Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020

Profiles of Intolerance of Uncertainty Among 108,540 Adolescents: Associations with Sociodemographic Variables and Mental Health

Intolerance of uncertainty (IU) is widely considered a transdiagnostic risk and maintaining factor for psychiatric disorders. However, little is known about the overall nature and profile of IU among adolescents. This study aims to investigate the profiles of IU among Chinese adolescents and explore their associations with sociodemographic characteristics and mental health problems. A sample of 108,540 adolescents provided data on IU, sociodemographic characteristics, and mental health via an online platform. Latent profile analysis revealed three profiles: Low IU, Medium IU, and High IU. Girls, older adolescents, and those with specific sociodemographics were more likely to belong to the "High IU" profile. Furthermore, the "High IU" profile was associated with the highest risk of several mental health problems. These findings provided valuable information for early prevention and intervention strategies targeting IU and highlighted the importance of IU-based interventions for mental health among adolescents.

From Challenge to Confidence: The Collapse of Trust in the Pandemic Era and the Protective Role of Belief in a Just World

Trust plays a fundamental role in almost every social domain, especially when society is facing multi-level threats. However, the impact of threats on trust and its underlying mechanism remains poorly examined. To address this gap, we conducted a series of studies with an array of methodologies spanning cross-cultural surveys, longitudinal designs, and experimental manipulations. Compelling evidence demonstrated that threats (particularly pandemics) precipitate a decline in levels of multiple forms of trust from interpersonal to institutional domains. Additionally, drawing on both correlational and causal methods (e.g., longitudinal design and priming manipulation), belief in a just world (BJW) mediates this relationship. The findings lay the groundwork for a universal Threats-BJW-Trust model of trust in times of crisis. This model extends its influence beyond the trust domain and holds profound implications for bolstering societal resilience and overall well-being.

[Hypochondriacal fears and corona fears among medical students compared to doctors]

Hypochondriacal fears among medical students were already investigated before the COVID pandemic. Studies on these fears under pandemic conditions and a possible influence of specific fear of illness have not yet been conducted.We asked medical students at two points in time about symptoms of hypochondria and corona anxiety. Doctors served as the comparison group. Hypochondria was assessed using the two MSD scales, corona anxiety using a separate questionnaire.Medical students exhibited significantly more hypochondriacal anxiety at both time points. At the second time point, 35.5% of students and 25.5% of doctors reported fear of contracting the virus.The time of the study did not appear to have any influence on the prevalence of the fears investigated. The influences of the measured anxiety prevalence were shown in the fact that medical students look to their professional careers with concern.

Sympathy towards people infected with COVID-19 mediates relations between media use and death anxiety

The COVID-19 pandemic threatened mental health. This study examined the longitudinal associations among pandemic-related media use, sympathy for people infected with COVID-19 (PIWC), and death anxiety. 132 Chinese adults completed measures three times, one week apart during the initial phase of COVID. The results showed that media use, sympathy, and death anxiety decreased significantly over the first month of the outbreak. Pandemic-related media use predicted increased future sympathy for PIWC, and sympathy predicted increased future death anxiety. The study identified the short-term effects of media use on sympathy and death anxiety, and suggests that reduced media exposure may be beneficial.

Predictors of COVID-Related stress in a community sample in Turkey: a cross-sectional study

The distinctive mental health features associated with COVID-19 have gained importance as the psychological effects of the pandemic on the community become more visible. This study aims to assess the COVID-related stress status and associated factors in the community sample of Turkey. The sample of this cross-sectional study is composed of 2.065 people between the ages of 18-90. Data were collected through an online survey prepared by Google.docs between October-December, 2020. Mild to moderate stress was found in the community with the most common symptoms of the fear of contamination and danger. Some variables, such as being female and the severity of COVID-19 illness, were associated with higher COVID-related stress. Vulnerable groups associated with high stress should be monitored during the pandemic. The findings of this study will guide the practices of professionals working in the field of public health, healthcare, or mental health in possible future pandemics.

Community's Educational Needs During the COVID-19 Pandemic: A Qualitative Study

Background

Due to its unknown nature, multifaceted symptoms, and rapid spread, the coronavirus has become a public health emergency, leading to international concerns. Therefore, this study aims to investigate the community's educational needs during the COVID-19 pandemic.

Materials and Methods

This qualitative research was conducted between 2020 and 2021 using a conventional content analysis approach. The research sample comprised 340 recorded calls from individuals who contacted the emergency hotline of Isfahan University of Medical Sciences during the COVID-19 pandemic to express their concerns and anxieties. Sampling was conducted randomly and purposively until data saturation was achieved. Additionally, Graneheim and Lundman's approach was utilized for data analysis.

Results

After analyzing the interviews, codes related to the reasons for contact were presented in five main categories, including awareness of the nature of the disease, awareness of preventive methods, awareness of diagnostic methods, awareness of treatment methods, and awareness of caring for high-risk groups and 15 subcategories.

Conclusions

The results of this study highlighted various concerns regarding the coronavirus disease during pandemic conditions, which can serve as a foundation for appropriate educational and counseling programs based on community needs during future infectious pandemics.

Intolerance of uncertainty, aging, and anxiety and mental health concerns: A scoping review and meta-analysis

Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.

From anxiety to coping: Understanding psychological distance and coping skills for climate change and COVID-19 in 10-12-year-old children

Children worldwide experience climate anxiety, defined as a chronic fear of environmental catastrophe. Following other scholars who sought comparison between the perceived risks and our collective responses with the COVID-19 pandemic, as they can both be considered global crises. Children's emotional responses, psychological distance and coping strategies to climate change compared and COVID-19 are compared, using a mixed-method longitudinal study among 231 primary school children across the Republic of Ireland. Pre-pandemic and post-lock down data were collected measuring children's emotions through surveys using Likert scales and sketches. Sketching, increasingly recognised as a method for assessing emotional expression, is especially useful when language skills are limited. Results suggest that because climate change was more psychologically distant than COVID-19, it was more difficult for children to effectively use emotional-, meaning-, problem-, and relationship-focused coping strategies to deal with their climate anxiety. One important conclusion of this study is that messages and strategies used to motivate adults to take climate action may increase climate anxiety among young children. Also, relationship-focused coping strategies are underutilised to help children deal with climate anxiety, whilst these were promising coping mechanisms during the COVID-19 pandemic. Therefore, creating positive social support and collective action may help young children to cope with climate anxiety.

Worry and Depressive Symptoms in Adolescents with Neurodevelopmental Disorders

Although worry is a normal cognitive process experienced by adolescents, for a significant number, it can reach intense and uncontrollable levels. If left untreated, these worries can lead to significant mental health problems that are maintained into adulthood. Adolescents with neurodevelopmental disorders (NDDs) may be more prone to cognitive biases (that precede worry) and therefore highly vulnerable to worry. Limited research has examined worry in adolescents with NDDs; however, most studies have focused on measuring anxiety. The present research administered an instrument specifically developed to measure worry to 404 10 to 16-year-old mainstream school-aged adolescents, 204 (123 males, 81 females) of whom had a formally diagnosed NDD. A measure of depressive symptoms was also administered. Confirmatory factor analysis revealed a satisfactory fitting model for worry. Multivariate analysis of variance revealed no interaction effects or main effect for worry according to NDD/non-NDD status. There were, however, main effects for sex, with females scoring significantly higher than males on worry about academic success and the future; worry about peer relationships; combined worry score; and depressive symptoms. The findings of this study offer psychologists and educators a brief validated measure of worry that is suited to mainstream school adolescents with or without NDDs. The wider implications of the findings in the context of education and intervention for students with NDDs are discussed.

