODS

A cross-sectional study was conducted in the spring of 2020 among cancer patients at the Department of Oncology, Aarhus University Hospital and Rigshospitalet, Denmark. Patients were invited to complete an online questionnaire on clinical, socioeconomic, emotional, behavioural, and quality-related aspects of oncological cancer care. Patients who experienced reduced treatment quality and those who reported no or slight reductions were compared using multiple logistic regression, exploring the associations with patient characteristics, behaviours, and fear of cancer progression or recurrence.

RESULTS

A total of 2,040/5,372 patients experienced changes in their treatment plans during the pandemic, and 1,570/5,372 patients experienced reduced treatment quality, with 236 reporting a high degree of reduction. Patients with breast, head and neck, and upper gastrointestinal cancers were more likely to experience reduced treatment quality. Altered interactions with healthcare providers, along with isolation, lack of social support, and heightened fear of cancer progression, were significant risk factors for experiencing reduced cancer care quality.

INTERPRETATION

We identified subgroups of cancer patients needing targeted communication and care during health crises affecting cancer treatment. The findings underscore the importance of safeguarding the needs of vulnerable patient populations in future healthcare emergencies.

Examining the relationship between physical literacy and resilience against COVID-19-induced negative mental states in Chinese adolescents

Research indicates that COVID-19 has had adverse effects on the mental health of adolescents, exacerbating their negative psychological states. The purpose of this study is to investigate the impact of Physical Literacy (PL) on Negative Mental State caused by COVID-19 (NMSC) and identify potential factors related to NMSC and PL in Chinese adolescents. This cross-sectional study involved a total of 729 Chinese high school students with an average age of 16.2 ± 1.1 years. Participants' demographic data, PL data, and NMSC data were collected. PL and NMSC were measured using the self-reported Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q), the Stress and Anxiety to Viral Epidemics-6 (SAVE-6), and the Fear of COVID-19 Scale (FCV-19). Adolescents in the current study demonstrated higher levels of NMSC and lower PL, with average scores of 3.45 and 2.26, respectively (on a scale of 5). Through multiple linear regression analysis, Motivation (MO), Confidence (CO), Emotional Regulation (ER), and Physical Regulation (PR) were identified as factors influencing NMSC in adolescents. The study findings contribute to providing guidance for actions aimed at alleviating NMSC among adolescents.

Internet addiction among adolescents during the COVID-19 pandemic: Associations with sociodemographic and psychological distress

Background

The COVID-19 pandemic has had tremendous implications for billions of adolescents worldwide due to school closures, forcing students to embrace internet usage for daily tasks. Uncontrolled use of the internet among adolescents makes them vulnerable to internet addiction (IA). This study aims to determine the prevalence of IA among adolescents and assess its association with sociodemographic factors, smartphone use, and psychological distress during the pandemic.

Method

A cross-sectional self-administered online survey was conducted among students aged 13-17 from May 15th, 2021, until May 30th, 2021, using the Malay version of the Internet Addiction Test (MVIAT), the Depression, Anxiety, and Stress Scale (DASS-21), and the Coronavirus Impacts Questionnaires, as well as a sociodemographic information form. The data was analyzed with IBM SPSS Statistics version 23.

Results

A total of 420 adolescents participated in the survey. The majority of them (70.7%) were female, with a mean age of 15.47 years (±1.49 years old). About 45.5% of the respondents were classified as internet addicted users. The Chi-square test analysis showed that age (p = 0.002), smartphone usage (p = 0.010), rate of midnight use (p < 0.001), frequency (p < 0.001), duration (p < 0.001) of device usage, and presence of depression, anxiety, and stress (p < 0.001) were all significantly associated with IA. Multiple logistic regression showed age (aOR = 1.16, 95% CI [1.00-1.35], p = 0.048), smartphone usage (aOR =3.52, 95% CI [1.43-8.67], p = 0.006), mild or moderate depression (aOR = 2.43, 95% CI [1.36-4.34], p = 0.003), severe or extremely severe stress (aOR = 6.41, 95% CI [2.18-18.82], p = 0.001) were significantly related to IA.

Conclusions

Late adolescence, the use of smartphones, and the presence of psychological distress like depression, and stress were potentially associated with IA. Wise use of smartphones and early identification of any psychological distress among adolescents are warranted, especially during the pandemic.

