COVID-19 behavioral health and quality of life

The Impact of COVID-19 on Substance Use and Related Consequences among Patients in Office-Based Opioid Use Disorder Treatment

OBJECTIVES

The COVID-19 pandemic led to increased substance-related morbidity and mortality and transformed care for opioid use disorder (OUD). We assessed the perceived impacts of the pandemic on substance use and related consequences among patients in office-based addiction treatment (OBAT).

METHODS

We recruited patients with OUD on buprenorphine from July 2021 to July 2022, with data collection at baseline and 6 months. Exposures of interest were the following 6 domains potentially impacted by COVID-19: personal or family infection, difficulty accessing healthcare/medication, economic stressors, worsening physical or mental health, social isolation, and conflicts/disruptions in the home. Outcomes were past 30-day alcohol and other substance use, increased use, and substance-related consequences at baseline and 6 months. Generalized estimating equations Poisson regression models quantified associations between increasing impact domain scores and relative risks of each outcome.

RESULTS

All participants (N = 150) reported at least one domain negatively impacted by COVID-19 at both time points. Higher "worsening physical or mental health" domain scores were associated with increased relative risk of recent alcohol or drug use (adjusted risk ratio [aRR] 1.04, 95% confidence interval [CI]: 1.01-1.07). Relative risks of experiencing substance-related consequences increased with higher scores in the domains of economic stressors (aRR 1.07, 95% CI: 1.02-1.13), difficulty accessing healthcare/medication (aRR 1.11, 95% CI: 1.04-1.19), and worsening physical or mental health (aRR 1.08, 95% CI: 1.04-1.12).

CONCLUSIONS

Among patients with OUD, stressors from COVID-19 were common. Three life domains impacted by COVID-19 appeared to be associated with consequential substance use, highlighting opportunities to address barriers to healthcare access and economic stressors.

Impact of Digital Media, School Problems, and Lifestyle Factors on Youth Psychosomatic Health: A Cross-Sectional Survey

BACKGROUND

Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups.

METHODS

Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores.

RESULTS

Data from 4525 participants (aged 7-19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children's health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls' psychosomatic well-being, boys showed improvement through sports.

CONCLUSION

The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being.

Care challenges and silver linings in HIV and behavioral health service delivery for individuals living with HIV and severe mental illness during the COVID-19 pandemic: a qualitative study

BACKGROUND

There has been a longstanding effort to integrate behavioral health and HIV care for people with comorbid HIV and behavioral health needs, including those with severe mental illness (SMI). As this population frequents both behavioral health and HIV care settings, they were likely to experience new obstacles to the quality and availability of care during the COVID-19 pandemic. This study aims to describe how clinics for HIV services or behavioral healthcare-as well as co-located sites providing both-sought to rapidly shift protocols to maintain a standard of patient care for people with comorbid HIV and SMI while adapting to the unprecedented circumstances of the pandemic.

METHODS

We interviewed HIV and behavioral healthcare providers, clinic leaders, and support service agencies that served clients impacted by both HIV and SMI. Seventeen key informants across three settings (HIV care settings, behavioral health care settings, and integrated or co-located care settings) were interviewed in 2022. Interviews focused on changes in clinical services, protocols, and care provision strategies during and at the onset of the COVID-19 pandemic. Interviews were transcribed and coded using thematic analysis.

RESULTS

Commonly endorsed themes included both positive and negative changes in care and care provision during the pandemic. Negative impacts of the pandemic included the loss of physical space, exacerbated mental health needs and disengagement in HIV care, patient barriers to telehealth and the digital divide, and increased healthcare workforce burnout. Positive changes included improved healthcare delivery and care engagement through telehealth, new opportunities to provide a wide range of social services, paradoxical increases in engagement in HIV care for certain patients, and broad institution of workforce wellness practices.

CONCLUSIONS

Though COVID-19 presented several complex barriers to care for providers serving patients with comorbid HIV and SMI, the increased flexibility afforded by telehealth and a greater focus on collaborative approaches to patient care may benefit this patient population in the future. Additionally, the focus on workforce wellness may serve to increase retention and avoid burnout among providers. The strategies and lessons learned through adapting to COVID-19 may be invaluable moving forward as healthcare systems respond to future pandemics.

Psychological and social determinants of adaptation: the impact of finances, loneliness, information access and chronic stress on resilience activation

Background

Many people who face adversity, such as disasters, demonstrate resilience. However, less is known about reactions to large scale disasters with longer recovery periods. The concern is that protracted disasters may result in more chronic or accumulated stressors with an uncertain or unknown end point and can exhaust the natural coping methods and ability to rebound. Thus, understanding patterns of longer-term disaster recovery, inclusive of resilience, is needed. Further resilience is not individual specific rather social determinants, such as support networks and available resources, are contributing factors.

Methods

The purpose of this study is to improve understanding of mental health and resilience during increased stress, we aim to identify profiles of adaptation and psychological and social determinants that predict membership within predominant symptom groupings. We conducted an exploratory cross-section study (N = 334) with two phases of multivariate analysis. Latent profile models were estimated to identify groups based on depression, anxiety, and resilience scores. The second phase included a step-wise multinomial logistic regression to predict class membership.

