Death anxiety in the time of COVID-19: theoretical explanations and clinical implications

"Talking About Funerals Won't Make You Dead": Dialogic Tensions in Death Café Design and Facilitation

Death Cafes (DCs) explicitly encourage conversation and constitute space to explore the dialogue around death and dying. This study draws on scholarship from communication and dialogue theory to explore the design features and facilitation practices used within DC meetings. Through qualitative analysis of the DC webpage and interviews with facilitators, the study uncovers how DC facilitators structure and manage conversations to help attendees normalize death conversations and manage the death anxiety of others in their lives. The analysis highlights three main tensions within the DC structure and facilitation guidelines: structure versus openness, authority versus equality, and conversation versus information. These fundamental contradictions are inherent in DCs, and facilitators need to manage them in order to promote meaningful dialogue among DC participants. This study deepens the theorizing around DC facilitation practices and has implications for death and dying practitioners hoping to foster dialogue about end-of-life topics.

The Relationship Between Death Anxiety and COVID-19 Fear and Anxiety in Women With Breast Cancer

This study determined the relationship between death anxiety and COVID-19 related fear and anxiety in women with breast cancer. This is a descriptive correlation-seeking study. The research included 140 women with breast cancer who visit the day treatment unit of the oncology department of a state university hospital. Personal Information Form, Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), and Death Anxiety Scale (DAS) were used to collect data. A significant difference was found between the DAS score and body mass index (p = .019) and between FCV-19S score and COVID-19 vaccination status (p = .007). As the fear of COVID-19 and coronavirus anxiety of women with breast cancer increase, death anxiety also increases. In conclusion, death anxiety should be taken into consideration for this patient group while maintaining the continuity of care for these patients now and in future pandemics.

The Impact of Infectious Diseases on Psychiatric Disorders: A Systematic Review

The complex connection between some infectious illnesses and some psychiatric disorders is an important area of study, with infections known to cause a diverse range of psychiatric symptoms. This association poses significant challenges for physicians in differentiating between mental illnesses induced by infections and those stemming from underlying psychiatric conditions. This study systematically synthesizes literature from various databases that explain the relationship between certain infectious diseases and specific psychiatric disorders. The systematic review explores mechanisms such as neuroinflammation, direct central nervous system (CNS) infection, and the interaction between the immune system and psychiatric conditions. The study examines various infectious pathogens, including viruses, bacteria, parasites, prion diseases, and fungi. An analysis of these findings is presented in the study's discussion section, along with a review of therapeutic methods such as drug use and psychological treatment. The review emphasizes the need for multidisciplinary teamwork and thorough clinical examinations in managing psychiatric symptoms caused by infections. It also highlights the significant role of public health measures in mitigating the impact of psychiatric diseases related to infectious illnesses. The study finds that current therapeutic methods include pharmacological and psychological treatments, which can effectively manage these conditions. The study has concluded that psychiatric manifestations are prevalent across various infectious diseases, including those caused by viruses, bacteria, parasites, and fungi. Key mechanisms identified include neuroinflammation, direct infection of the CNS, and the immuno-psychiatric interface, all of which contribute to the development of psychiatric symptoms. The future of managing these complex conditions lies in a comprehensive approach that combines clinical, therapeutic, and public health strategies.

Systematic review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID-19

BACKGROUND

The COVID-19 pandemic has underscored older adults' vulnerability to severe illness or death. Increased public awareness of mortality, with daily reminders of preventive measures, spurred interest in understanding the impact on death-related thoughts. This systematic review analyses existing literature on death attitudes among individuals aged 50 and older during the COVID-19 pandemic and focuses on associated factors.

METHODS

A systematic literature search was conducted using the WHO COVID database without any language limit, up until April 2023. The review protocol was registered in PROSPERO and PRISMA guidelines were followed. Included studies were systematically analysed and summarized using a predefined data extraction sheet.

RESULTS

Of the 2297 studies identified, 9 met inclusion criteria. The review showed moderate to high levels of death anxiety during the pandemic, linked to direct health risks from COVID-19 rather than mitigation measures. The impact of health and personal factors on older people's death anxiety was complex, with a range of health and personal factors such as chronic conditions, loss of capacity, loneliness, occupation, and resilience associated with it, suggesting potential intervention avenues.

CONCLUSION

The systematic review shows a significant link between COVID-19 and heightened death anxiety among individuals aged 50 and above. Negative attitudes to death can harm physical and mental health, diminish life satisfaction, increase avoidance behaviour, impair coping mechanism and undermine end-of-life decision making. Findings underscore the need for further research into risk and protective factors (personal, health, and environmental) and the importance of standardized data collection to guide interventions and public health strategies aimed at mitigating death anxiety.

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

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

Death and Other Losses in the COVID-19 Pandemic in Long-Term Care Facilities for Older Adults in the Perception of Occupational Therapists: A Qualitative Study

Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: "The proximity of death" and "Losses associated with living and dying in a LTCF." In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic.

Death Anxiety and WellBeing in Doctors During COVID-19: The Explanatory and Boosting Roles of Sleep Quality and Work Locality

The COVID-19 pandemic, a global public health crisis, has triggered anxiety and fear of death in general public and particularly among health professionals. This study aimed to assess the direct and mediated associations between death anxiety, sleep quality, and subjective wellbeing in doctors working during the pandemic. A secondary aim was tested to analyze the interactive role of workplace locality in these associations. An indirect-effect model was tested on a sample of 244 doctors working during the pandemic. Findings revealed that the association between death anxiety and subjective wellbeing was mediated through sleep quality. Furthermore, death anxiety significantly and negatively predicted subjective wellbeing in doctors working in rural setups compared to those working in urban setups. The theoretical and practical implications of the findings are discussed.

