Prevalence and risk factors of depression symptoms among Chinese seafarers during the COVID-19 pandemic: a cross-sectional study

Factors Impacting Seafarers' Mental Health and Career Intentions

The main objective of the present study was to investigate factors related to seafarers' mental health. A sample of seafarers from 12 countries participated in the study. A list of stressors was used to assess both perception of exposure to these stressors and their subjective significance. The Symptom Checklist (SCL-90) was used to assess seafarers' mental health on 5 of 9 subscales: Depression, Anxiety, Hostility, Interpersonal Sensitivity, and Somatisation. Three significant findings emerged from the analyses. The first was that 3 types of stressors contribute significantly to mental health problems: (1) environmental factors (eg, vibration), (2) social problems (eg, bullying, homesickness, working alone), and (3) health problems (eg, physical injuries, viruses, and the illnesses). The second finding was that both stress and mental health issues determine seafarers' motivation for their work and their consideration regarding leaving the maritime industry. The third finding was that factors contributing to seafarers' consideration of leaving the industry were mainly related to social stressors such as isolation from family and friends, cultural differences at work, demands from supervisors, and bullying. Factors such as bad weather, working shifts, length of employment contract or a ban on disembarkment in ports were found to be relatively less important for seafarers as factors toward considering leaving the industry. The implications of these findings are discussed.

Depressive symptoms among Thai male seafarers during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Prevalence of depressive symptoms among seafarers is higher than the general population because of their unique work conditions. Factors that can be changed must be considered and promptly addressed in order to decrease the prevalence of depression. This study aims to clarify the prevalence of depressive symptoms and its related factors among Thai seafarers in an effort to contribute to policies and to prevent depression among Thai seafarers.

METHODS

This cross-sectional study was conducted among 381 male seafarers working onboard ocean-going vessels of five Thai shipping companies. The questionnaire items comprised of personal factors, working factors and depressive symptoms. Depressive symptoms were assessed using the Thai version of the Patient Health Questionnaire-9. First, the chi-square test was used for univariate analysis. Then, variables significantly associated by the chi-square test were used for multivariate logistic regression analysis (employing the stepwise method) as independent variables.

RESULTS

The average age of participants in this study was 36.4 years. Prevalence of depressive symptoms was 19.5%. One half of the participants (58.3%) reported subjective sleep problems, and most (75.1%) experienced poor coping behaviors. Two thirds (67.5%) were officers, and 10.1% of participants reported that they sometimes or never performed occupational safety behaviors. Regarding work environments, 62.2% reported that their work was disturbed from performing repetitive tasks. Multivariate logistic regression analysis showed two personal factors; sleep problems (Adjusted Odds Ratio (AOR) = 7.97, 95% Confidence interval (CI) = 3.52-18.05) and poor coping behaviors (AOR = 4.46, 95%CI = 1.61-12.34), and three working factors; job assignment (AOR = 2.50, 95%CI = 1.33-4.70), inadequate occupational safety behaviors (AOR = 4.51, 95%CI = 1.85-11.01) and performing repetitive task (AOR = 2.27, 95%CI = 1.16-4.45), were significantly associated with depression.

CONCLUSION

During COVID-19 pandemic, 19.5% of Thai male seafarers had depressive symptoms. Personal and working factors including subjective sleep problems, poor coping behaviors, job assignment, performing inadequate occupational safety behaviors and performing repetitive tasks were risk factors of depressive symptoms among Thai male seafarers. Monitoring work environment rigorously and coping with work-related stress of the occupational safety behaviors program should be suggested.

The positive effect of mother-performed infant massage on infantile eczema and maternal mental state: A randomized controlled trial

Objective

To observe the influence of MPIM on infantile eczema, quality of life, growth and maternal mental state.

Methods

This trial was a randomized controlled study. Sixty-six full-term infants with eczema were randomly divided into eczema control group (EC group, n = 33) and eczema with MPIM group (EM group, n = 33), along with healthy full-term infants in the healthy control group (HC group, n = 31). The mothers in the EC group received the instruction of routine care, while the mothers in the EM group applied massage on the infants plus receiving the same instruction of the routine care. HC group received none of any specific intervention. Data were collected in the three groups at the baseline and at the end of 2- and 5-month intervention. Before and at the end of 2-month intervention, the following indexes were investigated in infants including the growth indexes, eczema area severity index (EASI), infantile dermatitis quality of life index (IDQOL). And the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were investigated in mothers at the same timepoints. At the end of 5-month intervention, the infants' growth and relapse condition of eczema were observed.

Results

Overall, 31 cases in HC group, 31 in EC group and 32 in EM group were included for data analysis. There were no significant differences in the indexes of infantile growth among the three groups (all P >0.05). The scores of EASI and IDQOL significantly lowered (both P < 0.001) in EC group following the instruction of routine care, along with reduced maternal scores of SAS and SDS (both P < 0.05). Compared with the EC group, the EM group showed significantly lower scores of EASI and IDQOL (both P < 0.001) and lower relapse rate (P < 0.01) in infants with eczema, along with significantly lower scores of SAS and SDS in mothers (both P < 0.01). Moreover, none of obvious adverse reaction was reported following MPIM, to which most of the mothers could adhere.

