Individual, social and national coping resources and their relationships with mental health and anxiety: A comparative study in Israel, Italy, Spain, and the Netherlands during the Coronavirus pandemic

The sense of coherence scale: psychometric properties in a representative sample of the Czech adult population

BACKGROUND

Sense of coherence (SOC) is a personal resource that reflects the extent to which one perceives the world as comprehensible, manageable, and meaningful. Decades of empirical research consistently show that SOC is an important protective resource for health and well-being. Despite the extensive use of the 13-item measure of SOC, there remains uncertainty regarding its factorial structure. Additionally, a valid and reliable Czech version of the scale is lacking. Therefore, the present study aims to examine the psychometric properties of the SOC-13 scale in a representative sample of Czech adults.

METHODS

An online survey was completed by 498 Czech adults (18-86 years old) between November 2021 and December 2021. We used confirmatory factor analysis to examine the factorial structure of the scale. Further, we examined the variations in SOC based on age and gender, and we tested the criterion validity of the scale using the short form of the Mental Health Continuum (MHC) scale and the Generalized Anxiety Disorder (GAD) scale as mental health outcomes.

RESULTS

SOC-13 showed an acceptable one- and three-factor fit only with specified residual covariance between items 2 and 3. We tested alternative short versions by systematically removing poorly performing items. The fit significantly improved for all shorter versions with SOC-9 having the best psychometric properties with a clear one-factorialstructure. We found that SOC increases with age and males score higher than females. SOC showed a moderately strong positive correlation with MHC, and a moderately strong negative correlation with GAD. These findings were similar for all tested versions supporting the criterion validity of the SOC scale.

CONCLUSION

Our findings suggest that shortened versions of the SOC-13 scale have better psychometric properties than the original 13-item version in the Czech adult population. Particularly, SOC-9 emerges as a viable alternative, showing comparable reliability and validity as the 13-item version and a clear one-factorial structure in our sample.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Fear of Cancer and State Anxiety Among Women Undergoing Hysterectomy: A Cross-sectional Study

BACKGROUND

Fear of cancer may develop after surgery in women who underwent surgery for suspected malignancy in preoperative examinations. It is important from a psychosocial point of view that the fear of cancer and the factors affecting anxiety are determined and necessary interventions are made.

OBJECTIVES

The aim of this study was to determine the level of state anxiety, fear of cancer, and influencing factors in women who had hysterectomies with a risk of cancer in the waiting period for the pathology result.

METHODS

The research data were collected from 109 women who underwent hysterectomy while waiting for the pathology result on the third or fourth postoperative day. Patients completed the Personal Information Form, State-Trait Anxiety Inventory-I, and Cancer Worry Scale.

RESULTS

Women who underwent hysterectomy with the risk of gynecological cancer had high levels of state anxiety and cancer fear after hysterectomy; type of hysterectomy significantly affected cancer fear (P = .022), and social support (P = .015), type of hysterectomy (P = .024), and family history of cancer (P = .022) significantly affected state anxiety.

CONCLUSION

The management of these women's concerns can be improved if healthcare professionals know more about the factors affecting their state anxiety and fear.

IMPLICATIONS FOR PRACTICE

Health professionals witness patients' most private experiences and play a key role in providing care and support. This study may be foundational in the planning and implementation of nursing interventions to manage causes of anxiety and fear during this waiting period.

Association between coping resources and mental health during the COVID-19 pandemic: a cross-sectional study in the Czech Republic

The COVID-19 pandemic has caused detrimental global consequences for public health, health-care systems, economies, and society in general. The Czech Republic was one of the most affected countries in the world regarding daily cases increases during the first waves of the pandemic. The present study investigates the association between coping resources, mental health and anxiety. We collected data (N = 476) via an online survey. A multiple regression analysis was performed to investigate the predictors of mental health and anxiety. Mental health was significantly predicted by SOC, SONC, social support and trust in institutions. Anxiety was significantly predicted only by SOC and SONC. The study provides support for the salutogenic model of health and adds to the evidence that sense of coherence, that is, one's ability to view life as comprehensible, manageable, and meaningful, is the most important coping resource in light of a major event, such as the COVID-19 pandemic.