Results

We identified four distinct groups: 33% of participants were categorized as anxious, 18% depressed, 9% comorbid, and 40% with above average levels of resilience. Psychosocial factors such as demographics, trauma history, information access, loneliness, and lack of financial resources predicted poorer mental health outcomes and lower resilience.

Conclusion

This study identified factors that contribute to overall wellbeing despite chronic stressors. Social determinants of adaptation, found in this study population, include loneliness, finances, and information access. The findings from this study support the need for both psychological and social adaption supports, inclusive of mental health treatment, to strengthen resilience activation.

Long-Term Quality of Life after COVID-19 Infection: Cross-Sectional Study of Health Care Workers

(1) Background: Post-COVID syndrome is defined as symptoms that occur simultaneously with or after a COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people's long-term quality of life following a COVID-19 infection. The aim of this cross-sectional study was to investigate the long-term quality of life after COVID-19 among employees of a hospital in Germany and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on the quality of life and global health status were collected in the following four domains: physical health, mental health, social relationships, and the environment. (3) Results: The response rate was 73.8 % (923/1250). Furthermore, 63.4 % of the hospital staff respondents reported at least one persistent symptom after a COVID-19 infection, leading to significant differences in quality of life. Pre-existing conditions, persistent symptoms, and disabilities after a COVID-19 infection as well as a high BMI, no partnership, and a low educational level were found to significantly contribute to a low long-term quality of life. (4) Conclusions: Obesity, a lack of partnership, and a low level of education were independent risk factors for a lower quality of life post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are required to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

Impact of COVID-19 Infection on Health-Related Quality of Life in the Japanese Population: A Large Health-Insurance-Based Database Study

Evidence for acute or long-term coronavirus disease 2019 (COVID-19) infection is relatively limited. We aimed to evaluate the impact of COVID-19 infection on health-related quality of life (HRQoL) in the Japanese population. Eligible study participants were 13,365 employees and their dependents who answered questionnaires at baseline and 18 months later and who had at least 6 months of continuous enrolment before and after baseline. Of the 711 study participants who developed COVID-19 infection, 29.0% reported a decline in HRQoL, whereas 25.2% of uninfected participants reported a decline. The adjusted odds ratios (95% confidence intervals) for the association between COVID-19 infection and declines in HRQoL in the age categories of less than 30 years, 30s, 40s, 50s, and 60 years or higher were 0.54 (0.15-1.92), 1.70 (1.03-2.81), 1.14 (0.82-1.57), 1.05 (0.77-1.42), and 0.87 (0.46-1.64), respectively. This study demonstrates a differential association between COVID-19 infection and declines in HRQoL by age group. A 1.7-fold increase in the odds of negative changes in HRQoL was observed in only those in their 30s. Further studies are needed to elucidate differences in the impact of COVID-19 infection on HRQoL between younger people such as those in their 30s and the older population.

Trajectories of quality of life in people with diabetes mellitus: results from the survey of health, ageing and retirement in Europe

Introduction

Previous longitudinal studies identified various factors predicting changes in Quality of Life (QoL) in people with diabetes mellitus (PwDM). However, in these studies, the stability of QoL has not been assessed with respect to individual differences.

Methods

We studied the predictive influence of variables on the development of QoL in PwDM across three waves (2013-2017) from the cross-national panel dataset Survey of Health, Ageing, and Retirement in Europe (SHARE). To determine clinically meaningful changes in QoL, we identified minimal clinically important difference (MCID). Linear regressions and Linear Mixed Models (LMM) were conducted to determine factors associated with changes in QoL.

Results

On average, QoL remained stable across three waves in 2989 PwDM, with a marginal difference only present between the first and last wave. However, when looking at individual trajectories, 19 different longitudinal patterns of QoL were identified across the three time-points, with 38.8% of participants showing stable QoL. Linear regression linked lower QoL to female gender, less education, loneliness, reduced memory function, physical inactivity, reduced health, depression, and mobility limitations. LMM showed that the random effect of ID had the strongest impact on QoL across the three waves, suggesting highly individual QoL patterns.

Conclusion

This study enhances the understanding of the stability of QoL measures, which are often used as primary endpoints in clinical research. We demonstrated that using traditional averaging methods, QoL appears stable on group level. However, our analysis indicated that QoL should be measured on an individual level.

Home-based lifestyle intervention for breast cancer survivors: A surprising improvement in the quality of life during the first year of COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic induced an extraordinary impact on public mental health to a degree not completely understood, especially in vulnerable populations such as breast cancer (BC) survivors. In this study, we described the short- (after 3-month) and long- (after 12-month) term effects of a multidisciplinary home-based lifestyle intervention in Italian women BC survivors during the first year of COVID-19 pandemic.

