Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults

Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study

Background

During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking.

Objective

This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals.

Methods

Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods.

Results

The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities.

Conclusions

This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.

Effectiveness of an occupational self-analysis intervention through a mobile application (OcupApp) in people with anxiety or depression: a randomised controlled trial protocol

The main objective of this protocol is to understand the effectiveness of the use of a mobile application (OcupApp) to generate a personal self-analysis about meaningful activities in a population of adults aged between 50 and 70 years with low or moderate depression/anxiety. A randomised study will be carried out comparing the effects of the use of the OcupApp application with a control intervention on health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. This is the first study to use occupational self-analysis in m-health to improve occupational balance, mental health, frequency of participation in meaningful activities and health-related quality of life. The app was co-created with a population whose characteristics are similar to those of the target users, and it was tested in both the intervention itself and the presentation, thus it is expected to be effective.

Trial Registration Number: Clinical Trial B1-2020_25.

Impact of COVID-19 on Physical Activity, Fatigue, and Frailty in Community-Dwelling Older Adults: A Cross-Sectional Study

This study aimed to describe the level of physical activity and its relation to fatigue and frailty during the COVID-19 pandemic in community-dwelling older adults aged 80 years and over. Three hundred and ninety-one older adults (aged 86.5 ± 3.00) completed a survey including physical activity, the Mobility Tiredness scale, and the FRAIL scale. Linear regression analysis was conducted to assess whether the variables age, sex, and physical activity (independent factors) were significantly related to fatigue and frailty. Respectively, 30.5% and 24.7% of the participants reported a decrease in walking and in energy-intensive activities; 25.4% reported increased sedentary behavior. A lower level of physical activity was associated with higher levels of fatigue and increased frailty risk (p < .05), independently from psychological symptoms. These results are important because participants with lower levels of physical activity and more sedentary behavior are more likely to feel fatigued and have higher risk to be frail.

Insights into parents' perceived worry before and during the COVID-19 pandemic in Australia: inequality and heterogeneity of influences

BACKGROUND

Excessive worry is an invisible disruptive force that has adverse health outcomes and may advance to other forms of disorder, such as anxiety or depression. Addressing worry and its influences is challenging yet crucial for informing public health policy.

METHODS

We examined parents' worries, influences, and variability before and during COVID-19 pandemic and across geography. Parents (n = 340) and their primary school-aged children from five Australian states completed an anonymous online survey in mid-2020. After literature review, we conceptualised the influences and performed a series of regression analyses.

RESULTS

Worry levels and the variables contributing to parents' worry varied before to during the pandemic. The proportion of parents who were "very worried all the time" increased by 14.6% in the early days of the pandemic. During the pandemic, ethnic background modified parents' worry and parents' history of daily distress symptoms was a significant contributor (p < 0.05). Excessive exposure to news remained significant both before and during the pandemic. The primary predictor of parents' worry before COVID-19 was perceived neighbourhood safety, while the main predictor during COVID-19 was financial risk due to income change. Some variable such as neighbourhood safety and financial risk varied in their contribution to worry across geographical regions. The proportion of worried children was higher among distraught parents.

CONCLUSION

Parents' worry during the health pandemic was not triggered by the health risks factors but by the financial risk due to income change. The study depicts inequality in the impact of COVID-19 by ethnic background. Different policies and reported virus case numbers across states may have modified the behaviour of variables contributing to the geography of parents' worry. Exposure to stressors before the COVID-19 pandemic may have helped parents develop coping strategies during stressful events. Parents are encouraged to limit their exposure to stressful news. We advocate for parents-specific tailored policies and emphasise the need for access to appropriate mental health resources for those in need. Advancing research in geographical modelling for mental health may aid in devising much-needed location-targeted interventions and prioritising resources in future events.