We only know that we don't know: attachment patterns and psychological coping during the COVID-19 pandemic - the mediation role of intolerance of uncertainty

The global outbreak of the COVID-19 pandemic created sudden changes in many areas of daily life and increased uncertainty about the future. Two studies examined the association between attachment patterns and mental well-being during the pandemic, the mediating role of intolerance of uncertainty (IOU), and factors related to social relationships and self-perceptions. The results of the first study, conducted at the outbreak of the pandemic, indicated that individuals with high levels of attachment anxiety experienced more negative emotions and fewer positive emotions at that time, and that IOU and perceived social support mediated these associations. The results of the second study, conducted several months into the pandemic, indicated an association between attachment anxiety and avoidance, and perceived stress during the time of the pandemic. Results of Study 2 also indicated that IOU mediated the association between attachment anxiety and stress, and that sense of coherence (SOC) mediated the association between attachment anxiety and avoidance, and stress. These findings underscore the adverse psychological effects of uncertain situations, especially for individuals with a fragile foundation of interpersonal support, thus emphasizing the need for action to reduce uncertainty, especially in times of emergency.

Sense of coherence and social support as predictors of mental health during COVID-19 pandemic

OBJECTIVES

to verify the role of sense of coherence, sense of national coherence, social support and trust in institutions to predict mental health in Brazilians during the COVID-19 pandemic.

METHODS

a cross-sectional study, carried out from November, 2020 to January, 2021 via an online survey. Standardized instruments were used. The sample consisted of 1,630 Brazilians. Pearson's correlation and linear regression were performed in data analysis.

RESULTS

sense of coherence was the only predictor of anxiety [β= -0.61; p<0.001], explaining 38% of the variance in its scores, while sense of coherence [β= 0.52; p<0.001], sense of national coherence [β= 0.16; p<0.001], and social support [β= 0.15; p<0.001] predicted positive mental health and together explained 51% of its variance.

CONCLUSIONS

the findings suggest that sense of coherence, sense of national coherence and social support represent important predictors for mental health and that strengthening these resources, could potentially promote Brazilians' mental health.

How does social support relate to emotional availability for learning during COVID-19? A multi-group structural equation model of university students from the U.S. and Israel

Given the social and emotional tolls of the COVID-19 pandemic on college and university students, many students have become academically disengaged during the pandemic. Although some colleges and universities have the capacity to promote social support for their students, research has yet to comprehensively demonstrate the relationship between social support and academic engagement. To fill this gap, we leverage survey results from four universities across the United States and Israel. Through multi-group structural equation modelling, we explore (a) how perceived social support relates to being emotionally unavailable for learning, (b) how this relationship is partially explained through coping and COVID-19 concerns, and (c) how these relationships can differ across countries. We find that students who perceived higher levels of social support had lower rates of being emotionally unavailable for learning. Part of this relationship occurred through greater rates of coping and, subsequently, fewer concerns about the pandemic. We also noticed significant differences in these relationships between countries. We conclude with a discussion of study implications for higher education policies and practices.

Exploring experiences with stressors and coping resources among Dutch socioeconomic groups during the COVID-19 pandemic