Differential Anxiety Responses in Acute Myocardial Infarction vs. COVID-19 Pneumonia Patients

Background and Objectives: Amidst the COVID-19 pandemic, concerns about the psychological impact of disease-related anxiety on public health have risen. This study aims to compare general and death anxiety levels between acute coronary artery syndrome and COVID-19 pneumonia patients. Materials and Methods: A cross-sectional study of 132 individuals, including acute myocardial infarction (MI), COVID-19 pneumonia patients, and healthy volunteers from Trakya University Hospital (Turkey), was analyzed. Validated scales like the Beck Anxiety Inventory (BAI), Coronavirus Anxiety Scale Short Form, and Thorson-Powell Death Anxiety Scale (TPDAS) were employed. Demographic data such as age, gender, income levels, employment status, presence of a close relative with COVID-19, and whether participants followed COVID-19-related news were collected and compared across groups with significance level of 0.05 set for all analyses. Results: Among 41 COVID-19, 41 MI, and 50 healthy subjects, the pneumonia group showed highest COVID-19 anxiety (p = 0.01) and BAI scores (p = 0.008). Both COVID-19 and MI patients had significantly higher BAI and TPDAS scores compared to healthy controls (p < 0.001). Factors like female gender (p = 0.004), low education (p = 0.003), current employment (p = 0.008), and low income (p = 0.002) correlated with higher BAI scores. Low income (p = 0.001) and COVID-19 news exposure (p = 0.002) correlated with higher TPDAS scores. Males and married patients had lower anxiety scores (p = 0.008). High income, education, and employment reduced anxiety levels (p = 0.008). TPDAS scores decreased with higher income (p = 0.001), but increased in the MI group (p = 0.002) with COVID-19 news exposure. The multivariate linear regression analysis found that MI and COVID-19 pneumonia were associated with TPDAS; female gender, university education, and COVID-19 pneumonia with the Beck scale; and COVID-19 pneumonia with anxiety scores on the COVID-19 Anxiety scale. Conclusions: This research showcases differing anxiety patterns between illnesses such as MI and COVID-19 pneumonia amidst the pandemic, emphasizing the amplifying influence of media coverage on death-related anxieties. It underscores the imperative of targeted interventions and socioeconomic considerations in managing psychological consequences and formulating responsive public health strategies.

Grief and bereavement beliefs and their associations with death anxiety and complicated grief in a U.S. college student sample

This study examined beliefs about grief and bereavement, and how the endorsement of myths is related to death anxiety and complicated grief. Results from a sample of college students in the United States (N = 391) suggested that myths about grief and bereavement are prevalent in this group. Additionally, the endorsement of certain myths significantly explained both death anxiety and complicated grief. Findings from this study provide additional support for death education in college and university settings to promote grief literacy. Implications for education, advocacy, research, and practice are discussed.

Lived Experiences of Critically Ill COVID-19 Patients About Death and Dying: A Descriptive Phenomenology

Thinking about death is one of the most common problems of critically ill patients with COVID-19 in ICUs. Therefore, this study aims to explore the experiences of critically ill patients with COVID-19 about death and dying. This is a descriptive phenomenology approach. Participants in this study had 12 participants who were purposefully selected. The data collection method was semi-structured through interviews. Data were analyzed based on Colaizzi's approach. Data analysis generated two main themes, including personal, and non-personal; challenge thinking about death, and eight sub-themes. Thinking about the death of critically ill COVID-19 patients is a significant challenge that affects the patient's health and prolongs the treatment process. Therefore, it should be careful in the patient's treatment and care program.

Death Anxiety in Patients with a History of Coronary Artery Bypass Graft Surgery During the COVID-19 Pandemic: The Role of Spiritual Well-Being and Coping Strategies

Patients who have previously undergone coronary artery bypass surgery (CABG) were prone to death anxiety during the COVID-19 pandemic. It appears that spiritual well-being and appropriate coping strategies may mitigate the harmful effects of death anxiety. Therefore, this study aimed to determine the level of death anxiety in patients with CABG during the COVID-19 pandemic and investigate the relationship between spiritual well-being, coping strategies and death anxiety.This cross-sectional study was conducted on 100 patients with CABG history in Tehran from June 2021 to February 2022. The face-to-face questionnaire, containing questions on demographics, Templer's death anxiety scale, the spiritual well-being questionnaire, and the ways of coping questionnaire was administered to collect data. Statistical analysis was performed using descriptive-analytical statistics, correlation tests, and logistic regression models.Participants' mean age was 55.59 ± 12.78 years. The mean death anxiety score was 10.00 ± 2.16, with 87% of participants reporting high levels and 13% reporting low levels of death anxiety. Based on the results, there was a significant negative correlation between death anxiety and coping strategies, as well as subscales of distancing, seeking social support, accepting responsibility, and planful problem-solving. Logistic regression showed that with the increase in the score of spiritual well-being, the odds of having high levels of death anxiety decreased (p < 0.05). Furthermore, increasing the total score of coping strategies, and the score of self-controlling, seeking social support, accepting responsibility, and planful problem-solving, significantly reduced the odds of high levels of death anxiety (p < 0.05).The study showed that patients with a CABG history experienced high death anxiety during the COVID-19 pandemic. According to the findings, spiritual well-being and coping strategies, especially self-controlling, seeking social support, accepting responsibility, and planful problem-solving, may reduce the odds of severe death anxiety. These should be considered as effective targets for psychological intervention in these patients.

Network Analysis on Family Resilience, Fear of Progression, and Quality of Life in Chinese Patients with Pulmonary Hypertension

BACKGROUND

The long-term quality of life of Chinese patients with pulmonary hypertension has been seriously compromised. Interventions to enhance patient quality of life of are urgently required.

OBJECTIVE

To investigate the relationship between quality of life and its influencing factors in patients through network analysis.

METHOD

247 patients with pulmonary hypertension in 3 hospitals in Jinan, Shandong Province, self-reported their immediate family resilience, fear of progression, and quality of life via questionnaires. A mixed graphical model was constructed to investigate the relationship among multidimensional structures of variables.

RESULTS

A total of 247 patients (173 female and 74 male) were included (age 18-34, n=115; age 35-49, n=99; age 50-64, n=23; age > 65 years, n=10). "Family communication and problem solving" was at the center of the network, with serving as a bridge node. Within communities, the strongest edge was "Family communication and problem solving-maintaining a positive outlook." Across communities, the strongest edge between family resilience and quality of life was "Family communication and problem solving-environmental domain quality of life," and the strongest edge across the fear of progression and quality of life was "physiological health fear-psychological domain quality of life."

CONCLUSIONS

Family resilience and fear of progression may affect the quality of life in patients with pulmonary hypertension. Developing a program with "family communication and problem solving" as a primary target may reduce patient fear of progression, enhance family resilience, and improve patient quality of life.

