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Ngamasana EL, Zarwell M, Gunn LH. Physical and mental health of informal caregivers before and during the COVID-19 pandemic in the United States. BMC Public Health 2023; 23:2349. [PMID: 38012592 PMCID: PMC10683238 DOI: 10.1186/s12889-023-17164-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Informal caregiving, a common form of social support, can be a chronic stressor with health consequences for caregivers. It is unclear how varying restrictions during the COVID-19 pandemic affected caregivers' physical and mental health. This study explores pre-post March 2020 differences in reported days of poor physical and mental health among informal caregivers. METHODS Data from the 2019/2020 Behavioral Risk Factor Surveillance System survey were used to match, via propensity scores, informal caregivers who provided care during COVID-19 restrictions to those who provided care before the pandemic. Negative binomial weighted regression models estimated incidence rate ratios (IRRs) and differences by demographics of reporting days of poor physical and mental health. A sensitivity analysis including multiple imputation was also performed. RESULTS The sample included 9,240 informal caregivers, of whom 861 provided care during the COVID-19 pandemic. The incidence rate for days of poor physical health was 26% lower (p = 0.001) for those who provided care during the COVID-19 pandemic, though the incidence rates for days of poor mental health were not statistically different between groups. Informal caregivers with low educational attainment experienced significantly higher IRRs for days of poor physical and mental health. Younger informal caregivers had a significantly lower IRR for days of poor physical health, but higher IRR for days of poor mental health. CONCLUSIONS This study contends that the physical and mental health burden associated with informal caregiving in a period of great uncertainty may be heightened among certain populations. Policymakers should consider expanding access to resources through institutional mechanisms for informal caregivers, who may be likely to incur a higher physical and mental health burden during public health emergencies, especially those identified as higher risk.
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Affiliation(s)
- Emery L Ngamasana
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Meagan Zarwell
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Laura H Gunn
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Matsushima M, Yamada H, Kondo N, Arakawa Y, Tabuchi T. Married women's decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021. BMC Public Health 2023; 23:1642. [PMID: 37641039 PMCID: PMC10464056 DOI: 10.1186/s12889-023-16476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic. METHODS From the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used. RESULTS The GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40-3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing-1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45-4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020. CONCLUSION During the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.
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Affiliation(s)
- Midori Matsushima
- Faculty of Humanities and Social Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Ibaraki, 305-8577, Japan.
| | | | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
| | - Yuki Arakawa
- Departments of Health and Social Behavior, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Tachikawa H, Matsushima M, Midorikawa H, Aiba M, Okubo R, Tabuchi T. Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan. BMJ Open 2023; 13:e063363. [PMID: 37188470 PMCID: PMC10186084 DOI: 10.1136/bmjopen-2022-063363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN Cross-sectional online survey. SETTING Community cohort study in Japan. PARTICIPANTS The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.
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Affiliation(s)
- Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Midori Matsushima
- Faculty of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Science, Toyo Gakuen University, Bunkyo-ku, Tokyo, Japan
| | - Ryo Okubo
- Department of Neuropsychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Hokkaido, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Hajek A, König HH. Loneliness and social isolation in old age: A look at research during the COVID-19 pandemic and a look ahead. Arch Gerontol Geriatr 2023; 108:104958. [PMID: 36796141 PMCID: PMC9911977 DOI: 10.1016/j.archger.2023.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Hajek A, Grupp K, Aarabi G, Gyasi RM, Freak-Poli R, Kretzler B, König HH. Long-term care need, loneliness, and perceived social isolation during the COVID-19 pandemic: evidence from the German Ageing Survey. Aging Clin Exp Res 2023; 35:1377-1384. [PMID: 37099237 PMCID: PMC10130804 DOI: 10.1007/s40520-023-02411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/12/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND There is a complete lack of studies focusing on the association between care degree (reflecting the long-term care need) and loneliness or social isolation in Germany. AIMS To investigate the association between care degree and loneliness as well as perceived social isolation during the COVID-19 pandemic. METHODS We used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. We used wave 8 of the German Ageing Survey (analytical sample: n = 4334 individuals, mean age was 68.9 years, SD: 10.2 years; range 46-100 years). To assess loneliness, the De Jong Gierveld instrument was used. To assess perceived social isolation, the Bude and Lantermann instrument was used. Moreover, the level of care was used as a key independent variable (absence of care degree (0); care degree 1-5). RESULTS After adjusting for various covariates, regressions showed that there were no significant differences between individuals without a care degree and individuals with a care degree of 1 or 2 in terms of loneliness and perceived social isolation. In contrast, individuals with a care degree of 3 or 4 had higher loneliness (β = 0.23, p = 0.034) and higher perceived social isolation scores (β = 0.38, p < 0.01) compared to individuals without a care degree. DISCUSSION/CONCLUSIONS Care degrees of 3 or 4 are associated with higher levels of both loneliness and perceived social isolation. Longitudinal studies are required to confirm this association.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany.