MATERIALS AND METHODS

In total, 30 Italian BC survivors with risk factors for recurrence took part in the ongoing MoviS trial (protocol: NCT04818359). Between January 2020 and January 2021, a 3-month lifestyle intervention based on psychological counseling, nutrition, and exercise was carried out. Participants were asked to fill out psychological questionnaires for the assessment of quality of life (QoL) indicators (European Organization for Research and Treatment of Cancer QoL, EORTC-QLQ-C30) and psychological health measures such as fatigue (Brief Fatigue Inventory, BFI), distress (Distress Thermometer, DT and Psychological Distress Inventory, PDI), cancer-related fatigue (Verbal Rating Scale, VRS), and mood states (Profile of Mood States Questionnaire, POMS). IBM SPSS Statistical Software version 27.0 and R Project for Statistical Computing version 4.2.1 were used to process data. All participants were assessed at four time points: T0 (baseline), T1 (3-month), and follow-up at T2 and T3 (6- and 12-month, respectively) to measure primary (quality of life indicators) and secondary (psychological health) outcomes. Friedman non parametric test and Wilcoxon signed rank test (with Bonferroni correction) were conducted to investigate the statistically significant differences in psychometric scores and between assessment times.

RESULTS

Compared to baseline (T0), at T1 most of the QoL indicators (i.e., symptoms of fatigue and general health) were improved (p < 0.017) with the exception of a worsening in participants' social functioning ability. Also, perception of severity of fatigue, distress, cancer-related fatigue, depression, and anger enhanced. Compared to baseline (T0), at T3 we mainly observed a stable condition with T0-T1 pairwise comparison, however other secondary outcomes (i.e., fatigue mood state, confusion, and anxiety) significantly improved.

DISCUSSION

Our preliminary findings support the proposal of this lifestyle intervention for BC survivors. Despite the home-confinement due to the COVID-19 pandemic, the intervention surprisingly improved QoL indicators and psychological health of the participants.

Development and initial psychometric evaluation of a COVID-related psychosocial experiences questionnaire for cancer survivors

BACKGROUND

Cancer survivors are at elevated risk of psychological problems related to COVID-19, yet no published measure adequately assesses their psychosocial experiences during the pandemic.

PURPOSE

Describe the development and factor structure of a comprehensive, self-report measure (COVID-19 Practical and Psychosocial Experiences questionnaire [COVID-PPE]) assessing the pandemic's impact on US cancer survivors.

METHODS

The sample (n = 10,584) was divided into three groups to assess COVID-PPE factor structure by conducting: (1) initial calibration/exploratory analysis of the factor structure of 37 items (n = 5070), (2) confirmatory factor analysis of the best-fitting model (36 items after item removal; n = 5140), and (3) post-hoc confirmatory analysis with an additional six items not collected in the first two groups (42 items; n = 374).

RESULTS

The final COVID-PPE was divided into two sets of subscales, conceptualized as Risk Factors and Protective Factors. The five Risk Factors subscales were labeled Anxiety Symptoms, Depression Symptoms, Health Care Disruptions, Disruptions to Daily Activities and Social Interactions, and Financial Hardship. The four Protective Factors subscales were labeled Perceived Benefits, Provider Satisfaction, Perceived Stress Management Skills, and Social Support. Internal consistency was acceptable for seven subscales (αs = 0.726-0.895; ωs = 0.802-0.895) but poor or questionable for the remaining two subscales (αs = 0.599-0.681; ωs = 0.586-0.692).

CONCLUSIONS

To our knowledge, this is the first published self-report measure comprehensively capturing psychosocial impact-both positive and negative-of the pandemic on cancer survivors. Future work should evaluate predictive utility of COVID-PPE subscales, particularly as the pandemic evolves, which may inform recommendations for cancer survivors and facilitate identification of survivors most in need of intervention.

Perceived social support and COVID-19 impact on quality of life in college students: an observational study

BACKGROUND

The purposes of this study were to assess the current status of perceived social support and COVID-19 impact on quality of life, to investigate the association of perceived social support with the COVID-19 impact on quality of life, and to examine differences in perceived social support between better and worse COVID-19 impact on quality of life for the total sample and by gender.

METHODS

Participants included 1296 university students (399 male, 871 female, 22 transgender, non-binary, or other) with a mean age of 21.5 (SD  =  2.6 years) from a large public university in the Midwest region of the US. Students voluntarily completed two questionnaires and demographic information via Qualtrics based on a cross-sectional study design. The Multidimensional Scale of Perceived Social Support (MSPSS) is a 12-item survey used to assess an individual's perception of social support from significant others, friends, and family. The COVID-19-Impact on Quality of Life scale (COVID-19 QoL) is a 6-item scale used to assess the impact of COVID-19 on quality of life. Data was analyzed using descriptive statistics, multiple linear regression, independent t-tests, and ANCOVA.