The mediating role of coping styles in the relationship between fear of COVID-19 and mental health problems: a cross-sectional study among nurses

Fear of being infected by coronavirus disease 2019 (COVID-19) could trigger mental health problems among nurses at the frontline. In such a situation, coping strategies are needed to deal with the imminent threat. The purpose of this study was to test the mediating effects of coping on relationships of fear of COVID-19 with anxiety, depression and post-traumatic syndrome among nurses who were in contact with COVID-19 patients. A cross-sectional and correlational research design was used to recruit a sample of 278 nurses who treated COVID-19 patients in four government referral hospitals in Indonesia. A bootstrap resampling procedure was used to test the significance of the total and specific indirect effects of coping on relationships of Fear of COVID-19 with anxiety, depression and post-traumatic syndrome. The nurses reported moderate levels of fear of COVID-19, considerable anxiety and depression, and a moderate level of coping. We found coping to be significantly negatively correlated with the reported levels of anxiety, depression and post-traumatic syndrome (p < 0.001). Coping mediated relationships of fear of COVID-19 on depression, anxiety and post-traumatic syndrome after controlling for relevant confounders for each dependent variable. This shows that enacting coping mechanisms is important to achieve an adaptive effect on nurses' mental health. Proper assessments and interventions should be tailored and implemented for nurses who have contact with COVID-19 patients to facilitate their use of coping strategies when needed in stressful situations.

Emotion Regulation Use Varies Across Socioecological Levels of Pandemic Stress in Older Adults

OBJECTIVES

COVID-19 escalated stress within family/neighborhood (local) and national/cultural (global) levels. However, the impact of socioecological levels of stress on pandemic emotion regulation remains largely unexplored.

METHODS

Thirty older adults from the Northeast US (63-92 years) reported on pandemic stress and emotion regulation in semi-structured interviews. Responses were coded into socioecological sources of local and global stress, and associated use of cognitive emotion regulation strategies from the Cognitive Emotion Regulation Questionnaire was explored.

RESULTS

Older adults experienced significant distress at global levels, and perception of lacking top-down safety governance may have exacerbated local distress of engaging in daily activities during the COVID-19 pandemic. Participants endorsed coping with local stressors via perspective-taking, acceptance, and other adaptive strategies, while global sources of stress were associated with greater use of maladaptive strategies, including other-blame and rumination.

CONCLUSION

Quantitative assessments may underestimate significant older adult distress and maladaptive coping toward global stressors. Findings should be replicated with more diverse populations beyond the COVID-19 context.

Death Anxiety Associated With Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

Death anxiety is a feeling that exists since birth, continues throughout life, lies at the root of all fears, and develops after the awareness that people will no longer exist and that they can lose themselves and the world. It is associated with death-induced anxiety with many features of the COVID-19 pandemic, which can be seen as a threat to human existence. In this study, it is aimed to compile studies on death anxiety associated with coronavirus disease, list the general characteristics of these studies through descriptive summaries, and combine findings on the level of death anxiety associated with coronavirus disease through meta-analysis. The findings of this study suggest that COVID-19 pandemic process and is affected by socio-demographic factors such as fear of COVID-19, gender, and occupation. As a result of this study, it was determined that death anxiety was relatively high during the COVID-19 pandemic process.

Exploring Mortality Salience and Pandemic Impact in the Context of COVID-19

Mortality salience refers to a state of conscious awareness of death and the inevitable conclusion of life, associated with psychological terror. The COVID-19 pandemic generated increased awareness of illness and death, and effectuated changes in death cognitions and people's experiences around psychological or sociocognitive domains of media and life goals. To understand these changes, this study administered the Multidimensional Mortality Awareness Measure (Levasseur et al., 2015) to 103 emerging adults in India, post which 6 participants proceeded for a semi-structured interview exploring pandemic experiences, news consumption and goal prioritization, to examine specific areas in relation to death cognition. The thematic analysis demonstrates psychological effects, and discusses developments in health and death-related psychological processes. Focus on career goals and health maintenance, cautious news consumption and disadvantageous impacts on mental health are seen, significant in navigating healthcare measures for emerging adults, as we move forward into this 'new normal'.

Spiritual-Cultural Needs as the Main Causative Factor of Death Anxiety in Iranian COVID-19 Patients: A Qualitative Study

COVID-19 patients have been reported to more than likely experience a variety of difficult physical and psychological problems. This qualitative study aims to perceive psychological experiences in COVID-19 patients in Iran. The study method is qualitative, with a conventional content analysis approach adopted. Purposive sampling was applied to 20 COVID-19 patients admitted to medical wards at hospitals in Tehran, Iran. Additionally, data were collected using semi-structured interviews. All data were analyzed based on the method proposed by Lindgren et al. (Int J Nurs Stud 108:103632, 2020). Data analysis identified the main theme to be "death fear and anxiety" with five main categories. These categories included the feelings of death panic and apprehension, uncertainty and ambiguity, fear of abandonment, fear of an unknown future for the family, and fear of unmet spiritual-cultural needs. Accordingly, the patients' experiences of COVID-19 contraction were unique. Against this backdrop, understanding COVID-19 patients' complexities, experiences, beliefs, and attitudes about anxiety and death, can lead to an  improved awareness and understanding of the psychological consequences of COVID-19 by executive decision-makers, healthcare personnel and mental health professionals.

Death Anxiety in Caregivers of Chronic Patients

This study aimed to determine the extent to which caregivers of patients with chronic illnesses experience death anxiety, and which variables from caregivers and patients might potentially be related to their death anxiety. It also aimed to compare the levels of death anxiety between patients and caregivers. Web of Science, Scopus, PubMed, Psychology Database, Cochrane, and Google Scholar were searched for original studies available until December 2022 that quantitatively addressed death anxiety in family and informal caregivers of individuals with chronic illnesses. The methodological quality of the included studies was assessed, and a meta-analysis was conducted using Hedges' g as the effect size index and the DerSimonian-Laird method to analyze differences between patients and caregivers in death anxiety. The results of the 11 included studies showed moderate levels of death anxiety in caregivers, and the meta-analysis (k = 7; 614 patients and 586 caregivers) revealed non-significant differences between the death anxiety experienced by patients and caregivers (pooled Hedges' g = -0.03, 95% CI = -0.29 to 0.25, p = 0.802). Some sociodemographic and psychological factors (e.g., gender, depression, and anxiety) might be related to the death anxiety experienced, but additional research is necessary to validate these findings.

