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Alarcão V, Candeias P, Stefanovska-Petkovska M, Neves J, Pintassilgo S, Machado FL, Santos O, Virgolino A, Santos RR, Heitor MJ, Costa A. Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach. BMC Public Health 2024; 24:2023. [PMID: 39075428 PMCID: PMC11285180 DOI: 10.1186/s12889-024-19563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. METHODS To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. RESULTS The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. CONCLUSIONS Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
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Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
| | - Pedro Candeias
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Júlia Neves
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Unbreakable Idea Research, Estrada Nacional 115, Sítio da Caniceira, nº 1, Casarão, Painho, 2550-426, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ricardo R Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Faculdade de Medicina, Universidade Católica Portuguesa, Lisboa, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
| | - Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
- Innovation and Development Centre of Lisbon (CIDNUR), Nursing Research, Nursing School of Lisbon, Lisbon, Portugal
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Zheng M, Kong D, Wu K, Li G, Zhang Y, Chen W, Hall BJ. The determinants of mental health inequalities between Chinese migrants and non-migrants during the Shanghai 2022 lockdown: a Blinder-Oaxaca decomposition. Int J Equity Health 2024; 23:136. [PMID: 38982412 PMCID: PMC11232248 DOI: 10.1186/s12939-024-02223-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The mental health inequality between migrants and non-migrants was exacerbated by the COVID-19 pandemic. Identifying key determinants of this inequality is essential in promoting health equity. METHODS This cross-sectional study recruited Shanghai residents by purposive sampling during the city-wide lockdown (from April 29 to June 1, 2022) using an online questionnaire. Migration statuses (non-migrants, permanent migrants, and temporary migrants) were identified by migration experience and by household registration in Shanghai. Mental health symptoms (depression, anxiety, loneliness, and problematic anger) were assessed by self-report scales. The nonlinear Blinder-Oaxaca decomposition was used to quantify mental health inequality (i.e., differences in predicted probabilities between migration groups) and the contribution of expected correlates (i.e., change in predicted probability associated with variation in the correlate divided by the group difference). RESULTS The study included 2738 participants (771 [28.2%] non-migrants; 389 [14.2%] permanent migrants; 1578 [57.6%] temporary migrants). We found inequalities in depression (7.1%) and problematic anger (7.8%) between permanent migrants and non-migrants, and inequalities in anxiety (7.3%) and loneliness (11.3%) between temporary migrants and non-migrants. When comparing permanent migrants and non-migrants, age and social capital explained 12.7% and 17.1% of the inequality in depression, and 13.3% and 21.4% of the inequality in problematic anger. Between temporary migrants and non-migrants, age and social capital also significantly contributed to anxiety inequality (23.0% and 18.2%) and loneliness inequality (26.5% and 16.3%), while monthly household income (20.4%) and loss of monthly household income (34.0%) contributed the most to anxiety inequality. CONCLUSIONS Significant inequalities in depression and problematic anger among permanent migrants and inequalities in anxiety and loneliness among temporary migrants were observed. Strengthening social capital and economic security can aid in public health emergency preparedness and promote mental health equity among migrant populations.
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Affiliation(s)
- Meng Zheng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Di Kong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Kunpeng Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Gen Li
- Center for Global Healthy Equity, NYU Shanghai, Shanghai, China
| | - Yi Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
- Center for Global Healthy Equity, NYU Shanghai, Shanghai, China.
| | - Brian J Hall
- Center for Global Healthy Equity, NYU Shanghai, Shanghai, China.
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Zlotnick C, Jabareen R, Madjar B, Hazoref RH, Gens I, Shachaf S. A country's efforts toward creating an advanced practice nurse in public health. Int Nurs Rev 2024; 71:396-406. [PMID: 38661535 DOI: 10.1111/inr.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
AIM The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. BACKGROUND No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. INTRODUCTION An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. METHODS This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). FINDINGS Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. DISCUSSION Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. CONCLUSIONS A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. IMPLICATION FOR NURSING POLICY Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.