People Living with HIV's Worry That the COVID-19 Health Crisis Could Impact Long-Term HIV Care: Lessons From the French Context for Future Disease Epidemics

Background: In 2020, people living with HIV (PLHIV) in France were worried that the COVID-19 health crisis would lead to long-term changes in their HIV care. Using data from the anonymous, online, cross-sectional survey ACOVIH, which was completed by PLHIV between July and September 2020, this study explored factors associated with worry about long-term changes to HIV care after the end of the first lockdown (17 March-11 May 2020). Methods: Using multivariate logistic regression, we compared participants who declared they were worried about long-term changes with those who did not, in terms of their demographic, behavioral, and socioeconomic characteristics, as well as their experience of the COVID-19 crisis and access to care. Results: Among the 249 respondents, 61.5% (n = 153) declared having worries about long-term changes to HIV care. Specifically, after adjustment for gender and age, PLHIV born outside of France (adjusted odds ratios (aOR) [95%CI] = 2.57[1.44;6.76]), those whose financial situation deteriorated since the beginning of the pandemic (4.87[1.97;13.20]), those with a history of HIV opportunistic infections (3.27[1.53;7.32]), and respondents who took psychotropic drugs (3.21[1.50;7.22]) were all more likely to declare having worries. In terms of related determinants, a deterioration in communication with their HIV medical team (3.47[1.61;7.94]), having worries about COVID-19 (1.36[1.14;1.62]), and believing that HIV treatment increased the risk of COVID-19 infection (1.52[1.15;2.03]), were all significantly associated with having worries about long-term changes to HIV care. Conclusion: In the context of future disease epidemics, taking into account the profiles of individual PLHIV, and providing clearer, targeted information on HIV care, could help reduce worry in this population about the continuity of HIV care and could foster efficient communication with care providers.

Exploring the relationship between personal and cohabiting family members' COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS)

OBJECTIVES

This study aims to explore the relationship between the combined experiences of COVID-19 infection in individuals and their family members and the resulting fear of COVID-19, with a focus on the severity of symptoms and various sociodemographic factors.

DESIGN

Longitudinal survey study.

SETTING

The Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale web panel survey administered in Japan.

PARTICIPANTS

Analysis was based on responses from 15 542 individuals who participated in all three waves of JACSIS conducted between 2020 and 2022.

MAIN OUTCOME MEASURES

The primary measure was the fear of COVID-19, assessed using the Fear of COVID-19 Scale. The study employed a two-way analysis of variance without repetition, Games-Howell post hoc tests and ordinary least-squares linear regression analysis, with time points treated as fixed effects.

RESULTS

The study revealed significant differences in fear levels based on the combined COVID-19 infection experiences of respondents and their family members, with variations observed across different time points. Mild symptoms in either the respondents or their family members correlated with reduced fear (β=-0.584, SE=0.181, p=0.001), while severe symptoms were associated with increased fear (β=1.244, SE=0.217, p<0.001). Gender, age, marital status and a history of respiratory disease or mental illness were also significant factors. For instance, females reported higher fear levels compared with males (β=0.707, SE=0.049, p<0.001), and those with a history of respiratory diseases showed increased fear (β=1.632, SE=0.286, p<0.001). Over time, the general fear of COVID-19 decreased, with the sharpest decline observed at T3 compared with T1 (β=-1.399, SE=0.061, p<0.001).

CONCLUSION

The study highlights the significant influence of the combined COVID-19 infection experiences of individuals and their family members (the severity of symptoms, in particular) on the fear of COVID-19. These results underscore the need for tailored mental health interventions that consider both personal and familial infection experiences, as well as other sociodemographic factors. The findings also reflect the evolving public response to the changing dynamics of the pandemic.

Assessing the Fear of Covid-19 in Psychiatric Patients: Results from an Italian Multicentric Study

Objective

Even though the COVID-19 emergency has concluded, its consequences are still relevant. Recent evidence suggests that a significant proportion of individuals experience persistent symptoms long after the initial infection has resolved, classified as "Long COVID" condition. Fear of COVID-19 increases anxiety and stress levels in healthy individuals and exacerbates the symptoms of those with pre-existing psychiatric disorders; therefore understanding the impact of the pandemic on psychiatric disorders remains of utmost importance. The present study aimed at assessing the prevalence and predictive factors of fear of COVID-19 in a sample of patients with different psychiatric conditions.

Method

A sample of 269 psychiatric patients were recruited from two different tertiary clinics in Italy and assessed with the Fear of COVID-19 Scale (FCV-19S). In order to compare patients with a significant fear of COVID-19 or without (Fear+ vs. Fear-) and to identify the main features in terms of clinical dimension, exploratory and predictive analysis were performed.

Results

Female gender, age at illness onset, and insight levels emerged as positive predictors of FCV-19S. Conversely, current substance abuse emerged as a negative predictor of fear levels. Moreover, significantly lower FCV-19S scores were observed in patients with a diagnosis of schizophrenia spectrum disorders.

Conclusions

Specific sociodemographic and clinical factors predicted higher levels of fear of COVID-19 in psychiatric patients. Further studies are warranted to determine the potential long-term consequences of the COVID-19 impact on mental health.

The voices of youths in COVID-19 times: exploring young people's emotional representations

Since the spread of the COVID-19 virus worldwide, the pandemic had psychological consequences for the entire population for various reasons including restrictions, isolation, and socioeconomic changes. Young people were particularly affected by these psychological consequences, which formed the focus of the mental health concerns voiced by the World Health Organization. This research aimed to analyze, first-hand, the primary emotions that COVID-19 evoked in young Spanish people after two years of the pandemic. Participants were recruited through a snowball sampling procedure using emails, virtual platforms of the schools, and social networks, and a google forms questionnaire was administered for data collection. A total of 479 Spanish young people (18-36 years) participated in this study. The questionnaire consisted of a free-association exercise based on the Grid Elaboration Method (GEM) to analyze the participants' emotional representations of COVID-19. In addition, lexical analysis was used to analyze the text corpus. As a result, it could be observed that sadness was the core emotion experienced among young people, followed by fear. Specifically, emotional breakdown, fear, fatigue, and anger figured centrally in their emotional representations. Moreover, the findings revealed new patterns of self- and onward blaming towards youths. It was concluded that results of this research provide important clues for managing the mental health of young people, particularly during future pandemics.

To what extent did households in developing countries forgo needed healthcare during the COVID-19 pandemic? Repeated survey estimates from 25 countries in 2020 and 2021

Introduction

During the first year of the COVID-19 pandemic, health system disruptions, fear of becoming infected with COVID-19, mobility restrictions and lockdowns, and reduced household incomes likely contributed to households forgoing needed healthcare. The objective of this study was to measure the prevalence of forgone healthcare and how its drivers changed between the early period of the pandemic in 2020 and the first half of 2021.

Methods

Using repeated measures collected over two time periods in 63 000 households in 25 low-income and middle-income countries, this analysis documents how the prevalence of forgone healthcare and its drivers changed between 2020 and 2021.

Results

In 2020, in the sample pooled across all countries, 17.9% of households reported not being able to obtain needed healthcare. The prevalence of forgone care was 15.6% in low-income countries (LICs), 17.0% in lower-middle-income countries (LMICs) and 20.5% in upper-middle-income countries (UMICs). In 2021, the prevalence of forgone care was lower-10.3% in the pooled sample, 7.9% in LICs, 15.1% in LMICs and 5.3% in UMICs. Financial barriers were the most common reason for not obtaining needed healthcare in both time periods: 42% in 2020 and 45% in 2021 and were higher in LICs and LMICs than in UMICs.

Conclusion

This study is a comprehensive analysis of the changes in forgone care in low-income and middle-income countries. It documents the predominance of financial barriers among those who could not obtain needed healthcare. It suggests the importance of pandemic preparedness to protect access by vulnerable households to essential healthcare service. The study also demonstrates that phone surveys could, at scale, be a cost-effective way to improve the monitoring of progress towards universal health coverage.