The COVID-19 crisis impacts populations globally. This impact seems to differ for groups with low- and high-socioeconomic status (SES). We conducted a qualitative study in the Netherlands using a salutogenic perspective to examine experiences with stressors and coping resources during the pandemic among both SES groups to gain insight on how to promote the health and well-being of these groups. We conducted 10 focus group discussions and 20 interviews to explore the experiences, including resources and stressors, of respondents from low- (N = 37) and high-SES (N = 38) groups (25-55 years, Dutch speaking). We analyzed the findings at individual, community, and national levels. The results show that coping depends on government-imposed measures and the way individuals handle these measures; restriction to the home context with positive and negative consequences for work and leisure; psychological negative consequences and resourcefulness; and social effects related to unity (e.g. social cohesion or support) and division (including polarization). Respondents with lower SES expressed more problems with COVID-19 measures and experienced more social impact in their neighborhood than those with higher SES. Where low-SES groups especially mentioned the effects of staying at home on family life, high-SES groups mentioned effects on work life. At last, psychological consequences seem to differ somewhat across SES groups. Recommendations include consistent government-imposed measures and government communication, support for home schooling children, and strengthening the social fabric of neighborhoods.

The Role of Sense of Coherence During the COVID-19 Crisis: Does it Exercise a Moderating or a Mediating Effect on University Students' Wellbeing?

The COVID-19 crisis caused extensive mental health strains. Sense of coherence (SOC) is considered a protective factor for mental health in crisis that might also be decisive during the COVID-19 pandemic, but the mechanisms are not yet well understood. Using longitudinal survey data of 117 Austrian university students collected in 2020, we tested both moderating and mediating effects of SOC for the association of different stressors with later wellbeing. SOC did not buffer but mediated the effects of stressors on wellbeing. Students especially suffered from reduced feelings of manageability when confronted with financial strains, dissatisfying study situations, or disrupted plans. Supporting them in managing the difficulties of the crisis should therefore be considered a crucial part of psychosocial support.

Positive mental health in Slovenia before and during the COVID-19 pandemic

Background

Mental health has been heavily affected during the COVID-19 pandemic. In this study we compared the prevalence of flourishing and languishing mental health during the pandemic and examined which factors are associated with either category of positive mental health respectively.

Methods

Data from two cross-sectional surveys with nationally representative samples of adult population in Slovenia conducted in 2019 (n = 9,047) and in 2021 (n = 3,429) are used. Positive mental health was measured with Mental Health Continuum-Short Form instrument. Logistic regression was used to examine the associations between flourishing and languishing mental health and relevant COVID-19 specific and other health-related factors.

Results

There was a substantial decrease in the prevalence of flourishing and an increase in the prevalence of languishing mental health during the pandemic. Distribution of both flourishing and languishing mental health followed the socio-economic gradient. Resilience, COVID-19 literacy and changes in family relations, social interactions, and dietary habits were associated with both flourishing and languishing mental health.

Conclusion

Positive mental health of the population worsened during the pandemic, more so in traditionally disadvantaged populations. Public health efforts need to be focused appropriately with an increased emphasis on strengthening resilience and health literacy.

Stress appraisal as a mediator between the sense of coherence and the frequency of stress coping strategies in women and men during COVID-19 lockdown

The COVID-19 lockdown experience is a unique and unexpected stressful life situation. In our research project, we explored gender differences in the mean level of stress appraisal (SAQ), the frequency of stress coping strategies (COPE), and the sense of coherence (SOC), as well as gender differences in the strength of the relationships between SAQ, COPE, and SOC during the COVID-19 lockdown. Finally, we tested if stressor appraisal (as a threat, harm/loss, or challenge) mediates the relationship between SOC and COPE in women and men respectively. Data were collected during the first wave of the COVID-19 lockdown in Poland in 2020. An online survey was conducted among 326 adults aged between 18 and 72. We observed gender differences in the level of SAQ, COPE, and SOC and gender differences in the significance and strength of the correlations between these variables. SOC had a twofold effect on COPE in men: direct and indirect through SOC-threat and SOC-harm/loss. In women, SOC did not directly predict COPE frequency but affected COPE in an indirect way through SAQ. SAQ is an important factor that modifies the strength of the SOC effect on COPE in women and men during the lockdown.