RESULTS

Multiple linear regression showed that perceived social support from family was a significant predictor of COVID-19 QoL (F = 35.154, p < .01) for the total sample. Further, t-test demonstrated significant differences between males and females on perceived social support (t = -2.184, p < .05) as well as COVID-19 QoL (t = -5.542, p < .01). Results of ANCOVA demonstrated a significant group effect on perceived social support for both males (F = 10.054, p < .01, η² = .025) and females (F = 5.978, p < .05, η² = 0.007), indicating that the better quality of life group scored higher on perceived social support than low quality of life.

CONCLUSIONS

Social support from family may act as a key buffer for quality of life during the fall semester of 2020, amid the COVID-19 pandemic in college students. With social interactions restricted during COVID-19, maintained access to social support is highly important.KEY MESSAGESSocial support is a crucial contributing factor to the impact of COVID-19 on quality of life, and support from social relationships may buffer these challenging and unpredictable times.The COVID-19 pandemic may have impacted the quality of life of males and females differently.

Impact of COVID-19 on health-related quality of life in the general population: A systematic review and meta-analysis

The World Health Organization declared coronavirus disease of 2019 as an epidemic and public health emergency of international concern on January 30th, 2020. Different factors during a pandemic can contribute to low quality of life in the general population. Quality of life is considered multidimensional and subjective and is assessed by using patient reported outcome measures. The aim and objective of this review is to assess the impact of coronavirus disease of 2019 and associated factors on the Quality of Life in the general population. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A protocol was registered in the international Prospective Register of Systematic Reviews database(CRD42021269897). A comprehensive electronic search in PubMed, EBSCO Host Research Databases, MEDLINE and Google scholar search engine was conducted. A total number of 1,7000,074 articles were identified from electronic search. 25 full text articles were retained for qualitative synthesis and seventeen articles for quantitative analysis. Seven main quality of life scales were used to assess the quality of life of the general population; World Health Organization Quality of Life-bref, EuroQuality of Life-Five dimensions, Short Form, European Quality of Life Survey, coronavirus disease of 2019 Quality of Life, General Health Questionnaire12 and My Life Today Questionnaire. The mean World Health Organization Quality of Life-brief was found to be 53.38% 95% confidence interval [38.50-68.27] and EuroQuality of Life-Five dimensions was 0.89 95% confidence interval [0.69-1.07]. Several factors have been linked to the Coronavirus disease of 2019 such as sociodemographic factors, peoples living with chronic diseases, confinement and financial constraints. This review confirms that the Coronavirus disease of 2019 pandemic affected the quality of life of the general population worldwide. Several factors such as sociodemographic, peoples living with chronic diseases, confinement and financial constraints affected the quality of life.

Economic uncertainty and population health: insights from emerging markets and developing countries

This study employs a Bayesian panel vector autoregressive model to examine the impact of economic uncertainty on public health, using an annual, country-level panel dataset of 103 emerging markets and developing countries spanning the years 1995 through 2019. The results from the full sample suggest that the immediate effects of heightened economic uncertainty on health are marginal, yet it may engender prolonged life expectancy and lowered mortality rates. The analysis unveils considerable heterogeneities among various country classifications. The health-enhancing effects of economic uncertainty are predominantly discernible in emerging markets, low-income and upper-middle-income countries. Additionally, a diminution in suicide rates, attributed to escalated economic uncertainty, is uniquely detected in upper-middle-income countries. Furthermore, economic growth and healthcare expenditure emerge as paramount determinants in bolstering overall population health, particularly in lower-middle-income countries. The detrimental effect of environmental pollution on health is more pronounced in emerging markets and middle-income nations. Excluding high-income countries, it is essential to emphasize the beneficial health outcomes resulting from financial development and globalization, as well as the deleterious effects of environmental pollution. Lastly, several policy implications aligned with the findings are outlined, providing a roadmap for decision-makers in these diverse economies to promote better health outcomes.

Quality of life in families under quarantine: a cross-sectional study in seven countries during the first outbreak of COVID-19

Background

The COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown.

Methods

A cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member's QoL.

Results

The survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8-43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p < 0.05). According to family structure, we found differences on QoL between nuclear and siblings' families (p = 0.024).

Conclusion

Families from seven countries of three continents reported poor QoL during the first outbreak of COVID-19. The pandemic scenario has dramatically weakened the QoL in 3/4 dimensions, where social relationships have remained high. It is important to fully address the impact of this reduced QoL on families after several waves of infection and to provide comprehensive support in the post-COVID future.

Administrative professionals' quality of life in educational institutions: a systematic review protocol

INTRODUCTION

Indicators of administrative professionals' quality of life (QoL) in educational institutions are essential for planning improvements in their daily lives. QoL is a recurring topic in academic research, particularly in the healthcare sector. Therefore, this study aims to evaluate the perceptions of administrative professionals in educational institutions regarding their QoL and the implications of remote and in-person work. Additionally, we aim to compare the QoL before, during and after the COVID-19 pandemic.

METHODS AND ANALYSIS

Five electronic databases will be searched for this systematic review: CINAHL, LILACS, PubMed, Scopus and Web of Science. Original, peer-reviewed articles published in any language, without time limitations, will be included in this study. Two researchers will screen the articles and extract the data. The included articles will be evaluated for the quality of their evidence using Grading of Recommendations, Assessment, Development and Evaluations. The risk of bias will be assessed using the Critical Appraisal Skills Programme checklist and the Downs and Black scale. A third reviewer will resolve any discrepancies.