Impact of hospital outpatients' experiences of patient safety on fear of infection: a secondary analysis of national data

INTRODUCTION

Amid the COVID-19 pandemic, outpatients' concerns about infection risk have increased. It is crucial to understand the factors that contribute to this fear of infection to promote patient safety and encourage outpatients to seek proper follow-up treatment without fear. This study aims to understand the relationship between outpatients' experiences of patient safety and their fear of infection.

DESIGN

This was a secondary analysis of national data from the Healthcare Service Experience Survey in 2020.

SETTING AND PARTICIPANTS

A total of 4416 patients with experience using outpatient services in the past year were included in South Korea.

PRIMARY AND SECONDARY OUTCOME MEASURES

Demographic characteristics, fear of infection and safety experiences were assessed in the original survey. Fear of infection served as the dependent variable, with safety experiences-specifically, patient identification, preinjection explanations, hand hygiene, proper use of injection supplies, skin disinfection and adverse drug reactions-as the independent variables.

RESULTS

Approximately 14% of outpatients had a fear of infection when receiving medical care. The unadjusted model showed that all patient safety categories were determinants of fear of infection, and the multivariate logistic model identified hand hygiene and medication safety experiences as significant factors associated with fear of infection.

CONCLUSIONS

This study revealed that patient safety experiences are associated with fear of infection in outpatient settings. Improving healthcare professionals' hand hygiene and managing adverse drug reactions are crucial for enhancing patient safety.

The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the COVID-19 Pandemic and the Impact of Pandemic on Tinnitus

OBJECTIVES

This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus.

METHODS

This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus.

RESULTS

Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic.

CONCLUSION

Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients.

Evaluating the General Health Risk Factors (Physical, Psychological, and Social Functions) of Hospital Staff a Year after COVID-19 Outbreak in 2020-2021, Isfahan Iran

Background

Healthcare workers are the first to be exposed to the virus and are at greater risk than the general public. This study aimed to examine the risk factors that affected hospital staff's general health during the COVID-19 pandemic in Isfahan, Iran.

Materials and Methods

This cross-sectional study was conducted on the staff of all hospitals in Isfahan one year after the COVID-19 outbreak (2021-2022). The General Health Questionnaire (GHQ) was used to determine social functioning, while the Patient Health Questionnaire (PHQ) was employed to assess physical and psychological health status.

Results

There was a significant positive relationship between work experience in the COVID-19 ward and the scores of physical health (r = 0.26, df = 298, p < 0.01), depressive symptoms (r = 0.24, df = 298, p < 0.01), and anxiety (r = 0.17, df = 298, p < 0.01). The job and income satisfaction score was negatively related to the scores of social function variables (r = -0.25, df = 298, p < 0.01) and depressive syndrome (r = -0.12, df = 298, p < 0.05). The fear of COVID-19 was related to social functioning (r = 0.12, df = 298, p < 0.01), physical health (r = 0.31, df = 298, p < 0.001), depressive symptoms (r = 0.36, df = 298, p < 0.001), panic attacks (r = 0.15, df = 298, p < 0.01), and generalized anxiety (r = 0.23, df = 298, p < 0.001). Gender and age significantly predicted general health.

Conclusions

The COVID-19 pandemic negatively affected all dimensions of hospital staff's health, particularly those with underlying physical conditions.

COVID-19 associated fear & anxiety among students: Findings from a large-scale online survey in Bangladesh

Objective: The study aimed to assess anxiety and fear of COVID-19 among home-staying Bangladeshi students. Participants: A total of 3997 university students across Bangladesh participated in the study. Methods: A cross-sectional study was conducted using the generalized anxiety disorder scale and the fear of COVID-19 scale to measure anxiety and fear, respectively. Results: 40.11% of participants had anxiety. Fear of death by COVID-19 (β1'=4.45; 95% CI: 3.99-4.90) and perceiving COVID-19-like symptoms as having COVID-19 (β1'=2.47; 95% CI: 1.76-3.18) were associated with higher fear. Exposure to COVID-19 news on social media was a predictor of fear and anxiety. Furthermore, the severe educational loss was associated with fear (β1'=2.88; 95% CI: 2.25-3.50) and anxiety (β2'=1.91; 95% CI: 1.41 to 2.41). Physical exercise and recreational activities were protective factors for fear and anxiety. Conclusion: The study reports a higher level of psychological difficulties among students during the COVID-19 pandemic which needs further longitudinal exploration to design appropriate interventions.

COVID-19 vaccination intention among people who use drugs in France in 2021: results from the international community-based research program EPIC

BACKGROUND

COVID-19 vaccination is crucial to reduce the incidence of severe forms of the disease in the population. However, people who use drugs (PWUD) face structural and individual barriers to vaccination, and little is known about vaccination intention and factors associated with that intention among PWUD. This study aimed to estimate vaccination intention in PWUD and associated factors in the early stage of vaccination campaigns.

METHODS

We conducted cross-sectional study in France among PWUD, as part of the international EPIC program, a community-based research study coordinated by Coalition PLUS. It included 166 unvaccinated PWUD attending harm reduction centers. A questionnaire collected data on sociodemographic characteristics, COVID-19 related difficulties, and mental health, among other things. Multivariate logistic regression was used to identify factors associated with low vaccination intention.

RESULTS

Only 19% of participants reported strong intention to get vaccinated against COVID-19. Factors independently associated with low vaccination intention were younger age (aOR = 0.90, 95%CI = 0.85-0.95), lower education level (aOR = 2.67, 95% CI = 0.95-7.55), and unstable housing (aOR = 6.44, 95% CI = 1.59-40.34). The most-cited reasons for low intention were mistrust in COVID-19 vaccines (66.1%), fear of side effects (48.7%), and non-belief in vaccinations in general (25.2%).

CONCLUSIONS

This study highlights the need for targeted COVID-19 information and interventions to increase vaccine uptake in PWUD, especially those living in precarity. Community-based interventions and targeted government assistance could play a crucial role in addressing vaccine hesitancy in this population, not only for COVID-19 but for future epidemics.

Determinants affecting the medical students adoption of mobile learning: extended UTAUT

BACKGROUND

This research investigates the fundamental factors which may stymie or simplify the adoption of m-learning by medical college educators in Sudan. We made use of the Extended Unified Theory of Acceptance and Use Technology (UTAUT) with COVID-19 fear (CF) and social isolation (SIS) as exogenous components.

OBJECTIVE

This research aims to find out factors impacting medical students' behavioural intention to use mobile learning.

METHODS

Data was gathered from 499 undergraduate learners from different universities in Sudan. Partial Least Square (PLS) and structural equation modeling (SEM) were used to examine the data.

THE RESULTS

Showed that expected performance, effort expectancy (EE), social influence (SI), facilitation condition (FC), COVID-19 fear, and social isolation (SIS) are predictors of behavioural intentions (BI). In addition, our findings show that COVID-19 fear and social isolation increase student adoption of mobile learning during the COVID-19 epidemics in developing countries.

CONCLUSIONS

The study unveiled that the suggested framework, derived from UTAUT, effectively discerns the factors impacting students' intentions in mobile learning during pandemics. Sudanese medical students' can strategize and execute effective classroom environments based on these findings.