Conclusion

MPIM could effectively promote the remission of infantile eczema and reduce its relapse, along with relieving maternal anxiety and depression mood.

Clinical trial registration

Identifier: ChiCTR2200066246.

A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic

Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.

Workplace Determinants of Depression, Anxiety, and Stress in U.S. Mariners during the COVID-19 Pandemic

United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward.

The impact of the COVID-19 pandemic on seafarers' mental health and chronic fatigue: Beneficial effects of onboard peer support, external support and Internet access

While commercial shipping remained vital for maintaining global supply chains during the COVID-19 pandemic, measures imposed to control the spread of infection have disrupted crew changes and impacted interactions with port personnel and among crew members on board. Initial reports indicate that this affected work and life on board, the length of seafarers' time on board as well as seafarers' employment and family concerns. However, the consequences for seafarers' well-being are not well understood. The purpose of this study was to examine the effects of the COVID-19 pandemic on seafarers' mental health and chronic fatigue, and to analyze the role of potential mitigating factors, notably onboard peer support, external support and Internet quality. Survey responses from 622 seafarers on international commercial vessels were analyzed using structural equation modeling. Findings suggested that the impact of the pandemic increased seafarers' fatigue and mental health problems. However, they also indicated ways of mitigating the negative impact of the pandemic and increasing resilience by enhancing support from fellow crew members on board, ensuring the availability of external support and providing fast and reliable Internet access.

Effects of the COVID-19 pandemic on the mental health of seafarers: A comparison using matched samples

The COVID-19 pandemic and the measures implemented to curb its transmission have altered workplaces and challenged occupational health and safety in unprecedented ways, with high levels of mental distress reported across several industries. In the maritime industry, occupational health and safety risks, including psychosocial risks, were a concern already before the COVID-19 pandemic. However, knowledge about the prevalence of mental health problems and the factors associated with them is still limited. The purpose of this study was to investigate the impact of the COVID-19 pandemic as well as the effects of respondent and work-related characteristics on seafarers' self-reported symptoms of depression and anxiety. Data came from two cross-sectional convenience samples of seafarers on international commercial vessels, surveyed before (N_pre-pandemic = 793) and during the pandemic (N_pandemic = 504). Matching the two samples on respondent and work-related characteristics using propensity scores, we found that the pandemic contributed to significantly higher levels of depression and anxiety. Further analyses showed that seafarers with longer work periods, those who had been on board longer than expected, and those working on vessels registered with "Flags of Convenience" reported significantly higher levels of both depression and anxiety during the pandemic, but not prior to the pandemic. Taken together, these findings suggest that the impact of the COVID-19 pandemic led to a deterioration of working conditions and increased mental health risks for seafarers. Practical implications for safe-guarding occupational health and safety during this and future crises are discussed.

A Quantitative Study on the Mental Health of Turkish Seafarers

AbstractPhysically and mentally healthy seafarers with professional knowledge and skills are needed for maritime transportation to be safe and sustainable. Mental problems experienced by seafarers can lead to negative consequences, such as bullying, substance dependency, assault, murder, and suicide. Accordingly, this study examined the differences between the socio-demographic characteristics of Turkish seafarers on their depression, which is an important criterion for determining mental disorders. Data collected from 403 participants through quantitative research methods were analyzed by using Statistical Package for the Social Sciences (SPSS) version 25.0 and Analysis of Moment Structure (AMOS) version 23.0 software. Although periodic physical and mental health checks are performed on seafarers, it was found from the analysis results that 33.2% of Turkish seafarers experience mental issues. Moreover, the study determined that the socio-demographic characteristics of seafarers made some differences in their depression levels.

Mental health and wellbeing of seafaring personnel during COVID-19: Scoping review

OBJECTIVES

We aimed to synthesize published literature on seafarers' mental health and wellbeing during the COVID-19 pandemic.

METHODS

This scoping review searched four electronic databases for literature on the mental health and wellbeing of seafarers during the COVID-19 pandemic.

RESULTS

Fourteen studies were included in the review. Few reported on the prevalence of mental health conditions. Only one compared mental health data gathered during the pandemic to pre-pandemic matched samples, suggesting symptoms of depression and anxiety were greater during the pandemic. There was some evidence that mental health worsened with longer stays on board during the pandemic and being on board longer than expected. Crew exchange difficulties forced many participants to extend their contracts or delay repatriation, often with little information as to when they might get to go home, leading them to feel they had no control over their lives and causing concern about fatigue and the potential for accidents and injuries. Participants described other challenges such as denial of shore leave; concerns about finances and future employment; loneliness and isolation; fears of COVID-19 infection; limited access to essential supplies; and feeling unsupported by management.

CONCLUSIONS

Maritime organizations must understand how best to support their staff in the aftermath of the COVID-19 pandemic and in any other prolonged crises that may arise in the future. Recommendations include ensuring that staff feel valued by their organization; enhancing work-related autonomy; ensuring that communication is accurate, consistent, and timely; and using lessons learned from the COVID-19 pandemic to inform emergency preparedness policies.