Fear of the COVID-19 vaccine in a public healthcare system and university setting

Despite the known benefits, some individuals remain apprehensive about receiving the COVID-19 vaccine, which hampers vaccination efforts and the achievement of herd immunity. Therefore, this cross-sectional study aimed to assess vaccination rates and identify factors influencing fear of the COVID-19 vaccine among individuals served by the public healthcare system (Family Health Strategy - FHS) and in a university community in Minas Gerais, Brazil. Surveys were conducted face-to-face with FHS participants and online with university members, employing a free sharing approach on social media. A total of 1896 and 312 responses were collected, respectively. The survey covered sociodemographic information, COVID-19 fear levels, and vaccination status for both individuals and their children Vaccination coverage was 83% among FHS participants and 99.1% in the university setting. Female respondents in both groups exhibited higher levels of COVID-19 fear (p<0.05), with FHS-assisted women reporting greater apprehension towards vaccination (p<0.05). Educated parents demonstrated better understanding of the importance of child vaccination, while younger parents expressed heightened concerns about vaccine side effects. Among FHS participants, women exhibited a 1.6 times higher fear of vaccination compared to men. Additionally, fear of vaccination increased by 1.10 times for each additional point on the COVID-19 Fear Scale (physiological domain). Effective communication strategies and dispelling misconceptions surrounding immunization could alleviate fear and promote vaccination acceptance.

Demand for mental health support services among health professionals in Vietnam: Lesson from COVID-19 Pandemic

BACKGROUND

This study aimed to measure the preferences for mental health support among health professionals, their willingness to support the mental health of colleagues and associated factors.

METHOD

A descriptive cross-sectional study was performed from August to October 2022 within five hospitals located in Hanoi, Vietnam. A total of 244 health professionals participated in the study. Data on socio-economic status, health and COVID-19-related characteristics, Depression Anxiety Stress Scale (DASS-21); and preferences for mental health support services were collected by using a structured self-reported questionnaire. Multivariate logistic regression models were utilized to identify associated factors with the demand for mental support services.

RESULTS

13.9%, 17.1% and 8.6% reported having at least mild depression, anxiety and stress, respectively. There 13.9% did not seek any mental health support during the COVID-19 pandemic. The most common support included talking with friends (52.9%), family (50.8%), colleagues (47.6%) and using social networks/Internet (43.5%). There 31.1% had been aware of mental health services, but only 18.0% used this service at least once. Regarding preferences, 47.3% had a demand for mental support services, and the most preferred service was providing coping skills (25.9%), followed by skills to support others against mental problems (22.2%). Major sources of support included psychiatrists (34.4%), colleagues (29.1%) and family (27.9%). The main preferred channels for support included telephone/mobile phone (35.7%) and Internet (20.9%). Only 12.3% were willing to provide mental support for colleagues during the pandemic. Age, education, perceived mental health status, ever seeking any mental service, and DASS-21 depression score were associated with demand for mental support services.

CONCLUSION

This study found a lack of awareness of mental health services for health professionals, as well as moderate levels of demand for this service in this population. Raising awareness and developing tailored mental health support services are important to enhancing the mental well-being of health professionals in Vietnam to prepare for the next pandemic.

Psychological Factors Associated with General Quality of Life in the Context of COVID-19 Pandemic: A Cross-Sectional Study on a Multicultural Sample of Romanian Medical Students

The COVID-19 pandemic had a significant impact on the general quality of life (GQOL) of a large number of individuals, including those in the academic environment. This study investigated GQOL in a sample of 613 Romanian medicine students (81.57% were female; mean age = 21.40 ± 1.749 years) in relation to their Big Five personality characteristics, Perceived Stress and Fear of COVID-19. The study was conducted between June 2020 and March 2022. These variables were investigated with the Big Five Inventory-2: Extra-Short Form, the Fear of COVID-19 Scale (FCV-19S), the Perceived Stress Scale-10 and the Satisfaction with Life Scale (SWLS). Statistical analysis included hierarchical linear regression and t-tests. The results indicated a significant direct relationship between GQOL and the personality traits of Conscientiousness, Extraversion and Agreeableness. However, a significant inverse relationship was observed between GQOL and Perceived Stress and Neuroticism. Fear of COVID-19 was significantly higher in women, while no other socio-demographic variables were associated with GQOL. A total of 61.7% of the studied population returned to their original residency during the pandemic years. These results could be important for better understanding the vulnerability to significant epidemiological events in academic populations and for planning adequate preventive or interventional measures.