Which Occupations Did People Engage in during Lockdown? A European Cross-Sectional Descriptive Survey by Generation

Objective

The primary objective was to describe the occupations people engaged in more frequently during lockdown than before the coronavirus disease 2019 pandemic as a function of generation. The secondary objectives were to (i) describe the levels of importance, performance, and satisfaction for these occupations and (ii) identify factors affecting the levels of importance, performance, and satisfaction.

Method

We conducted an online, cross-sectional survey of young adults (YAs, aged 18-39), middle-aged adults (MAs, aged 40-59), and older adults (OAs, aged 60 or over).

Results

2534 participants (YAs: 47%, MAs: 33%, and OAs: 20%) cited 4500 occupations. The occupations in which people most engaged were leisure occupations (67%), followed by productive occupations (31%) and then self-care (2%) occupations. YAs gave a median (interquartile range) importance score of 8 (6; 9) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. MAs gave a median importance score of 8 (6; 10) to leisure, 8 (7; 10) to productivity, and 8 (7; 10) to self-care. OAs gave a median importance score of 8 (7; 10) to leisure, 8 (7; 9) to productivity, and 9 (8; 10) to self-care. In a pre-/postlockdown comparison, the changes in performance scores among YAs were +5 (3; 6) for leisure, +4 (2; 5) for productivity, and +4 (3; 6) for self-care. Among MAs, these changes were, respectively, +4 (3; 6), +3 (2; 5), and +4.5 (3; 6). Among OAs, these changes were, respectively, +3 (1; 5) for leisure, +3 (2; 5) for productivity, and +2 (0; 4) for self-care. The changes in satisfaction scores among YAs were +3 (0; 5) for leisure, +3 (0; 5) for productivity, and +3 (1; 6) for self-care. Among MAs, these changes were, respectively, +3 (0; 5), +2 (0; 4), and +5 (0; 6). Among OAs, these changes were, respectively, +2 (0; 4), +2 (0; 4), and +2 (0; 4).

Conclusions

Lockdown led to stronger engagements in quiet leisure and alternative forms of socialization. Occupational therapists may have a role in helping community-dwelling people to balance and structure their new daily routine.

Data collection in pandemic times: the case of the Belgian COVID-19 health surveys

BACKGROUND

Survey data were needed to assess the mental and social health, health related behaviors and compliance with preventive measures of the population during the COVID-19 pandemic. Yet, the pandemic challenged classical survey methods. Time and budgetary constraints at the beginning of the pandemic led to ad hoc recruitment of participants and easily manageable data collection modes. This paper describes the methodological choices and results in terms of participation for the COVID-19 health surveys conducted in Belgium.

METHODS

The COVID-19 health surveys refer to a series of ten non-probability web surveys organized between April 2020 and March 2022. The applied recruitment strategies were diverse including, amongst others, a launch through the website and the social media of the organizing research institute. In addition, the survey links were shared in articles published in the national press and participants were requested to share the surveys in their network. Furthermore, participants were asked consent to be re-contacted for next survey editions using e-mail invitations.

RESULTS

These mixed approaches allowed to reach a substantial number of participants per edition ranging from 49339 in survey 1 to 13882 in survey 10. In addition, a longitudinal component was created; a large share of the same individuals were followed up over time; 12599 participants completed at least 5 surveys. There were, however, sex, age, educational level and regional differences in participation. Post-stratification weighting on socio-demographic factors was applied to at least partly take this into account.

CONCLUSION

The COVID-19 health surveys allowed rapid data collection after the onset of the pandemic. Data from these non-probability web surveys had their limitations in terms of representativeness due to self-selection but were an important information source as there were few alternatives. Moreover, by following-up the same individuals over time it was possible to study the effect of the different crisis phases on, amongst others, the mental health. It is important to draw lessons from these experiences: initiatives in order to create a survey infrastructure better equipped for future crises are needed.

