COVID-19 Pandemic and Stress: Coping with the New Normal

Teaching gender medicine can enhance the quality of healthcare

Teaching gender and sex differences is fundamental in medical classes because it has a strong impact in reducing disparity in treatment, in defining effective and personalized therapies that respect the different physiology and pathophysiology of women. Furthermore, it is the prerequisite for the pharmacoequity.

The relationship between depression, stress and anxiety levels of mothers with preschool children and their stress-coping styles during the pandemic: A descriptive study in Turkey

PURPOSE

This study aims to determine the depression, stress and anxiety levels of mothers with preschool children during the pandemic and to determine their coping strategies with stress.

DESIGN AND METHODS

This descriptive study sampled 300 mothers with kindergarten children in the 2021-2022 academic year. The data were collected with a personal information form, The Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress-Coping Styles Scale (SCSS). Numerical variables were presented as mean and standard deviation, and categorical variables were presented as numbers and percentages. The Mann Whitney U test was used for the dual group and the Kruskal Wallis test for more than two groups in the comparison of the scale mean scores. The relationship between the two scales was determined by Pearson's correlation analysis. p < 0.05 value was accepted statistically significant.

RESULTS

The depression, anxiety and stress mean scores of the mothers in the study were high (10.01 ± 4.79; 9.07 ± 5.09; 10.28 ± 4.28, respectively). There is a high level of negative correlation between the SCSS self-confidence approach scores, optimistic approach scores and depression, anxiety and stress scores, and a high level of positive correlation between the helpless/self-accusatory approach, submissive approach, optimistic approach and depression, anxiety and stress scores.

CONCLUSION

Mothers with pre-school children have been found to experience intense depression, anxiety and stress during the pandemic, and as their depression, stress and anxiety levels increase, they move away from self-confident and optimistic approaches, and they embrace more the helpless/self-accusatory approach and submissive approach, seeking social support.

IMPLICATIONS TO PRACTICE

In the event of a future pandemic, psychiatry and pediatric nurses should strengthen positive coping styles and make mothers aware of social support resources to ensure that mothers, who are the most vulnerable group in terms of mental health, and thus children, do not experience psychiatric problems. Thus, nurses, as mandated by the holistic care approach, provide the qualified care that the individual and his family deserve.

What can we learn about stress and sleep from COVID-19 pandemic-perspective from the theory of preventive stress management

Background

The COVID-19 pandemic has presented unique challenges to individuals worldwide, with a significant focus on the impact on sleep. However, the precise mechanisms through which emotional and cognitive variables mediate this relationship remain unclear. To expand our comprehensive understanding of variables, the present study utilizes the Preventive Stress Management theory, to test the relationship between perceived social support and sleep quality, as well as the effect of perceived COVID-19 stress, hope, negative emotions and coping styles.

Methods

Data were collected in March 2022 from 1,034 college students in two universities located in Liaoning Province, China, using an online survey platform regarding perceived social support, perceived COVID-19 stress, sleep quality, hope, negative emotions and coping styles. The moderated mediation model were conducted using Process macro program (Model 6) and the syntax in SPSS.

Results

The results revealed perceived COVID-19 stress and negative emotions sequentially mediated the negative relationship between perceived social support and sleep quality. Furthermore, hope and coping styles were found to moderate the sequential mediating effect.

Conclusion

The present study sheds light on the pathways that affect sleep quality among college students during the COVID-19 pandemic. Findings highlight the protective roles played by positive social and personal resources, such as perceived social support, hope, and effective coping styles, against sleep problems. These insights have important implications for the development of targeted interventions to improve sleep outcomes during this challenging time.

Depression and Anxiety in Long-Term Care Residents During the COVID-19 Pandemic: The Influence of Telehealth Availability, Cognitive Status, and Trauma History

OBJECTIVES

The present study investigates the impact of disrupted mental health services during the COVID-19 pandemic on depression and anxiety symptoms in long-term care (LTC) residents.

METHODS

The study examined clinical data from 5,645 residents who received at least two psychological services in a long-term care (LTC) or assisted living (AL) setting between March 2019 and March 2021. A series of multiple regressions were run to explore the effects of the COVID-19 shutdown on depression and anxiety symptoms while examining the effects of COVID-19-related facility closure and facility telehealth capabilities. Follow-up regression analyses explored the impact of cognitive impairment and positive trauma history on depression and anxiety symptoms.

RESULTS

Post-COVID levels of anxiety and depression were higher for residents with higher levels of pre-COVID anxiety and depression. The interaction between facility closure and availability of telehealth services and trauma history predicted self-report anxiety symptoms. Clinician-observed anxiety symptoms were predicted by cognitive impairment. Residents with a history of trauma had an increase in self-reported anxiety symptoms.

CONCLUSIONS

Telehealth appeared to mitigate anxiety during the pandemic for residents with higher pre-COVID anxiety.

