Psychometric Validation of the Bangla Fear of COVID-19 Scale: Confirmatory Factor Analysis and Rasch Analysis

From information to action: modelling social and cognitive factors in health decisions

BACKGROUND

This study examines the social and cognitive factors influencing health decisions to adopt protective behaviors in a U.S.

SAMPLE

A theoretical framework was developed, incorporating key variables such as perceived severity, perceived vulnerability, use of formal and informal health information, conspiracy beliefs, and political ideology. The protective behaviors studied included mask-wearing and vaccination intentions.

METHODS

This study employed a cross-sectional design to explore how cognitive appraisals and socio-political factors influence health decisions. Data were collected from 742 U.S.-based participants via Amazon Mechanical Turk (MTurk) between January 28-30, 2023.

RESULTS

Perceived vulnerability and perceived severity had distinct effects on information source preferences. Reliance on formal sources positively correlated with compliance behaviors such as mask-wearing and vaccination, while perceived severity strongly predicted mask adherence. In contrast, perceived vulnerability was associated with conspiracy beliefs and informal information use. Notably, fear of COVID-19 did not significantly influence health behaviors. Instead, political ideology and conspiracy beliefs played a more dominant role, emphasizing the importance of integrating socio-political factors into traditional health behavior models.

CONCLUSIONS

Understanding the complex interplay of cognitive and socio-political factors is crucial for developing effective public health strategies to enhance compliance with health guidelines during the COVID-19 pandemic and future crises.

Validation of the uncertainty stress scale-high-risk pregnancy - Chinese brief version: Rasch analysis

BACKGROUND

High-risk pregnancy leads to uncertainty and stress in pregnant women due to the threatened of mother and fetus health. The Uncertainty Stress Scale High-Risk Pregnancy Version, a 54-item Chinese version (USS-HRPV-C), has been widely used to assess the uncertainty and stress that women experience during pregnancy. However, the length of the scale may result in a burden for respondents. Thus, a brief version of the USS-HRPV-C is needed for a concise and vigorous assessment. The aim of this study was to shorten the USS-HRPV-C and validate the brief version.

METHODS

This study used a cross-sectional design. A convenience sample of 200 women with high-risk pregnancies completed the 54-item USS-HRPV- C. Confirmatory factor analysis (CFA) and Rasch model to examine the construct validity of the short version of the USS-HRPV-C. Rasch analysis was used with a stepwise approach to select items with better goodness-of-fit and no differential item functioning (DIF). Additionally, Cronbachs' α and Pearson correlations to evaluate the internal consistency of the original and brief versions. Test analysis modules (TAM) and Lavaan packages in R were used for data analyses.

RESULTS

The results of CFA supported a two-factor structure of the HRPV-C. Using the Rasch analysis, we reduced the USS-HRPV-C scale from 54 to 17 items. The selected 17 items were robust without displaying differential item functioning. Further, the 17-item short version exhibited satisfactory fit statistics that infit and outfit mean square ranged between 0.71 and 1.35, respectively. Internal consistency of Cronbach's α for the short version of the USS-HRPV-C scale ranged was 0.90 and 0.92 for the subscales of uncertainty and stress respectively. Both subscales of the brief version were significantly related to the original version of USS-HRPV-C.

CONCLUSIONS

This study developed a 17-item brief version of the USS-HRPV-C scale, which has demonstrated its satisfactory psychometric properties. Healthcare providers can use the validated brief version of the USS-HRPV-C to proficiently assess women's psychosocial stress and uncertainty during pregnancy.

Rasch analysis of the perceptions of palliative care instrument (PPCI) in patients with advanced cancer

RATIONALE, AIMS, AND OBJECTIVES

The Perceptions of Palliative Care Instrument (PPCI) is a tool used to access perceptions towards palliative care in patients with advanced cancer. However, its psychometric properties have not been widely tested using modern psychometric methods. This study aimed to examine the psychometric properties of the PPCI in patients with advanced cancer using Rasch analysis.

METHODS

Four hundred and forty four Participants were recruited from the Department of Medical Oncology at a tertiary care hospital in Xinxiang City, Henan Province, China, between October 2020 and February 2021. Participants completed the PPCI. Rasch analysis procedures were conducted, including assessment of unidimensionality, model-date fit, rating scale function, differential item functioning, item-person map, and person and item reliability.

RESULTS

The unidimensionality of the PPCI was confirmed, although two items (18 and 21) did not fit the Rasch model. The degree of fit of each item to its respective dimension was excellent, with Infit MNSQ and Outfit MNSQ values ranging from 0.73 to 1.33. The PPCI demonstrated high reliability, with an item reliability of 0.99 and a person reliability of 0.77.

CONCLUSION

The PPCI is a valid and reliable instrument for assessing perceptions of palliative care in advanced cancer patients. However, to further improve the quality and applicability of the PPCI, the deletion of items 18 and 21 is recommended, as they did not fit the Rasch model.

Validation of the Chinese version of the autism spectrum knowledge scale general population version (ASKSG) with a parent sample

BACKGROUND

The early detection and diagnosis of autism spectrum disorder (ASD) in children are a first step in determining follow-up assessments and personalized treatment plans. Parents play an extremely crucial role in children's development; therefore, it is essential to identify a valid and reliable instrument to evaluate the knowledge of parents about ASD. The aim of this study was to translate and determine the psychometric properties of the Autism Spectrum Knowledge Scale General Population Version (ASKSG) with a parent sample.

DESIGN AND METHODS

A cross-sectional study was conducted with 858 parents of children aged 0-14 years in China. The demographic characteristics form and ASKSG were used for data collection. The psychometric properties of the ASKSG were evaluated by examining reliability, exploratory factor analysis (EFA), categorical confirmatory factor analysis (CCFA), unidimensionality, person and item reliability, item fit and item difficulty, and item-person mapping.

RESULTS

The Cronbach's alpha coefficient of the ASKSG was 0.865. In terms of EFA, principal component analysis revealed a fixed number of five factors, explaining 41.642% of the total variance. For the CCFA, the structure of the thematically derived five-factor model was observed to be a marginal fit to the data. The eigenvalue was 31.00, with a variance of 62.7%. The person reliability was 0.85, and the person separation was 2.38. The item reliability was 1.00, and the item separation was 15.02. The infit and outfit statistical analysis fell within acceptable ranges from 0.75 to 1.35, and the item difficulty ranged from -2.43 to 2.44. An item-person map with excellent targeting would be symmetric along the vertical axis from more difficult endorsement at the top (question 1 and question 20) to easier endorsement at the bottom (question 1). Some items do appear to function differently across sexes, and they assess the latent trait unequally across both sexes.

CONCLUSIONS

The Chinese version of the ASKSG is a reliable and valid tool for assessing knowledge of parents about ASD.

PRACTICE IMPLICATIONS

Chinese ASKSG now offers medical professionals and teachers a robust means of assessing parental knowledge about ASD. Therefore, professionals may use the scale to help them screen or identify parents who are in need of additional support or advice.

A systematic compilation of rating scales developed, translated, and adapted in India

Background

There is a lack of comprehensive data sources on various rating instruments that have been developed, translated, and adapted in Indian context.

Aim

Accordinly, this review aimed to compile the available scales/questionnaires/instruments developed, adapted, and translated for use in India.

Methods

For this, the search engines like PUBMED, Google Scholar, MedKnow, and Science Direct were searched for scales that have been developed, translated, and adapted in Indian context or an Indian language. Only articles reporting a scale/questionnaire development/interview schedules from India or in an Indian language were included.

Results

Available data suggests that most of the instruments that have been translated in the Indian context have been done so in Hindi language. Very few instruments are available in other languages. The scales/instruments that are available in multiple languages include Mini International Neuropsychiatric Interview (MINI), General Health Questionnaire (GHQ), Patient Health Questionnaire (PHQ), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), Edinburgh postnatal depression, Epworth sleepiness scale to evaluate daytime sleepiness, Columbia-Suicide Severity Rating Scale (C-SSRS), Recovery quality of life, World Health Organization Quality of Life-Bref version, Subjective happiness scale, Hospital Anxiety and Depression scale (HADS), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS), Internalized Stigma of Mental Illness (ISMI), COVID-19 stigma scale, Dyadic adjustment scale, Broad Autism Phenotype Questionnaire (BAPQ), Strength and Difficulties Questionnaire (SDQ), and Rosenzweig picture frustration study (Children's form). Overall, very few instruments have been developed in India.