Anxiety and Depression in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension after the Removal of COVID-19 Pandemic Restrictions

Background: There was increased risk of mental disturbances during the COVID-19 pandemic. Patients with chronic diseases, including pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), were particularly vulnerable. Our previous study showed high levels of fear of COVID-19 (FCV-19S), anxiety (HADS-A), and depression (HADS-D) in the second year of the pandemic among PAH/CTEPH patients. The aim of the present study was to assess changes in the levels of FCV-19S, HADS-A, and HADS-D after removing restrictions related to the COVID-19 pandemic. Methods: In this prospective, single-center study, 141 patients (62% females, 64% PAH) with a median age of 60 (range 42-72) years were included. Patients completed appropriate surveys in the second year of the pandemic, and then, after the restrictions were lifted in Poland (after 28 March 2022). Results: FVC-19S decreased significantly from 18 (12-23) to 14 (9-21), p < 0.001. The levels of anxiety (HADS-A ≥ 8 points) and depression (HADS-D ≥ 8 points) were abnormal in 26% and 16% of patients, respectively; these did not change at follow-up (p = 0.34 for HADS-A and p = 0.39 for HADS-D). Conclusions: Among PAH/CTEPH patients, fear of COVID-19 decreased significantly after the COVID-19 pandemic restrictions were removed, but anxiety and depression remained high, indicating that the COVID-19 pandemic was not a major factor in causing these disorders.

Factors Related to Caregivers' Intention to Vaccinate Their Elderly Family Members with Major Neurocognitive Disorders against COVID-19

Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers' intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members' attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers' intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers' perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers' intention to vaccinate elderly family members with MNDs, whereas elderly family members' age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members' age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers' intentions to vaccinate their elderly family members with MNDs against COVID-19.

The impact of mindfulness training on alleviating COVID-19 fear among international students in China: A quasi-experimental study

This study investigated the effects of mindfulness training on alleviating fear of the COVID-19 epidemic among international students in China during the academic year 2020. The training group participants (N = 41) and the control group participants (N = 44) were surveyed pre-and post-training with the two English questionnaires: The Five-Facet Mindfulness Questionnaire (FFMQ) and the fear of the COVID-19 scale (FCV-19S). The results showed that, regarding the relationship between the two main variables in the study, mindfulness is related negatively to the COVID-19 epidemic. Moreover, compared to the control group, results showed that individuals in the training group demonstrated significant improvements in mindfulness levels and decreased Fear of COVID-19. Thus, findings suggest that a short online mindfulness meditation training may reduce fear of the COVID-19 epidemic.

Real-world predictors of changes in fear of COVID-19 in the Japanese general population: a large-scale internet-based cohort study with 20,712 participants

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a respiratory infection that considerably impacts both physical and mental health. In particular, the prolonged nature of psychological issues associated with COVID-19 has become a concern. However, evidence based on longitudinal studies investigating the changes in fear of COVID-19 has been limited, posing a public health challenge.

METHODS

We investigated the predictors of changes in the Fear of COVID-19 Scale (FCV-19S) scores in the general Japanese population using data from a large-scale internet-based cohort study.

RESULTS

We included 20,712 study participants (mean age = 51.1 years, percentage of males = 49.9%). The baseline FCV-19S score for the research participants was 17.0, and one year later, the FCV-19S score decreased to 15.8. The predictors of increase in FCV-19S scores were older age, male sex, COVID-19 requiring oxygen therapy, higher baseline FCV-19S total score, severe psychological distress, never married, worsening subjective health status, a greater number of COVID-19 vaccinations, a history of alcohol dependency, and living with family members. Conversely, the predictors of decrease in FCV-19S scores included habitual alcohol intake, COVID-19 not requiring oxygen therapy and a higher household income. Our study was an internet-based survey focused on residents of Japan, which raises the possibility of selection bias and makes it unclear whether the findings can be extrapolated to other countries and cultures.