Changes in Daily Occupations Patterns, Optimism, and Positive Affect During COVID-19 Lockdown

Background. The COVID-19 outbreak caused an initial 2-week lockdown throughout Israel. Purpose. To identify (1) changes in time-usage patterns of daily occupations during the first COVID-19 lockdown, by gender and employment status, and (2) correlations among optimism, positive affect, and daily occupations during the lockdown. Method. In a voluntary, anonymous, retrospective, online cross-sectional survey, 481 participants completed the Life Orientation Test, Positive Affect Questionnaire, and Occupational Questionnaire. Findings. During lockdown, participants spent more time in recreation, rest, and sleep regardless of their employment status, and more women than men lost their employment. Both before and during lockdown, women spent significantly higher percentage of time performing everyday tasks but reported less rest and sleep than men. Recreation was associated with positive affect. Conclusion. The COVID-19 pandemic created a temporary occupational disruption. Although people devoted their time differently, the lockdown forced people to find ways to continue engaging in their occupations.

Occupational value outcomes among people with mental health issues participating in activity-based interventions - The importance of internal and external factors

BACKGROUND

Perceived occupational value is an important treatment outcome but is still relatively unexplored as a phenomenon.

AIM

To evaluate whether the Balancing Everyday Life (BEL) intervention for people with mental health issues was effective compared to Standard Occupational Therapy (SOT) regarding improvement on three dimensions of occupational value (concrete, socio-symbolic and self-reward), and how internal factors (self-esteem and self-mastery) and external factors (sociodemographics) were related to occupational value.

METHODS

The study was a cluster RCT (n = 226) and used self-report questionnaires on three occasions (baseline = T1, completed intervention = T2, six-month follow-up = T3).

RESULTS

No differences between the groups were seen in occupational value change scores. Within-group analyses (T1-T3) indicated a change in the BEL group on concrete value and self-reward value. No change was indicated in the SOT group. Associations showed that self-esteem and self-mastery were correlated with all three aspects of occupational value. Having children was negative for experiencing occupational value, whereas having a friend was positive. None of the correlates could predict changes in occupational value.

CONCLUSION

Self-related factors appeared to be integral in occupational value.

SIGNIFICANCE

Since occupational value is essential for a meaningful life, therapists should consider such factors and peer support when supporting people with mental health issues.

Activities Carried Out during the First COVID-19 Lockdown by Italian Citizens

The SARS-CoV-2 pandemic has altered how citizens engage in activities. This study describes the new activities citizens engaged in during the first lockdown, factors that helped them cope with the confinement, the supports they used the most, and which supports they would have liked to receive. This cross-sectional study consists of an online survey made of 49 questions that was completed by the citizens of the province of Reggio Emilia (Italy) from 4 May until 15 June 2020. The outcomes of this study were explored by focusing on four of the survey questions. Of the 1826 citizens who responded, 84.2% had started new leisure activities. Males, participants who lived in the plain or foothills, and those who experienced nervousness engaged less in new activities, while those whose employment status changed, whose lifestyle worsened, or whose use of alcohol increased engaged in more activities. The support of family and friends, leisure activities, continuing to work, and an optimistic attitude were perceived to be of help. Grocery delivery and hotlines providing any type of information and mental health support were used frequently; a lack of health and social care services and of support in reconciling work with childcare was perceived. Findings may help institutions and policy makers to better support citizens in any future circumstances requiring prolonged confinement.

Emotional Impact and Perception of Support in Nursing Home Residents during the COVID-19 Lockdown: A Qualitative Study

Social isolation measures implemented in nursing homes during the COVID-19 pandemic generated occupational imbalance, discomfort, and mental health impairment in residents. We aimed to analyze the lived experience of elderly nursing home residents during the lockdown and social contact restrictions resulting from the COVID-19 pandemic.

METHODS

Exploratory qualitative study. Information was collected through in-depth interviews and field notes. An inductive thematic analysis was performed and international recommendations for the development of qualitative studies were followed.

RESULTS

Twenty-four participants residing in nursing homes were included. Two main themes were identified: (1) emotional impact of the experience of COVID-19 lockdown (subthemes: experience of contradictory feelings; illness and death; importance of routine; feeling busy; and role of religious beliefs); and (2) support as a therapeutic tool (subthemes: family support; peer support; and professional support).