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Affiliation(s)
| | | | | | - Rivka Hazan Hazoref
- Department for Licensing and Nursing Exams, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Ilana Gens
- Chief Nurse of Public Health Services, Ministry of Health, Jerusalem, Israel
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Koks-Leensen MC, Menko A, Raaijmakers F, Fransen-Kuppens GA, Bevelander KE. An Accessible Web-Based Survey to Monitor the Mental Health of People With Mild Intellectual Disability or Low Literacy Skills During the COVID-19 Pandemic: Comparative Data Analysis. JMIR Public Health Surveill 2024; 10:e44827. [PMID: 38607229 PMCID: PMC11176870 DOI: 10.2196/44827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/30/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related control measures affected the mental health of all populations. Particular subgroups are underrepresented in mainstream surveys because they are hard to reach, and study measurements are not adapted to their skills. These subgroups include people with lower cognitive and literacy skills, such as people with mild intellectual disability (MID), who were considered vulnerable during the COVID-19 pandemic given their low socioeconomic status, small social networks, increased risks of health problems, and difficulties understanding health-related information. OBJECTIVE This study examines the impact of the COVID-19 pandemic on mental health among people with MID or low literacy skills compared with those predominantly represented in national surveys. METHODS A repeated cross-sectional study of people with MID or low literacy skills and a general population sample was conducted in the Netherlands. An easy-read web-based survey was co-designed with, and tested among, people with MID or low literacy skills and conducted in 3 rounds within 1 year of the COVID-19 pandemic (T1: November to December 2020, T2: March to April 2021, and T3: September to October 2021). The survey contained questions about demographics and 6 aspects of mental health: feeling happy, feeling energized, feeling stressed, worry, feeling lonely, and sleeping problems. RESULTS Our adapted survey and recruitment procedure enabled 1059 persons with MID or low literacy skills to participate (T1: n=412, 38.9%; T2: n=351, 33.1%; and T3: n=296, 28%). They were significantly younger, had a lower level of education, and more often than not were born outside the Netherlands compared to the general population sample (P<.001). Approximately half of them (604/1059, 57.03%) received professional care. They displayed poorer mental health scores than the general population sample. The percentages of people with MID or low literacy skills who reported more negative feelings in T1 ranged from 20.6% (85/412) reporting feeling lonely often or almost always to 57.8% (238/412) reporting feeling happy almost never or sometimes. The general population sample's percentages were 5.4% (160/2930) and 32.2% (941/2918), respectively. Although scores improved over time in both populations, the disproportional effects remained. CONCLUSIONS General COVID-19-related restrictions for the entire Dutch population affected people with MID or low literacy skills more negatively than the general population. Our study underscores the relevance of including these subpopulations in public health research because they are often overlooked in regular health data. An accessible web-based survey particularly targeted at this population enabled us to do so, and we reached a group of respondents significantly different from regular survey participants. This survey's results provided insights into the health of people with MID or low literacy skills and gained knowledge to be used by care organizations and policy makers to reduce health disparities during a pandemic and in general.