CONCLUSION

During the observation period, the FCV-19S scores significantly decreased. Severe COVID-19 requiring oxygen therapy within one year of baseline was the most impactful predictor of an increase in FCV-19S score. On the other hand, mild COVID-19 not requiring oxygen therapy was a predictor of a decrease in FCV-19S scores. Therefore, we believe that it is necessary to adopt individualized approaches stratified by the severity of the infection when addressing the fear of COVID-19.

Older Adults' Exposure to Food Media Induced Unhealthy Eating during the COVID-19 Omicron Lockdown? Exploring Negative Emotions and Associated Literacy and Efficacy on Shanghainese

The COVID-19 pandemic, propelled by the highly transmissible Omicron variant, had a global impact and significantly affected Shanghai, a major city in China. This study investigates how food media exposure influenced unhealthy eating habits among older adults during the COVID-19 lockdown in Shanghai, focusing on the roles of negative emotions, food literacy, health consciousness, and eating self-efficacy. The random sample comprised 400 individuals aged ≥50 years who lived in Shanghai from March to June 2022. A path and correlation analysis was performed. The exposure of older adults to food media resulted in the acceleration of unhealthy eating. The relationship was significantly exacerbated by food literacy and negative emotions. In contrast, eating self-efficacy and health consciousness effectively countered the media. The enhanced pathway from food-related media influence to eating habits through negative emotions or self-efficacy towards health awareness and food literacy showed significant effects. The findings provide insights for future research and public health strategies. Importantly, this study has practical significance for media professionals, public health decision-makers, and healthy food businesses regarding how to enhance older adults' cognition to respond to unhealthy eating crises.

Experiences and Attitudes Toward Telemedicine in an Adult Congenital Heart Disease Clinic: Lessons Learned from the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has driven a broader adoption of telemedicine (TM). We aim to describe adult congenital heart disease (ACHD) patient experiences with TM and explore factors associated with positive attitude toward future TM visits. This is a cross-sectional, single-center study in an outpatient ACHD clinic from February to June, 2022. Between-group comparisons were made using Wilcoxon-Rank Sum, Chi-Square, or Fisher-Exact tests. Univariate logistic regression was performed for variables that could correlate with a "positive" attitude toward future TM visits. Significance was determined using an alpha level of 0.05. Of 262 patients (median age 33 years, 55% female, 81% White), 115 (44%) had a prior TM visit and 110 (96%) reported a positive experience. There were 64 (24%) with a positive attitude toward future TM visits. Concerns include lack of cardiac testing and limited quality of visit. Patients with visits every 3-6 months (Odds Ratio [OR] 2.44; p < 0.01) and prior TM visit (OR 1.89; p = 0.03) had higher odds of a positive attitude toward future TM, whereas males had lower odds (OR 0.53; p = 0.04). Age, annual income, disease complexity, distance from clinic, and employment status were not associated. There is high rate of satisfaction with TM among ACHD patients but only one-quarter indicated interest in using TM in the future. Factors associated with interest in TM visits are identified, and together with patient feedback, can be used to understand potential role of TM for the ACHD population in the post-pandemic era.

The Motivation for COVID-19 Vaccination and Preventive Behavior

COVID-19, a viral infection that emerged in late 2019, induces a severe acute respiratory syndrome marked by significant clinical symptoms, and the potential for progressive respiratory failure and death. People facing the threat of COVID-19 not only feared being infected, but were also worried about the side-effects of vaccination. This conflict affected their epidemic prevention behavior. To understand this issue, the present study explored whether infection anxiety affected the psychological avoidance or approach to getting vaccinated and the intention to take epidemic prevention measures. The study implemented a cross-sectional, web-based survey. We created questionnaires using Surveycake, an online e-form questionnaire platform. We used the snowball sampling method via a social media app to recruit participants. If individuals were willing to participate in the research, we emailed the e-form questionnaire link to them to collect data. After questionnaire collection, 288 questionnaires were returned, and 277 valid questionnaires were obtained for structural equation modeling analysis. According to the statistical results, it was found that infection anxiety was positively related to avoidance-avoidance conflict, and the power of infection anxiety on avoidance conflict was 23.0%. Infection anxiety was negatively related to approach-approach conflict regarding vaccination, and the power of infection anxiety on approach-approach conflict was 22.0%. Approach-approach conflict regarding vaccination was negatively related to prevention behavior, while avoidance-avoidance conflict regarding vaccination was positively related to prevention behavior. The two conflicts explained 12.5% of the total variance in prevention behavior. The study results highlight the long-term importance of achieving vaccine goals in order to prepare for future health emergencies similar to the recent COVID-19 pandemic.