CONCLUSION

Social restrictions by COVID-19 caused significant changes in residents' occupations and routines, producing fear, loneliness, and abandonment of desired occupations; however, very important supports were also identified that helped to overcome the lockdown, such as social support, spirituality, and gratitude.

The impact of covid-19 lockdown on the Quality of life, meaningful activities, and frailty in community-dwelling octogenarians: A study in Belgium

OBJECTIVES

To investigate the impact of COVID-19 lockdown on quality of life (QoL), meaningful daily activities, and (pre)frailty in community-dwelling octogenarians.

METHODS

Cross-sectional design with bivariate and multiple linear regression modeling using a stepwise approach examining the level of QoL during the COVID-19 lockdown in a group of 215 community-dwelling octogenarians (M_age = 86.49 ± 3.02). A comprehensive set of biopsychosocial variables (FRAIL scale, general health, engagement in meaningful activities survey, questions on loneliness, and feelings) were used as explaining variables.

RESULTS

Particularly, a decrease in daily activities, social activities, and an increase in free times activities were observed, but the decrease in QoL could be explained by the meaningfulness in activities, together with experiencing emptiness in life, taking ≥ 4 medications a day and feeling down or depressed.

CONCLUSIONS

We tried to understand which components contribute to and might affect a person's QoL caused by restrictions imposed by the governance and its influence on the lives of the community-dwelling octogenarians. As such, this output could be a baseline for the development of minimally impacting countermeasures during future lockdowns.

CLINICAL IMPLICATIONS

Studying lifestyle changes and thus also variables related to QoL during a pandemic, may support policymakers and practitioners to develop relevant interventions.

Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic

The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.

The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study

INTRODUCTION

During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question.

MATERIAL AND METHODS

During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively.

STATISTICAL ANALYSIS

It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small.

CONCLUSIONS

The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups.

Association between workplace and mental health and its mechanisms during COVID-19 pandemic: A cross-sectional, population-based, multi-country study

BACKGROUND

The COVID-19 pandemic worsens populations' mental health. However, little is known about the COVID-19-related mental health among remote workers.

METHODS

We retrieved data from survey of Health, Ageing and Retirement in Europe, covering 27 countries. Eligible people were those employed. The main outcome is the mental disorder, covering four aspects: depression, anxiety, sleep disorder, and loneliness. Country-specific weighted mixed models were fitted to estimate the association of workplaces with mental health, controlled for age, gender, education level, living alone, making ends meets, working hours, closing to suspected or confirmed COVID-19 cases, received anti-virus protection, social contact, disability, and chronic disease. Moderate analyses were conducted to explore possible mechanisms.

RESULTS

11,197 participants were included, among them 29.3% suffered at least one worse mental disorder. After controlling for covariates, compared with those who worked at the usual workplace, those who worked at home only or part of the time did not associate with worse mental disorders (p-value ≥0.1395), and those who worked at neither the usual workplace nor home had a 55% higher likelihood of suffering from worse mental disorders (OR = 1.55, 95%CI 1.03-2.36). The mediation analyses identified three indirect pathways by which workplaces influence mental health, including making ends meets, social contact, and receiving anti-virus protection. Detailed results on subtypes of mental disorders were also provided.

LIMITATIONS

All assessments were self-reported, resulting in a risk of method bias.

CONCLUSIONS

During the COVID-19 pandemic, working at other places, neither at the usual workplace nor home, worsened mental health. Evidence provided in this study will contribute to more nuanced and practical public health policy strategy making.

Effect of the COVID-19 pandemic on depression in older adults: A panel data analysis

Background

This paper investigates the impact of the COVID-19 pandemic on depression in the older population, an especially vulnerable group for which to date there is limited empirical research.