Conclusion

To conclude, our review suggests that a limited number of scales have been developed in India and in terms of translation and adaptation, most of these have been done in Hindi only. Keeping these points in mind, there is a need to develop more psychometrically sound scales for research and routine clinical practice. Additionally, efforts must be made to translate and adapt scales available in different languages and subject the same to psychometric evaluations.

Depression anxiety stress and fear of COVID-19 among adolescent students and its relationship with possible predictors

Background

During the COVID-19 pandemic prolonged lockdowns, school closures requiring online education support, and uncertainty about examinations caused stress in students.

Aim

To estimate the levels of depression, anxiety, stress, and fear of COVID-19 in adolescent students of Jamnagar and its relationship with possible predictors.

Materials and Methods

This is a cross-sectional study using a proportionate probability sampling method during the third wave of COVID-19 of 4423 adolescent students of Jamnagar, Gujarat. The Fear of COVID-19 Scale (FCV-19S) and Depression, Anxiety, and Stress Scale-21 (DASS-21) measured the main construct. T-tests for two independent samples and multiple linear regression analysis were used to assess the relationship.

Results

Among the adolescent students, 14.81% had moderate fear, while severe fear was found in 3.37%. Moderate or severe depression was observed in 1.31% and 0.16% of students, respectively; severe and extremely severe anxiety was present in 0.65% and 0.11% of students; and stress was found to be moderate in 0.23%. Depression was associated with education, anxiety with education, gender, and a history of COVID-19 in the family and stress with a history of COVID-19 infection in the family and fear of COVID-19 with gender, standard of class, geographical area, socioeconomic class, and father's education.

Conclusion

In our study, the students having a higher fear of COVID-19 were found to have higher depression, anxiety, and stress. The factors associated with a lower level of psychological impact can be used to formulate the interventions needed for the betterment of adolescent mental health.

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.

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.

Sociodemographic determinants of vaccination and willingness to pay for COVID-19 vaccines in Hungary, results of a cross-sectional online questionnaire

BACKGROUND

Several different coronavirus disease (COVID-19) vaccines were authorized and distributed all over the world, including Hungary, but vaccination rates and acceptance of the different vaccines varied through 2021 and subsequent years. In Hungary Western vaccines and the Chinese and Russian vaccines were available in early 2021. Understanding preference and willingness to pay (WTP) for the COVID-19 vaccine could provide information for policy decision making to control the COVID-19 pandemic. We aimed to assess the socio-demographic factors influencing the COVID-19 vaccination and to analyse individual preferences for the available COVID-19 vaccines in Hungary.

METHODS

A cross-sectional online questionnaire survey was conducted between 25-05-2021 and 08-06-2021 exploring the vaccine acceptance and WTP for vaccination in the Hungarian general population. To assess the preferences towards the different vaccines available in Hungary at the time of the study, we used a multi-step WTP task.

RESULTS

Altogether 2,000 respondents filled out our survey, with the average age of 49.1 (SD = 15.3), out of whom 370 respondents (18.5%) stated that they already had a COVID-19 infection. Age above 65 years, male gender, higher level of education, higher income and residence in the capital or county seats were associated with a higher probability of vaccination. The average WTP ranged from 14.2 to 30.3 EUR for the different vaccine types.

CONCLUSIONS

Males, respondents with higher education and income stated a higher WTP value for all vaccines. Better socioeconomic status increased both vaccination coverage and willingness to pay for vaccines.

Validity, reliability, and factor analysis of organoleptic tests of Dangke Deppamil as an alternative treatment of nutrition problems in pregnant women in Indonesia

BACKGROUND

Dangke is a traditional food product sourced from high-quality cow's milk from Enrekang Regency, South Sulawesi, Indonesia. The nutrients contained in Dangke are a source of calories needed by the body and can help meet the nutritional needs of pregnant women. The present study was conducted to validate the organoleptic instrument of Deppamil Dangke through validity, reliability, and factor analysis; the organoleptic test of Deppamil Dangke was carried out.

MATERIALS AND METHODS

This type of research is a mix method with an explanatory sequential design approach. Qualitative analysis was done using Atlas Ti software.

RESULTS

The results of the instrument validation showed a reliable level of instrument validity with Kaiser-Meyer-Olkin results (0.747), and the Cronbach's coefficient alpha values of each of the two types of Deppamil Dangke were 0.84 and 0.91. Exploratory factor analysis identified two main factors using the varimax rotation and excluded items with a factor loading below 0.3, which included taste (2 items), color (2 items), aroma (2 items), and texture (2 items), which explains 52.7% of the general variance of the Deppamil Dangke organoleptic test. The confirmatory factor analysis results showed that the factor structure of the Deppamil Dangke organoleptic instrument matched the data (CFI = 0.948, TLI = 0.936, RMSEA = 0.069, and WRMSR = 0.891). The factor loading of the model ranged from 0.691 to 0.825 and was statistically significant. The organoleptic test results of the Deppamil Dangke on 30 panelists of pregnant women showed that pregnant women really liked the taste as much as 63.3%, texture as much as 53.3%, and color as much as 50%, and those who really liked the aroma were as much as 46.7%.

CONCLUSION

Recommendation: Deppamil Dangke is liked by pregnant women and is very suitable to be used as an additional food product for pregnant women. It is necessary to make changes and innovations from the Dangke Deppamil product in terms of both texture and appearance and especially in the variety of flavors so that pregnant women can choose flavors according to their wishes and needs.

Translation and validation of the Breastfeeding Motivation Scale in China

BACKGROUND

There are several versions of the Breastfeeding Motivation Scale (BMS), which have been shown to measure maternal breastfeeding motivation, but there is not a Chinese version yet. The study aimed to translate the BMS into Chinese and subsequently assess its psychometric properties among Chinese mothers during the postpartum period.

METHODS

The study was composed of two phases. The translation of BMS closely followed the principals of good practices. Phase 1 included a comprehensive translation, back-translation, cross-cultural adaptation, and pretest to develop the Chinese version of the BMS. From 1 December 2021 to 1 July 2022, the Chinese version of the BMS was administered to 206 postnatal mothers in our maternity wards to assess its psychometric properties. Phase 2 involved psychometric property testing, including testing of the internal consistency, test-retest reliability, content validity, construct validity, convergent validity and discriminant validity.

RESULTS

Minor modifications in four items were recommended after translations. The Cronbach's α coefficient of the Chinese version of the BMS was .887, and the intraclass correlation coefficient was .897 (P < 0.001). The model fit was acceptable (χ2/df = 2.40, P < 0.001, RMSEA = 0.08, CFI = 0.91, IFI = 0.92 and TLI = 0.90) according to the confirmatory factor analysis. The composite reliability values corresponding to each latent variable were 0.733 ~ 0.926, and the average variance extracted values were 0.476 ~ 0.653. The correlations among the five measured variables were all lower than .85 and the square roots of average variance extracted from the variable were greater than the interconstruct correlations among the five measured variables in the model.

CONCLUSIONS

The Chinese version of the BMS has good reliability and validity and provides a reliable assessment tool for measuring maternal breastfeeding motivation. It also provides support to develop culturally sensitive interventions for Chinese mothers' who are breastfeeding.

The development of the fear of earthquake scale: validity and reliability study in Türkiye after the 2023 earthquake

BACKGROUND

In 2023, Türkiye experienced a significant earthquake disaster that profoundly impacted 11 provinces. The enduring consequences of these earthquakes on daily life triggered widespread fears and anxieties in society, leading to scholarly investigations in this field.

OBJECTIVE

The primary objective of this study was to create and evaluate the psychometric properties of the Fear of Earthquake Scale (FES), a modified adaptation of the Fear of COVID-19 Scale (FCV-19 S), tailored to measure earthquake-related experiences in Türkiye.

METHODS

A total of 315 Turkish adult participants (106 men, 209 women), with a mean age of 37.71 years, completed the FES, along with the Brief Psychological Resilience Scale (BPRS). Psychometric analyses included confirmatory factor analysis as well as the evaluation of alternative factor structures, internal consistency, convergent validity, and criterion validity with respect to resilience.