Spirituality, Intolerance and Fear of COVID-19: Psychological Distress Among Older Adults in Pakistan

The present study aimed to investigate the role of spirituality, intolerance of uncertainty (IU), and fear of COVID-19 as correlates and predictors of psychological distress among older adults in Pakistan and also assess the gender differences among research variables. Using a quantitative correlational survey research design, a sample of 150 (75 = Men, 75 = Women) older adults aged 55 years and above from different cities of Pakistan were approached through a non-probability purposive sampling strategy. Participants completed the Daily Spiritual Experience Scale, Intolerance of Uncertainty Scale IUS-12, Fear of COVID-19, and Kessler Psychological Distress Scale-K10. Spirituality has a significant negative relationship with psychological distress. Whereas, IU (Inhibitory anxiety and prospective anxiety) and fear of COVID-19 have a significant positive relationship with psychological distress. Results also showed that spirituality, IU dimensions, and fear of COVID-19 emerged as significant predictors of psychological distress among older adults after controlling for the effect of covariates. In addition, elderly females significantly showed more spirituality, less IU, and fear of COVID-19 as compared to elderly males. It is proposed that mental health care plays an important role in treating the psychological needs of older adults in pandemic situations and that further study is needed to develop effective solutions for older persons in stressful situations such as pandemics.

Determination of the effect of the pre-surgery COVID-19 fear level and hygiene behaviours of the patients on the personal protective clinical measures developed after the surgery: A cross-sectional study

AIM

This study aims to examine patients' preoperative COVID-19 fear levels, hygiene behaviours, postoperative personal protective clinical measures, and their correlations with each other.

DESIGN

This research is a cross-sectional type of study.

METHODS

The study sample consisted of 131 patients hospitalized in the general surgery inpatient ward of a hospital in Turkey. The sample was determined by G-Power analysis. The data were collected in two stages in a research hospital between 1 April 2021 and 1 March 2022. Sociodemographic and Clinical Information Form, COVID-19 Fear Scale, COVID-19 Hygiene Scale were used before surgery; COVID-19 personal protective clinical measures questionnaire was used after surgery. Descriptive statistics, independent t-test, ANOVA test, Wilcoxon test and Spearman correlation analysis were used to evaluate the data.

RESULTS

It was determined that preoperative COVID-19 fear levels, hygiene behaviours, and the personal protective clinical measures developed after the surgery were above moderate. A statistically significant and positive correlation was found between the COVID-19 Fear Scale and the preoperative COVID-19 Hygiene Scale and postoperative COVID-19 personal protective clinical prevention questionnaire total score and sub-dimension score averages. Patients' COVID-19 fears, preoperative and postoperative hygiene behaviours are statistically significantly associated with each other at a low level; postoperative clinical precautions and preoperative hygiene behaviours are statistically significantly associated with each other at a high level.

CONCLUSION

The results of this study show that patients are terrified of COVID-19 while they are hospitalized due to surgical intervention during the pandemic process, and they increase their hygiene measures. It is thought that the results of the study will guide the regulation of clinical measures, patient education, and nursing care to be developed for patients during pandemic periods.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Messenger Use and Video Calls as Correlates of Depressive and Anxiety Symptoms: Results From the Corona Health App Study of German Adults During the COVID-19 Pandemic

BACKGROUND

Specialized studies have shown that smartphone-based social interaction data are predictors of depressive and anxiety symptoms. Moreover, at times during the COVID-19 pandemic, social interaction took place primarily remotely. To appropriately test these objective data for their added value for epidemiological research during the pandemic, it is necessary to include established predictors.

OBJECTIVE

Using a comprehensive model, we investigated the extent to which smartphone-based social interaction data contribute to the prediction of depressive and anxiety symptoms, while also taking into account well-established predictors and relevant pandemic-specific factors.

METHODS

We developed the Corona Health App and obtained participation from 490 Android smartphone users who agreed to allow us to collect smartphone-based social interaction data between July 2020 and February 2021. Using a cross-sectional design, we automatically collected data concerning average app use in terms of the categories video calls and telephony, messenger use, social media use, and SMS text messaging use, as well as pandemic-specific predictors and sociodemographic covariates. We statistically predicted depressive and anxiety symptoms using elastic net regression. To exclude overfitting, we used 10-fold cross-validation.

RESULTS

The amount of variance explained (R2) was 0.61 for the prediction of depressive symptoms and 0.57 for the prediction of anxiety symptoms. Of the smartphone-based social interaction data included, only messenger use proved to be a significant negative predictor of depressive and anxiety symptoms. Video calls were negative predictors only for depressive symptoms, and SMS text messaging use was a negative predictor only for anxiety symptoms.

CONCLUSIONS

The results show the relevance of smartphone-based social interaction data in predicting depressive and anxiety symptoms. However, even taken together in the context of a comprehensive model with well-established predictors, the data only add a small amount of value.

Fear of COVID-19 predicts increases in anxiety, depressive symptoms, health anxiety, psychosocial distress, and loneliness: Findings from a prospective two-year follow-up study

The role of fear of COVID-19 in prospectively predicting changes in psychopathological symptoms during the COVID-19 pandemic remains unclear. The present data were obtained from a longitudinal non-probability sample in Germany, initially assessed at the beginning of the COVID-19 pandemic in Germany (April-May 2020) and reassessed after two years (n = 846; 83% female; mean age: 44.59 years, SD = 12.32; response rate: 19.5%). Multiple linear regressions were used to examine associations of fear of COVID-19 at baseline with depressive symptoms, anxiety, health anxiety, psychosocial distress, and loneliness controlling for (a) the respective symptom measure, and (b) all psychopathological symptoms at baseline. The data were weighted to minimize attrition and representativeness biases. Overall, loneliness decreased from the beginning of the COVID-19 pandemic until the two-year follow-up, whereas all other symptoms did not change. Fear of COVID-19 at the beginning of the pandemic predicted an increase in anxiety symptoms, health anxiety, psychosocial distress, and loneliness two years later. In addition, fear of COVID-19 predicted higher health anxiety, depressive symptoms, psychosocial distress, and loneliness, but not anxiety symptoms when controlling for all baseline symptom measures at once. Fear of COVID-19 seems to play a central role in predicting negative mental health outcomes, emphasizing the necessity of indicated prevention and intervention to decrease worry and manage anxiety, thereby reducing the negative impact on mental health caused by fear during future pandemics.

Far from the threatening crowd: Generalisation of conditioned threat expectancy and fear in COVID-19 lockdown

Fear and anxiety are rarely confined to specific stimuli or situations. In fear generalisation, there is a spread of fear responses elicited by physically dissimilar generalisation stimuli (GS) along a continuum between danger and safety. The current study investigated fear generalisation with a novel online task using COVID-19-relevant stimuli (i.e., busy or quiet shopping street/mall scenes) during pandemic lockdown restrictions in the United Kingdom. Participants (N = 50) first completed clinically relevant trait measures before commencing a habituation phase, where two conditioned stimuli (CSs; i.e., a busy or quiet high street/mall scene) were presented. Participants then underwent fear conditioning where one conditioned stimulus (CS+) was followed by an aversive unconditioned stimulus (US; a loud female scream accompanied by a facial photograph of a female displaying a fearful emotion) and another (CS-) was not. In a test phase, six generalisation stimuli were presented where the US was withheld, and participants provided threat expectancy and fear ratings for all stimuli. Following successful conditioning, fear generalization was observed for both threat expectancy and fear ratings. Trait worry partially predicted generalised threat expectancy and COVID-19 fear strongly predicted generalised fear. In conclusion, a generalisation gradient was evident using an online remote generalisation task with images of busy/quiet streets during the pandemic. Worry and fear of COVID-19 predicted fear generalisation.

Intolerance of Uncertainty as a Situational Vulnerability Factor in the Context of the Pandemic: A Systematic Review and Meta-Analysis of COVID-19-Related Psychological Impacts

BACKGROUND

Intolerance of uncertainty (IU) is widely accepted as a transdiagnostic vulnerability factor for a range of mental health problems. It is considered a transsituational vulnerability factor associated with a range of responses to different stressful life situations. The aim of this systematic review and meta-analysis is to examine the association between IU and specific psychological responses to the COVID-19 pandemic and the moderators of this relationship drawn from IU research and other studies on COVID-19.