Methods

We employ a panel data consisting of seven waves of the English Longitudinal Study of Ageing (2010–2020). The breadth and depth of the data considered enabled us to control for individual fixed effects, to adjust for pre-pandemic trends in depression levels and to perform a heterogeneity analysis, depending on the intensity of the lockdown measures implemented and relevant socioeconomic characteristics.

Results

We find that, following the COVID-19 pandemic, study participants reported a statistically significant increase in the depressive symptoms by around 0.7 over 8 points as measured by the Centre for Epidemiologic Studies Depression (CES-D) index. The estimated coefficients were larger in November than in July, for individuals who lost their job, retired and women. Interestingly, we observed that mental health has worsened substantially relative to the pre-pandemic period across all income groups of the older population, suggesting a limited role of income as a protective mechanism for mental health.

Conclusions

Our findings provide compelling evidence that depression levels amongst older adults have worsened considerably following the COVID-19 pandemic, and that factors other than income, such as social interactions, may be highly relevant for well-being in later life.

Changes in Mental Health Among People with HIV During the COVID-19 Pandemic: Qualitative and Quantitative Perspectives

People with HIV (PWH) are at risk for adverse mental health outcomes, which could be elevated during the COVID-19 pandemic. This study describes reasons for changes in mental health among PWH during the pandemic. Data come from closed- and open-ended questions about mental health changes from a follow-up to a cohort study on PWH in Florida during part of the COVID-19 pandemic (May 2020-March 2021). Qualitative data were analyzed using thematic analysis. Among the total sample of 227 PWH (mean age 50.0, 49.7% men, 69.2% Black/African American, 14.1% Hispanic/Latino), 30.4% reported worsened mental health, 8.4% reported improved mental health, and 61.2% reported no change. The primary reasons for worsened mental health were concerns about COVID-19, social isolation, and anxiety/stress; reasons for improved mental health included increased focus on individual wellness. Nearly one-third of the sample experienced worsened mental health. These results provide support for increased mental health assessments in HIV treatment settings.

Relationships Between Physical Activity, Boredom Proneness, and Subjective Well-Being Among U.K. Adults During the COVID-19 Pandemic

This investigation sought to examine physical activity (PA) as a potential determinant of chronic boredom and associated well-being within the context of COVID-related restrictions. A representative sample of U.K. adults (N = 1,521) completed a survey on June 1, 2020. Bivariate analyses demonstrated that individuals who met guidelines and maintained or increased PA scored higher on life satisfaction, worthwhileness, and happiness and lower on anxiety (i.e., indicators of well-being) and boredom proneness (d = 0.13-0.43). Boredom proneness was correlated with all indicators of well-being (r = .38-.54). A series of regression models revealed that PA predicted lower boredom proneness and better life satisfaction, worthwhileness, and happiness. Boredom proneness accounted for the covariance between PA and well-being. Prospective research is needed to confirm causality of the observed relationships.

Activities for Residents of Dutch Nursing Homes during the COVID-19 Pandemic: A Qualitative Study

To protect nursing home residents from getting infected with COVID-19, several measures have been imposed. The aim of this study was to describe the impact of these measures on activities for Dutch nursing home residents, the conditions under which the activities could take place, and the considerations when making decisions about the (dis)continuation of activities. The study consisted of the data of the qualitative MINUTES-study. Textual units derived from documentation of an outbreak team (OT) meetings on activities, well-being, informal caregivers, and volunteers from 39 long-term care organizations were re-analyzed using a content analysis. The results shows that OTs more often discussed restarting and continuing activities than stopping activities during the COVID-19 pandemic. There were differences between time periods, but activities never completely stopped according to the minutes. Activities were offered in an adapted way, often under certain conditions, such as organizing activities at other locations (e.g., outside), with limited group size, and following specific guidelines. The main focus of the considerations made were the ability to adhere to the guidelines, the well-being of residents, ensuring safety, and balancing benefits versus risks given vaccination availability and coverage. Overall, the study showed that organizing activities for nursing home residents despite COVID-19 measures is possible.

