Concerns About Information Regarding COVID-19 on the Internet: Cross-Sectional Study

Implications for long COVID: A systematic review and meta-aggregation of experience of patients diagnosed with COVID-19

AIMS AND OBJECTIVES

This review aims to synthesize the available evidence of what patients experience when infected with COVID-19, both in hospital and post-discharge settings.

DESIGN

This review was conducted using the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews and evidence synthesis. Reporting of results was presented according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist.

BACKGROUND

Coronavirus disease 2019 (COVID-19) continues to be a public health crisis worldwide. Many patients diagnosed with COVID-19 have varied levels of persisting mental disorders. Previous studies have reported the degree, prevalence and outcome of psychological problems. Minimal research explored the experience of patients with long COVID. The real-life experience of patients with COVID-19 from diagnosis to post-discharge can deepen the understanding of nurses, physicians and policymakers.

METHODS

All studies describing the experience of patients were included. Two authors independently appraised the methodological quality of the included studies using the JBI Critical Appraisal Checklist for Qualitative Research 2020.

RESULTS

This systematic review aggregated patients' experience of being diagnosed with COVID-19 in both hospitalized and post-discharge settings. Finally, 17 studies met inclusion criteria and quality appraisal guidelines. The selected studies in the meta-synthesis resulted in 12 categories, and further were concluded as five synthesized findings: physical symptoms caused by the virus, positive and negative emotional responses to the virus, positive coping strategies as facilitators of epidemic prevention and control, negative coping strategies as obstacles of epidemic prevention and control, and unmet needs for medical resource.

CONCLUSIONS

The psychological burden of patients diagnosed with COVID-19 is heavy and persistent. Social support is essential in the control and prevention of the epidemic. Nurses and other staff should pay more attention to the mental health of the infected patients both in and after hospitalization.

RELEVANCE TO CLINICAL PRACTICE

Nurses should care about the persistent mental trauma of COVID-19 survivors and provide appropriate psychological interventions to mitigate the negative psychological consequences of them. Besides, nurses, as healthcare professionals who may have the most touch with patients, should evaluate the level of social support and deploy it for them. It is also needed for nurses to listen to patient's needs and treat them with carefulness and adequate patience in order to decrease the unmet needs of patients.

Hot Topic Recognition of Health Rumors Based on Anti-Rumor Articles on the WeChat Official Account Platform: Topic Modeling

BACKGROUND

Social networks have become one of the main channels for obtaining health information. However, they have also become a source of health-related misinformation, which seriously threatens the public's physical and mental health. Governance of health-related misinformation can be implemented through topic identification of rumors on social networks. However, little attention has been paid to studying the types and routes of dissemination of health rumors on the internet, especially rumors regarding health-related information in Chinese social media.

OBJECTIVE

This study aims to explore the types of health-related misinformation favored by WeChat public platform users and their prevalence trends and to analyze the modeling results of the text by using the Latent Dirichlet Allocation model.

METHODS

We used a web crawler tool to capture health rumor-dispelling articles on WeChat rumor-dispelling public accounts. We collected information from health-debunking articles posted between January 1, 2016, and August 31, 2022. Following word segmentation of the collected text, a document topic generation model called Latent Dirichlet Allocation was used to identify and generalize the most common topics. The proportion distribution of the themes was calculated, and the negative impact of various health rumors in different periods was analyzed. Additionally, the prevalence of health rumors was analyzed by the number of health rumors generated at each time point.

RESULTS

We collected 9366 rumor-refuting articles from January 1, 2016, to August 31, 2022, from WeChat official accounts. Through topic modeling, we divided the health rumors into 8 topics, that is, rumors on prevention and treatment of infectious diseases (1284/9366, 13.71%), disease therapy and its effects (1037/9366, 11.07%), food safety (1243/9366, 13.27%), cancer and its causes (946/9366, 10.10%), regimen and disease (1540/9366, 16.44%), transmission (914/9366, 9.76%), healthy diet (1068/9366, 11.40%), and nutrition and health (1334/9366, 14.24%). Furthermore, we summarized the 8 topics under 4 themes, that is, public health, disease, diet and health, and spread of rumors.