Death anxiety and satisfaction with life among the adults in the social isolation process of Covid-19 pandemic: the mediating role of perceived stress

BACKGROUND

The present study examined the mediating role of perceived stress during the social isolation process of the Covid-19 pandemic on the association between death anxiety and satisfaction with life. The participants of the study included 410 individuals (212 females and 198 males) from Turkey. Data were collected using the Death Anxiety Scale, the Perceived Stress Scale and the Satisfaction with Life Scale.

AIMS

The aim of this study was to reveal the relationships between death anxiety, perceived stress and satisfaction with life and to test the mediating role of perceived stress on the effect of death anxiety and satisfaction with life in the Covid-19 pandemic process.

METHODS AND RESULTS

The structural equation modelling results indicated that stress mediated the impact of death anxiety on satisfaction with life. Moreover, the bootstrapping procedure revealed significant links from death anxiety to satisfaction with life through perceived stress in the social isolation process of Covid-19.

CONCLUSIONS

The findings of the study contributed to the structuring of psychological health services to be offered within the scope of public health during the Covid-19 pandemic and the understanding of the complex nature of the relationship between psychological factors and satisfaction with life. Possible explanations and limitations were discussed.

Risk Factors for Long COVID in Older Adults

As time has passed following the COVID-19 pandemic, individuals infected with SARS-CoV-2 have gradually exhibited a variety of symptoms associated with long COVID in the postacute phase of infection. Simultaneously, in many countries worldwide, the process of population aging has been accelerating. Within this context, the elderly population has not only become susceptible and high-risk during the acute phase of COVID-19 but also has considerable risks when confronting long COVID. Elderly individuals possess specific immunological backgrounds, and during the process of aging, their immune systems can enter a state known as "immunosenescence". This further exacerbates "inflammaging" and the development of various comorbidities in elderly individuals, rendering them more susceptible to long COVID. Additionally, long COVID can inflict both physical and mental harm upon elderly people, thereby reducing their overall quality of life. Consequently, the impact of long COVID on elderly people should not be underestimated. This review seeks to summarize the infection characteristics and intrinsic factors of older adults during the COVID-19 pandemic, with a focus on the physical and mental impact of long COVID. Additionally, it aims to explore potential strategies to mitigate the risk of long COVID or other emerging infectious diseases among older adults in the future.

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

Background

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

Methods

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

Results

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

Conclusion

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

A meta-analysis of systematic reviews and meta-analyses to evaluate the psychological consequences of COVID-19

BACKGROUND

Several meta-analysis studies have been reported in the literature on the incidence of psychopathological conditions resulting from the COVID-19 pandemic. This investigation aims to compile and analyze the findings of previously published meta-analysis research, as shown by the present meta-analysis of previous meta-analysis studies.

METHODS

The PubMed and Scopus databases were searched from 1 January 2019 to 30 May 2022. The procedure was carried out according to the PRISMA flow chart and the qualities of the identified studies were analyzed using AMSTAR 2. Heterogeneities and risk of bias were assessed using the Meta-MUMS tool. The corresponding results, forest and funnel plots of the psychological consequences of COVID-19 were synthesized.

RESULTS

Eleven meta-analysis studies were included. Random-effects meta-analysis of anxiety and depression showed (ER = 0.318 p-value < 0.001, ER = 0.295 p-value < 0.001) high heterogeneities (I2 = 99.70%, I2 = 99.75) between studies. Random-effects meta-analyses of sleep difficulties and insomnia were shown (ER = 0.347 p-value < 0.001, ER = 0.265, p-value < 0.001) along with heterogeneities (I2 = 99.89, I2 = 99.64). According to the random meta-analysis of post-traumatic stress syndrome (PTSS) and post-traumatic stress disorder (PTSD) (ER = 0.246, p-value = 0.001, ER = 0.223 p-value < 0.001) with heterogeneities (I2 = 99.75, I2 = 99.17). Random-effects meta-analyses of somatic and fear symptoms have been shown (ER = 0.16 p-value < 0.001, ER = 0.41, p-value = 0.089) with high heterogeneities (I2 = 99.62, I2 = 98.63). Random-effects meta-analysis of obsessive-compulsive symptoms and distress (ER = 0.297 p-value = 0.103; ER = 0.428, p-value = 0.013) with high heterogeneity, as I2 = 99.38%. Subgroup analysis of all symptoms and Egger's tests for detecting publication bias were also assessed.

CONCLUSION

The data from the current meta-analysis showed different psychological disorders of COVID-19 during the pandemic. Clinicians should be aware of the prevalence with which COVID-19-infected patients experience emotional distress, anxiety, fatigue, and PTSD. About half of the included systematic reviews (SRs)/meta-analyses (MAs) suffered from poorer methodological quality and increased risk of bias, reducing confidence in the findings. There must be more SRs/MAs and high-quality clinical trials conducted to confirm these findings.

Bereavement Experiences of Families of Elderly Individuals Who Died Due to COVID-19

This study was conducted to evaluate the bereavement experiences of families of elderly individuals who died due to the COVID-19 pandemic. One of the qualitative research methods, the case study method, was used in the study. The sample of the research consisted of 19 people who agreed to participate in the research between April and July 2022. The research data were collected using a Personal Information Form and a Semi-Structured Interview Form, which was created to conduct individual in-depth interviews. As a result of the descriptive analysis, four main themes, the ability to perform religious rituals related to the bereavement experience, feelings and thoughts about death, attitudes of those around after death, and coping strategies in the COVID-19 process. It was determined that individuals had difficulty accepting death, felt inadequate about spirituality due to limited religious rituals, had feelings of despair and guilt, and limitedly utilized social support systems.

Community-based end-of-life care in Singapore and nursing care implications for older adults in the post-COVID-19 world

PURPOSE OF REVIEW

To render holistic overview on community-based end-of-life care in the context of Singapore, with analysis of nursing care implications for older adults requiring end-of-life care services.

RECENT FINDINGS

Healthcare professionals caring for older adults with life-limiting conditions had to play an active role in the constantly evolving healthcare landscape during the coronavirus disease 2019 (COVID-19) pandemic. Usual meetings and community-based end-of-life care interventions were converted to online mode, utilizing digital technology. In order to provide value-based and culturally relevant care, further studies are warranted to evaluate healthcare professionals, patients and family caregivers' preferences whilst utilizing digital technology. As a result of COVID-19 pandemic restrictions to minimize infection transmissions, animal-assisted volunteering activities were conducted virtually. Regular healthcare professionals' engagement in wellness interventions is necessary to boost morale and prevent potential psychological distress.