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Affiliation(s)
- Monique Cj Koks-Leensen
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, Netherlands
| | - Anouk Menko
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
| | - Fieke Raaijmakers
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
- Safety and Health Region Gelderland-Midden, Arnhem, Netherlands
| | - Gerdine Aj Fransen-Kuppens
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
- Municipal Health Service Gelderland Zuid, Nijmegen, Netherlands
| | - Kirsten E Bevelander
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Academic Collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, Netherlands
- Academic Collaborative AMPHI - Integrated Health Policy, Nijmegen, Netherlands
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Markey K, Msowoya U, Burduladze N, Salsberg J, MacFarlane A, Dore L, Gilfoyle M. Antecedents and Consequences of Health Literacy among Refugees and Migrants during the First Two Years of COVID-19: A Scoping Review. Trop Med Infect Dis 2024; 9:116. [PMID: 38787049 PMCID: PMC11126087 DOI: 10.3390/tropicalmed9050116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/26/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Supporting refugee and migrant health has become a critical focus of healthcare policy. Developing and designing health literacy interventions that meet the needs of refugees and migrants is core to achieving this objective. This literature review sought to identify antecedents and consequences of health literacy among refugees and migrants during the first two years of the COVID-19 pandemic. We systematically searched nine electronic databases and numerous grey literature sources to identify studies published between December 2019 and March 2022. The antecedents (societal and environmental determinants, situational determinants, and personal determinants) and consequences of health literacy among refugees and migrants were mapped to a validated integrated health literacy model. Social and environmental determinants (n = 35) were the most reported antecedent influencing health literacy among refugees and migrants during the first two years of COVID-19. Language (n = 26) and culture (n = 16) were these determinants' most frequently reported aspects. Situational determinants (n = 24) and personal determinants (n = 26) were less frequently identified factors influencing health literacy among refugees and migrants. Literacy (n = 11) and socioeconomic status (n = 8) were the most frequently reported aspects of personal determinants. Media use (n = 9) and family and peer influence (n = 7) were the most cited situational determinants reported. Refugees and migrants with higher levels of health literacy were more likely to use healthcare services, resulting in better health outcomes. The findings of this review reveal personal and situational factors that impacted health literacy among refugees and migrants during COVID-19 that require attention. However, the inadequate adaptation of health literacy interventions for linguistic and cultural diversity was a greater problem. Attention to this well-known aspect of public health preparedness and tailoring health literacy interventions to the needs of refugees and migrants during pandemics and other public health emergencies are paramount.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery and Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Uchizi Msowoya
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Nino Burduladze
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Jon Salsberg
- School of Medicine and Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Anne MacFarlane
- School of Medicine and Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Liz Dore
- Glucksman Library, University of Limerick, V94 T9PX Limerick, Ireland
| | - Meghan Gilfoyle
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON M5S 1B2, Canada
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Duong TV, Nguyen MH, Lai CF, Chen SC, Dadaczynski K, Okan O, Lin CY. COVID-19-related fear, stress and depression in school principals: impacts of symptoms like COVID-19, information confusion, health-related activity limitations, working hours, sense of coherence and health literacy. Ann Med 2022; 54:2064-2077. [PMID: 35876321 PMCID: PMC9318216 DOI: 10.1080/07853890.2022.2101688] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND School principals have been reported to have a higher prevalence of burnout and psychological problems than their colleagues. During the pandemic, extra workload and pressure from unprecedented situations potentially cause fear, stress and depression. Therefore, we aimed to explore associated factors of stress, fear of COVID-19 (F-CoV-19S) and depressive symptoms among school principals. METHODS A cross-sectional online survey was conducted in Taiwan from 23 June to 16 July 2021. Data of 413 school principals were collected, including socio-demographic factors, COVID-19-related factors, work-related information, health status, sense of coherence (SoC), health literacy (HL), F-CoV-19S, stress and depression. Multiple linear and logistic regression models were utilized to explore associations. RESULTS School principals with symptoms like COVID-19 (S-COVID-19-S), or with health-related activity limitations had a higher score of stress (B = 0.92; p = .039) (B = 1.52; p < .001) and a higher depression likelihood (OR = 3.38; p < .001) (OR = 3.06; p < .001), whereas those with a better SoC had a lower stress score (B = -1.39; p < .001) and a lower depression likelihood (OR = 0.76; p = .020). School principals confusing about COVID-19-related information had a higher score of stress (B = 2.47; p < .001) and fear (B = 3.77; p < .001). The longer working time was associated with a higher fear score (B = 1.69; p = .006). Additionally, school principals with a higher HL score had a lower stress score (B = -1.76; p < .001), a lower fear score (B = -1.85; p < .001) and a lower depression likelihood (OR = 0.53; p = .043). CONCLUSIONS Health-related activity limitations, S-COVID-19-S, COVID-19-related information confusion and longer working hours were positively associated with at least one mental health problem (e.g. stress, fear and depression), whereas better SoC and HL showed the benefits to mitigate fear, stress and depressive symptoms in school principals. Our study provides evidence for appropriate strategies to improve principals' mental health during the pandemic.Key messages:School principals with health-related activity limitations or with symptoms like COVID-19 were more likely to be stressed and depressed.Higher levels of stress and fear were observed in school principals who confused about COVID-19-related information, and who had longer working time than before the pandemic.Better sense of coherence and higher health literacy could potentially mitigate the fear, stress and depressive symptoms in school principals.