Psychological impact of the quarantine during the COVID-19 pandemic on the general European adult population: a systematic review of the evidence

AIMS

Due to the coronavirus disease 2019 (COVID-19) different countries implemented quarantine measures to limit the spread of the virus. Many studies analysed the mental health consequences of restrictive confinement, some of which focused their attention on specific populations. The general public's mental health also requires significant attention, however. This study aimed to evaluate the effects of the COVID-19 quarantine on the general population's mental health in different European countries. Risk and protective factors associated with the psychological symptoms were analysed.

METHODS

A systematic search was conducted on four electronic databases (PubMed, PsycINFO, Scopus and Google Scholar). Studies published up until 20th April 2021, and following eligibility criteria were selected for this review. One thousand three hundred thirty-five (1335) studies were screened, 105 of which were included. Via network analysis, the current study investigated the pathways that underlie possible risk factors for mental health outcomes.

RESULTS

Anxiety, depression, distress and post-traumatic symptoms are frequently experienced during the COVID-19 quarantine and are often associated with changes in sleeping and eating habits. Some socio-demographic and COVID-19-related variables were found to be risk factors for an individual's wellbeing. In particular, being female, young, having a low income, being unemployed and having COVID-19-like symptoms or chronic disorders, were found to be the most common risk factors for mental health symptoms.

CONCLUSIONS

The COVID-19 pandemic represented an unprecedented threat to mental health globally. In order to prevent psychological morbidity and offer support tailored to short-, medium- and long-term negative outcomes, it is essential to identify the direct and indirect psychosocial effects of the lockdown and quarantine measures, especially in certain vulnerable groups. In addition to measures to reduce the curve of viral transmission, policy makers should urgently take into consideration provisions to alleviate hazards to mental health.

Translation and Cultural Adaptation into Spanish of the Engagement in Meaningful Activities Survey

Background

Participation in meaningful activities contributes to individual well-being, so it is essential to have specific evaluation tools that can assess this complex construct

Objectives

To create a Spanish version (EDIAS) of the Engagement in Meaningful Activities Survey (EMAS) by following best practices in instrument translation. Methodology. The translation was made according to the Principles of Good Practice for the translation and cultural adaptation of patient-reported outcome measures.

Results

The adaptation process involved a meticulous analysis of item equivalence by the expert committee and an expert on the EMAS. Also, harmonization with other translated versions and a cognitive debriefing was carried to assess comprehensibility.

Conclusion

Following best practice, this study has developed the EDIAS, a tool for evaluating participation in meaningful activities adapted to the Spanish context.

Psychological Antecedents and Consequences of Social Integration Based on Self-Disclosure in Virtual Communities: Empirical Evidence From Sina Microblog

Introduction

With the normalization of COVID-19 prevention and control, a large number of intergenerational audiences with different cognition preferences and value orientations have started to pour into non-acquaintance virtual communities (VCs) to address their social needs by disclosing their own thoughts, feelings and experiences toward certain topics. To avoid the negative impacts of self-disclosure, this study introduced the concept of social integration into cyber society among non-acquaintance VCs, such as the topic-based VCs. Our theoretical model considers both the psychological antecedents and consequences of VC audiences’ social integration and our findings have implications for public online (and even offline) social life. Moreover, this research could play a guiding role in improving VC audiences’ social integration status in future online learning and telecommuting scenarios.

Method

To assess the theoretical model constructed in this manuscript, we conducted an online survey in two different topic-based VCs among Microblog and yielded 472 useable responses from intergenerational audiences, among which 28.81% were born before 1985, 26.67% were born from 1985 to 1995, and 48.52% were born after 1995. Our sample consisted of 208 individuals from Health Regimen VC and 264 individuals from Star Chasing VC, 200 (42.37%) were men and 272 (57.63%) were women.