CONCLUSIONS

Our study shows that topic modeling can provide analysis and insights into health rumor governance. The rumor development trends showed that most rumors were on public health, disease, and diet and health problems. Governments still need to implement relevant and comprehensive rumor management strategies based on the rumors prevalent in their countries and formulate appropriate policies. Apart from regulating the content disseminated on social media platforms, the national quality of health education should also be improved. Governance of social networks should be clearly implemented, as these rapidly developed platforms come with privacy issues. Both disseminators and receivers of information should ensure a realistic attitude and disseminate health information correctly. In addition, we recommend that sentiment analysis-related studies be conducted to verify the impact of health rumor-related topics.

Content and User Engagement of Health-Related Behavior Tweets Posted by Mass Media Outlets From Spain and the United States Early in the COVID-19 Pandemic: Observational Infodemiology Study

BACKGROUND

During the early pandemic, there was substantial variation in public and government responses to COVID-19 in Europe and the United States. Mass media are a vital source of health information and news, frequently disseminating this information through social media, and may influence public and policy responses to the pandemic.

OBJECTIVE

This study aims to describe the extent to which major media outlets in the United States and Spain tweeted about health-related behaviors (HRBs) relevant to COVID-19, compare the tweeting patterns between media outlets of both countries, and determine user engagement in response to these tweets.

METHODS

We investigated tweets posted by 30 major media outlets (n=17, 57% from Spain and n=13, 43% from the United States) between December 1, 2019 and May 31, 2020, which included keywords related to HRBs relevant to COVID-19. We classified tweets into 6 categories: mask-wearing, physical distancing, handwashing, quarantine or confinement, disinfecting objects, or multiple HRBs (any combination of the prior HRB categories). Additionally, we assessed the likes and retweets generated by each tweet. Poisson regression analyses compared the average predicted number of likes and retweets between the different HRB categories and between countries.

RESULTS

Of 50,415 tweets initially collected, 8552 contained content associated with an HRB relevant to COVID-19. Of these, 600 were randomly chosen for training, and 2351 tweets were randomly selected for manual content analysis. Of the 2351 COVID-19-related tweets included in the content analysis, 62.91% (1479/2351) mentioned at least one HRB. The proportion of COVID-19 tweets mentioning at least one HRB differed significantly between countries (P=.006). Quarantine or confinement was mentioned in nearly half of all the HRB tweets in both countries. In contrast, the least frequently mentioned HRBs were disinfecting objects in Spain 6.9% (56/809) and handwashing in the United States 9.1% (61/670). For tweets from the United States mentioning at least one HRB, disinfecting objects had the highest median likes and retweets, whereas mask-wearing- and handwashing-related tweets achieved the highest median number of likes in Spain. Tweets from Spain that mentioned social distancing or disinfecting objects had a significantly lower predicted count of likes compared with tweets mentioning a different HRB (P=.02 and P=.01, respectively). Tweets from the United States that mentioned quarantine or confinement or disinfecting objects had a significantly lower predicted number of likes compared with tweets mentioning a different HRB (P<.001), whereas mask- and handwashing-related tweets had a significantly greater predicted number of likes (P=.04 and P=.02, respectively).

CONCLUSIONS

The type of HRB content and engagement with media outlet tweets varied between Spain and the United States early in the pandemic. However, content related to quarantine or confinement and engagement with handwashing was relatively high in both countries.

High response rate and low cost of WeChat-based data collection of infant and young child feeding data in rural Qinghai Province, China

Background

Measuring the infant and young child feeding (IYCF) indicators is key to effectively tracking the progress of child health programs and making evidence-based decisions. WeChat is the most popular mobile social media platform in China and has become a promising tool for collecting health data. This study aims to explore the response rate and costs of a WeChat-based questionnaire on IYCF information in rural China.

Methods

We conducted two cross-sectional surveys with caregivers of children aged 6-23 months in two rural counties in Qinghai Province (Menyuan and Datong County), China, from January to March 2022. Both surveys used the same WeChat IYCF questionnaire to collect household information, infant feeding practices, and caregivers’ feeding knowledge. Village doctors sent a quick response (QR) code to caregivers that was linked to the WeChat IYCF questionnaire. Participating caregivers scanned the QR code using their own WeChat account on their smartphone and filled in the questionnaire online. If they could not use WeChat themselves, village doctors administered the questionnaire. Once caregivers finished the questionnaires, they received a personalized report with infant feeding recommendations.