METHOD

The studies included were as follows: (i) English-language articles published in peer-reviewed journals or thesis/dissertations; (ii) reporting specific psychological impacts of COVID-19; (c) reporting IU; (iii) case-control studies, prospective cohort studies, experimental studies and cross-sectional studies of large populations and (iv) reporting correlation coefficients between the variables of interest. Studies on participants with a diagnosis of neurological and/or organic impairment were excluded. The databases searched were Google Scholar, PubMed, ScienceDirect, and ProQuest, up until 31 December 2022. The risk of bias was assessed using the Risk of Bias Utilized for Surveys Tool (ROBUST, Nudelman et al., 2020). Sensitivity analysis was conducted using the one-study remove method, and studentized residuals and Cook's distance were examined. A random effects model was used.

RESULTS

We examined the association between IU and COVID-19-related psychological impacts across 85 studies from 22 countries (N = 69,997; 64.95% female; mean sample age, 32.90 ± 9.70). There was no evidence of publication bias. We found a medium and positive association between IU and COVID-19-related psychological impacts (N = 69,562, r = 0.35, k = 89, 95% CI [0.32, 0.37]), which was independent of the IU measure used or whether the psychological impact was measured in relation to the virus alone or broader aspects of the pandemic. It was also independent of severity, publication year, sample type and size, study quality, age and sample levels of anxiety, depressive symptoms, stress, mental well-being and social support. However, the observed association varied significantly between countries and country income levels (stronger among low-incomes) and across genders (stronger among males) and was stronger for measures with greater reliability and more items, but lower among samples with more people who had been exposed to COVID-19.

CONCLUSIONS

The findings support that IU is a higher order transsituational vulnerability factor related to cognitive, behavioural and distress responses during the pandemic. Limitations include English-language-only sources, reliance on a wide range of measures that were coded using a novel system and variable risk of bias across studies. The implications are considered in relation to the management of psychological consequences of major situational stressors experienced at a global scale, but the variations at a national and socioeconomic level also have implications for different or localized stressors at a regional or community level.

Characterizing the impact of the Covid-19 pandemic on adults with autosomal dominant polycystic kidney disease: a cross-sectional study

BACKGROUND

The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated.

METHODS

Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020.

RESULTS

N = 34 (51.5%) of participants reported a positive Covid-19 test result. N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic.

CONCLUSIONS

In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management. This was likely due to this cohort's excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

Childhood maltreatment is linked to larger preferred interpersonal distances towards friends and strangers across the globe

Childhood maltreatment (CM) is thought to be associated with altered responses to social stimuli and interpersonal signals. However, limited evidence exists that CM is linked to larger comfortable interpersonal distance (CID) - the physical distance humans prefer towards others during social interactions. However, no previous study has investigated this association in a comprehensive sample, yielding sufficient statistical power. Moreover, preliminary findings are limited to the European region. Finally, it is unclear how CM affects CID towards different interaction partners, and whether CID is linked to social functioning and attachment. To address these outstanding issues, adults (N = 2986) from diverse cultures and socio-economic strata completed a reaction time task measuring CID towards an approaching stranger and friend. Higher CM was linked to a larger CID towards both friends and strangers. Moreover, insecure attachment and less social support were associated with larger CID. These findings demonstrate for the first time that CM affects CID across countries and cultures, highlighting the robustness of this association.

Longitudinal changes in depression and anxiety during the COVID-19 pandemic and the impact of COVID-related factors

OBJECTIVE

This study is an investigation of five specific COVID-related stressors and their longitudinal impact on adult depression and anxiety.

METHOD

A total of 592 adults comprised the initial sample at Time 1 in April/May 2020. Follow-ups were conducted about a month later, again in March 2021 and then in March 2022.

RESULTS

Applied linear mixed effect models showed a significant decrease in mean depression scores and anxiety scores from Time 1 to both Times 3 and 4. Neither change over time in anxiety or depression were found to be related to COVID diagnosis, COVID hospitalization, or COVID death. Self-quarantine was related to changes over time in both depression and anxiety, and household quarantine was related to changes over time in depression.

CONCLUSION

While the fallout of the pandemic continues, it is important to understand how these factors may be affecting mental health to better understand where intervention is necessary.

Death Obsession, COVID-19-Related Fear and Religiosity in People Living with Type 2 Diabetes

Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.

Seeking Protection in the Heart of the Storm: Findings from a Grounded Theory Study

Background

Nurse protection is a multifaceted concept that has become increasingly relevant in recent years. Despite its importance in effectively managing pandemics, there is still a gap in knowledge about how nurses achieve protection in hospitals.

Objective

To describe the process of seeking protection among nurses during the COVID-19 pandemic.

Methods

A grounded theory approach from 2020 to 2022, employing purposive and theoretical sampling. Face-to-face and online interviews were conducted with 25 participants, resulting in 29 interviews. Data analysis was carried out using Corbin and Strauss's method (2015).

Results

The analysis revealed that nurses encountered numerous obstacles related to patients, nurses themselves, organizations, and the passage of time during the COVID-19 pandemic. These challenges were intertwined with three key concepts: transformations, inequalities, and emotional challenges, highlighting the multifaceted nature of nurses' protection concerns. In response, nurses employed a protective strategy bolstered by catalysts to address these challenges. This strategy encompassed both optimistic outlooks ("Bright horizon") and somber reflections ("Unpleasant reflection"). Ultimately, seeking protection in the heart of the storm emerged as the core concept, representing the multifaceted process through which nurses navigate and seek protection amidst the unique challenges posed by the pandemic.

Conclusions

This study presents a comprehensive theory that explicitly explains the multifaceted process of seeking protection among hospital-employed nurses during a pandemic. The theory captures the interconnectedness of challenges faced by nurses and the protective strategies they employ while acknowledging the nuanced balance between hopeful prospects and sobering reflections. Implications for Nursing Management. Policymakers, managers, and educators can utilize the findings to improve nursing management and support systems. By increasing awareness, addressing challenges, and providing robust support, they can enhance the well-being and effectiveness of nurses during healthcare crises, ultimately improving patient care quality.

Ameliorative Effects of Television Watching Behavior and Motivation on the Fear of COVID-19 in Older Chinese Adults During the Pandemic

Purpose

The aim of this study was to investigate the television (TV) consumption patterns (viewing behavior and motivation) of older adults in Wuhan, China, during the COVID-19 pandemic and its impact on older adults' mental health, particularly in relation to COVID-19-induced fear.

Participants and Methods

A questionnaire survey was conducted with 405 older adults in Wuhan, China. The data were analyzed using a structural equation model to understand the relationship between TV viewing behavior, motivation, and fear related to COVID-19.

Results

The findings indicate that the motivation to watch TV has a positive influence on viewing behavior among older adults during the pandemic. However, this motivation negatively impacts their COVID-19-related fear. Furthermore, a negative correlation was observed between viewing behavior and fear. The primary motivations for TV viewing among older adults during the pandemic were identified as social interaction and emotion management, followed by information seeking and value expression.

Conclusion

The findings suggest that TV viewing plays a significant role in the mental well-being of older adults during the COVID-19 pandemic. By addressing the motivations of social interaction, emotion management, information seeking, and value expression, public health organizations and TV stations can contribute to the mental health of this vulnerable population.

Investigating fear, depressive symptoms and coping mechanisms among Egyptian nursing students amidst the covid-19 pandemic: a cross-sectional study

BACKGROUND

Amidst the ongoing COVID-19 pandemic, nursing students' contribution to combating this global health crisis is becoming more significant. However, we need a more comprehensive understanding of the psychological impact of this crisis on these students. Therefore, this study holds immense importance as it offers valuable insights into the connection between COVID-19 pandemic fear, coping strategies, and depressive symptoms among nursing students.