Results

Our structural equation model (SEM) indicated that individuals’ self-disclosure in topic-based VCs might not directly guide them to acquire social integration. However, intimacy and cognitive communion derived from VC audiences’ self-disclosure might not only enhance their social integration, but also improve their psychological well-being. In addition, VC audiences’ social integration mediated the relationship between intimacy and psychological well-being, and the relationship between cognitive communion and psychological well-being. Moreover, VC audiences’ intimacy was found to have a direct influence on their cognitive communion.

Conclusion

In the context of topic-based VCs, audiences’ self-disclosure could significantly foster their intimacy and cognitive communion with others, and both intimacy and cognitive communion are conductive to VC audiences’ social integration. Thus, audiences in topic-based VCs who wish to improve their psychological well-being need to disclose themselves and build corresponding psychological foundations (i.e., intimacy and cognitive communion) to enhance their social integration. Meanwhile, topic-based VCs should pay attention to the cultivation of intimacy and cognitive communion among audiences while encouraging them to reveal themselves.

COVID-19 and Its Lockdown in Belgium: How Limited Access to Environmental Satisfaction Impacts Emotions?

The COVID-19 pandemic has been shown to induce several psychological consequences (e.g., increases in anxiety and stress). Accordingly, it seems relevant to investigate how individuals cope with their emotions. Indeed, when facing negative emotions, individuals need to rely on adaptive emotion regulation strategies to alleviate their negative impacts (e.g., decrease in quality of life, increase in sleep disturbances). Moreover, lockdown’s measures led to a restriction of the access to activities which, in turn, might have decreased the “environmental satisfaction”. Then, this research investigates the pandemic’s psychological impacts on emotions and regulation strategies, intolerance of uncertainty, and environmental satisfaction. Our approach’s originality relies on comparing one’s actual psychological functioning (i.e., since the pandemic) to one’s general psychological functioning (i.e., before the pandemic). This study also assesses the relationships between both negative and positive emotions and (1) emotion regulation strategies, (2) intolerance of uncertainty and, (3) environmental satisfaction since the pandemic and its lockdown. The total sample comprised 948 adults from the general population. Results show that, since the pandemic, individuals experience higher levels of negative emotions, lower levels of positive emotions and environmental satisfaction. They also tend to worry less and to resort to acceptance more often. Also, environmental satisfaction is the most important predictor of both negative emotions and positive ones. Overall, findings confirm previous ones and seem to indicate that environmental satisfaction should be addressed more thoroughly.

Occupational disruptions during lockdown, by generation: A European descriptive cross-sectional survey

Introduction

The periods of lockdown during 2020 led to changes in daily occupations. As participation relies on dynamic interactions between the person, his/her occupations and his/her environment, we wondered whether people from different generations shared the same perception of occupational disruptions during the lockdown.

Methods

We performed an online survey based on the Canadian Occupational Performance Measure (COPM) of adults in 27 European Union countries, the United Kingdom and Switzerland. Three groups were compared: young adults (YAs, aged 18–39), middle-aged adults (MAs, aged 40–59) and older adults (OAs, aged 60 and over).

Results

2865 participants (YAs: 47%; MAs: 33%; OAs: 20%) reported a total of 6549 disrupted occupations. The most frequently disrupted domain was leisure (83%), followed by productivity (16%) and self-care (2%); there were no significant intergroup differences ( p = 0.18). In a multivariate analysis, socializing disruptions were more likely to be associated with younger age (adjusted odds ratio (OR) [95% confidence interval (CI)] = 0.62 [0.50–0.76] for YAs versus MAs and 0.46 [0.30–0.71] for YAs versus OAs.

Conclusion

With the exception of socializing, the main disrupted occupations were similar from one generation to another. Our findings might enable the more accurate assessment of the risk of occupational disruption in a restrictive environment.