SUMMARY

To strengthen the delivery of end-of-life community care services, the following recommendations are proposed: active youth engagement via inter-collaborations and connectedness of community organizations; improving support for vulnerable older adults in need of end-of-life care services; and enhancing healthcare professionals well-being through the implementation of timely support interventions.

Relationship between Psychological Resilience, Perceived Stress, Death Anxiety and Progression of Disease in Individuals with COVID-19

Introduction

This study examines the association between perceived stress, death anxiety, psychological resilience and the sociodemographic and clinical features of patients with Coronavirus Disease 2019 (COVID-19).

Methods

304 patients with COVID-19 diagnosis, who were admitted to İstanbul University İstanbul Faculty of Medicine Hospital "COVID-19 Patients Monitoring Center" were recruited. No sample selection was made, all the patients who were followed up and treated in the center were included. Data was collected by the researchers through face-to-face interviews using the Sociodemographic Information and Disease Progression Form, Psychological Hardiness Scale (PHS), Perceived Stress Scale (PSS), and Templer Death Anxiety Scale (TDAS).

Results

Women scored higher in PSS and TDAS. Participants with chronic diseases reported higher death anxiety whereas perceived stress was higher in individuals with psychiatric disorders and ones without a history of intensive care unit stay. Participants without psychiatric disorders, who had longer hospitalization and who fully recovered scored higher in PHS-Control. Patients' report of negative attitudes from their relatives/friends was associated with lower scores in PHS. Perceived stress was correlated with death anxiety and psychological resilience.

Conclusion

Being female, comorbid physical and mental illnesses, continuation of disease symptoms and low psychological resilience were found to be risk factors in terms of stress and death anxiety in COVID-19 patients. These vulnerable groups need to be closely evaluated with a bio-psychosocial approach and provided psychological support during the course of the disease. Health institutions are recommended to conduct medical treatment in cooperation with psychological care.

Spiritual Well-Being and Death Anxiety: A Cross-Sectional Study Among Iranian Patients With Acute Coronary Syndrome

Acute coronary syndrome (ACS) patients experience a tremendous psychological burden, typically in the form of death worry due to acute medical conditions and the possibility of mortality. The unfavourable conditions of ACS patients cause them to reconsider the meaning of life and their spiritual well-being. This study evaluated the association between death anxiety and spiritual well-being in a total of 241 ACS patients in Shahroud, northeast of Iran. The data were collected using the Templer Death Anxiety Scale, and the Spiritual Well-being Scale by convenience sampling method. All patients indicated a high degree of death anxiety, and roughly half reported a moderate level of spiritual well-being. There was a significant and direct correlation between death anxiety and spiritual well-being levels. Older age, single status, and non-smoking were other predictors of good spiritual well-being. A multidisciplinary health team should identify and implement approaches to promote spiritual well-being and reduce mental suffering.

Resilience, Coping, and the Covid-19 Pandemic Across the Globe - an Update: What Have we Learned?

The SARS-CoV-2 (COVID-19) pandemic is a mass traumatic event that has universally and indiscriminately negatively affected the world. The adverse consequences of the pandemic have globally impacted psychological health and well-being via increased stressors, such as uncertainty, health anxieties, and financial instability. During the initial months of the pandemic, we (Polizzi et al., 2020) identified coping strategies that may be well-suited to address the sequelae of the pandemic. These strategies included behavioral activation, acceptance-based coping, mindfulness practice, and loving-kindness meditation. We argued that these coping skills may foster resilience and recovery during the pandemic by generating a sense of social connection, encouraging meaning-making, and enhancing feelings of control amid uncertainty. Three years later, we update our initial suggestions by providing a narrative review that considers empirical evidence collected during the pandemic to support the utility of the previously identified coping strategies as well as additional strategies. We also discuss cross-cultural similarities and differences among these strategies and how research supports their application across diverse countries and groups. Finally, we conclude by synthesizing the literature within a regulatory flexibility framework that emphasizes flexible skill implementation with respect to sensitivity to context, coping repertoires, and feedback from the environment.

Children's Experiences of Death Anxiety and Responses to the Covid-19 Pandemic

The aim of this study was to explore children's experience and responses to the Covid-19 pandemic through their illustrations and short narrations. During October 2020 and January 2021 data was collected from thirteen children aged 9-10 years old in a primary school in the North-West of England. Children were asked to draw their thoughts and feelings about the pandemic and to write a short narration to accompany the drawing. Thematic analysis of data revealed that during the pandemic children at this age have an understanding of death, experience death anxiety and are able to use creative expression to facilitate meaning of the impact of lockdown on their lives such as feeling isolated, lonely, sad and bored. Creative expression also facilitated adaptive coping mechanisms derived from being able to spend more time with family. The data on primary school children is part of a larger study which involved surveys and interviews with children aged 12-16 years in secondary schools.

Relationship between resilience and death anxiety of the older adults during the coronavirus disease 2019 (COVID-19) pandemic

BACKGROUND

The outbreak of coronavirus disease 2019 (COVID-19) caused an increase in the incidence of physical and psychological problems, particularly in the older adult. Considering the special physical and mental health conditions of the older adult, they were more exposed to psychological problems associated with the pandemic, such as death anxiety. Therefore, assessing the psychological status of this group is necessary in order to implement appropriate interventions. The present study aimed to investigate the relationship between resilience and death anxiety in the older adult during the COVID-19 pandemic.

METHODS

This descriptive-analytical study was conducted on 283 older adult people over the age of 60 years. The older adult population was selected from 11 municipal districts of Shiraz, Iran, using the cluster sampling method. The resilience and death anxiety scales were used for data collection. Data analysis was performed in SPSS version 22, using Chi-square test, t-test, and Pearson's correlation coefficient test. A P-value less than 0.05 was considered statistically significant.

RESULTS

The mean and standard deviation of the older adult's resilience and death anxiety scores were 64.16 ± 9.59 and 6.3 ± 2.95, respectively. There was a significant correlation between resilience and death anxiety scores (P < 0.01, r=-0.290). Also, sex (P = 0.00) and employment status (P = 0.00) were significantly associated with the older adult's resilience. Besides, sex (P = 0.010) and employment status (P = 0.004) were significantly related to death anxiety.