ETHICS AND DISSEMINATION

The systematic review results will be published in a peer-reviewed journal and presented at a relevant conference. The data will not include individual patient data; therefore, ethical approval is not required.

PROSPERO REGISTRATION NUMBER

CRD42022365862.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model

BACKGROUND

Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers.

METHODS

In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors.

RESULTS

In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (βs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (βs = -0.61 to -0.43, ps < 0.001).

CONCLUSION

Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Quality of life is associated with vaccine reluctance via mental health and fear of covid-19: an exploratory investigation on a Palestinian sample

Quality of life (QoL) has been studied as an antecedent of good mental health in contexts characterized by extreme poverty and acute conflict. The covid-19 crisis exacerbated the risks of health-related consequences in such contexts. Vaccination campaigns have been started worldwide to contain the virus outbreak with high rates of hesitancy and refusal. Our exploratory study sheds light on the relationship between QoL and vaccine reluctance via mental health and fear of covid-19 in a Palestinian population affected by military occupation or socioeconomic marginalization. Who-QolBref, Fcov-19, and Dass were administered to 1122 Palestinian adults living in the occupied territories and Israel. Structural equation modelling was applied to test the relations between variables. Results showed that fear of COVID-19, stress, anxiety and depression mediated the association between QoL and vaccination reluctance with a good model fit (χ2 (5) = 828.37; p = .001; GFI=.93; AGFI=.94; RMSEA=.046; NFI=.94; CFI=.95). QoL and mental health were negatively associated with stress (βX, Y = - .35; p < .001), depression (βX, Y = -.37; p < .001), and anxiety (βX, Y = -.36; p < .001). QoL and fear of COVID- 19 (βX, Y = -.16; p < .001) were inversely correlated. A positive effects was found between stress (βM, Y = .17; p < .001), anxiety (βM, Y = .18; p < .001), and depression (βM, Y = .17; p < .001), fear of COVID-19 and vaccination reluctance (βX, Y = .23; p < .001). According to our findings, Public health measures to ease the social suffering of people with low QoL due to conflict and social marginality might favour the acceptance of the vaccine.

Trajectories of quality of life and mental health during the Covid-19 lockdown and six months after in Italy. A longitudinal exploration

Aim

Covid-19 pandemic and its relative containment measures have affected populations' quality of life and psychological well-being worldwide. The fear related to the pandemic and the imposed containment measures has acted as a trigger causing a global increase in negative mental health states. Thus, we aimed to explore the relationship between fear of covid-19 and mental health via QoL (the first and the second lockdown in Italy, 2020).

Subject and methods

Through a quantitative cross-lagged path model research design, the study investigates people's fear of Covid-19, quality of life, and negative mental states in a population of 444 Italian adults (Mean=40.7; Standard Deviation=16.9; 80% women), in the period between the first and the second waves of the pandemic.

Results

Results show that participants' Covid-19 fear decreased between waves, contributing to a decrease in negative mental states (stress, anxiety and depression), thus improving the perceived quality of life. Furthermore, quality of life emerged as able to buffer the impact of fear of Covid on people's psychological distress in short and medium terms, confirming its central role in regulating mental distress.

Conclusion

The study suggests important guidelines for developing interventions to support the populations' well-being and mental health.

Prospective single-center study of health-related quality of life after COVID-19 in ICU and non-ICU patients

Long-term sequelae in hospitalized Coronavirus Disease 2019 (COVID-19) patients may result in limited quality of life. The current study aimed to determine health-related quality of life (HRQoL) after COVID-19 hospitalization in non-intensive care unit (ICU) and ICU patients. This is a single-center study at the University Hospital of Wuerzburg, Germany. Patients eligible were hospitalized with COVID-19 between March 2020 and December 2020. Patients were interviewed 3 and 12 months after hospital discharge. Questionnaires included the European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L), patient health questionnaire-9 (PHQ-9), the generalized anxiety disorder 7 scale (GAD-7), FACIT fatigue scale, perceived stress scale (PSS-10) and posttraumatic symptom scale 10 (PTSS-10). 85 patients were included in the study. The EQ5D-5L-Index significantly differed between non-ICU (0.78 ± 0.33 and 0.84 ± 0.23) and ICU (0.71 ± 0.27; 0.74 ± 0.2) patients after 3- and 12-months. Of non-ICU 87% and 80% of ICU survivors lived at home without support after 12 months. One-third of ICU and half of the non-ICU patients returned to work. A higher percentage of ICU patients was limited in their activities of daily living compared to non-ICU patients. Depression and fatigue were present in one fifth of the ICU patients. Stress levels remained high with only 24% of non-ICU and 3% of ICU patients (p = 0.0186) having low perceived stress. Posttraumatic symptoms were present in 5% of non-ICU and 10% of ICU patients. HRQoL is limited in COVID-19 ICU patients 3- and 12-months post COVID-19 hospitalization, with significantly less improvement at 12-months compared to non-ICU patients. Mental disorders were common highlighting the complexity of post-COVID-19 symptoms as well as the necessity to educate patients and primary care providers about monitoring mental well-being post COVID-19.