Results

We recruited 1274 caregivers of children aged 6-23 months in Menyuan County and 1748 caregivers in Datong County. The total response rate in the two counties was 98.2%; 77.6% of questionnaires were self-administered by caregivers and 20.6% were interviewer-administered by village doctors. The questionnaires were filled in twice by 209 (6.9%) caregivers. The cost of these two WeChat IYCF surveys was much lower than the cost of a previously conducted face-to-face survey: 11.8 yuan (US$1.85) in Menyuan County and 7.5 yuan (US$1.18) in Datong County for the WeChat survey vs 112.7 yuan (US$17.70) for the face-to-face survey in Huzhu County.

Conclusions

This study showed that using WeChat for IYCF surveys can achieve a very high response rate at a low cost in rural China. Village doctors played a very important role in achieving this high response rate. Providing feedback to caregivers may improve their feeding practices and this intervention could be incorporated into the data collection process.

Concerns about Wearing Masks to Avoid COVID-19 Infection in China: Assessment of an Internet-based Cross-sectional Study

BACKGROUND

The novel coronavirus disease of 2019 (COVID-19) is likely to spread from person to person in close contact settings. The Chinese Center for Disease Control and Prevention has released a handbook on COVID-19 which introduced health information to the public, specifically related to wearing masks correctly and adopting preventive measures to avoid the COVID-19 infection.

OBJECTIVE

The current study aimed to assess the level of mask knowledge, behavior related to mask usage, and major information channels in China.

METHODS

An Internet-based survey was conducted primarily using the DingXiang Doctor WeChat public accounts. The data about mask knowledge and behavior were recollected and analyzed. Besides descriptive statistical analysis, logistic regression was used to analyze significant risk factor.

RESULTS

There were a total of 10,304 respondents to the survey, more than half were under 30 years old, and nearly three-quarters were women. Over 80% of participants had a bachelor's degree or higher, as well as the largest amounts of respondents were business/service workers (40.80%). Over half of the study participants got married (51.46%). The findings revealed that 67.49% of the participants practiced protective mask behavior, 97.93% believed that wearing masks is effective against COVID-19, 96.85% chose the mask that has two or more layers of washable, breathable fabric, 70.57% wore masks correctly. Gender, age, occupation, and education level had significant effects on behavior, while marital and infection status of family members were not significant. In addition, it was found that WeChat public accounts (89.55%) were the most prominent source of health information for Chinese netizens after the break of COVID-19.

CONCLUSIONS

This study elucidated that the Chinese netizens' protective mask behavior was far lower than mask knowledge. Improved information channels and adequate information on wearing masks are necessary to improve the public's protective mask behavior, particularly among the males, elderly, and people with less education.

CLINICALTRIAL

Readiness of healthcare providers for e-hospitals: a cross-sectional analysis in China before the COVID-19 period

OBJECTIVES

The growth and development of smartphones and eHealth technologies have enabled the potential for extended care hospitals (e-hospitals) in China in order to facilitate the success of a primary healthcare centre (PHC)-based integrated delivery model. Although the adoption of e-hospitals is essential, few studies have directed their research towards understanding the perspectives of healthcare providers. This study aims to identify the current readiness of healthcare providers to adopt e-hospital technologies, determine the factors influencing this adoption and describe the perceived facilitators and barriers in regard to working at e-hospitals.

DESIGN

A cross-sectional study conducted in Sichuan, China, between June and September 2019.

SETTINGS

Information was collected from healthcare providers who have more than 3 years of work experience from a tertiary hospital, secondary hospital, PHCs and private hospital.

PARTICIPANTS

2298 medical professionals were included in this study.

OUTCOME MEASURE

This study included a self-administered questionnaire that was used to assess participants' sociodemographic characteristics, online medical practices, willingness to use e-hospitals and perceived facilitators/barriers to working at e-hospitals. Multivariate regression analysis was performed in order to evaluate the independent factors associated with e-hospital work.