CONCLUSIONS

Our findings showcase levels of resilience and death anxiety in older adults during the covid-19 pandemic and suggest that resilience and death anxiety are inversely linked. This has implications on policy planning for future major health events.

Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: Predictive and Mediating Roles of Fear of Death and Psychological Inflexibility

The literature has widely acknowledged the impact of the COVID-19 pandemic on the mental health of young adults. Despite extensive research, eudaimonic well-being, which focuses on self-knowledge and self-realization, has been scarcely investigated. This cross-sectional study aimed to add knowledge on the eudaimonic well-being of young adults one year after the outbreak of the COVID-19 pandemic, verifying its potential linkages with fear of death and psychological inflexibility. A total of 317 young Italian adults (18-34 years), recruited through a chain sampling method, completed measures of psychological inflexibility, fear of death, and eudaimonic well-being included in an online survey. The study's hypotheses were tested with multivariate multiple regression and mediational analyses. Results showed that psychological inflexibility was negatively associated with all the dimensions of well-being, while fear of the death of others was associated with autonomy, environmental mastery, and self-acceptance. Furthermore, in the association between fear of death and well-being, the mediation role of psychological inflexibility was verified. These results contribute to the extant literature on the factors associated with eudaimonic well-being, providing clinical insights into the work with young adults within challenging times.

Exploration of Lived Experiences and Measurement of Burnout Among US Clinical Research Nurses

OBJECTIVE

The aims of this study were to explore the experiences of US clinical research nurses supporting the conduct of clinical trials before and during the COVID-19 pandemic and assess dimensions of burnout among these nurses using the Maslach Burnout Inventory-Human Services Survey.

BACKGROUND

Clinical research nurses are a subspecialty of nursing that supports clinical trial conduct. Postpandemic clinical research nurse well-being, including indicators of burnout, has not been established.

METHODS

A cross-sectional descriptive study via online survey was conducted.

RESULTS

A sample of US clinical research nurses scored overall high for the Maslach category of Emotional Exhaustion, moderate for Depersonalization, and moderate for Personal Achievement. Themes included together or apart, rewarding but challenging, and surviving or thriving.

CONCLUSION

Supportive measures such as workplace appreciation and consistent change communication may benefit clinical research nurse well-being and reduce burnout during times of unpredicted crisis and beyond.

Stigmatization, panic disorder, and death anxiety among patients of Covid-19: Fourth wave of pandemic in Pakistan

BACKGROUND

In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus.

METHODS

The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory.

RESULTS

Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates.

CONCLUSION

This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.

From fearful to hopeful: A thematic content analysis of COVID-19 survivors' YouTube videos

COVID-19 survivors experienced a spectrum of emotions as a result of surviving the said disease. Employing thematic content analysis, the researchers characterized the various emotional manifestations among recovered COVID-19 patients, which are crucial indicators of their mental well-being postinfection. From March 2020 to June 2021, data was collated from 31 Filipino COVID-19 Survivors' YouTube videos. 51.61% of the videos were posted in 2020 and 48.39% were posted in 2021 where 70.97% of the survivors were female while 29.03% were male. 579 primary codes emerged and were narrowed down into sixteen themes where Hope (18.83%) arose as the most predominant emotion followed by Gratitude (14.68%), Joy and Relief (14.16%), Faith (11.57%), Plight Response (10.88%), Sadness (10.88%), Fear (6.39%), and nine others (12.61%).

Surviving COVID-19: Biopsychosocial Impacts, Death Anxiety, and Coping Strategies

As the COVID-19 pandemic erupted, attempts to contain the spread of the virus took two concurrent forms, including mobility restrictions (aka lockdowns) and the race to produce a vaccine. However, it is quite striking that, amidst both the lockdown and the race to produce a vaccine, the question of how COVID-19 survivors/patients coped with the disease has not received the degree of attention it deserved. To navigate this issue, we employed a sample consisting of 100 COVID-19 survivors; this paper explores the relationship between the biopsychosocial (BPS) impacts of COVID-19, death anxiety, and coping strategies. In this context, the mediating role of death anxiety is placed in the spotlight. The analysis reveals a significant positive association between the BPS impact of COVID-19 and death anxiety and a significant negative association between death anxiety and coping strategies among COVID-19 survivors. Thus, death anxiety mediates the relationship between the BPS impact and the coping strategies that COVID-19 survivors adopt. Given the general recognition of the validity of the BPS model in contemporary medical science and practice, a thorough examination of COVID-19 survivors and their experiences related to surviving is necessary to match the challenges of today, including the increased probability of pandemics.

COVID-19 Pandemic Fatigue and Its Sociodemographic, Mental Health Status, and Perceived Causes: A Cross-Sectional Study Nearing the Transition to an Endemic Phase in Malaysia

This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.

Self-care for coronavirus disease through electronic health technologies: A scoping review

Background and Aims

Considering the rapid spread and transmission of COVID-19 and its high mortality rate, self-care practices are of special importance during this pandemic to prevent and control the spread of the virus. In this regard, electronic health systems can play a major role in improving self-care practices related to coronavirus disease. This study aimed to review the electronic health technologies used in each of the constituent elements of the self-care (self-care maintenance, self-care monitoring, and self-care management) during the COVID-19 pandemic.

Methods

This scoping review was conducted based on Arksey and O'Malley's framework. In this study, the specific keywords related to "electronic health," "self-care," and "COVID-19" were searched on PubMed, Web of Science, Scopus, and Google.

Results

Of the 47 articles reviewed, most articles (27 articles) were about self-care monitoring and aimed to monitor the vital signs of patients. The results showed that the use of electronic health tools mainly focuses on training in the control and prevention of coronavirus disease during this pandemic, in the field of self-care maintenance, and medication management, communication, and consultation with healthcare providers, in the field of self-care management. Moreover, the most commonly used electronic health technologies were mobile web applications, smart vital signs monitoring devices, and social networks, respectively.

Conclusion

The study findings suggested that the use of electronic health technologies, such as mobile web applications and social networks, can effectively improve self-care practices for coronavirus disease. In addition, such technologies can be applied by health policymakers and disease control and prevention centers to better manage the COVID-19 pandemic.