METHODS

A cross-sectional survey was conducted to collect and analyze data from 319 undergraduate nursing students. They participated in the study by responding to an online questionnaire. The questionnaire consisted of the Fear of the Coronavirus Questionnaire, Brief Coping Orientation to Problems Experienced, and the Beck Depression Inventory-II.

RESULTS

The study revealed that 45.5% of the participants had a severe fear of COVID-19, 21.9% showed severe depressive symptoms, and 64.6% used moderate coping mechanisms. A positive correlation (r = 0.160, p = 0.01) was found between the fear of COVID-19 and depressive symptoms. Interestingly, this correlation turned negative (r = -0.074, p = 0.01) when adaptive coping strategies such as religion, acceptance, planning, positive reframing, instrumental support, emotional support, active coping, and humor were used. However, when participants resorted to maladaptive coping strategies like venting, self-distraction, self-blame, behavioral disengagement, denial, and substance abuse, the correlation between high fear levels and depressive symptoms became positive (r = 0.352, p = 0.01).

CONCLUSION

The study demonstrated that the fear of COVID-19 and depressive symptoms among nursing students are significantly correlated. However, the nature of this correlation is influenced by the type of coping strategies employed. Adaptive coping mechanisms can mitigate the impact of fear on depressive symptoms. In contrast, maladaptive coping can exacerbate the relationship between fear and depressive symptoms. Therefore, promoting adaptive coping strategies could be a crucial approach to managing the psychological impact of the COVID-19 pandemic.

The social evolution of COVID-19: pandemics as total social facts

The COVID-19 pandemic was an unprecedented global event in recent history. Beginning with an initial outbreak in Wuhan, China, in December 2019, the virus spread rapidly across the globe, causing millions of deaths and triggering an unprecedented health, economic, and social crisis. The initial response to the outbreak in many countries was the implementation of social distancing measures, including the closure of schools and businesses, the cancellation of mass events, and the banning of travel. These measures were aimed at reducing the virus' spread and preventing health systems from being overwhelmed by the numerous severe COVID-19 cases. However, these measures also had a devastating economic impact, especially on precarious workers and freelancers, as well as those who were unable to work from home. As the pandemic (also considered a syndemic or synergistic epidemic) dragged on, countries adopted more flexible approaches to dealing with the virus, adopting mitigation measures rather than social distancing measures. These included the use of masks, testing and contact tracing, and the opening of businesses and schools with the implementation of additional safety measures. This paper highlights the social consequences of the pandemic, ultimately arguing that it is a total social fact (from the French fait social total), based on Marcel Mauss' categorization, since it encompassed and impacted all facets of human life.

The Psychological Burden of Surgery During a Pandemic: Evaluating Preoperative Anxiety in the COVID-19 Era

Background The COVID-19 pandemic has introduced unprecedented challenges to global healthcare systems, including heightened psychological stress among patients. This study evaluates the preoperative anxiety levels among patients scheduled for surgery during the COVID-19 pandemic. Methods This cross-sectional observational study was conducted between April 2020 and March 2022. Adult patients aged 18-80 years, scheduled for elective or emergency surgery, were included. Exclusion criteria were mental illness, impaired communication, and hemodynamic instability. A pre-validated questionnaire addressing demographics, prior surgery exposure, surgery-related anxiety, and COVID-19-related fears was administered. Anxiety levels were scored on a 1-5 Likert scale. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, USA). Results A total of 112 patients participated, with a mean age of 42.3±14.2 years. The majority were female (61 patients, 54.5%), married (96 patients, 85.7%), and resided in urban areas (85 patients, 75.9%). Most patients had no prior surgical history (87 patients, 77.7%). Surgery-related fears were prevalent, with 110 patients (98.2%) fearing surgical complications and 111 patients (99.1%) fearing postoperative pain. COVID-19-related fears were also significant, with 108 patients (96.4%) fearing infection during hospital stay and 100 patients (89.3%) fearing infecting family members. Mild fear was the most common anxiety level (70 patients, 62.95%), followed by moderate fear (25 patients, 22.5%). Discussion The study highlights the dual stressors of surgery and the pandemic, contributing to heightened preoperative anxiety. Findings indicate that significant anxiety levels were present, driven by fears related to surgery, anesthesia, and COVID-19. This aligns with other studies that report high preoperative anxiety levels exacerbated by the pandemic. The comprehensive assessment of anxiety factors underscores the need for tailored interventions to mitigate these anxieties. Conclusion The COVID-19 pandemic has significantly increased preoperative anxiety among surgical patients. Addressing both surgical and pandemic-related anxieties is crucial for improving patient outcomes. Healthcare providers should implement psychological support programs to alleviate these anxieties. Understanding the multifaceted nature of preoperative anxiety during the pandemic can enhance patient care.

Managing Fear During Pandemics: Risks and Opportunities

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

Emotion Regulation in Families: Exploring the Link between Parent-Child Alexithymia and Child Post-Traumatic Stress Symptoms Amidst the COVID-19 Pandemic

The COVID-19 pandemic comprises a mass trauma for children and families, and children may face particular vulnerability to post-traumatic stress symptoms (PTSS) through processes of parent and child emotional dysregulation, such as alexithymia. With 88 U.S. children (Mage = 9.94 years; 54.5% female; 59.1% White) and their parents/caregivers (68.2% female; 59.1% White), a path model was tested in which child alexithymia symptoms partially mediated the association between parent alexithymia symptoms and child COVID-19-related posttraumatic stress symptoms (PTSS). We also tested an alternative model in which child alexithymia symptoms moderated the association between parent alexithymia symptoms and child PTSS. The hypothesized mediation model was supported (β = 0.15, SE = 0.05, 95% CI: [0.07, 0.25], p < 0.001), whereas the hypothesized moderator model was not (β = 0.06, p = 0.44). Findings highlight the importance of parents' emotional understanding and regulation for child mental health during mass traumas such as pandemics.

Characterizing the Impact of the Covid-19 Pandemic on Adults with Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Study

Background

The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated.

Methods

Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020.

Results

N = 34 (51.5%) of participants reported a positive Covid-19 test result and N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic.

Conclusions

In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management, like due to excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

Exploring the Interplay of Food Security, Safety, and Psychological Wellness in the COVID-19 Era: Managing Strategies for Resilience and Adaptation

The global population surge presents a dual challenge and opportunity in the realms of food consumption, safety, and mental well-being. This necessitates a projected 70% increase in food production to meet growing demands. Amid this backdrop, the ongoing COVID-19 pandemic exacerbates these issues, underscoring the need for a deeper understanding of the intricate interplay between food consumption patterns and mental health dynamics during this crisis. Mitigating the spread of COVID-19 hinges upon rigorous adherence to personal hygiene practices and heightened disease awareness. Furthermore, maintaining stringent food quality and safety standards across both public and private sectors is imperative for safeguarding public health and containing viral transmission. Drawing upon existing research, this study delves into the pandemic's impact on mental health, food consumption habits, and food safety protocols. Through a comprehensive analysis, it aims to elucidate the nuanced relationship among food, food safety, and mental well-being amid the COVID-19 pandemic, highlighting synergistic effects and dynamics that underpin holistic human welfare. Our study offers a novel approach by integrating psychological wellness with food security and safety. In conceiving this review, we aimed to comprehensively explore the intricate interplay among food security, safety, and psychological wellness amid the backdrop of the COVID-19 pandemic. Our review is structured to encompass a thorough examination of existing research, synthesizing insights into the multifaceted relationships among food consumption patterns, mental health dynamics, and food safety protocols during the crisis. Our findings provide valuable insights and practical recommendations for enhancing food security and psychological well-being, thus supporting both academic research and real-world applications in crisis management and policy development.