RESULTS

The findings indicate that the Turkish version of the Fear of Earthquake Scale has strong psychometric properties in terms of validity and reliability. After assessing various factor structures, it was observed that the two-factor model which represents the emotional and somatic response to fear, exhibited the best-fit values The Cronbach's alpha coefficients were calculated as 0.89 for the overall FES, 0.84 for the emotional subscale and 0.86 for the somatic subscale, indicating high internal consistency. Additionally, the negative correlation between resilience and the FES supports the criterion validity of the scale, and multi-group confirmatory factor analyses proved that measurement invariance held across genders and whether they experienced an earthquake or not for all groups. Furthermore, the results of the study revealed that women and individuals with prior earthquake experience reported higher levels of fear of earthquakes.

CONCLUSIONS

The FES emerged as a reliable and valid tool for assessing earthquake-related fears among the Turkish population.

The General Mattering Scale, the Anti-Mattering Scale, and the Fear of Not Mattering Inventory: Psychometric Properties and Links with Distress and Hope Among Chinese University Students

Purpose

Mattering is essential to university students' mental health. Feeling valued by others or unimportant can affect their overall well-being. However, most measures for assessing mattering have been developed and tested in Western countries, with limited evaluation of the measures when administered to university students in other regions. This study evaluated the reliability and validity of three mattering-related instruments - the General Mattering Scale (GMS), Anti-Mattering Scale (AMS), and Fear of Not Mattering Inventory (FNMI) among Chinese university students using classical test theory and Rasch analysis.

Methods

The study comprised 3594 university students from 19 universities across 13 provinces in mainland China, with a balanced gender distribution of 47.2% females and 52.8% males. Participants' ages ranged from 18 to 37, averaging 20.02 years. Most (78.4%) were in four-year programs, with the rest in three-year programs. The majority were freshmen (54.2%), and 86.3% had siblings. The predominant major was engineering (43.4%), followed by roughly equal representations in science, social science, and literature/art.

Results

The three scales showed high reliability and factorial validity, with Rasch analysis confirming their unidimensionality and monotonicity, although 2 of 15 items (one GMS item and one FNMI item) had lower fit. There were no substantial differences in item functioning between male and female respondents. Further analyses indicated that mattering, anti-mattering, and fear of not mattering all explained significant unique variance in levels of hope and distress.

Conclusion

All three mattering-related instruments are suitable for assessing Chinese students' mattering, anti-mattering, and fear of not mattering and changes in levels of these mattering dimensions. Moreover, each measure represents a unique element of the mattering construct in terms of associations with levels of hope and distress assessed in during the COVID-19 pandemic.

Psychological impact of COVID-19 and determinants among Spanish university students

Background

University students are a vulnerable population and faced a significant psychological impact from the COVID-19 pandemic. Therefore, this study aimed to determine the level of fear of COVID-19 among university students and to evaluate the possible relationship between fear of COVID-19 and socio-demographic, health-related determinants, variables related to the COVID-19 and variables related to the psychological impact of the COVID-19 pandemic.

Methods

We conducted a cross-sectional study between December 2020 and December 2021 on a sample of 950 university students from two universities in southern Spain. Participants completed a form that collected socio-demographic, health-related and COVID-related variables, a validated questionnaire related to the psychological impact of the COVID-19 pandemic and the fear of COVID Scale (FCV-19S). Descriptive, inferential, and multivariable linear regression analyzes were conducted.

Results

The mean FCV-19S score was 14.86 ± 5.16 points. The factors identified as predictors of FCV-19S were being female (p < 0.001), holding religious beliefs (p = 0.04), living in towns with over 10,000 inhabitants (p < 0.01), living with someone vulnerable to COVID-19 (p = 0.02), watching TV to keep informed about COVID-19 (p < 0.01), believing in a low probability of surviving if infected with COVID-19 (p < 0.001), having a higher level of death anxiety (p < 0.001) and suffering from insomnia (p < 0.001).

Conclusion

An average fear of COVID-19 score of 14.86 ± 5.16 points has been found among university students in Spain. These findings can aid in identifying specific factors contributing to fear of COVID-19 and in developing coping strategies to alleviate the stress of the pandemic.

Development and validation of the COVID-19 Impact Scale in Australia

OBJECTIVE

The COVID-19 pandemic significantly impacted and continues to impact the health and well-being of Australian adults. However, there has been no instrument validated to comprehensively measure how the COVID-19 pandemic impacted adults in Australia across several domains (e.g. fear of COVID-19, attitudes towards vaccination, psychosocial impact of lockdowns).The current study conducted a rigorous psychometric process to develop and validate an instrument to measure the impact of the COVID-19 pandemic in Australia, the COVID-19 Impact Scale (CIS).

METHOD

Data was obtained from the Australian population. Participants (N = 563) aged between 19 and 91 years (M = 54.50, SD = 16.16) provided online responses between June, 2021 and May, 2022. The majority of participants were female (60.9%), employed either full-time (37.7%) or part-time (22.0%), and had completed an undergraduate degree or higher (70.1%). An initial pool of 30 items was developed based on a review of the literature and input from a panel of experts including psychologists, epidemiologists, and public health experts, among others. The study used network psychometrics to examine the psychometric properties of: (1) item score distributions; (2) item redundancy; (3) dimensionality; (4) model fit; (5) measurement invariance; (6) reliability; and (7) criterion validity.

RESULTS

Following an evaluation of items for ceiling/floor effects and redundancy, the final CIS network model included eighteen nodes and displayed a three-dimensional structure. The three communities of "Fear" (consisting of three nodes; ω = 0.82), "Attitudes" (consisting of ten nodes; ω = 0.89), and "Ill-being" (consisting of five nodes; ω = 0.79) displayed adequate reliability. The evaluation of model fit indicated a good fit of the network model (RMSEA = 0.047; CFI =0.98).

CONCLUSION

The instrument is available to be used by Australian researchers and implemented to evaluate public policies, adapted for future pandemics, or used internationally.

Knowledge, Concerns, and Psychological Distress Among Caregivers of Patients Seeking Emergency Medical Care for Non-COVID-19-Related Illness During the COVID-19 Pandemic: A Cross-Sectional Study

Introduction During the active phase of the COVID-19 pandemic, the global healthcare system failed to meet the increased demand for healthcare resources, infrastructures, and facilities. The brunt of the healthcare crisis was faced not only by COVID-19 victims; a large majority of non-COVID patients were deprived of routine and emergency care. Factors that possibly affected resource utilization, healthcare-seeking behavior, service delivery patterns, and national health systems' priority during the pandemic were the knowledge and attitudinal concerns related to the COVID-19 disease and its control measures. Here, we evaluated the knowledge, concern, and psychological distress among the caregivers of the patients attending the emergency department at a tertiary healthcare center in India.​ Methodology We conducted a survey-based study using a pre-validated questionnaire on the caregivers of the patients visiting the emergency department (ED) from June to September 2020 (during the first wave of the COVID-19 pandemic). The demographic details and responses of the participants were documented in the semi-structured proforma. A pre-validated COVID-19 Peritraumatic Distress Index (CPDI) questionnaire was used to assess psychological stress. Results Out of 1014 participants interviewed, the majority were male attendants (72%), aged 18-45 (82%), and seeking medical attention for patients with chronic illnesses (76%). Acute onset emergencies like stroke, myocardial infarction, trauma, etc. were the ED presentation in only one-fifth of patients. COVID-19-related knowledge was adequate for questions related to age groups at risk for the viral infection (97% agreed that all age groups were at risk), mode of transmission (75-90% were aware of the common modes of transmission), and >65% knew the common symptoms of COVID-19 infection. However, only 38.5% knew about frequent handwashing as a protective measure. More than half of the participants considered the COVID-19 vaccine as the sole ray of hope and disregarded the effectiveness of alternative medicines such as Ayurvedic/homeopathic/allopathic medicines as preventive options. One-third were first-time visitors to the hospital, while two-thirds of all participants were afraid to visit any hospital during the COVID-19 pandemic. The majority (84%) faced difficulty in accessing the index tertiary care center due to transport, socioeconomic support, or lockdown-related restrictions. In comparison, 60% reported some form of discrimination at almost all levels of healthcare settings due to COVID-19-related priority changes. Nearly half (48%) of all enrolled caregivers reported experiencing mild-to-moderate distress (CPDI score=28-51), and 15.7% felt severe distress (CPDI score >51) while seeking treatment for the non-COVID-19 illness of their patient. Age and socioeconomic status were significantly associated with COVID-19-related psychological distress levels (p<0.001 in logistic regression), while gender, education, and residence showed no significant associations. Conclusion Most of the patient caregivers visiting the emergency department during the COVID-19 pandemic had an adequate understanding of risk factors and preventive measures. The major barriers to accessing healthcare facilities were transport, financial issues, and lockdown-related restrictions. Almost two-thirds of the caregivers revealed mild-to-moderate to severe psychological distress due to the pandemic and lockdown-related concerns.

Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study

Aim

This study aims to investigate depression, anxiety, stress, and fear of the COVID-19 pandemic and the associated risk factors among Bangladeshi medical students. It also explored qualitative insights on mental health from medical students during the first wave of the pandemic.

Methods

This mixed-methods study was conducted online in Bangladesh from June 2020 to September 2020. Participants were Bangladeshi medical students from the first year to the final year. The quantitative part included a structured online survey. One focus group discussion (FGD) was organized using the Zoom platform to collect qualitative insights from the students. To determine levels of stress, anxiety, and depression, the Bangla-validated version of the Depression, Anxiety, and Stress Scale 21 (DASS-21) was used. A 7-item and Bangla-validated Fear of COVID-19 Scale, also known as FCV-19S, was used to explore the COVID-19-specific fear of the students. A semi-structured topic guide was used for exploring the qualitative insights of medical students' perceptions of fear of COVID-19, mental health impacts during COVID-19, overall recommendations to support students, and the impact of the pandemic on the future of the medical curriculum.

Results

The study reported that 51.20%, 59.40%, and 64% of the 406 respondents had moderate to severe stress, anxiety, and depressive symptoms, respectively, according to the DASS-21. The mean fear score for the COVID-19 scale was 19.4 (SD 6.4). Respondents with family members aged 50 years or older (B = 2.1; CI: 0.3-3.9) and those who had infected family members (B = 1.9; 95% CI: 0.1-3.7) exhibited a higher level of fear of COVID-19. Moreover, depression was associated with a history of having cancer among family members (AOR = 2.9, CI: 1.1-7.5), anxiety was strongly associated with having symptoms of COVID-19 (AOR = 2, CI: 1.3-3.2), and stress was associated with having symptoms of COVID-19 infection among family members (AOR = 1.9, CI: 1.3-3). Altered sleep was a potential risk factor for developing stress, anxiety, and depression symptoms. Manual thematic analysis of qualitative data generated four major themes, including the perception of fear of COVID-19, the perception of mental health impacts during COVID-19, the change in the medical curriculum along with the pandemic, and recommendations from the medical students to support the mental health concerns of medical students during public health crises like this pandemic. Qualitative findings showed that the participants experienced fear of their parents becoming infected by COVID-19, and this fear was more prominent in those who had their loved ones hospitalized. They were also stressed and anxious, with thoughts of death. Their fear also extended to their thoughts on academic progress and the effectiveness of online classes.

Conclusion

A substantial proportion of medical students experienced mental health difficulties in Bangladesh. Appropriate interventions should be designed, and adequate support should be provided to the medical students to protect their mental health and wellbeing, considering their potential impact on the future health system in a low-resource setting like Bangladesh.

Assessing psychometric properties of the Turkish version of the Fear of COVID-19 Scale for Nurses

AIM

The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Fear of COVID-19 Scale (FCV-19S).

METHODS

The study used a descriptive design and was conducted between April and May 2020. The participants were 213 nurses who were working in 12 hospitals in eight cities in Turkey. Content validity index, exploratory factor analysis and confirmatory factor analysis were used to evaluate validity. Cronbach's alpha, item-scale correlation and test-retest reliability were used to evaluate reliability.

RESULTS

The CVI was 0.92 (0.81-1.00). A one-factor solution was identified and the factor loading of items in scale varied from 0.377 to 0.909. The Cronbach's alpha value was 0.889 in the current study. Item-scale correlations ranged between 0.570 and 0.815. Intraclass correlation coefficient ranged from 0.71 to 0.93.

CONCLUSION

The Turkish version of the FCV-19S for nurses was found to be valid and reliable measure of the fear of nurses towards COVID-19.

Temporal dynamics and fatality of SARS-CoV-2 variants in Bangladesh

Background and Aims

Since the beginning of the SARS-CoV-2 pandemic, multiple new variants have emerged posing an increased risk to global public health. This study aimed to investigate SARS-CoV-2 variants, their temporal dynamics, infection rate (IFR) and case fatality rate (CFR) in Bangladesh by analyzing the published genomes.

Methods

We retrieved 6610 complete whole genome sequences of the SARS-CoV-2 from the GISAID (Global Initiative on Sharing all Influenza Data) platform from March 2020 to October 2022, and performed different in-silico bioinformatics analyses. The clade and Pango lineages were assigned by using Nextclade v2.8.1. SARS-CoV-2 infections and fatality data were collected from the Institute of Epidemiology Disease Control and Research (IEDCR), Bangladesh. The average IFR was calculated from the monthly COVID-19 cases and population size while average CFR was calculated from the number of monthly deaths and number of confirmed COVID-19 cases.

Results

SARS-CoV-2 first emerged in Bangladesh on March 3, 2020 and created three pandemic waves so far. The phylogenetic analysis revealed multiple introductions of SARS-CoV-2 variant(s) into Bangladesh with at least 22 Nextstrain clades and 107 Pangolin lineages with respect to the SARS-CoV-2 reference genome of Wuhan/Hu-1/2019. The Delta variant was detected as the most predominant (48.06%) variant followed by Omicron (27.88%), Beta (7.65%), Alpha (1.56%), Eta (0.33%) and Gamma (0.03%) variant. The overall IFR and CFR from circulating variants were 13.59% and 1.45%, respectively. A time-dependent monthly analysis showed significant variations in the IFR (p = 0.012, Kruskal-Wallis test) and CFR (p = 0.032, Kruskal-Wallis test) throughout the study period. We found the highest IFR (14.35%) in 2020 while Delta (20A) and Beta (20H) variants were circulating in Bangladesh. Remarkably, the highest CFR (1.91%) from SARS-CoV-2 variants was recorded in 2021.

Conclusion

Our findings highlight the importance of genomic surveillance for careful monitoring of variants of concern emergence to interpret correctly their relative IFR and CFR, and thus, for implementation of strengthened public health and social measures to control the spread of the virus. Furthermore, the results of the present study may provide important context for sequence-based inference in SARS-CoV-2 variant(s) evolution and clinical epidemiology beyond Bangladesh.

Mental Health and the COVID-19 Pandemic: Observational Evidence from Malaysia

The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.

Fear of COVID-19 and Fear of Earthquake: Multiple Distressing Events and Well-Being in Croatia

People in Croatia have recently experienced two major earthquakes in the midst of COVID-19 pandemic, which are possible sources of increased fear. In order to capture and understand the effects of the simultaneously occurring threatening events, the aims of this study were threefold. First, we aimed to examine the psychometric properties and factor structure of the Croatian version of the Fear of COVID-19 scale (FCV-19S). Second, bearing in mind that there is a lack of instruments for measuring fear of earthquakes, the study aimed to develop and examine the psychometric properties the Fear of Earthquake Scale (FES), as a version of FCV-19S, modified for the earthquake experience. Finally, the study aimed to examine differences in well-being indicators (life satisfaction, positive and negative affect) between four groups of participants who either had/did not have COVID-19 disease or had experienced/did not have experienced earthquake. The study was conducted among 1136 participants adults who took part in the fourth year of the Croatian longitudinal study on well-being. Among them, N = 665 participants experienced earthquake and responded to additional questions regarding that experience. The analyses demonstrated valid psychometric properties and one-factorial structure of FCV-19S and FES scales. The findings showed that people who went through earthquake experience (vs. those without earthquake experience and COVID-19 infection) reported higher negative affect and lower positive affect, indicating that people in Croatia seem to have been more fearful of earthquakes than COVID-19 pandemic. Findings suggest the long-term negative effects of earthquake on fear and well-being in comparison to COVID-19 pandemic.