Small business managers and Covid-19-The role of a sense of coherence and general resistance resources in coping with stressors

BACKGROUND

The response of small business managers to an external event such as the pandemic can have a profound effect on the work environment, health and well-being for themselves and their employees. Previous research on small business managers during the pandemic has mainly focused on traditional pathogenic effects, and there is a lack of studies looking at the issue from a salutogenic health promotion perspective. The aim of this study is to explore whether a sense of coherence and general resistance resources were experienced by small business managers in Sweden and Norway during the Covid-19 pandemic.

METHODS

A qualitative design was applied through exploratory interviews with 16 managers of small businesses in Sweden and Norway. A content analysis of the interviews was conducted using the sense of coherence concept by Aaron Antonovsky, with the three main components of comprehensibility, meaningfulness and manageability acting as a conceptual framework for the analysis process.

RESULTS

Within the three main sense-of-coherence categories, six general resistance resources were identified as being important for the managers to handle uncertainty during the pandemic. These were understanding rules and regulations, social support, optimism, proactivity, problem-solving and flexibility and cooperation.

CONCLUSIONS

The small business managers handled the pandemic in a way that worked well in their contexts, and the pandemic generally did not have a negative effect on their businesses or themselves. A salutogenic approach, through which the managers focused on identifying and using resources, was an important factor for managing stressors and adversity during the pandemic. Hence, the concept of salutogenesis may be used as an intervention to foster better health in small businesses, both at a personal and organisational level in order to handle future challenges effectively.

Filial Piety and Mental Health Among Older Chinese Immigrants in the Netherlands

Filial piety is important to Chinese adults and is associated with mental health among older Chinese immigrants in the United States. However, it is unclear whether filial piety is linked to the mental health of Chinese immigrants in European countries. Therefore, this study aims to gain insights into the association between mental health and filial piety of first-generation Chinese immigrants in the Netherlands. A random sample of 143 participants took part in the study. A cross-sectional design was used. Data were collected through a postal survey conducted in the Chinese language between January 2021 and March 2021. The survey included a Mental Health Continuum-Short Form (MHC), and expected and perceived filial piety scale. The results indicated that in general, perceived filial piety exceeded expected filial piety (‘filial piety sufficient’). Regression analysis revealed that ‘filial piety sufficient’ is associated with a higher emotional MHC (B =.498, p =.035). This study provided new insights into the wellbeing of older Chinese immigrants in the Netherlands and showed accordance with the literature that filial piety remains an important factor for mental health.

Salutogenesis and COVID-19 pandemic impacting nursing education across SEANERN affiliated universities: A multi-national study

BACKGROUND

The COVID-19 pandemic has disrupted the lives of many. Particularly, nursing students experience greater stress as their normal curriculum is interrupted and some of them face the risk of being infected as frontline workers. Nursing faculty members may face similar struggles, in addition to developing teaching materials for online learning. Thus, it is important to examine the faculty members' and students' views on their ability to adapt during the pandemic to obtain a holistic view of how learning and training has been affected.

DESIGN

The descriptive cross-sectional quantitative design was used.

SETTINGS

Data were collected from Southeast and East Asian Nursing Education and Research Network (SEANERN) affiliated nursing institutions from January 2021 to August 2021.

PARTICIPANTS

A total of 1897 nursing students and 395 faculty members from SEANERN-affiliated nursing institutions in Cambodia, Hong Kong, Indonesia, Japan, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam were recruited for this study.

METHODS

Quantitative surveys were used to explore the satisfaction levels in education modalities, confidence levels, psychosocial well-being, sense of coherence and stress levels of nursing students and faculty members during the COVID-19 pandemic.

RESULTS

Participants were mostly satisfied with the new education modalities, although most students felt that their education was compromised. Both groups showed positive levels of psychosocial well-being, despite scoring low to medium on the sense of coherence scale and experiencing great stress. The participants' sense of coherence was positively correlated with their psychosocial well-being and negatively correlated with stress levels.

CONCLUSIONS

While the COVID-19 pandemic had negatively impacted the lives of nursing students and faculty members, most of them had a healthy level of psychosocial well-being. Having a strong sense of coherence was associated with better psychosocial health and lower stress levels. As such, it may be helpful to develop interventions aimed at improving the sense of coherence of nursing students and staff to help them manage stressors better.