Routines, Time Dedication and Habit Changes in Spanish Homes during the COVID-19 Lockdown. A Large Cross-Sectional Survey

Many countries chose to establish social distancing as lockdowns after the COVID-19 outbreak. Households had to adapt their day-to-day lifestyles to new circumstances, affecting routines and time dedication to tasks. This national study was carried out to find out how the confinement by COVID-19 affected Spanish households on the perceived habit changes during this period, in relation to their socio-demographic characteristics and household composition. An online questionnaire was launched during the COVID-19 lockdown, from 30 April to 22 June 2020. Descriptive statistics were analyzed, stratified by gender, on time dedication, routine, home leaving, and habit change variables. Chi-square tests were used to explore the relations of significance with socio-demographic characteristics and home composition. All contrast analyses were performed for a 95% confidence level (significance considered for p < 0.05). In total, 1673 respondents participated from different age groups, educational level, employment status and household composition. Sixty percent of respondents maintained their routines. A third tried to establish a new one, being related to women, young people, not a university student, and living with others, including minors. Regarding dedication to tasks, adults aged 35-54 years, with more cohabitants, especially women, devoted themselves intensively to the home or to care, while those under 35 were dedicated more to rest, leisure, television or reading. People with university studies were more related to teleworking. The frequency of going outside was related to gender, age, educational level and living with elders, specifically for grocery shopping and taking out garbage. Changes in habits, routines and time dedication in confinement were strongly linked to the sociodemographic and coexistence conditions in Spanish homes. The greatest impacts were suffered by women, people with children, and adults between 35-54 years of age, especially on care and domestic chores.

COVID-19 incidence, hospitalizations and mortality trends in Croatia and school closures

Objectives

COVID-19 pandemic affected majority of students worldwide because school closures were one of the first and frequently taken measures in tackling epidemic. This study analyzed trends in COVID-19 morbidity and mortality from the beginning of pandemic in Croatia, in relation to schools opening and closing.

Study design

Retrospective data review.

Methods

Data on COVID-19 positive patients in Croatia from week 9 of 2020 to week 10 of 2021 in Croatia were analyzed using joinpoint regression. Analysis also included hospitalizations and mortality trends for age groups 26 to 65 and 66+ from week 30 of 2020.

Results

Schools opened in fall after the summer holidays in week 37. Joinpoint regression analysis revealed a statistically significant increase in cumulative incidence rates of COVID-19 in all age groups until 50th week, except in the 19–25 age group which saw an increase until 49th week. During the period of increase, there were periods of moderate increases and rapid increases in incidence that were present between 39/41 week and 43/44 week in all age groups except in those 0–6 years [from 40th till 43rd week in age groups 7–14 and 15–18, average percentage change (APC) = 87.41, P = 0.035, and APC = 83.47, P = 0.013; from 39th till 43rd in 19–25, APC = 91.90, P = 0.002; from 40th till 44th in 26–65, APC = 74.79, P < 0.001; from 41st till 44th in 66+, APC = 81.95, P = 0.004]. Steeper increase in hospitalizations was seen in 40th week for age groups 26 to 65 (40th to 45th week APC = 34.67, P < 0.001) and 66+ (40th to 45th week APC = 38.76, P < 0.001). Steeper increase in mortality started in 41st week for both age groups 26 to 65 and 66+ (41st to 46th week APC = 59.59, P < 0.001 and 41st to 45th week APC = 70.28, P < 0.001). Schools were closed for winter holidays in week 51. A steep decrease occurred in week 50 for cases and in week 51 for mortality and hospitalizations. There was no significant increase in hospitalizations and mortality after schools were re-opened in week 03 of 2021 (primary schools) and week 07 (secondary schools).

Conclusion

COVID-19 morbidity and mortality trends in Croatia observed in fall 2020 in Croatia perhaps cannot completely exclude potential association of school opening in all age groups. However, in winter 2021 effect was completely lacking and numbers were independent of schools’ dynamics. The observed inconsistent pattern indicates that there were no association of school openings and COVID-19 morbidity and mortality trends in Croatia and that other factors were leading to increasing and decreasing numbers. This emphasizes the need to consider the introduction of other effective and less harmful measures by stakeholders, or at least to use school closures as a last resort.