CLINICAL IMPLICATIONS

For those individuals with severe anxiety, results suggest the importance of ensuring that mental health services are available to mitigate symptoms via telehealth when infection control disrupts the usual delivery of treatment.

Occupational Stress Levels among Radiologists and Radiographers in Hungary during the COVID-19 Era

The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. A cross-sectional survey was conducted between September and November 2022, with participants comprising radiographers and radiologists affiliated with the Hungarian Society of Radiographers and the Hungarian Society of Radiologists. The online survey collected socio-demographic and COVID-19 data, and the participants completed an effort-reward imbalance questionnaire. The analysis of 406 responses revealed significantly higher effort-reward imbalance (ERI) levels among the radiologists compared to the radiographers (p < 0.05). The healthcare professionals with over 30 years of experience exhibited significantly lower ERI levels than those with 1-9 years, 10-19 years, or 20-29 years of experience (p < 0.05). Additionally, the individuals aged 31-40 demonstrated higher ERI levels compared to their counterparts aged 19-30, 41-50, and over 51 (p < 0.05). The respondents cohabiting with a spouse/partner reported significantly higher stress levels than their single colleagues (p < 0.05), while the dog owners exhibited significantly lower ERI levels (p < 0.05). Elevated occupational stress highlights specific groups requiring targeted interventions to reduce stress and mitigate burnout among radiologists and radiographers.

Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data

BACKGROUND

The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces.

METHODS

The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes.

RESULTS

Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03).

DISCUSSION

Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.

Impact of Easing COVID-19 Restrictions on Fear of COVID-19 and Social Support Among Chinese Students: A Longitudinal Analysis

Introduction

This longitudinal study aims to investigate the relationship between fear of COVID-19, support-seeking behaviors, and perceived social support among Chinese college students during two distinct periods of the COVID-19 pandemic: the period of strict control (time 1) and the period following a relaxation of restrictions (time 2).

Methods

A total of 408 Chinese college students participated in this study. Data collection included demographic information, measures of fear of COVID-19, support-seeking behaviors, and perceived social support.

Results

Fear of COVID-19 at time 1 showed a significant positive association with fear of COVID-19 at time 2. The relationship between support-seeking behavior at time 1 and fear of COVID-19 at time 2 was significantly mediated through a chain mediation effect of support-seeking behavior at time 1 and perceived social support at time 2.

Discussion

This study contributes to the growing body of evidence on the psychological impacts of the COVID-19 pandemic and underscores the significance of social support in mitigating fear of COVID-19. It calls for a re-evaluation of public health policies considering their potential psychological effects and introduces new opportunities for developing psychosocial interventions.

Contribution of risk and resilience factors to anxiety trajectories during the early stages of the COVID-19 pandemic: A longitudinal study

The COVID-19 pandemic, and the response of governments to mitigate the pandemic's spread, resulted in exceptional circumstances that comprised a major global stressor, with broad implications for mental health. We aimed to delineate anxiety trajectories over three time-points in the first 6 months of the pandemic and identify baseline risk and resilience factors that predicted anxiety trajectories. Within weeks of the pandemic onset, we established a website (covid19resilience.org), and enrolled 1362 participants (n = 1064 from US; n = 222 from Israel) who provided longitudinal data between April-September 2020. We used latent growth mixture modelling to identify anxiety trajectories and ran multivariate regression models to compare characteristics between trajectory classes. A four-class model best fit the data, including a resilient trajectory (stable low anxiety) the most common (n = 961, 75.08%), and chronic anxiety (n = 149, 11.64%), recovery (n = 96, 7.50%) and delayed anxiety (n = 74, 5.78%) trajectories. Resilient participants were older, not living alone, with higher income, more education, and reported fewer COVID-19 worries and better sleep quality. Higher resilience factors' scores, specifically greater emotion regulation and lower conflict relationships, also uniquely distinguished the resilient trajectory. Results are consistent with the pre-pandemic resilience literature suggesting that most individuals show stable mental health in the face of stressful events. Findings can inform preventative interventions for improved mental health.

The pandemic's unseen wounds: COVID-19's profound effects on mental health

Objective

This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions.

Methodology

A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights.

Main findings

Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress.

Conclusion

The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.