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Affiliation(s)
- Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Minh H Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Feng Lai
- Department of Education, National Taichung University of Education, Taichung, Taiwan
| | - Sheng-Chih Chen
- Master's Program of Digital Content and Technologies, College of Communication, National Chengchi University, Taipei, Taiwan
| | - Kevin Dadaczynski
- Public Health Centre Fulda, Fulda University of Applied Sciences, Fulda, Germany.,Center for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
| | - Orkan Okan
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Cheng-Yu Lin
- Department of Radio, Television & Film, Shih Hsin University, Taipei, Taiwan
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Nguyen MH, Do TX, Nguyen TT, Pham MD, Pham TTM, Pham KM, Kim GB, Do BN, Nguyen HT, Nguyen NM, Dam HTB, Nguyen YH, Nguyen KT, Nguyen TTP, Nguyen TT, Duong TV. Fear of COVID-19, healthy eating behaviors, and health-related behavior changes as associated with anxiety and depression among medical students: An online survey. Front Nutr 2022; 9:938769. [PMID: 36211498 PMCID: PMC9538633 DOI: 10.3389/fnut.2022.938769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Medical students' health and wellbeing are highly concerned during the COVID-19 pandemic. This study examined the impacts of fear of COVID-19 (FCoV-19S), healthy eating behavior, and health-related behavior changes on anxiety and depression. Methods We conducted an online survey at 8 medical universities in Vietnam from 7th April to 31st May 2020. Data of 5,765 medical students were collected regarding demographic characteristics, FCoV-19S, health-related behaviors, healthy eating score (HES), anxiety, and depression. Logistic regression analyses were used to explore associations. Results A lower likelihood of anxiety and depression were found in students with a higher HES score (OR = 0.98; 95%CI = 0.96, 0.99; p = 0.042; OR = 0.98; 95%CI = 0.96, 0.99; p = 0.021), and in those unchanged or more physical activities during the pandemic (OR = 0.54; 95%CI = 0.44, 0.66; p < 0.001; OR = 0.44; 95%CI = 0.37, 0.52; p < 0.001) as compared to those with none/less physical activity, respectively. A higher likelihood of anxiety and depression were reported in students with a higher FCoV-19S score (OR = 1.09; 95%CI = 1.07, 1.12; p < 0.001; OR = 1.06; 95%CI = 1.04, 1.08; p < 0.001), and those smoked unchanged/more during the pandemic (OR = 6.67; 95%CI = 4.71, 9.43; p < 0.001; OR = 6.77; 95%CI = 4.89, 9.38; p < 0.001) as compared to those stopped/less smoke, respectively. In addition, male students had a lower likelihood of anxiety (OR = 0.79; 95%CI = 0.65, 0.98; p = 0.029) compared to female ones. Conclusions During the pandemic, FCoV-19S and cigarette smoking had adverse impacts on medical students' psychological health. Conversely, staying physically active and having healthy eating behaviors could potentially prevent medical students from anxiety and depressive symptoms.