RESULTS

Overall, 86.3% had a positive response towards working at e-hospitals. Age (p<0.05), familiarity with e-hospitals (p<0.001) and prior work practices in online healthcare settings (p<0.001) were associated with participants' readiness to work at e-hospitals. Gender, education level, professional level, the tier of their affiliated hospital and workload were not statistically associated. Healthcare providers who had positive attitudes towards e-hospitals considered improved efficiency, patient satisfaction, communication among physicians, increased reputation and income, and alleviated workload to be advantages of adoption. The participants who were unwilling to work at e-hospitals perceived lack of time, insufficient authenticity/reliability and underdeveloped policies as potential barriers.

CONCLUSION

Improving operative proficiency in electronic devices, accommodating to work schedules, increasing familiarity with e-hospitals and regulating practices will improve the readiness of healthcare providers to work at e-hospitals.

Designing a conceptual framework for misinformation on social media: a qualitative study on COVID-19

OBJECTIVE

This study was aimed to present a conceptual framework about the misinformation surrounding COVID-19 outbreak in Iran. For this purpose, discourse analysis of two of the most common social virtual networks were conducted via a four step approach as follows: defining the research question and selecting the content of analysis, gathering information and theory on the context, content analysis for establishing the themes and patterns and, presenting the results and drawing conclusions.

RESULTS

Cultural factors, demand pressure for information during the crisis, the easiness of information dissemination via social networks, marketing incentives and the poor legal supervision of online content are the main reasons for misinformation dissemination. Disease statistics; treatments and prevention are the main subjective categories of releasing misinformation. The consequences of misinformation dissemination include psychosocial, economic, health status, health system and ethical ones. The most recommended strategies for dealing with the issue could be divided into demand and supply-side strategies.

Human information behavior during the Covid-19 health crisis. A literature review

The research carried out on human information behavior (HIB) during the Covid-19 health crisis was reviewed, with the premise that HIB and information practices allow humans to adapt to the changing circumstances of existence. A literature search was run on the LISTA and Google Scholar databases from middle March 2020 up to the end of March 2021. After filtering retrieved results, 52 studies were selected. Results are summarized into seven main themes, including the use of traditional and social media, infoveillance of search engines and social media activity, misinformation, disinformation and infodemics, and uncertainty and emotions. Results point to the need to carry out additional research in specific contexts and addressing vulnerable and marginalized groups. Further areas of inquiry include the interplay of emotions, knowledge and behaviors during the information seeking process, a better understanding of local knowledge and experiential knowledge, and the need to comprehend the limitations of ICT.

Identify and measure the degree of over-prevention behaviors in the post-COVID-19 era in China

Background

With the spread of vaccines, more and more countries have controlled the outbreak of the COVID-19. In this post-epidemic era, these countries began to revive their economy. However, pollution remains in the environment, and people’s physical and psychological health has been under threat due to some over-prevention behaviors. Instruments for governmental agencies to manage these behaviors are not yet available. This study aims to develop a measurement model to identify and measure the degree of over-prevention behaviors during the COVID-19 epidemic in China.

Methods

A survey online was conducted to collect cognition from 1528 Chinese people, including descriptions of various over-prevention behaviors defined by health authorities. Factor analyses were used to develop the measurement model and test its validity. Logistic regression analyses were conducted to explore demographic characteristics, indicating people who are inclined to exhibit over-prevention behaviors.

Results

Four main factors were extracted to develop the model (eigenvalue = 7.337, 3.157, 1.447, and 1.059, respectively). The overall reliability (Cronbach’s α = 0.900), the convergent (AVE > 0.5, CR > 0.8 for each factor) and discriminant validity is good. There is also a good internal consistency among these factors (Cronbach’s α = 0.906, 0.852, 0.882, and 0.763, respectively). In Factor 1, gender has a negative effect (Beta = − 0.294, P <  0.05, OR = 0.745), whereas employment has a positive effect. Workers in institutions exhibit the greatest effect (Beta = 0.855, P <  0.001, OR = 2.352). In Factor 2, employment has a negative effect, with workers in institutions exhibit the greatest role (Beta = − 0.963, P <  0.001, OR = 0.382). By contrast, education level has a positive effect (Beta = 0.430, P <  0.001, OR = 1.537). In Factor 3, age plays a negative role (Beta = − 0.128, P < 0.05, OR = 0.880).

Conclusions

People show a discrepancy in the cognition toward various over-prevention behaviors. The findings may have implications for decision-makers to reduce the contradiction between the epidemic and economic revival via managing these behaviors.