Health-related quality of life before and during the COVID-19 pandemic in Switzerland: a cross-sectional study

INTRODUCTION

The COVID-19 pandemic forced people to give up their daily routines and adjust to new circumstances. This might have affected health-related quality of life (HRQOL). We aimed to compare HRQOL during the first COVID-19 wave in 2020 to HRQOL before the pandemic and to identify determinants of HRQOL during the pandemic in Switzerland.

METHODS

We conducted a cross-sectional online survey during the pandemic (between May and July 2020; CoWELL sample; convenience sample). Before the pandemic (2015-2016), we had conducted a cross-sectional paper-based survey among a representative random sample of the Swiss general population (SGP sample). In both samples, we assessed physical and mental HRQOL (Short Form-36) and socio-demographic characteristics. In the CoWELL sample, we additionally assessed health- and COVID-19-related characteristics. Data were analysed using linear regressions.

RESULTS

The CoWELL sample included 1581 participants (76% women; mean age = 43 years, SD = 14 years) and the SGP sample 1209 participants (58% women, mean age = 49 years, SD = 15 years). Adjusted for sex, age, and education, the CoWELL sample reported higher physical HRQOL (PCS, +5.8 (95% CI: 5.1, 6.6), p < 0.001) and lower mental HRQOL (MCS, -6.9 (-7.8, -6.0), p < 0.001) than the SGP sample. In the CoWELL sample, especially persons with lower health literacy, who had no support network or who have had COVID-19, reported lower HRQOL.

DISCUSSION

Aspects unique to the COVID-19 pandemic affected HRQOL. Vulnerable persons such as those having had COVID-19, less support opportunities, and with lower health literacy are especially prone to impaired HRQOL during the COVID-19 pandemic.

Investigating the Relationship between Home Parenteral Support and Needs-Based Quality of Life in Patients with Chronic Intestinal Failure: A National Multi-Centre Longitudinal Cohort Study

Home parenteral support (HPS) is an essential but potentially burdensome treatment that can affect quality of life (QoL). The aims of this longitudinal study were to understand whether any changes in HPS over time were associated with QoL. The Parenteral Nutrition Impact Questionnaire (PNIQ) was used, and data were collected on HPS prescribed at three time points. Data were analysed using multi-level mixed regression models presented as effect size and were adjusted for confounders. Study recruited 572 participants from 15 sites. Of these, 201 and 145 completed surveys at second and third time-points, respectively. PNIQ score was out of 20 with a higher score indicating poorer QoL. Any reduction in HPS infusions per week was associated with an improved PNIQ score of -1.10 (95% CI -2.17, -0.02) unadjusted and -1.34 (95% CI -2.45, -0.24) adjusted. Per day change to the number of infusions per week was associated with a change in the PNIQ score of 0.32 (95% CI -0.15, 0.80) unadjusted and 0.34 (95% CI -0.17, 0.85) adjusted. This is the largest national study to demonstrate improvements in QoL associated with HPS reduction over time using an HPS-specific and patient-centric tool, adding unique data for use of therapies in intestinal failure.

Stress, coping, and quality of life in the United States during the COVID-19 pandemic

While research has widely explored stress, coping, and quality of life (QOL) individually and the potential links between them, a critical dearth exists in the literature regarding these constructs in the context of the COVID-19 pandemic. Our study aims to identify the salient stressors experienced, describe the coping strategies used, and examine the relationships between stressors, coping, and QOL among individuals during the pandemic. Data are from a sample of 1,004 respondents who completed an online survey. Key measures included stressful life events (SLEs), coping strategies, and the physical and psychological health domains of QOL. Staged multivariate linear regression analyses examined the relationships between SLEs and the two QOL domains, controlling for sociodemographic and pre-existing health conditions and testing for the effects of coping strategies on these relationships. The most common SLEs experienced during the pandemic were a decrease in financial status, personal injury or illness, and change in living conditions. Problem-focused coping (β = 0.42, σ = 0.13, p < 0.001 for physical QOL; β = 0.57, σ = 0.12, p < 0.001 for psychological QOL) and emotion-focused coping (β = 0.86, σ = 0.13, p < 0.001 for psychological QOL) were significantly related to higher levels of QOL, whereas avoidant coping (β = -0.93, σ = 0.13, p < 0.001 for physical QOL; β = -1.33, σ = 0.12, p < 0.001 for psychological QOL) was associated with lower QOL. Avoidant coping partially mediated the relationships between experiencing SLEs and lower physical and psychological QOL. Our study informs clinical interventions to help individuals adopt healthy behaviors to effectively manage stressors, especially large-scale, stressful events like the pandemic. Our findings also call for public health and clinical interventions to address the long-term impacts of the most prevalent stressors experienced during the pandemic among vulnerable groups.