Stress during the COVID-19 Pandemic and Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Results in Girls: Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress related to the outbreak of the COVID-19 pandemic may have caused substantial changes in eating behaviors, and may have been associated with emotional eating, especially in female individuals. The aim of the present study was to analyze the association between stress perceived during the COVID-19 pandemic and emotional eating in girls, within the third phase of the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. A nationwide sample of 818 Polish female adolescents, aged 15-20, was gathered. The adolescents were recruited to the study based on a random quota sampling procedure. Using a computer-assisted web interview (CAWI) survey, participants filled out the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) to assess the urge to cope with negative emotions by eating, and the Adolescent Stress Questionnaire (ASQ) to assess perceived stress. Additionally, the data concerning body mass, height, as well as body mass change during the COVID-19 pandemic were verified. The groups most susceptible to emotional eating were excessive body mass female adolescents, those who gained weight during the COVID-19 pandemic and those experiencing high stress levels while facing negative emotions. In order to plan effective therapeutic interventions dealing with the issue of emotional eating, both psychological therapy and dietary strategy tailored to the individual should be considered for the indicated susceptible groups.

Older adults' coping strategies during the COVID-19 pandemic - a longitudinal mixed-methods study

Introduction

Older age is a main risk factor for severe COVID-19. In 2020, a broad political debate was initiated as to what extent older adults need special protection and isolation to minimize their risk for SARS-CoV-2 infection. However, isolation might also have indirect negative psychological (e.g., loneliness, stress, fear, anxiety, depression) or physical (e.g., lack of exercise, missing medical visits) consequences depending on individual strategies and personality traits to cope longitudinally with this crisis.

Methods

To examine the impact of individuals' coping with the pandemic on mental health, a large sample of 880 older adults of the prospective longitudinal cohort TREND study were surveyed six times about their individual coping strategies in the COVID-19 pandemic between May 2020 (05/2020: Mage = 72.1, SDage = 6.4, Range: 58-91 years) and November 2022 in an open response format. The relevant survey question was: "What was helpful for you to get through the last months despite the COVID-19 pandemic? E.g., phone calls, going for a walk, or others."

Results and Discussion

In total, we obtained 4,561 records containing 20,578 text passages that were coded and assigned to 427 distinct categories on seven levels based on qualitative content analysis using MAXQDA. The results allow new insights into the impact of personal prerequisites (e.g., value beliefs, living conditions), the general evaluation of the pandemic (e.g., positive, irrelevant, stressful) as well as the applied coping strategies (e.g., cognitive, emotional- or problem-focused) to deal with the COVID-19 pandemic by using an adapted Lazarus stress model. Throughout the pandemic emotional-focused as well as problem-focused strategies were the main coping strategies, whereas general beliefs, general living conditions and the evaluation were mentioned less frequently.

"Knowing when it's time to take a break": Nursing home social workers' coping during COVID-19

Background

Nursing home (NH) social workers face many challenges in meeting the psychosocial needs of residents while balancing their own well-being needs.

Methods

This study employed a cross-sectional survey of NH social workers via social media and professional networks about their coping strategies during COVID-19. Open-ended responses were analyzed qualitatively using the rigorous and accelerated data reduction technique (RADaR).

Results

The study included a sample of 63 (N = 63) NH social workers. Four themes defined ways the in which NH social workers coped with stress during COVID-19, including relying on friends and family, mindfulness and spirituality/religion, self-care strategies, and setting boundaries at work.

Conclusion

These techniques appear to be effective; however there remains a need for institutional programs and policies to provide the time and space to holistically support coping in NH social workers and to prevent burnout and turnover, particularly during times of crisis.

Fear and Anxiety in Pregnant Women During the COVID-19 Pandemic: A Systematic Review

Objectives: The aim of this study was to explore the impact of the 2020-2022 pandemic on the levels of fear and anxiety in pregnant women and to identify risk and protective factors. Methods: A systematic review was conducted. Electronic databases were consulted for studies published between January 2020 and August 2022. The methodological quality was assessed using a critical appraisal tool for non-randomised studies. Results: Seventeen studies were included in the review. A high prevalence of levels of fear and anxiety were observed. Risk factors such as unplanned pregnancy, poor support from partners, or intolerance of uncertainty were identified for high levels of fear. Regarding anxiety, risk factors such as maternal age, social support, financial status, or concern about being able to maintain antenatal follow-ups were identified. Conclusion: The COVID-19 pandemic had a significant impact on the mental health of pregnant women through increased levels of fear and anxiety. It has not been possible to establish a relationship between significant factors such as gestational age or health emergency control measures with high levels of fear or anxiety.

Stressful Events, Psychological Distress and Well-Being during the Second Wave of COVID-19 Pandemic in Spain: A Gender Analysis

The present study investigates gender differences in stressful events, psychological distress and well-being during the second wave of COVID-19 in Spain, analyzing women's and men's risk and resilience factors for psychological distress and for well-being. Participants were 1758 individuals from the general population, 50.8% women, aged between 18 and 79 years. Women and men did not differ in age, number of children, educational level, occupation or marital status. The participants were assessed by seven self-report questionnaires and scales. The results revealed that women experienced more psychological distress, more negative feelings, more stressful events related to the COVID-19 pandemic, more social support, and lower thriving and self-esteem than men. Multiple regression analyses showed that, in the case of women and men as well, self-esteem was the most important predictor of higher well-being and lower psychological distress and negative feelings while more COVID-19 pandemic-related stressful events were associated with higher psychological distress and lower well-being. Another important predictor of greater well-being for either gender was social support while unemployment was associated with lower well-being. In women and men, a higher educational level was associated with greater psychological distress and negative feelings; the male sample revealed that psychological distress was also connected to younger age while in women it was associated with lower instrumental social support. The results suggest that gender plays an important role in the mental health effects of the COVID-19 pandemic, with the risk being higher for women than for men.