How Do People Cope During the COVID-19 Pandemic and Stay Well? A Salutogenic Longitudinal Study in Israel

Employing the salutogenic approach, this longitudinal study explored the effects of coping with the COVID-19 pandemic in Israel, as it evolved from an acute to a chronic stress situation, during the first year. We examined the role of individual [sense of coherence (SOC)], social (perceived social support), and national [sense of national coherence (SONC)] coping resources, as well as situational and demographic factors, in predicting mental health and anxiety. Data was collected in five phases between March 2020 and February 2021 via a repeated panel sample and included 198 Jewish Israelis (52% males) age 18-64 (M = 43.5). The results confirmed the expected pattern of moving from acute to chronic stressful situation: levels of general anxiety were higher in the first phase of the pandemic outbreak as compared to the other phases. Levels of social and national coping resources significantly decreased over time. However, as expected, the salutogenic resource of the individual sense of coherence remained stable and was also found as the main predictor of both anxiety and mental health in the 5 phases of the study. Beyond the explanatory factor of SOC, mental health was better explained by the social and national coping resources, while anxiety was explained by situational factors (level of financial risk and gender). The discussion delineates the longitudinal effects of individual, social, and national coping resources on mental health and anxiety during the dynamic process of the long period of 1 year of the pandemic, evolving from acute to chronic phases of the complicated health, economic, social, and political crisis.

Living in opposition: How women in the United States cope in spite of mistrust of federal leadership during the pandemic of Covid-19

International research collaborators conducted research investigating sociocultural responses to the Covid-19 pandemic. Our mixed methods research design includes surveys and interviews conducted between March and September of 2020 including 249 of 506 survey responses and 18 of 50 in-depth, exploratory, semi-structured interviews with self-defined politically left-leaning women in the United States. We employ a sequential design to analyze statistical and qualitative data. Despite international data suggesting that trust in federal governments reduces anxiety, women who did not trust and actively opposed the Trump administration reported lower levels of anxiety than expected. Results indicate reliance on and development of new forms of connection that seem to mitigate symptomatic anxieties when living in opposition. Women living in opposition to the leadership of the federal government use and develop resources to help them cope. Research on coping strategies and mental health and anxiety during crisis can inform recommendations for ways to support and strengthen sense of coherence during tumultuous times.

Social Isolation During COVID-19 Pandemic. Perceived Stress and Containment Measures Compliance Among Polish and Italian Residents

BACKGROUND

In this study, we analyze the association of social isolation in the first phase of the pandemic with perceived stress among residents of Poland and Italy with a look at how these populations adjust to and comply with implemented regulations, guidelines, and restrictions.

MATERIALS AND METHODS

Internet survey with Perceived Stress Scale (PSS-10) and questions regarding mobility patterns, attitude, and propensity to adjust toward the implemented measures and current health condition was made among Polish and Italian residents (Cronbach's alpha 0.86 and 0.79, respectively). The sample size was 7,108 (6,169 completed questionnaires in Poland and 939 in Italy).

RESULTS

The Polish group had a higher stress level than the Italian group (mean PSS-10 total score 22,14 vs 17,01, respectively; p < 0.01). There was a greater prevalence of chronic diseases among Polish respondents. Italian subjects expressed more concern about their health, as well as about their future employment. Italian subjects did not comply with suggested restrictions as much as Polish subjects and were less eager to restrain from their usual activities (social, physical, and religious), which were more often perceived as "most needed matters" in Italian than in Polish residents.

CONCLUSION

Higher activity level was found to be correlated with lower perceived stress, but the causality is unclear. Difference in adherence to restrictions between Polish and Italian residents suggests that introducing similar lockdown policies worldwide may not be as beneficial as expected. However, due to the applied method of convenience sampling and uneven study groups, one should be careful with generalizing these results.