Association between stringency of lockdown measures and emergency department visits during the COVID-19 pandemic: A Dutch multicentre study

INTRODUCTION

The COVID-19 outbreak disrupted regular health care, including the Emergency Department (ED), and resulted in insufficient ICU capacity. Lockdown measures were taken to prevent disease spread and hospital overcrowding. Little is known about the relationship of stringency of lockdown measures on ED utilization.

OBJECTIVE

This study aimed to compare the frequency and characteristics of ED visits during the COVID-19 outbreak in 2020 to 2019, and their relation to stringency of lockdown measures.

MATERIAL AND METHODS

A retrospective multicentre study among five Dutch hospitals was performed. The primary outcome was the absolute number of ED visits (year 2018 and 2019 compared to 2020). Secondary outcomes were age, sex, triage category, way of transportation, referral, disposition, and treating medical specialty. The relation between stringency of lockdown measures, measured with the Oxford Stringency Index (OSI) and number and characteristics of ED visits was analysed.

RESULTS

The total number of ED visits in the five hospitals in 2019 was 165,894, whereas the total number of visits in 2020 was 135,762, which was a decrease of 18.2% (range per hospital: 10.5%-30.7%). The reduction in ED visits was greater during periods of high stringency lockdown measures, as indicated by OSI.

CONCLUSION

The number of ED visits in the Netherlands has significantly dropped during the first year of the COVID-19 pandemic, with a clear association between decreasing ED visits and increasing lockdown measures. The OSI could be used as an indicator in the management of ED visits during a future pandemic.

Have the effects of Covid-19 been overcome? Levels of Covid-19 fear, Covid-19 anxiety and hopelessness in young adolescents: A structural equation modeling

OBJECTIVE

This research aimed to determine the level of fear, anxiety, and hopelessness of Covid-19 in young adolescents' post Covid-19 period.

DESIGN AND SAMPLES

Young adolescents in the 17-24 age group were included in this study, which was conducted in a descriptive-cross-sectional design.

MEASUREMENTS

Sociodemographic characteristics questionnaire form and Coronavirus (Covid-19) Fear Scale, Coronavirus Anxiety Scale, and Beck Hopelessness Scale were used to collect data.

RESULTS

90.8% of the participants had been vaccinated, 26.9% had previously caught in Covid-19, and 10.3% of those who had been caught in the disease had a severe course. 10.7% of young adolescents had to take medicines, 56.4% had a family history of Covid-19, and 18.7% had lost a relative as a result of Covid-19, was found. The level of fear, anxiety and hopelessness was higher among women, first-grade students, those who did not receive the Covid-19 vaccine, those who have caught in Covid-19 before, and those who have lost a family due to Covid-19.

CONCLUSION

It is thought that the increase in the awareness level of young adolescents about Covid-19 improves preventive health behaviors and enables the development of positive behaviors related to the disease.

Health related quality of life and its predictors among postpartum mother in Southeast Ethiopia: A cross-sectional study

Background

Post-childbirth, woman's health-related quality of life (HRQOL) is significantly impacted, leading to decreased daily activity, reduced self-care, challenges with breastfeeding and baby weaning, and increased medical costs for both mother and newborn.This study aimed to assess the HRQOL and its predictors among postpartum women in Southeast Ethiopia.

Methods

A cross-sectional study was conducted in Southeast Ethiopia between March and May 2022, involving randomly selected sample of 794 postpartum women attending immunization services in public health facilities. Data was collected using a validated questionnaire, and descriptive statistics were computed. A bivariable and multivariable logistic regression model was fitted to predict HRQOL, with odds ratios and 95% confidence intervals used to estimate associations.

Results

The study revealed that the overall HRQOL, physical component summary, and mental component summary of quality of life had mean scores of 43.80 ± 27.88, 45.39 ± 28.58, and 42.20 ± 28.15(mean ± SD) respectively. Walking to the health facility (AOR = 2.09; 95% CI: (1.31,3.31); using public transport (AOR = 2.58; 95% CI = 1.69-3.93); having the fear of COVID-19 (AOR = 1.46; 95% CI = 1.08-1.99); having health facility admission history during the recent pregnancy (AOR = 1.62; 95% CI = 1.08-2.44); having postpartum depression (PPD) (AOR = 2.13; 95% CI = 1.57-2.89) were predictors of a lower level of overall HRQOL among postpartum women.

Conclusion

The study found that nearly half of postpartum women in Ethiopia have lower HRQOL, with factors such as transport use, recent baby's pregnancy admission history, and postpartum depression (PPD) significantly affecting their overall, physical, and mental HRQOL. Fear of COVID-19 was found to be significantly associated with lower overall and physical HRQO. The implementation of appropriate strategies addressing identified factors is crucial for enhancing the HRQOL among postpartum women in Ethiopia.

The Effect of Ear Acupressure on Behavioral Problems in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial

Objective

Due to the limits on treatment for people with attention-deficit/hyperactivity disorder (ADHD), ear acupressure treatment has been considered. This study examined the effect of ear acupressure on behavioral problems of children with ADHD.

Materials and Methods

This randomized controlled trial was conducted in 70 children with ADHD who were randomized into 2 groups. The intervention group received ear acupressure in treatment points and the control group received massage at neutral points. Behavioral problems were measured 3 times: (1) baseline; week 4; and week 8. The last timepoint was a follow-up, using the Child Behavior Checklist.

Results

The intervention group had fewer behavioral problems at all 3 timepoints than the control group (Cohen's ∂ = 1.49; 95% confidence interval at week 4: 20.97, 47.43).The ear acupressure group had a large effect size with respect to reduction of attention problems at week 4 (∂ = 1.88) and week 8 (∂ = 1.48) than the control group.

Conclusions

Ear acupressure induced significant reduction of the behavioral problems of children with ADHD. Further research can evaluate the use and continuity of the effectiveness of this treatment as a complementary treatment in addition to the usual treatments for these children.

COVID-19 anxiety and its relation to anxiety-related disorder symptoms and mechanisms

The COVID-19 pandemic had a significant impact on the mental health of individuals, particularly in the area of anxiety-related disorders. Anxiety regarding COVID-19 has been associated with health anxiety, panic disorder, and obsessive-compulsive disorder symptoms. Additionally, COVID-19 anxiety has been associated with anxiety sensitivity, disgust, maladaptive metacognitions, and intolerance of uncertainty. While researchers have established that anxiety disorders and anxiety-related mechanisms were associated with COVID-19 anxiety, which specific anxiety-related symptoms and mechanisms are primarily associated with COVID-19 anxiety needs to be more extensively explored. The current study sought to further this area by examining which particular anxiety-related disorder symptoms and mechanisms were uniquely associated with COVID-19 anxiety. A non-clinical sample of 593 Canadian undergraduate participants (Mage = 21.13 years; 67.7 % female) completed this cross-sectional study between September 2020 and February 2021. Participants completed online questionaries assessing anxiety-related disorder symptoms and mechanisms in addition to multiple scales of COVID-19 anxiety. When examining symptoms, health anxiety (prs = 0.17-0.29) and obsessive-compulsive disorder (prs = 0.16-0.35) symptoms had the strongest unique associations with COVID-19 anxiety. Among the anxiety-related mechanisms, disgust sensitivity (prs = 0.14-0.16) and health anxiety-specific intolerance of uncertainty (prs = 0.12-0.30) had the strongest unique associations with COVID-19 anxiety. Individuals experiencing these disorders and anxiety-related mechanisms may be at a heightened vulnerability to experiencing heightened anxiety during future pandemics. Mental health professionals should discuss COVID-19 anxiety with individuals experiencing health anxiety or obsessive-compulsive disorder symptoms. Lastly, the study highlights the significance of considering a variety of specific anxiety-related disorder symptoms and mechanisms when working to understand pandemic anxiety.