Dental students’ academic performance before and after the Covid-19 pandemic: A retrospective analysis

Delivering quality education to students with fair assessment strategies is a key indicator of an excellent educational institution. The present study explored the impact of the COVID-19 pandemic on the academic performance of dental students in terms of the evaluations/grades awarded to them before and during the pandemic. The targeted groups were dental students, studying in the third year of 2018-2019 and 2020-2021 academic years. The sample size included all male and female students who enrolled and completed the following courses: pre-clinical fixed prosthodontics (SDS333), pre-clinical removal prosthodontics (SDS323), clinical operative dentistry-1 (RDS313), and pre-clinical endodontics (RDS323). Evaluations for students who did not complete the requirements were not included in the statistical analysis. Paired sample statistics were used for comparisons between the different groups at p < 0.05. Results revealed statistically significant differences (p ≤ 0.05) for all the course pairs. It was found that students’ grades for all the courses during the pandemic year were higher compared to the grades before the pandemic. While female students demonstrated the highest mean difference (6.13) before and during the pandemic year for RDS323, males demonstrated the highest mean difference (8.14) for SDS323. However, both male and female students demonstrated the lowest mean difference (0.25 and 2.03, respectively) for SDS333. The grades were higher during the COVID-19 pandemic. Overall, female students achieved higher grades than male students.

The Start-Up Manager in Times of Crisis: Challenges and Solutions for Increasing the Resilience of Companies and Sustainable Reconstruction

The effects of the COVID-19 pandemic, amplified by the Russian–Ukrainian military conflict, have had a significant impact on economies and industries around the world, with serious implications for the activities of companies, including start-ups. In this context, this paper aims to examine the challenges and critical issues faced by the managers of start-ups during crises, and to identify solutions for increasing the resilience of companies and moving towards sustainable business reconstruction. Given that there are currently only limited data related to the long-term economic consequences of the COVID-19 pandemic on start-ups, and especially concerning the implications of the Russian–Ukrainian war, we use a qualitative research approach to explore Romanian start-up managers’ perceptions of how this difficult context affects their businesses, taking into account the economic, social, and psychological factors that affect their management. The issues faced by start-up managers in times of unprecedented crisis in recent history are highlighted. The results of the research identify response measures that can contribute to increasing companies’ resilience, helping start-up managers to overcome critical events, and making sustainable choices for subsequent business recovery and reconstruction.

Determinants of Quality of Life in the COVID-19 Pandemic Situation among Persons Using Psychological Help at Various Stages of the Pandemic

This article presents the results of three surveys conducted during the initial stage of the COVID-19 pandemic, in March 2020 and in late June/early July 2020, when pandemic restrictions were in force. The surveys covered patients who had used psychological assistance before the pandemic. two were cross-sectional and one was longitudinal. The first survey involved 270 people (age: M = 29.59, SD = 10.74, women 79.3%), and the second one covered 117 subjects (age: M = 29.40, SD = 11.49, women 85.5%). The third, longitudinal, survey covered 83 subjects (age: M = 26.61, SD = 7.17, women 89.2%). In our research we used the Conservation of Resources Evaluation questionnaire, the abbreviated version of the Coping Orientation to Problems Experienced, the WHO Quality of Life Scale, and a questionnaire for collecting sociodemographic information. Our analysis of the quality-of-life correlates in the two cross-sectional studies leads to an observation that for people using psychological help, the constant determinants of quality of life during a pandemic are high gain in resources and little loss of resources. In the first phase of the pandemic, active strategies were not linked to the sense of quality of life. This sense, however, was diminished by a number of negative strategies, such as denial, venting, substance use, restraint, and self-blame. After 3 months of the ongoing pandemic, perceived quality of life was positively correlated with strategies related to seeking instrumental support and active coping. this most likely points to a process of adapting to a difficult situation. The results of our longitudinal surveys demonstrate increasing escapism. Our attempt at explaining which factors determined the quality of life after 3 months of the ongoing pandemic showed that the crucial factors are: a sense of quality of life before the occurrence of the pandemic, changes in the distribution of resilience-oriented resources, changed frequency of using passive strategies, and active ways of coping-but only after 3 months into the pandemic. The results thus obtained can be used both in prevention and in work with persons affected by the negative consequences of the COVID-19 pandemic.