Hopelessness and burnout in Italian healthcare workers during COVID-19 pandemic: the mediating role of trait emotional intelligence

Objective

The study aims to assess the impact of COVID-19 on healthcare workers' work-related stress during the first wave of the pandemic in Italy. The main objective is to investigate the existence of a positive correlation between hopelessness and burnout, assuming that burnout may be a risk factor for the development of hopelessness, and to analyze the role that trait Emotional Intelligence (TEI) and changes in workload could have in this relationship. Furthermore, evaluate any significant differences in burnout and hopelessness levels in the function of some demographic variables, such as gender, professional profiles, and different working zones of Italy, to better understand how the diverse diffusion of pandemic had affected Italian healthcare workers.

Methods

An online survey was used to collect data between April and June, 2020, with 562 responses among nurses (52.1%) and physicians (47.9%). Demographics and changes in workload and work conditions were collected through an ad hoc questionnaire. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), The Beck Hopelessness Scale (BHS), and the Link Burnout Questionnaire (LBQ) were used to assess Trait Emotional Intelligence (TEI), hopelessness, and burnout, respectively.

Results

Correlation analysis showed a significant positive relationship between hopelessness and each burnout dimension. TEI showed negative correlations both with burnout dimensions and hopelessness. Significant differences in burnout and hopelessness levels emerged as a function of some demographic variables such as gender, professional profiles (nurses or physicians), and different working zone of Italy (northern or southern). Results showed that TEI partially mediated the relationship between hopelessness and every burnout dimension, while the interaction of changes in workload was non-significant.

Discussion

The mediating role of TEI in the burnout-hopelessness relationship partly explains the protective role that individual factors had on healthcare workers' mental health. Our findings support the need to integrate considerations on both psychological risk and protective factors into COVID-19 care, including the monitoring of psychological symptoms and social needs, especially among healthcare workers.

Musculoskeletal system symptoms in patients with COVID-19 and the impact of these symptoms on quality of life

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and also affects the musculoskeletal system.

OBJECTIVE

This study was conducted to investigate the musculoskeletal symptoms, type of pain and effect on quality of life in patients presenting with pain after COVID-19.

METHODS

This prospective, descriptive study included 97 patients aged 18 years or older who were diagnosed with COVID-19 based on a positive polymerase chain reaction test result, with or without musculoskeletal pain prior to COVID-19 infection. Patients who applied to the post-COVID-19 outpatient clinic with the complaint of pain at least 1 month and maximum 1 year after the diagnosis of COVID-19 were included. Patients' demographic characteristics and musculoskeletal examination findings were evaluated. The patients were examined, and the questionnaire forms were completed. The pain was assessed using the visual analog scale (VAS), the Douleur-Neuropathique-4 (DN-4) questionnaire, while the quality of life was assessed using the Short Form-36 (SF-36) survey. Patients were divided into groups in terms of gender, age, body mass index. Shapiro-Wilk's test, the independent samples t-test and the Mann-Whitney U test were used for statistical analyses.

RESULTS

The mean age of the patients was 46.5 ± 13.5 years, 30 of them were male. Pain increased in patients with pre-COVID-19 arthralgia and myalgia (p< 0.001). Post-COVID-19 VAS was significantly higher than pre-COVID-19 VAS (7 ± 1.2 vs. 3.2 ± 1.9, p< 0.05). Pre-COVID-19 patients with myalgia had significantly worse SF-36 physical function, social function, pain, general health perception (p< 0.05). The mean scores of females in the SF-36 physical function, pain were significantly worse than males (p< 0.05). According to DN-4, 41 (42.3%) patients had neuropathic pain. There was moderate negative correlation between VAS, DN-4 and SF-36 (p< 0.05).

CONCLUSIONS

Arthralgia, myalgia, and neuropathic pain, all of which negatively affect the quality of life, are often observed in the patients infected with COVID-19.

Psychological Distress and Heavy Alcohol Consumption Among U.S. Young Women During the COVID-19 Pandemic

INTRODUCTION

The predictors of heavy drinking among U.S. young women during the COVID-19 pandemic are not well-examined. This study aims to determine the prospective relationship between COVID-19 psychological distress and heavy alcohol use among U.S. young adult women.

DESIGN

This study used the COVID-19 Adult Resilience Experiences Study (CARES) data collected from April 13, 2020, to August 31, 2020 (T₁) and September 21, 2020, to March 15, 2021 (T₂). Among the young adults (ages 18-30) who participated in both surveys, a total of 684 identified as women (including transgender women) and were included in the analysis. Three or more drinks as a typical intake were defined as heavy drinking. Psychological distress in T₁ was measured using scores for financial stress, COVID-19-related worry, and COVID-19-related grief. A series of logistic regression analyses were performed to identify risk factors associated with young women's heavy drinking during the pandemic.