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Affiliation(s)
- Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tinh X. Do
- Department of Psychiatry, Military Hospital 103, Hanoi, Vietnam
| | - Tham T. Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh D. Pham
- Department of Clinical Nutrition, Military Hospital 103, Hanoi, Vietnam
- Department of Nutrition, Vietnam Military Medical University, Hanoi, Vietnam
| | - Thu T. M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Khue M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
- President Office, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Giang B. Kim
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Center for Assessment and Quality Assurance, Hanoi Medical University, Hanoi, Vietnam
| | - Binh N. Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
- Division of Military Science, Military Hospital 103, Hanoi, Vietnam
| | - Hiep T. Nguyen
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
- Pham Ngoc Thach Clinic, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
- President Office, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Ngoc-Minh Nguyen
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Hoa T. B. Dam
- Department of Psychiatry, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Yen H. Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Department of Pharmacy, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Kien T. Nguyen
- President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Thao T. P. Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Trung T. Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Tuyen Van Duong
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Zhang TH, Tham JS, Waheed M, Kim JN, Jeong JS, Chang PK, Ahmad AM. Pathway linking health information behaviors to mental health condition during the COVID-19 infodemic: A moderated mediation analysis. Front Public Health 2022; 10:924331. [PMID: 36106161 PMCID: PMC9464915 DOI: 10.3389/fpubh.2022.924331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Background The COVID-19 outbreak is no longer a pure epidemiological concern but a true digital infodemic. Numerous conflicting information and misinformation occupy online platforms and specifically social media. While we have lived in an infodemic environment for more than 2 years, we are more prone to feel overwhelmed by the information and suffer from long-term mental health problems. However, limited research has concentrated on the cause of these threats, particularly in terms of information processing and the context of infodemic. Objective This study proposed and tested moderated mediation pathways from two types of health information behaviors (social media engagement and interpersonal communication) on information overload and mental health symptoms-long-term stress. Methods We conducted a cross-sectional online survey between May and June of 2021 among the Malaysian public. The final sample size was 676 (N = 676). A conceptual model was built to guide the data analysis. We conducted structural equation modeling (SEM), moderation and mediation analyses to examine each direct pathway, moderating and mediating effects. Results According to the pathway analysis, we found that, during the infodemic period, engaging COVID-19 information on social media positively associated with information overload, but interpersonal communication was negatively related to it. As the proximal outcome, there was also a positive association between information overload and the final outcome, perceived stress. The moderation analysis only reported one significant interaction: risk perception weakened the association between social media engagement and information overload. A conditional indirect effect was demonstrated and the indirect associated between social media engagement and perceived stress mediated through information overload was further moderated by COVID-19 risk perception. Conclusion This research offers new grounds for understanding health information behaviors and their consequences in the COVID-19 infodemic. We particularly highlighted the distinct functions of health information behaviors in causing information overload, as well as the importance of personal health belief in this process. Our proposed model contributes to the strategies of developing health messaging strategies that may be utilized by public health researchers and health educators in the future.