The Fear of Covid-19 Among Adults with Chronic Disease

Objective: The Covid-19 epidemic is known to have caused many setbacks worldwide. This study determined the Covid-19 fears in the epidemic process of individuals with chronic disease and the factors that could cause this fear. This study aims to be a guide in the process of the Covid-19 epidemic and the development of the right health strategies for potential new outbreaks. Methods: The universe of our work is composed of 92,350 people over 18 who applied to XXX Faculty of Medicine between 01.07.2020 and 30.09.2020. When the sample was calculated with a 5% margin of error, a 95% confidence interval and a 10% chance of data loss, 421 people were identified. The data was obtained through the application of surveys generated by the literature screening using face-to-face discussions with the volunteers. In addition to various questions about sociodemographic features and the epidemic process, the coronavirus (Covid-19) scare scale has been applied in the survey. Statistical analysis was performed using the SPSS 21.0 package program. Results: In our study, the majority of the healthy group (52.5%) is made up of men, while the majority of the patient group (56.9%) in women. The healthy group has the most common 53.1 to 18-34% age group, and the patient group has the most common 33.0 to 50-64% age group. The frequency of 65 years and older was 0.6% in the healthy group and 13.8% in the patient group. The difference between age groups is statistically significant (p

The experience of COVID-19 among people with depression: Impact on daily life and coping strategies

BACKGROUND

The prevalence of depression symptoms among U.S. adults increased dramatically during the early months of the COVID-19 pandemic. We sought to understand the impact of the pandemic on people with a history of depression.

METHODS

In June 2020, a national sample of 5023 U.S. adults, including 760 reporting past/current diagnoses of depression, completed survey measures related to the COVID experience, coping, anxiety, depression, and PTSD.

RESULTS

After adjusting for sociodemographic characteristics, a history of depression increased the odds of negative effects of pandemic on multiple aspects of life: routines, access to mental health treatment, alcohol use, prescription painkiller use, and other drug use. Those with a history of depression also scored significantly higher on the PHQ-8, GAD-7, and PDS-5 (all ps < 0.0001). Greater use of adaptive coping strategies was significantly associated with lower scores, and greater use of maladaptive strategies with higher scores. Individuals reporting a history of depression reported greater use of both adaptive and maladaptive strategies.

CONCLUSIONS

Adaptive coping strategies appear to be protective and help regulate symptomatology, suggesting that particular focus during the clinical encounter on developing tools to promote well-being, alleviate stress, and decrease perceptions of helplessness could mitigate the effects.

Relationship between COVID 19 prevention and panic and distress tolerance, spiritual intelligence and happiness in undergraduate, postgraduate accounting students

Purpose

This study aims to investigate the relationship between prevention and panic of COVID-19 and distress tolerance, happiness and emotional intelligence (EI) in undergraduate and postgraduate accounting students in Iraq. In other words, this study seeks to answer whether or not different types of prevention and fear of COVID-19 can lead to improved distress tolerance, happiness and EI.

Design/methodology/approach

The study’s statistical population comprises 298 undergraduate and 138 postgraduate students in Iraq who were selected as the sample size using the Cochran sampling method. In this study, partial least squares regression (PLS) have been used to investigate the effect of independent variables on the dependent variable.

Findings

The results showed a positive and significant relationship between COVID-19 prevention and distress tolerance and happiness, but no significant relationship was observed between COVID-19 prevention and EI. Also, no significant relationship was observed between fear of COVID-19 and distress tolerance and happiness, but there was a positive and significant relationship between fear of COVID-19 and EI.

Originality/value

The present study’s results can provide valuable information to everyone and help the development of science and knowledge because so far, and to the best of the authors’ knowledge, no research has examined the impact of prevention and panic of COVID-19 on distress tolerance, happiness and EI in students.

Suicide related to the COVID-19 pandemic in India: A systematic review

Background

The suicide rate has increased during the pandemic in India. Moreover, several studies, especially press-media reporting suicide studies have been conducted but no systematic review has been attempted in this context. Therefore, the present study systematically investigated the risk factors associated with suicidal behaviors, and the method of suicide during the COVID-19 pandemic in India.

Methods

Following the PRISMA guidelines, a systematic search was performed to include papers published up until September 30, 2022. From an initial 144 papers, 18 studies which met the inclusion criteria were included in the present review. The Pierson’s method was used for quality assessment of the included studies in the present review.

Results

The risk factors associated with suicide comprised: (i) socio-demographic factors (e.g., being aged between 31 and 50 years, male, married, unemployed), (ii) behavior and health-related factors (e.g., unavailability of alcohol and alcohol withdrawal symptoms, poor state of physical health and health issues, family disputes, relationship complexities, and sexual harassment), (iii) COVID-19-related factors (e.g., fear of COVID-19, COVID-19 test results, quarantine or isolation, financial hardship due to the pandemic, having influenza-like symptoms, experiencing stigmatization and ostracism despite testing negative, separation from family due to transport restrictions, misinterpreting other illness symptoms as COVID-19, saving the village from infection, watching COVID-19 videos on social media, online schooling, perceived stigma toward COVID-19, and being suspected of having COVID-19), and (iv) psychopathological stressors (depression, loneliness, stress, TikTok addiction, and poor mental health, suicidal tendencies, helplessness, and worrying). Hanging was the most common method of suicide. In addition, jumping from high buildings, poisoning, drowning, burning, cutting or slitting throat or wrists, self-immolation, medication overdose, electrocution, pesticide, and gun-shot were also used to carry out the suicide.

Conclusions

Findings from this research suggest multiple reasons for suicide during the COVID-19 pandemic and knowledge of such factors could aid in developing suicide prevention strategies focusing the most vulnerable cohorts inside and outside India.

Comparison of Fear of COVID-19 in Medical and Nonmedical Personnel in a Public Hospital in Mexico: a Brief Report

The world is social distancing, and compulsory confinement has caused stress, psychological instability, stigmatization, fear, and discrimination in the general population. In this cross-sectional survey study, we administered the Fear of COVID-19 Scale (FCV-19S) to hospital medical and nonmedical personnel. A total of 1216 participants were surveyed from May 25 to May 29 of 2020. We asked all the staff for their participation in the study, and physical copies of the survey were distributed to the staff willing to participate. All surveys were answered anonymously. We found that the global FCV-19S mean score was 16.4 ± 6.1, with a significant difference between women and men's scores. Medical students presented higher scores than experienced medical personnel. Additionally, the medical and nursing personnel presented a higher level of fear than hospital staff who did not work directly with COVID-19 patients. Our findings suggest that greater knowledge of medicine or infectious diseases could decrease the overall psychological impact of the pandemic disease.

Evaluation of the English Version of the Fear of COVID-19 Scale and Its Relationship with Behavior Change and Political Beliefs

The COVID-19 pandemic has many individuals around the world fearing for their lives. The constant news coverage, rapid transmission, and relatively high mortality rate, make fearfulness a natural response. To assess the fear of COVID-19, the Fear of COVID-19 Scale (FCV-19S) was developed. The primary aim of the present study was to conduct the first psychometric assessment and validation of the English version of the FCV-19S. Two samples were collected in New Zealand. Sample 1 comprised 1624 participants of which 1397 completed all questions and were used in the analyses. Sample 2 comprised 1111 participants of which 1023 completed all questions and were used in the analyses. Several psychometric tests were conducted to ascertain the scale's reliability and validity. Across both samples, the FCV-19S had high internal consistency. Consistent with the earlier validation studies, the FCV-19S displayed a moderately strong relationship with the perceived infectability and germ aversion subscales of the perceived vulnerability to disease scale (PVDS). Furthermore, FCV-19S scores were negatively correlated with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) scores. With respect to the motivating role of fear, there was a significant relationship between FCV-19S scores and adherence to the lockdown rules that were implemented in New Zealand. Finally, consistent with recent reports on the politicization of the COVID-19 pandemic, an exploratory question found that participants who rated themselves as more conservative tended to report lower FCV-19S scores. The English version of the COVID-19S is a sound unidimensional scale with robust psychometric properties and can be used with confidence among English-speaking populations.

Development of Social Distancing Phobia Scale and Its Association with Anxiety and Perceived Stress

The aim of the present study is to develop the social distancing phobia scale and is to determine the role of generalized anxiety disorder of the individual in predicting social distancing phobia and perceived stress. The sample of the study consists of 1260 people selected according to the convenience sampling method. Social distancing phobia scale, generalized anxiety disorder, perceived stress scale, and positive negative emotion scale were used in the study. As a result of the analysis, this scale consists of 17 items with three factors including "physiological, emotional, and behavioral response." With its psychometric properties in assessing the three-sub-dimensional construct of the social distancing phobia scale, this scale will help to provide a better understanding of the emotions and psychological or psychiatric disorders during the COVID-19 pandemic. In addition, generalized anxiety disorder was found to significantly predict perceived stress and social distancing phobia.