RESULTS

Twenty-two and one-half percent of young women reported heavy drinking in a typical intake. After controlling for covariates, women who reported high levels of COVID-19-related grief were more likely to report heavy drinking (odds ratio, 1.06; 95% confidence interval [CI], 1.01-1.13; p < .05). Those with high levels of COVID-19-related worry were less likely to report drinking heavily (odds ratio, 0.90; 95% confidence interval, 0.85-0.97; p < .01).

CONCLUSIONS

Those who suffer from a deeper sense of COVID-19-related grief are particularly at risk of heavy drinking and should be targeted for outreach and clinical intervention. Further research is necessary to determine the long-term impacts of the pandemic on heavy drinking among young women and should include a more comprehensive assessment of psychological distress.

Health-Related Quality of Life Among Patients Recovered From COVID-19

The Coronavirus disease 2019 (COVID-19) has impacted the lives and well-being of individuals worldwide, affecting both short-term and long-term quality of life. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients who have recovered from COVID-19. A cross-sectional survey was conducted at 2 hospitals in Ho Chi Minh City, Vietnam between January and March 2022. Data were obtained from patients who recovered from COVID-19 using a structured questionnaire which included the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale to quantify problems in 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and the EuroQoL-Visual Analog Scale (EQ-VAS) to determine self-rated health status. Factors associated with HRQoL were determined using a generalized linear model (GLM). A total of 325 participants were included in the analysis. The overall mean score from the EQ-5D-5L and EQ-VAS was 0.86 (SD 0.21) and 78.6 (SD 19.9), respectively. Anxiety/Depression and Pain/Discomfort were the major problems experienced by the participants. Lower HRQoL scores were reported among those who were 60 years and older, female, had comorbidities, persistent symptoms, living alone and experiencing stress (all P < .05). This study showed that there was a significant reduction in HRQoL among individuals who recovered from COVID-19, compared with the general population. The findings suggest that more interventions need to be implemented to increase such individuals' quality of life, particularly for those who exhibit high-risk factors such as females, those with comorbidities, persistent symptoms, living alone and experiencing from stress.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model

BACKGROUND

Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers.

METHODS

In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors.

RESULTS

In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( β s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( β s = -.61 to -.43, p s < .001).

CONCLUSION

Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Mechanisms of recovery: Community perceptions of change and growth following multiple disasters

Introduction and purpose

The geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG).

Methods

Participants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill—for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded.

Results

The following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31).

Discussion and implications

These findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.

The Association between COVID-19 Pandemic and the Quality of Life of Medical Students in Silesian Voivodeship, Poland

(1) Background: Since the COVID-19 pandemic spread rapidly in 2020, medical universities have been affected by a particular crisis. Due to the increased risk of SARS CoV-2 transmission, the authorities of medical faculties all over the world, including Poland, started to minimize direct contact between students. The objective of the paper is to identify and assess determinants of the quality of life among medical students in Poland before and during the COVID-19 pandemic. (2) Methods: We analyzed data obtained in a cross-sectional study performed among three groups of students tested in three consecutive research periods: period before the COVID-19 pandemic, the COVID-19 pandemic lockdown period and the COVID-19 pandemic period following lockdown. (3) Results: The total number of participants was 1098. We identified that the research period before the COVID-19 pandemic was the risk factor for lower quality of life in terms of the somatic and environmental domains. It was also confirmed that determinants such as poor financial situation, low frequency of physical activity and bad self-declared health status harmed the QoL scores in all domains. (4) Conclusions: The obtained results confirmed that better financial situation, higher physical activity and better self-declared health status were statistically significant factors improving the quality of life of first-year medical students in Poland. The findings of our study also showed that the declared somatic and environmental domains of QoL among medical students were better during the COVID-19 pandemic period. Our observations confirmed that the immediate implementation of e-learning could protect against the deterioration of mental health and quality of life in first-year medical students during possible future epidemic crises.

The Emotions, Coping, and Psychological Well-Being in Time of COVID-19: Case of Master's Students

Background: Master’s students have been affected by COVID-19 and the changing study conditions due to the lockdown. The aim was to uncover changes in emotions, coping strategies, and psychological well-being during a pandemic. Methods: Ryff scale, multidimensional emotion questionnaire, and Brief COPE scale. Participants: sample of 118 master’s students after the first wave and 128 master’s students after the second wave. Results: After the second wave of COVID-19, the happy, enthusiastic, and inspired scores of the emotion construct components increased statistically significantly (p < 0.05), but the scores of the components sad, afraid, angry, ashamed, and anxious decreased significantly (p < 0.05). After the first wave, students commonly used planning, positive reframing, self-blame, humor, and acceptance coping strategies, which are classified as problem-focused and emotion-focused coping strategies. The psychological well-being of master’s students after the second wave was statistically (p < 0.05) better than that after the first wave in many indicators. Environment mastery skills did not change significantly. Significant associations were revealed between the same components of psychological well-being, emotion, and coping strategies. Conclusions: This study showed that the master’s students improved their adaptive abilities probably in the environment of long-term exposure to coronavirus disease, as most psychological well-being indicators improved significantly after the second wave.