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Affiliation(s)
- Thomas Hongjie Zhang
- Department of Communication, Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
| | - Jen Sern Tham
- Department of Communication, Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia,*Correspondence: Jen Sern Tham
| | - Moniza Waheed
- Department of Communication, Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
| | - Jeong-Nam Kim
- Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, OK, United States
| | - Jae-Seon Jeong
- Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Peng Kee Chang
- School of Media and Communication, Taylor's University, Subang Jaya, Malaysia
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Dryjanska L, Zlotnick C, Suckerman S. Agency of English-Speaking Migrant Women during the Pandemic in Israel. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2021. [DOI: 10.1080/10720537.2021.2016523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Laura Dryjanska
- Rosemead School of Psychology, Biola University, La Mirada, CA, USA
| | - Cheryl Zlotnick
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
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Hiltrop K, Hiebel N, Geiser F, Kriegsmann-Rabe M, Gambashidze N, Morawa E, Erim Y, Weidner K, Albus C, Ernstmann N. Measuring COVID-19 Related Health Literacy in Healthcare Professionals-Psychometric Evaluation of the HL-COV-HP Instrument. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211959. [PMID: 34831720 PMCID: PMC8624823 DOI: 10.3390/ijerph182211959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Thus far, there is no instrument available measuring COVID-19 related health literacy of healthcare professionals. Therefore, the aim of this study was to develop an instrument assessing COVID-19 related health literacy in healthcare professionals (HL-COV-HP) and evaluate its psychometric properties. METHODS An exploratory factor analysis, a confirmatory factor analysis, and descriptive analyses were conducted using data from n = 965 healthcare professionals. Health literacy related to COVID-19 was measured with 12 items, which were adapted from the validated HLS-EU-Q16 instrument measuring general health literacy. RESULTS Exploratory factor analysis demonstrated that 12 items loaded on one component. After removing one item due to its high standardized residual covariance, the confirmatory factor analysis of a one-factor model with 11 items showed satisfactory model fit (χ2 = 199.340, df = 41, χ2/df = 4.862, p < 0.001, RMSEA = 0.063, CFI = 0.963 and TLI = 0.951). The HL-COV-HP instrument showed good internal consistency (Cronbach's alpha 0.87) and acceptable construct reliability. CONCLUSIONS The HL-COV-HP is a reliable, valid, and feasible instrument to assess the COVID-19 related health literacy in healthcare professionals. It can be used in hospitals or other healt hcare settings to assess the motivation and ability of healthcare professionals to find, understand, evaluate, and use COVID-19 information.
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Affiliation(s)
- Kati Hiltrop
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany;
- Correspondence: ; Tel.: +49-228-287-11803
| | - Nina Hiebel
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Franziska Geiser
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Milena Kriegsmann-Rabe
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany; (N.H.); (F.G.); (M.K.-R.)
| | - Nikoloz Gambashidze
- Institute for Patient Safety, University Hospital Bonn, 53127 Bonn, Germany;
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (E.M.); (Y.E.)
| | - Kerstin Weidner
- Department for Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany;
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital Cologne, 50931 Cologne, Germany;
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany;
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Solà-Sales S, Pérez-González N, Van Hoey J, Iborra-Marmolejo I, Beneyto-Arrojo MJ, Moret-Tatay C. The Role of Resilience for Migrants and Refugees' Mental Health in Times of COVID-19. Healthcare (Basel) 2021; 9:1131. [PMID: 34574904 PMCID: PMC8470365 DOI: 10.3390/healthcare9091131] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 01/02/2023] Open
Abstract
Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the nature of resilience was examined as a mixed component though life experiences. For this proposal, an interview was carried out in a sample of 245 participants who volunteered to participate in the study. The sample was divided into Spanish non-migrants, Spanish migrants, non-Spanish migrants and refugees. Attitudes towards COVID-19, resilience (based on BRCS) and mental health (based on DASS-21) were measured. The results obtained can be described as follows: (i) Migrant participants indicated worse mental health than non-migrants, and within the migrant group, refugees presented worse scores; (ii) No differences were found in attitudes towards COVID-19 in any of the subgroups; (iii) A moderating effect of group was found for the relationship between resilience and mental health but not between resilience and fear of COVID-19. These results might be of great interest in making visible the vulnerability of migrants and specifically refugees, and the proposal of intervention programs based on resilience training.
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Affiliation(s)
- Sara Solà-Sales
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
| | - Natalia Pérez-González
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
| | - Julie Van Hoey
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
| | - Isabel Iborra-Marmolejo
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
| | - María José Beneyto-Arrojo
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
| | - Carmen Moret-Tatay
- Mind, Emotion and Behavioural Research Laboratory (MEB Lab), Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Valencia, Spain; (S.S.-S.); (N.P.-G.); (J.V.H.); (I.I.-M.); (M.J.B.-A.)
- Dipartamento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Faculty of Medicine and Psycology, Università Sapienza di Rome, 00187 Rome, Italy
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