Proposed Cut-Off Score for the Japanese Version of the Fear of Coronavirus Disease 2019 Scale (FCV-19S): Evidence from a Large-Scale National Survey in Japan

The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.

Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings

Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.

Suicidal ideation among people with disabilities during the COVID-19 pandemic in Bangladesh: prevalence and associated factors

BACKGROUND

Evidence from pandemic and pre-pandemic studies conducted globally indicates that people with disabilities (PWDs) have a higher risk for suicidality. However, none of these studies has assessed suicidality among PWDs in Bangladesh.

AIMS

The purpose of this study was to determine the prevalence of and factors associated with suicidal ideation among PWDs during the COVID-19 pandemic in Bangladesh.

METHOD

Using a snowball sampling technique, a cross-sectional survey was conducted from February to April 2021 among PWDs from six districts in the northern region of Bangladesh. Information related to sociodemographic factors, clinical characteristics, behavioural factors and suicidal ideation was collected. Chi-squared test and logistic regression were used to describe the data and explain the relationship of factors associated with suicidal ideation.

RESULTS

The prevalence of COVID-19-related past-year suicidal ideation was 23.9%. The factors associated with suicidal ideation included: age above 35 years, being female, acquiring a disability later in life, lack of sleep and current substance use. In addition, higher education appeared to be a protective factor against suicidal ideation.

CONCLUSIONS

This study highlighted that PWDs had an increased risk of suicide; that is, one-fourth of them had past-year suicidal ideation. This may have been because of COVID-19-related restrictions and stressors. Thus, the government and policy makers need to pay more attention to developing effective suicide assessment, treatment and management strategies, especially for at-risk groups, to minimise the impact of the COVID-19 outbreak.

Aggression and violence during the lockdown caused by the COVID-19 pandemic in Kuwait

Background

The lives of the global population have been drastically altered since the emergence of the 2019 coronavirus disease (COVID-19) pandemic. These changes comprise their daily lifestyle practices and the professional, and educational systems. In addition to these changes, many psychological illnesses issues have been detected globally.

Methods

This study aimed to investigate whether there are significant sociodemographic differences in reported cases of physical and verbal aggression, anger, hostility, and violence among 815 Kuwaiti residents during the lockdown caused by the COVID-19 pandemic. A non-random sample was recruited through the WhatsApp platform. The online survey contained sociodemographic information and 29 self-reported items rated on a Likert scale. In addition to demographic questions, online questionnaires included the Aggression Questionnaire (AQ). Questions regarding violence and COVID-19 infection were included in the online survey.

Results

Men, younger people, those who were single or divorced, students, and those with a lower level of education were more likely to report more instances of physical and verbal aggression, as well as hostility.

Conclusions

To assist psychologically vulnerable individuals in overcoming the negative effects of the COVID-19 pandemic, it is crucial to develop community-based strategies that are tailored to the specific conditions and cultural traditions of each country. Diverse strategies for mental health support programs administered by social workers and mental health professionals are required to reduce aggression and violence levels. Since this study is a cross-sectional survey conducted during the total lockdown, it is difficult to conclude that the lockdown provoked the escalation of the aggression.

Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries

Introduction

The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line.

Methods

This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded.

Results

Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF.

Discussion

This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.

The Association between Fear of COVID-19 and Health-Related Quality of Life: A Cross-Sectional Study in the Greek General Population

The aim of this cross-sectional study was to assess the level of fear related to the SARS-CoV-2 virus and the association of fear, and of sociodemographic and clinical characteristics, with health-related quality of life (HRQoL). A large sample of the Greek general population (N = 583) completed the validated versions of the Fear of COVID-19 scale (FCV-19s) and the 12-item Short Form (SF-12), and provided data on socio-demographic status, health history and COVID-19 protective behaviors. Variables were compared with Mann-Whitney and Kruskal-Wallis tests and associations with Spearman’s correlations. Gamma regression models investigated the influence of sociodemographic and COVID-related variables on HRQoL. The mean FCV-19s score for the sample was 18.3 ± 5.6, and physical and mental component summary scores were 50.2 ± 7.9 and 46.7 ± 10.1, respectively. More fear of COVID-19 was expressed by females (p < 0.001), individuals with comorbidities (p < 0.01), those with contacts with comorbidities (p < 0.001), and individuals not having caught COVID-19 (p < 0.05). Contrastingly, less fear was expressed by unvaccinated individuals and those with less frequent intake of information about the pandemic. Item level and overall FCV-19s scores were negatively associated with SF-12 summary scores, and fear of COVID-19 was the most important predictor of both physical and mental HRQoL. The findings from this and other similar studies could help to identify specific population groups in need of interventions to improve their physical and mental health, which had deteriorated due to the pandemic.

An attempted "suicide pact" in Covid-19 era - psychiatric perspectives

BACKGROUND

A "suicide pact" is a joint and actively induced death of two individuals with the essential and unavoidable characteristic of a mutual consent. One of the partners (dominant in the relationship, commonly male) usually induces the action and in most cases, it is the one who actively carries it out. Undiagnosed psychopathological dimension or pathological subthreshold traits are found in those who enter into suicide agreements, the presence of cluster B personality traits such as narcissistic or borderline is of particular relevance in the dominant partner, while in the submissive one dependent personality traits are more frequent. As in the case of other similar health emergencies, COVID-19 pandemic seems to lead to greater suicidality, including the "suicide pacts" of couples whose motivation varies including firstly financial problems, strictly followed by fear of infection and not being able to return home from abroad.

CASE PRESENTATION

We reported a case of a couple who entered a suicide agreement consequently to the economic difficulties caused by COVID-19 pandemic, hospitalized in our department. Both partners were assessed with Adult Autism Subthreshold Spectrum (AdAS Spectrum) and both crossed the threshold for clinically relevant autistic traits (M = 67; F = 49).

CONCLUSION

This case further confirms the link between COVID-19 pandemics and suicidality. The role of autism spectrum traits as a vulnerability factor towards the development of severe psychopathological consequences after traumatic events is also stressed.

The development of coronaphobia scale and psychometric effect among UAE people

The effects of the COVID-19 pandemic on mental health are likely to worsen as the epidemic progresses and will last long even after the pandemic has passed. The present study developed a coronaphobia scale during the pandemic to measure its psychological effects such as fear, anxiety, and depression in the majority of the cases in the United Arab Emirates (UAE). It is a 35-item scale that measures anxiety symptoms connected with COVID-19 and may be used to identify people who require mental health treatment. Based on 618 adults, the reliability and validity of these items were appropriate. The scales were distributed via social media using a Google form. Internal consistency, reliability analysis, and structural equation models, particularly confirmatory factor analysis, were carried out. The elevated scores on the coronaphobia scale were associated with social phobia, anxiety, stress, and depression. The coronaphobia score distinguishes well between those with and without dysfunctional anxiety (85% specificity and 90% sensitivity). These results support the coronaphobia scale as a valid and effective tool for clinical practice and research.

General psychiatric symptoms among Bangladeshi people approximately one year after the onset of the COVID-19 pandemic

BACKGROUND

Coronavirus disease-2019 (COVID-19) has had negative physical and mental impacts on people globally. The current study examined general psychiatric symptoms (fear, anxiety, depression, and insomnia) and loneliness, and their interrelationships and correlates among Bangladeshi individuals approximately 1 year after the onset of the COVID-19 outbreak.

METHODS

An internet-based cross-sectional survey was conducted among 1004 Bangladeshi people (51.8% male; mean age: 25.41 ± 7.80; age range: 18-60 years). Data were collected using a semi-structured e-questionnaire including informed consent, socio-demographics, lifestyle measures, and psychometric tools assessing loneliness, anxiety, depression, insomnia, and fear of COVID-19.

RESULTS

Sizeable participants screened positive for loneliness (63.5%), anxiety (26.3%), depression (46.4%), and insomnia (50.7%). Considerable numbers of respondents also reported fear of COVID-19. In hierarchical regression analyses, loneliness, anxiety, depression, insomnia, and fear of COVID-19 were associated with socio-demographic and lifestyle factors. Loneliness, anxiety, depression, insomnia, and fear of COVID-19 were positively correlated with each other (p < 0.001). In exploratory path analyses, anxiety, depression, and insomnia mediated the relationship between loneliness and fear of COVID-19.