The Uncertain Certainty: A Mixed Methods Exploration of Personal Meanings of Death and Preliminary Insights Into Their Relationship With Worldview

The present mixed methods study investigated personal meanings of death, i.e., concepts, views, and expectations associated with one's own death, and explored their relation to worldview. To this end, a sample of 202 young, German-speaking adults completed the Death Statements Test, a new qualitative assessment tool, as well as quantitative measures of religiosity, spirituality, atheism, and agnosticism. Qualitative data was transformed to enable quantitative analyses. Results indicated that the spectrum of personal meanings of death is generally broad and multifaceted. The most prevalent view on death was "death as source of motivation and meaning in life." The frequencies of emotionally positive and negative death meanings were relatively balanced, while neutral statements dominated. Relationships between participants' death meanings and worldview dimensions turned out to be small but existent. The Death Statements Test proved to be a valuable and economic assessment tool, eliciting rich qualitative material on personal meanings of death.

Death Anxiety and Correlates in Cancer Patients Receiving Palliative Care

Background: Death anxiety is powerful, potentially contributes to suffering, and yet has to date not been extensively studied in the context of palliative care. Availability of a validated Death Anxiety and Distress Scale (DADDS) opens the opportunity to better assess and redress death anxiety in serious illness. Objective: We explored death anxiety/distress for associations with physical and psychosocial factors. Design: Ancillary to a randomized clinical trial (RCT) of Dignity Therapy (DT), we enrolled a convenience sample of 167 older adults in the United States with cancer and receiving outpatient palliative care (mean age 65.9 [7.3] years, 62% female, 84% White, 62% stage 4 cancer). They completed the DADDS and several measures for the stepped-wedged RCT, including demographic factors, religious struggle, dignity-related distress, existential quality of life (QoL), and terminal illness awareness (TIA). Results: DADDS scores were generally unrelated to demographic factors (including religious affiliation, intrinsic religiousness, and frequency of prayer). DADDS scores were positively correlated with religious struggle (p < 0.001) and dignity-related distress (p < 0.001) and negatively correlated with existential QoL (p < 0.001). TIA was significantly nonlinearly associated with both the total DADDS (p = 0.007) and its Finitude subscale (p ≤ 0.001) scores. There was a statistically significant decrease in Finitude subscale scores for a subset of participants who completed a post-DT DADDS (p = 0.04). Conclusions: Findings, if replicable, suggest that further research on death anxiety and prognostic awareness in the context of palliative medicine is in order. Findings also raise questions about the optimal nature and timing of spiritual and psychosocial interventions, something that might entail evaluation or screening for death anxiety and prognostic awareness for maximizing the effectiveness of care.

Death Anxiety and COVID-19 Anxiety. The Mediating Role of Religious Relational Identification and the Impact of Emotional Regulation Strategies

Management theory of terror (TMT) explains the way disease and death anxiety (DA) are managed through religion during crisis (i.e., COVID-19 pandemic). 344 women students completed self-reported questionnaires regarding death and COVID-19 anxiety, religious relational identification, and emotional regulation. Results show positive relation between religious relational identification and death anxiety, and COVID-19 anxiety. The interaction between death anxiety and emotional regulation shows that both cognitive reappraisal and expressive suppression are dysfunctional for COVID-19 anxiety. A moderated mediation effect is significant, showing that COVID-19 anxiety is not decreasing due to usual and natural ways of coping (i.e., religious relational identification and cognitive reappraisal).

Exploring the impacts of a coffin-lying experience on life and death attitudes of medical and nursing students: preliminary findings

BACKGROUND

Physicians and nurses often exhibit strong negative emotional and behavioral reactions when patients they care for die, and death education helps them cope with these difficulties. When implementing death education, the literature shows that experiential activities are more effective than lecturing, and progressive exposure is the best way to reduce death anxieties. This study examined the effects of coffin-lying, an activity sometimes seen in Asian cultures, on life and death attitudes of medical and nursing students.

METHODS

During a period from 2020 to 2021, 134 medical and nursing students from a medical university in northern Taiwan voluntarily participated in this study. Among them, 53 were in the experimental group, who participated in a coffin-lying activity for nearly 3 hours, and the other 81 were in the control group. All participants filled out questionnaires 1 week before the activity (T1), 1 week after the activity (T2), and 6 ~ 11 weeks after the activity (T3). Three waves of data were analyzed by a repeated-measure multivariate analysis of variance (MANOVA).

RESULTS

The effects of "love and care" and "feeling of existence" were only manifested at T2, however, the scores of "fear of death" and "death avoidance" between the experimental and control groups significantly differed at T2 and T3. In addition, there were no significant differences between the experimental and control groups in "neutral acceptance", "approach acceptance", or "escape acceptance".

CONCLUSIONS

The coffin-lying activity based on desensitization was effective in improving "fear of death" and "death avoidance", and the effects were sustained to 6 ~ 11 weeks. Coffin-lying is not only a well-designed activity that quickly reduces negative tendencies toward death, but it is also worth adopting by medical and nursing schools to make death education more comprehensive.

Analyzing the role of resilience and life satisfaction as mediators of the impact of COVID-19 worries on mental health

The aim of this study was to test whether resilience and life satisfaction (two traditional protective factors) mediate between COVID-19 related worries and the development of symptoms of depression, anxiety, and stress in adolescents and young adults. Participants involved 392 adolescents and young adults (70.20% female) aged between 12 and 25 years (M = 17.05 years, SD = 3.08). Participants completed the COVID-19 related worries scale, the CD-RISC to analyse resilience, the Satisfaction with Life Scale, and the Depression, Anxiety, and Stress Scales-21 to study emotional symptoms. Descriptive analyses and Pearson correlations were conducted, together with a structural equation modeling testing a mediational model and multigroup invariance. Results show that resilience and life satisfaction play a mediating role in the relation between the COVID-19 related worries and emotional symptoms (depression, anxiety, and stress). This study highlights the role of protective factors on adolescents' and young adults' emotional symptoms during the COVID-19 pandemic.

Predicting resilience during the COVID-19 Pandemic in the United Kingdom: Cross-sectional and longitudinal results

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.