The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy

Background: This study aimed to assess the impact of the COVID-19 pandemic in terms of the prevalence of anxiety, depression and stress symptoms in Italian medical students and to identify the associated factors. Design and Methods: A cross-sectional online survey was administered to second-sixth year medical students of the University of Torino, collecting data on the students' sociodemographics, COVID-19 exposure, anxiety, depression and stress symptoms. Three hierarchical regressions adjusted for age, gender and year of study were executed. Results: The sample size was 1359. The prevalence of anxiety, depression symptoms, moderate perceived stress and severe perceived stress was 47.8%, 52.1%, 56.2% and 28.4%, respectively. The factors associated with mental health symptoms were: being a woman, a family history of psychiatric disorders, living off-site, competitive/hostile climates and unsatisfying friendships among classmates, poor relationships with cohabitants, negative judgment of medical school choice, fear of COVID-19 infection, feelings of loneliness, distressing existential reflections, and a worsening psychological condition related to the pandemic. Being in the fourth or sixth year constituted a protective factor for depression symptoms. Conclusions: Mental health in medical students was associated with both COVID-independent and COVID-related factors. Accessibility to effective interventions must be increased to counteract these changes.

How Is the Fear of War Impacting Italian Young Adults' Mental Health? The Mediating Role of Future Anxiety and Intolerance of Uncertainty

The Russian-Ukrainian conflict is affecting mental health even in communities that are not directly involved in the war; added to this is the escalating conflict in the Middle East and its dangerous spread, which brings the war back to the center of the contemporary social and economic horizon. The present study aims to explore the psychological impact of war in a sample of 310 Italian young adults (18-30 years; M = 22.0; SD = 2.6) while exploring the relationship between Fear of War and psychological distress and evaluating the mediating effects of Future Anxiety and Intolerance of Uncertainty in this relation. Findings highlighted how Fear of War positively and significantly affects Stress, Anxiety, and Depression, and, at the same time, how it fuels both Future Anxiety and Intolerance of Uncertainty. These constructs, in addition to positively affecting the mental health outcomes considered, mediate the relationship between Fear of War and youth psychological distress with a significant indirect effect observed in all three mediation models performed. Finally, significantly higher levels of psychological distress, Fear of War, and Future Anxiety are reported in women than in men. The findings are discussed with reference to the recent literature on the psychological impact of war and on contemporary youth psychological distress, indicating the importance of educational policies and targeted interventions aimed at supporting this target in coping with multiple contemporary collective stressors.

Contamination-Focussed Vignettes as an Analogue of Infectious Pandemics: An Experimental Validation using the State Disgust and Anxiety Responses in OCD

Despite infectious pandemics proving particularly detrimental to those with Obsessive-Compulsive Disorder (OCD), the investigation of analogous experimental paradigms is lacking. To address this gap, we conducted two studies employing vignettes that depicted contamination-related situations commonly experienced during a pandemic (e.g., Coughing into hands and failing to use hand sanitizer). We manipulated the salience of these vignettes across three levels: high contamination, low contamination, and a neutral control condition. Our examination of state anxiety and disgust responses in all participants revealed the successful manipulation of the vignettes' impact. Specifically, individuals with more severe OCD symptoms reported significantly higher levels of state disgust and anxiety for both high and low contamination vignettes, in contrast to the group with lower symptom severity. No significant differences were observed in the neutral vignette condition between the high- and low-scoring groups. Interestingly, for those with higher OCD symptoms, high salience contamination-focused vignettes resulted in similarly elevated state disgust and anxiety, regardless of whether the vignettes were situated in public (Study 1) or domestic (Study 2) settings. This suggests that the heightened sensitivity to contamination-related scenarios observed in individuals with OCD symptoms in the present study is not confined to a specific context. These findings support the use of contamination-focused vignettes as analogues for studying infectious pandemics and provide valuable insights into OCD models, interventions, and future research.

Perceptions and practices of people with a total laryngectomy during COVID-19 pandemic: A mixed methods analysis

PURPOSE

People with a total laryngectomy (PTL) confront safety threats related to altered airway anatomy and risk of adverse events is amplified during healthcare crises, as exemplified by COVID-19 pandemic. Understanding these challenges, how they are navigated by PTL, and what resources can be deployed to alleviate risk can improve interprofessional care by speech-language pathologists (SLPs), otolaryngologists, and other professionals.

MATERIALS AND METHODS

An online survey was disseminated to PTL in the United States during the COVID-19 pandemic, querying participants about safety concerns and sources of information accessed to address care. Descriptive statistics and Chi-square were used to analyze information sources consumed by tracheoesophageal, esophageal, and electrolaryngeal speakers. Content analysis was completed to identify themes and quantify responses by subtheme.

RESULTS

Among 173 respondent PTL, tracheoesophageal speakers preferentially sought otolaryngologist input, whereas esophageal and electrolaryngeal speakers more often chose SLPs (p < .01). Overall, tracheoesophageal speakers had more SLP or otolaryngologist contact. Many PTL reported stringent handwashing, neck cleaning, and hygienic risk mitigation strategies. Six themes emerged in content analysis involving risk of infection/transmission, heightened vigilance, changes to alaryngeal communication, modified tracheostoma coverage, diagnostic testing, and risk from comorbid conditions. Limited provider contact suggested pandemic barriers to healthcare access.

CONCLUSIONS

PTL have a range of laryngectomy-specific needs and concerns, and type of alaryngeal communication was associated with source of information sought. Collaborations among healthcare professionals need to be optimized to improve patient navigation and overall access to specialized care.

Psychometric evaluation of the Chinese version of new fear of the coronavirus questionnaire

The fear of COVID-19 significantly impacting the health of people globally. This study translated newly developed measurement tool New Fear of the Coronavirus Questionnaire (New_FCQ) into Chinese language and evaluated the psychometric properties of the Chinese version of New_FCQ among Chinese population. A total of 522 participants were included in the study. Internal consistency, construct validity, criterion validity, and concurrent validity of the Chinese version of New_FCQ were assessed in this study. The Chinese version of New_FCQ had excellent internal consistency (α = 0.97) and exploratory factor analysis demonstrated one-dimensional structure of the Chinese version of New_FCQ. The preliminary criterion validity revealed statistically significant differences in the fear of COVID-19 scores based on age and education level (P = .002 and P = .03, respectively). The good concurrent validity also established with the Chinese version Fear of COVID-19 Scale(P < .001). Psychometric proportions of the Chinese version of New_FCQ were established, which exhibited sufficient validity and reliability among Chinese population.

Testing a decoy donation incentive to improve online survey participation: Evidence from a field experiment

This study introduces a new randomized field experiment exploring the impact of offering a decoy charity donation incentive together with a monetary reward to increase response rates in an online survey about coronavirus fears. The study used a two-stage approach, starting with a preliminary survey to investigate participant attitudes toward different types of donations. Subsequently, an experiment was conducted wherein a less desirable £2 donation (the decoy) was introduced as an alternative to a £2 Amazon voucher (the target) within the choice set. The study sample consisted of 431 university students. They were split into three groups: a control group with a standard £2 Amazon voucher incentive (216 participants), a decoy group with the target shown first (108 participants), and a decoy group with the decoy shown first (107 participants). We found significantly higher survey completion rates in the decoy than in the control condition (82.3% vs. 74.5%). Notably, an order effect was observed-presenting the target before the decoy led to a higher completion rate (89.8%) compared to presenting the decoy first (74.8%). Importantly, the inclusion of the decoy incentive did not introduce any response bias. This study offers a proof of principle that incorporating a decoy charity donation incentive into the choice set can have a positive impact on survey participation without adversely affecting response behaviour. It demonstrates the potential of such incentives to encourage participants to complete online surveys, even when a small monetary reward is offered.