Impacts of demographic factors and the COVID-19 pandemic on job stress in Japanese childcare workers

BACKGROUND

Japan has a shortage of childcare personnel, and the high levels of stress causing turnover in childcare workers must be urgently resolved. However, there is a lack of knowledge regarding the characteristics and influencing factors of job stress in Japanese childcare workers.

OBJECTIVE

This study aimed to evaluate the job stress of childcare workers and explore the influence of demographic factors and the COVID-19 pandemic on such stress.

METHODS

The data were collected through an Internet survey from 2,472 respondents. A 23-item version of the Brief Job Stress Questionnaire was used to measure occupational stress in childcare workers. The instrument is recommended in the stress-check program implemented as a mental health measure in workplaces in Japan.

RESULTS

The percentage of childcare workers with high stress exceeded that of general workers. Multiple regression analyses showed that the only factor affecting all job stressors and social support was the fear of contracting COVID-19. Job stressors and the COVID-19 pandemic had a significant large effect on stress responses. Additionally, being married and having children moderated childcare workers' stress.

CONCLUSIONS

This study provided basic data regarding job stress in Japanese childcare workers and compared them with those of other professionals. In the future, it will be necessary to clarify how stress is related to turnover intention and turnover in Japanese childcare workers to promote their career continuity.

The Fear of COVID-19 Scale: Psychometric properties and measurement invariance across 10 months

The coronavirus disease 2019 (COVID-19) has led to various negative consequences including fear. The Fear of COVID-19 Scale (FCV-19S) has been widely used in diverse cultures, but no study has ever investigated its longitudinal measurement invariance and predictive validity. Therefore, we examined its longitudinal measurement invariance and predictive validity over 10 months. A sample of Chinese undergraduates (N = 682; first wave 842; 682 second wave) completed the FCV-19S as well as measures assessing depression, anxiety, and stress. Exploratory and confirmatory factor analyses were conducted along with measurement invariance testing. The results showed that the bifactor model fitted well, and significantly predicted stress and anxiety, but not depression. The FCV-19S demonstrated partial measurement invariance (i.e. configural and metric invariances) across time. These findings suggest that the Chinese version of FCV-19S is a reliable tool and could be used in evaluating the severity of fear of COVID-19 among Chinese young adults.

Nurses' COVID-19-related fear and anxiety and their attitudes to the COVID-19 vaccine: A descriptive and correlational study

BACKGROUND

The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine-related information and have a primary role in building confidence regarding vaccines.

AIM

The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID-19) and their attitudes towards the COVID-19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated.

METHODS

A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling.

RESULTS

Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID-19. Age and fear were also positively associated with anxiety related to COVID-19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine.

CONCLUSION

Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination.

Évaluation de la structure factorielle et des qualités psychométriques de l'Échelle de Fatigue Pandémique parmi la population adulte québécoise: Evaluation of the factorial structure and psychometric qualities of the Pandemic Fatigue Scale among Quebec adult population

OBJECTIVE

The objective of the study is to evaluate the factorial structure and the psychometric qualities of the Pandemic Fatigue Scale among the Quebec adult population.

METHOD

The data analyzed come from a web survey conducted in October 2021 among 10 368 adults residing in Quebec. The scale's factor structure and invariance by gender, age and language used to complete the questionnaire were tested using confirmatory factor analyses. Convergent and divergent validity were also assessed. Finally, the reliability of the scale was estimated from the alpha and omega coefficients.

RESULTS

The analyzes suggest the presence of a bidimensional structure in the sample of Quebec adults with informational fatigue and behavioral fatigue. The invariance of the measure is noted for sex, for age subgroups and for the language used for the questionnaire. The results of convergent and divergent validity provide additional evidence for the validity of the scale. Finally, the reliability of the scale scores is excellent.

CONCLUSION

The results support the presence of a bidimensional structure as in the initial work of Lilleholt et al. They also confirm that the scale has good psychometric qualities and that it can be used among the adult population of Quebec.