| | - Katharina Grupp
- Division of Plastic, Reconstructive and Aesthetic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Razak Mohammed Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, 3004, Australia
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
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Faghani S, Ahmadi F, Mohammadi E. Caregiver, secondary victim: outcome of caring for patients with COVID -19: a qualitative content analysis study. BMC Health Serv Res 2023; 23:308. [PMID: 36997933 PMCID: PMC10062248 DOI: 10.1186/s12913-023-09319-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Considering the importance of caring for patients with COVID -19 at home and the majority of care being the responsibility of family caregivers, it is necessary to identify and assess the problems during the implementation of patient care in family caregivers. Therefore, the present study was conducted to discover the different consequences of caring for patients with COVID-19 in family caregivers. METHOD Using Purposive sampling, 15 female family caregivers were included in the study. This study was conducted between 2021 and 2022 in Iran. Unstructured face-to-face and virtual interviews were used to collect data until data saturation was reached. Data were analyzed through Granheim and Lundman conventional content analysis approach. RESULTS The analysis of data related to the outcome of caring for patients with COVID -19 in family caregivers, led to the extraction of six subcategories: " caregivers experiencing physical symptoms ", "perception of extra pressure and psychological symptoms in the caregiver", "disruption in marital relations", "feeling of homelessness and rejection" and " role pressure due to lack of family support". The subcategories led to the development of the main category "caregiver, the secondary victim", which is experienced by family caregivers during the provision of care for patients with COVID -19. CONCLUSION Family caregivers experience high levels of negative consequences from providing care to patients with COVID-19. Therefore, more attention should be paid to all dimensions of caregiver health such as physical, mental, and marital to provide quality care to patients finally.
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Affiliation(s)
- Safieh Faghani
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Kikuchi K, Anzai T, Takahashi K. The Unusual Increase in Suicides Among Women in Japan During the COVID-19 Pandemic: A Time-series Analysis Until October 2021. J Epidemiol 2023; 33:45-51. [PMID: 36244746 PMCID: PMC9727214 DOI: 10.2188/jea.je20220186] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Japan has witnessed an unusual increase in the number of suicides among women during the coronavirus disease 2019 pandemic. An analysis is required to identify the influencing factors during the pandemic and develop new measures for preventing suicides. METHODS Data on the number of monthly suicides were collected from the National Police Agency of Japan. The expected number of suicides among women during the pandemic was estimated using a time-series model based on pre-pandemic data, considering year-to-year trends. The observed-to-expected (O/E) ratio of suicides was estimated from March 2020 to October 2021 using job status, suicide motive, and age. RESULTS The number of suicides among women in Japan increased beyond the expected number until October 2021. The O/E ratio based on job status, suicide motive, and age (except self-employed, unknown job status, and women aged ≥80 years) was significantly above 1.0 from March-December 2020, and the increase in suicides continued in almost all categories in 2021. CONCLUSION Although several reasons were reported for increased suicides among women in Japan during the pandemic (eg, economic downturn, financial instability, and loneliness), suicides increased irrespective of job status, suicide motive, or age. Comprehensive measures to prevent suicide might have been important during the pandemic, instead of limiting interventions to the reported specific population.
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Affiliation(s)
- Kohtaro Kikuchi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan,Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
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McGarrigle C, Ward M, De Looze C, O'Halloran A, Kenny R. Caring in the time of COVID-19, longitudinal trends in well-being and mental health in carers in Ireland: Evidence from the Irish Longitudinal Study on Ageing (TILDA). Arch Gerontol Geriatr 2022; 102:104719. [PMID: 35588613 PMCID: PMC9085370 DOI: 10.1016/j.archger.2022.104719] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic in 2020 resulted in the older population being asked to remain at home and avoid other people outside their household. This could have implications for both receipt and provision of informal caring. OBJECTIVE To determine if informal care provision by older carers changed during the first wave of the COVID-19 pandemic from pre-pandemic care and if this was associated with a change in mental health and well-being of carers. DESIGN AND SETTING Longitudinal nationally representative study of community dwelling adults from The Irish Longitudinal Study on Ageing (TILDA) (Waves 3-COVID-Wave 6). METHODS We studied a cohort of 3670 adults aged ≥60 in Ireland during the COVID-19 pandemic (July-November 2020) and compared with previous data collections from the same cohort between 2014-2018. Independent variables were caregiving status and caregiving intensity, outcome measures included depressive symptoms (CES-D8), Perceived Stress (PSS4) and Quality of life (CASP12). Mixed models adjusting for socio-demographics and physical health were estimated. RESULTS Caregiving increased from 8.2% (2014) to 15.4% (2020). Depression, and stress scores increased while quality of life decreased for all participants. Carers reported poorer mental health, and higher caring hours were associated with increased depression and stress and decreased quality of life scores on average, and increased depression was higher for women. CONCLUSIONS Informal caregiving increased during the pandemic and family caregivers reported increased adverse mental health and well-being and this continued throughout the early months of the pandemic. The disproportionate burden of depression was highest in women providing higher caring hours.
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Affiliation(s)
- C.A. McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Corresponding author
| | - M. Ward
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - C. De Looze
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - A. O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - R.A. Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Mercer's Institute for Successful Ageing, St James’ Hospital, Dublin, Ireland
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