CONCLUSIONS

The findings indicate that many people in Bangladesh have experienced psychiatric concerns approximately 1 year after the onset of the COVID-19 outbreak. Investigation into empirically supported interventions and their implementation is needed.

The Level of COVID-19 Anxiety among Oncology Patients in Poland

Cancer patients tend to have a high psychological burden. Half of cancer patients suffer from severe affective disorders and anxiety disorders, while one-third struggle with mild forms of these. The COVID-19 pandemic is damaging the mental health of the population due to social restrictions. A growing number of studies note the role of COVID-19 anxiety in the health and quality of life of cancer patients. The purpose of this study is to estimate the level of COVID-19 anxiety among oncology patients and to test the utility of the FCV-19S scale in a population study of cancer patients. The study included 600 respondents (300 oncology patients and 300 control subjects not undergoing oncological treatment). The FCV-19S scale and the GAD-7 scale were used in the study. The results were interpreted according to the following verbal scale: 76-100%, high anxiety; 56-75%, moderate anxiety; 26-55%, low COVID-19 anxiety; <25%, no COVID-19 anxiety. In the analysis of the GAD-7 questionnaire results, the mean score obtained was 8.21 (min. 0; max. 21; SD 5.32). For 81% of respondents in the group of oncology patients, the total score indicated the presence of anxiety symptoms with varying degrees of severity; in the control group, this proportion was 55% of respondents. The FCV-19S scale score as a percentage was 57.4% for oncology patients, indicating a moderate level of fear of the SARS-CoV-2 virus, and 30.3% for the control group, indicating a low level of fear of the SARS-CoV-2 virus. One-fifth of oncology patients were afraid of losing their lives due to the SARS-CoV-2 virus; in the control group, this proportion was 13% of respondents. Oncology patients were characterized by a higher prevalence of sleep disturbance than control group respondents, which was associated with greater anxiety. The study, therefore, shows that oncology patients have moderate levels of anxiety associated with the COVID-19 pandemic, and non-oncology patients show lower levels of anxiety.

The mediating role of hope in relation with fear of COVID-19 and mental health: A study on tertiary level students of Rajshahi District

Background and Aims

The novel coronavirus disease (COVID-19) is influential in all parts of people's lives, specifically psychological states due to the fear related to the pandemic. Thus, this study aimed to investigate the mediating role of hope in the connection between the fear of COVID-19 and mental health among tertiary college students of Rajshahi district during the COVID-19 disease.

Method

A cross-sectional survey was conducted among tertiary college students a sample of 498 participants (53.4% females and 46.6% males) ranged between ages 19 and 31 (M = 22.03 ± 1.92) and participants filled out the fear of COVID-19 Scale, Trait Hope Scale, and General Health Questionnaire.

Result

In the case of correlation analysis, fear of COVID-19 is reversely correlated with mental health, while lower but positive correlations were found with hope. Findings from the process macro v3.5 by Hayes analysis for the study model indicated that hope mediated in the relationship between the fear of COVID-19 and mental health controlling for gender, and socioeconomic status, and the hypothesized model explained approximately 27% of the variance in mental health.

Conclusion

Overall, the findings suggest that a high level of mental health is impacted by a low level of fear of COVID-19. Additionally, a low level of fear of COVID-19 contributes to increasing levels of hope, which enhances mental health.

Psychometric properties and clinical utility of COVID-19-related distress scale among children and adolescents with Disabilities

Background

The aim was to estimate the psychometric properties of the COVID-19-related distress scale in our society, as well as verifying the global structure of the COVID-19-related distress scale through exploratory factor analysis and the confirmatory factor analysis model for the dimensions prepared in the light of previous studies and the general factor model.

Methods

The study follows the design of the exploratory cross-sectional studies by applying a scale electronically using the Google Forms tool. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach's alpha reliability coefficient, and test-retest methods were used to evaluate reliability.

Results

In the analysis made for internal consistency in the reliability study of the scale, the Cronbach's alpha reliability coefficients were determined as α = 0.93 for the physical dimension subscale, 0.90 for the psychological and emotional dimension, 0.92 for cognitive dimension, 0.91 for the social dimension, 0.92 for behavioral dimension, 0.87 for living Dimension and 0.94 for the whole scale. The total number of items on the scale is 62. It is clear that the items of the scale explained 55.49 % of the variance of the correlation matrix between the items, which indicates that the scale has an appropriate degree to extract the variance that explains COVID-19-related distress. The fit indices were found to be Chi square = 862.30 (p < .001), degree of freedom = 210 (χ2 = 862.30; df = 210, χ2/df = 4.10), root mean square error of approximation (RMSEA) = 0.07 (p < .05) standardized root mean- square residual (SRMR) = 0.05, comparative fit index (CFI) = 0.92, non-normed fit index (NNFI) = 0.95, goodness of fit index (GFI) = 0.95, and adjusted goodness of fit index (AGFI) = 0.94.

Conclusions

The COVID-19-related distress scale is an easy to administer, valid, and reliable instrument to assess COVID-19-related distress. This instrument can be a helpful tool informing us about distress related to COVID-19 and hence may prevent adverse long-term consequences arising due to pandemic.

Evaluation of COVID-19 fear and quality of life in patients with haematopoietic stem cell transplantation during the COVID-19 pandemic

OBJECTIVE

We aimed to determine the coronavirus disease 2019 (COVID-19) fear state in haematopoietic stem cell transplant patients and to examine its relationship with quality of life.

METHODS

In this prospective study, 64 patients who underwent HSCT during the pandemic were included. The COVID-19 fear situation was evaluated with the Fear of COVID-19 Scale (FCV-19S). Quality of life was evaluated with the European Organisation for Quality of Life Research and Treatment Core Questionnaire (EORTC QLQ-C30) (Version 3).

RESULTS

The median FCV-19S score was 16.5 (12.0-22.0). The FCV-19S score was significantly higher in urban residents than rural residents. The general health score was 59.64 ± 20.04. The strongest positive correlation between fear level and life quality was found in emotional function. A weak, significant, positive correlation was observed between role function, nausea-vomiting, pain, appetite loss and fear level.

CONCLUSION

FCV-19S is a quick, safe and valid tool that can be used to determine the COVID-19 fear level in vulnerable patient groups such as HSCT patients and to direct them to the necessary psycho-oncological support.

Validation of the fear of COVID-19 scale in a central Balkan country - Serbia

Validation of the fear of introduction

High levels of fear of COVID-19 may be associated with increased levels of stress, anxiety, and depression, as well as decreased resilience and life expectancy.

Objective

This study aimed to translate and confirm the Serbian version of the Fear of COVID-19 scale as well as to investigate its psychometric properties.

Methods

The translation and intercultural adaptation of the Fear of COVID-19 scale was performed by the leading standard of the International Society for Pharmacoeconomics and Outcome Research. When the distribution was normal, the Kolmogorov-Smirnov test was used. The reliability of the Serbian version of FCV-19S was tested by measuring the internal consistency through the value of Cronbach's alpha.

Results

The original version of the Fear of COVID-19 scale was tested on a sample of 256 subjects with a mean age of 25.38 ± 12.47. The Cronbach's alpha value was 0.864. We divided the scale by the split-half method (Spearman-Brown), and the value of the coefficient for the questionnaire as a whole was 0.882. Divergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Fear of Hospitalization scale. A score of the Fear of COVID-19 scale was calculated as the sum of each question for each of the respondents. Convergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Emotional Regulation Questionnaire.

Conclusion

The validated version of the scale in Serbia complements versions available in other cultures and other languages and facilitates global studies related to mental health during the COVID-19 pandemic.

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

Background

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

Methods

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

Results

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

Conclusions

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

Mental Health Condition among University Students of Bangladesh during the Critical COVID-19 Period

Bangladesh's education sector has been in a state of flux since COVID-19. During the pandemic, all university campuses were closed. There was a mental health issue among the students. This study aims to examine the mental health condition and the determinants that contribute to adverse mental health conditions among university students of Bangladesh. A survey was performed online among university students in Bangladesh, in mid-June 2020 when averaging 3345 affected cases of the population daily. The convenience sampling technique was used and the survey gathered data from 365 university students. The relationship between general information and Depression, Anxiety, and Stress Scale 21 (DASS-21) subscales of university students was determined. The questionnaire was administered to respondents during the pandemic, which ensured fast replies. Linear regression models were used for statistical analysis. University students indicated normal levels of depression (30.41%), anxiety (43.29%), and stress (47.40%). However, a disproportionate number of extremely depressed, anxious, and stressed university students suggested a mental health status of concern. There were significant connections between the individual's opinion of social satisfaction, mental health concerns, and the present location's safety with an undesirable mental health condition. Female students were shown to be much more anxious and stressed than male students. Capital Dhaka city students were more depressed and anxious than students outside of Dhaka. Financial and psychological support for students may help mitigate the psychological impact. Authorities should make effective efforts to reduce mental health problems among these students. This research may aid organizations, health care providers, and social workers in their attempts to prepare for and respond to pandemics.