Long-term impacts of COVID-19 pandemic on travel behaviour

The need to understand the influence of the COVID-19 pandemic on the long-term travel behaviour of people has never been higher as a consequence of the second wave of pandemic. In this context, the current study aims to understand the willingness of people to use sustainable modes of transportation including shared modes of transport, and non-motorized transport, against non- shared modes of transport such as personal 2-wheelers and 4-wheelers in a post-vaccinated scenario. The study further models the willingness to choose public transportation under various COVID-19 preventive measures representing the perception of safety among people. An Integrated Choice and Latent Variable (ICLV) framework a employed in the modelling. The fear of contracting COVID-19 and the belief in remedial measures significantly influenced the mode choice of individuals. This highlighted a significant long-term impact of the pandemic on the travel behaviour of individuals. The study concludes by presenting different strategies that could be adopted to make the existing sustainable modes safer, and hence, more attractive.

COVID-19 symptoms and compliance: The mediating role of fundamental social motives

Background

Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance.

Methods

An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis.

Results

The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained.

Conclusion

Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.

Applying terror management theory as a framework to understand the impact of heightened mortality salience on children, adolescents, and their parents: A systematic review

Terror Management Theory (TMT) posits that controlling death anxiety is a driving force behind many aspects of social behavior. The objective in this systematic review was to explore how TMT is used to explain children's, adolescents', and parents' behavior when exposed to situations that increase mortality salience. A systematic search identified 2484 papers; 14 studies met eligibility criteria. Key topics explored were mortality salience, death thoughts, and distal defenses. Findings indicate that adolescents comprehend death and have mortality salience reactions like adults, highlighting the potential for TMT to be used to explain children's and adolescents' social behavior in high-stress situations.

COVID-19 Anxiety and Wellbeing at Work in Finland during 2020-2022: A 5-Wave Longitudinal Survey Study

The COVID-19 pandemic impacted workers globally during 2020-2022 and it has had major psychological implications for workers' wellbeing. This longitudinal study analyzed risk and protective factors predicting COVID-19 anxiety among workers in Finland. Longitudinal national sample of Finnish workers (n = 685) participated in a five-wave study conducted in 2020-2022, covering multiple waves of the COVID-19 pandemic and its aftermath. Our outcome measure was COVID-19 anxiety. Predictors were psychological distress, work exhaustion, technostress, and loneliness. Models also controlled for self-regulation; social support at work and remote working; and socio-demographic background factors. Both within-person and between-person effects were analyzed using multilevel hybrid regression models. COVID-19 anxiety varied between time points which is explained by changes in circumstances during the pandemic. Highest anxiety was expressed in the middle of the Delta variant surge and lockdown in spring 2021. Within-person changes in psychological distress, work exhaustion, technostress, self-regulation, and perceived loneliness were all associated with COVID-19 anxiety. Between-person results showed that distressed, exhausted, technostressed, and lonely workers expressed more anxiety than others. Remote workers reported higher anxiety over time than others. Those who had reported high self-regulation reported lower anxiety than others. Female gender and younger age were associated with higher anxiety. COVID-19 anxiety continues to be an important phenomenon with a magnitude of consequences on people and numerous industries. This study showed that general mental health and work stressors predict COVID-19 anxiety. Promoting social support and workers' self-regulation skills can be beneficial for overcoming anxiety during and after the pandemic.

Potential Factors Conditioning the Compliance to Mandatory Face Covering in the Public Space Due to SARS-CoV-2 Pandemic

BACKGROUND

During the SARS-CoV-2 pandemic, we could observe different attitudes towards restrictive bans and orders.

AIM

The research aimed to examine the potential psychological factors, such as generalized anxiety, fear of COVID-19 or social approval, related to the approach to mandatory face covering in public spaces.

METHODS

The web-assisted interviews survey was used among 202 participants, which included socio-demographical data, approach to face covering, the Generalized Anxiety Disorder Scale, the COVID-19 Anxiety Scale, and The Questionnaire of Social Approval.

RESULT

The data showed a statistically significant correlation between compliance to the rule of face and nose covering vs. anxiety and compliance to the rule of face and nose covering vs. generalized anxiety. The results indicate differences between vaccinated and non-vaccinated people in the anxiety of COVID-19, generalized anxiety, and compliance with the rule of face and nose covering.

CONCLUSIONS

People vaccinated has a higher level of anxiety and more often compliance with the rule of face covering. It is worth noting that an overly pronounced fear of COVID-19 could be a risk factor for mental health. More research about coping with anxiety in the group of vaccinated people is recommended.

Beyond Wishful Thinking during the COVID-19 Pandemic: How Hope Reduces the Effects of Death Arousal on Hostility toward Outgroups among Conservative and Liberal Media Users for COVID-19 Information

The COVID-19 pandemic has made death more salient to individuals, which has partly contributed to the amplification of hostility toward others who have different perspectives from oneself. Recognizing that the politicization of COVID-19 and the resulting polarization have become increasingly critical issues, this study investigates how death-related thinking and hope about the pandemic can affect hostility toward outgroups as well as how conservative and liberal media usages moderate the indirect effects of hope. An online survey experiment of people in the U.S. (N = 759) during the pandemic showed that death arousal reduced hope and that these low levels of hope exacerbated hostility toward outgroups in the pandemic context, confirming the positive impact of hope. Importantly, however, our study did not show that hope had a beneficial impact for heavy conservative media users.

Meaning in Life, Death Anxiety, and Spirituality in the Lesbian, Gay, and Bisexual Community: A Scoping Review

The changes in people's way of life through the years raise questions on how they address existential needs and concerns, particularly those related to life and death and spiritual connections. Through a scoping review, we surveyed studies on meaning in life, death anxiety, and spirituality within the lesbian, gay, and bisexual (LGB) community. We determined the extent to which these variables have been studied among LGB participants. A total of 28 eligible articles were reviewed. Six studies were found about meaning in life, five studies about death anxiety, and 16 studies about spirituality. Results suggest that meaning in life was derived from experiences related to parenthood, couplehood, and work satisfaction. Studies on death anxiety among LGB participants, which date back to the 1980 and 1990s, indicated the need to conduct present studies in this area. The review showed that LGB members distinguished between spirituality and religion, giving them more positive recognition of the former than the latter. The forms of spiritual expression were anchored to religious practices, for some, and other expressions of belief and faith outside the confines of formally established religions. Spiritual expressions generally accorded the LGB members direction and satisfaction in life. Not all segments of the LGB community were represented in the studies. The available studies, dominantly quantitative, centered only on the LGB experience. Target age groups varied across the studies. The review indicates that future studies can work on exploring these existential factors considering the emerging contexts and paradigms. Future research can focus on determining what factors contribute to meaning in life, given the changes in time.