The Level of Fear in the Polish Police Population during the COVID-19 Pandemic with the Impact of Sociodemographic Variables

This study has a twofold objective. First, we aim to measure the levels of fear among Polish police officers using the COVID-19 Fear Scale (FCV-19S) that has a stable unidimensional structure allowing for the provision of additional data by combining variables. This structure allows the second objective to be met to measure the correlation with sociodemographic variables. The utilitarian objective of the study is to provide information for updating support policies for stress management in the service. The questionnaire was completed by 1862 people with a mean age of 38.75 years with a good Cronbach's alpha (0.89). The perceived level of fear associated with COVID-19 should be considered relatively low. Caring for the elderly does not affect the level of fear. The factors of gender, age and having children statistically significantly differentiate the perceptions of fear. Therefore, there is a necessity to focus on building support for police officers who are over 50 years old, as well as for women, where higher levels of fear in both men and women can translate into the development of psychosomatic illnesses.

Mental health outcomes and associated factors among vaccinated and unvaccinated teachers against COVID-19 infection in Bangladesh

Background

Vaccination of teachers is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their students, as well as to encourage their parents to get immunized. The present study investigated the mental health outcomes and associated factors among vaccinated and unvaccinated teachers against COVID-19 infection in Bangladesh.

Methods

A cross-sectional survey was conducted in Bangladesh from March 4 to September 9, 2021. The frequency of symptoms of psychological distress, depression, anxiety, stress, post-traumatic stress disorder (PTSD), insomnia, and fear was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and FCV-19S scales, respectively.

Results

A total of 1,527 Bangladeshi teachers completed the questionnaire, with 678 (44.4%) being vaccinated and 849 (55.6%) being unvaccinated. Compared with unvaccinated teachers, vaccinated teachers had a statistically significant lower prevalence of psychological distress (35.8 vs. 42.9%), depression (37.6 vs. 46.4%), anxiety (31.9 vs. 45.1%), stress (18.3 vs. 32.0%), PTSD (33.0 vs. 43.8%), insomnia (25.2 vs. 36.9%), and fear symptoms (23.3 vs. 29.6%). Among vaccinated teachers, participants with master's or lower degree levels had significantly higher symptoms of depression, stress, and fear than other education levels. Respondents with children had a significantly higher risk of depression, anxiety, stress, and fear symptoms than those who did not have children. Participants who lost family members, friends, or colleagues due to the COVID-19 pandemic had a significantly higher chance of experiencing symptoms of anxiety, PTSD, and fear than those who did not. On the other hand, unvaccinated male teachers were significantly associated with a higher risk of all mental health outcomes except psychological distress and PTSD symptoms compared to female teachers. Participants who were smokers had a significantly higher chance of anxiety, stress, and fear symptoms than non-smokers. Compared to participants with strong social support, those with poor social support had a higher risk of all mental health outcomes except PTSD symptoms.

Conclusion

This study suggests emphasizing the vaccinated to unvaccinated teachers as soon as possible to control the infection and improve mental health outcomes. Vulnerable teachers also required special attention, health-related education, and psychological support.

Parallel exploratory and confirmatory factor analysis of the Hungarian Fear of COVID-19 Scale in a large general population sample: a psychometric and dimensionality evaluation

BACKGROUND

This study aims to confirm validity and reliability of the Hungarian version of Fear of COVID-19 Scale (FCV-19S) and evaluate its dimensional structure.

METHODS

Cross-sectional survey was carried out in 2021 among Hungarian general population. In addition to classical test theory methods, construct dimensionality of FCV-19S was assessed using EFA with principal axis factoring method and CFA with diagonally-weighted least squares estimation. Fear score was compared in age, gender, educational level, vaccination and infection subgroups.

RESULTS

Significant differences in FCV-19S mean scores were observed between three subgroups (age, gender, vaccination). Items showed good internal consistency (Cronbach α = 0.88). EFA identified two latent factors (eig = 4.2 and 1.02), though parallel analysis supports the one-factor model. The two-dimensional structure was confirmed by CFA, items 3,4,6,7 correlated with Factor 1 (physiological fear), items 1,2,5 with Factor 2 (emotional fear).

CONCLUSION

The Hungarian version of FCV-19S seems valid and reliable. The EFA identified two-latent factors (emotional and physiological fear), that was confirmed by CFA. The two-factor structure had better model fit, though its' acceptance is limited.

Factors influencing UK residents' preferences in how psychologists present themselves online: a conjoint analysis during the early months of the COVID-19 pandemic

Background

The COVID-19 pandemic has led to a surge in mental health issues in the UK and worldwide, yet many UK residents have not received the help they have needed. Earlier research has indicated that accommodating client preferences leads to better therapeutic outcomes, however, little is known about preferences in how psychologists present themselves online and what might facilitate or slow help-seeking individuals’ decision about whom to seek help from. Based on literature suggesting personal branding as an effective way for clients to choose between psychologists, we sought to investigate UK residents’ preferences for specialization and self-disclosure in online presentations of psychologists based on level of fear of COVID-19 and diagnostic status.

Methods

A sample of 187 UK residents were surveyed mid-April 2020 and analyzed using a rating-based conjoint analysis with a fractional factorial design consisting of 22 profiles. Each profile consisted of six attributes (Years of experience, area of expertise, gender, self-disclosure, training institution and facial trustworthiness). Analyses of variance (ANOVA) were used to explore preferences for area of expertise and self-disclosure depending on fear of COVID-19. An independent sample t-test was done to explore preference for self-disclosure among diagnosed residents.

Results

The conjoint model yielded a good fit (Kendall’s tau = .90, p < .001). Relative importance scores (RI) were highest for years of experience (RI = 28.84) and area of expertise (RI = 22.78). Residents with a high fear of COVID-19 preferred psychologists specialized in anxiety disorders and fear (also fear of COVID-19) more than residents with a low fear of COVID-19 (MD = .92, 95% CI = [.198, 1.64], p = .013). Residents with a high fear of COVID-19 also preferred self-disclosing psychologists more than residents with a low fear of COVID-19 (MD = 1.05, 95% CI = [.184, 1.92], p = .013). Diagnostic status was not associated with preference for self-disclosure.

Conclusions

Listing de facto specialization in psychologist profiles might facilitate prospective clients’ decision-making process. Self-disclosure appears to be important for some clients, but more research is warranted.

Role of positive mental health in reducing fears related to COVID-19 and general anxiety disorder in Khyber Pakhtunkhwa, Pakistan

Background

The outbreak of the novel coronavirus disease (COVID-19) has posed multiple challenges to healthcare systems. Evidence suggests that mental well-being is badly affected due to compliance with preventative measures in containing the COVID-19 pandemic. This study aims to explore the role of positive mental health (subjective sense of wellbeing) to cope with fears related to COVID-19 and general anxiety disorder in the Pashtun community in Pakistan.

Methods

A cross-sectional survey was conducted among 501 respondents from Khyber Pakhtunkhwa participating in an online-based study. We performed correlational analysis, hierarchical linear regression and structural equational modeling (SEM) to analyze the role of mental health in reducing fears and general anxiety disorder.

Results

The results of the SEM show that positive mental health has direct effects in reducing the fear related to COVID-19 (β = − 0.244, p < 0.001) and general anxiety (β = − 0.210, p < 0.001). Fears of COVID-19 has a direct effect on increasing general anxiety (β = 0.480). In addition, positive mental health also has an indirect effect (β = − 0.117, p < 0.001) on general anxiety (R² = 0.32, p < 0.001) through reducing fear of coronavirus.

Conclusion

Based on these findings, there is a need to develop community health policies emphasizing on promotive and preventive mental health strategies for people practicing social/physical distancing.