Effect of vacation on health: moderating factors of vacation outcome

Sports-related leisure behavior in Alpine regions during the COVID-19 pandemic-A cross-sectional study in Austria, Germany and Italy

Introduction

As a planetary health challenge, COVID-19 forced governments around the world to take action to prevent the most severe consequences resulting from the spread of the virus. These measures ranged from stay-at-home orders to limitations on indoor and outdoor activities, travel restrictions and the cancelation of sports events, all of which affected people's leisure activities and daily lives. Therefore, the aim of this study is to examine changes in sports-related leisure behavior in terms of attending major sports events, following major sports events via media, travel intentions and the use of new sports offerings. Furthermore, we aimed to identify variables associated with changed sports-related leisure behavior during the pandemic.

Methods

A cross-sectional online survey (n = 1,809) was conducted from December 2020 to January 2021 in the Alpine regions of Austria, Germany and Italy. Sports-related leisure behavior was investigated for changes during the pandemic compared to the time before the coronavirus outbreak and for differences between the three countries.

Results

Results showed that the self-reported importance of attending major sports events decreased significantly in the Alpine regions of all three countries during COVID-19. Prevailing restrictions affected vacation planning for over 80% of participants. A majority of approximately three quarters of respondents stated they had spent their holidays at home during the travel restrictions. Sports facilities and opportunities played an important role in the choice of vacation destination for more than half of participants. A binary logistic regression showed significant correlations between vacation planning during COVID-19 and the variables gender, income, quality of life and mental health. 31.9% of all respondents tried new sports offerings during extended restrictions, with a large proportion (72.4%) using apps, online tools or courses. Furthermore, approximately 30% of respondents increased their e-sports consumption.

Discussion

The results showed that sports-related leisure behavior in Alpine regions changed in the course of the COVID-19 pandemic. In the future, policymakers as well as sports and leisure providers should react to these behavioral changes and adapt their portfolio and services to meet consumers92 demands.

Effects of a one-week vacation with various activity programs on well-being, heart rate variability, and sleep quality in healthy vacationers-an open comparative study

OBJECTIVES

This open comparative study aimed to analyze the effects of a one-week vacation with various activity programs on well-being, heart rate variability (HRV) and sleep quality in healthy vacationers.

METHODS

Fifty-two healthy untrained vacationers spent a one-week vacation with regular exercise in East Tyrol. Exercise was performed on six of seven days. The study participants were divided into a) Group 1, playing golf (G), and b) Group 2 performing Nordic walking or e-biking (NW&EB). Well-being was measured with the WHO-5 well-being-index; stress and recovery status was obtained with the EBF-24-questionnaire (recovery-stress questionnaire). HRV parameters in the time and frequency domain (SDNN, pNN50, r-MSSD, log LF/HF and total power) were measured with a 24-h-ECG (electrocardiogram). Sleep quality was derived from the EBF-24 questionnaire and sleep architecture from HRV-analysis. Examinations were performed one day before and after the vacation.

RESULTS

Well-being significantly improved in the G group (+ 40%, p < 0.001) and NW&EB group (+ 19%, p = 0.019). The stress and recovery profile also improved significantly in both groups (stress-decrease: -43.7% G group; -44.7% NW&EB group; recovery-increase: + 23.6% G group; + 21.5% NW&EB group). Except for the SDNN (standard deviation of the NN interval), no significant change was noted in HRV-parameters. SDNN improved significantly only in the NW&EB group (+ 9%, p < 0.05). Sleep quality (+ 21% G group, p = 0.029; + 19% NW&EB group, p = 0.007) and architecture (-10% G group, p = 0.034; -23% NW&EB group, p = 0.012) significantly improved in both groups.

CONCLUSION

A short-term vacation with regular exercise was well tolerated by the study participants and improved well-being, sleep quality, HRV and autonomic regulation.

TRIAL REGISTRATION

Registry and the registration no. of the study/trial: Approval was received from the ethics committee of the Leopold Franzens University of Innsbruck (AN2013-0059 332/4.8).

A Two-Week Vacation in the Tropics and Psychological Well-Being-An Observational Follow-Up Study

Despite the vast annual number of international visitors to the tropics, surprisingly little data are available on the psychological well-being associated with the travels or with travelers’ diarrhoea (TD). We herein recruited participants of a vaccination trial, OEV-123, before their 12-day holiday in Benin, West Africa. We assessed the travelers’ psychological distress with a general health questionnaire (GHQ-12) and retrieved data on TD from the trial database. The GHQ-12 was completed before (wave 0), at return (wave 1), and 1-month after (wave 2) the trip. Of the 174 participants, 73% were women, with a mean age 40 years. Moreover, 24% reported psychological distress before traveling, 10% immediately after, and 16% 1-month after the trip (GHQ-12, 3 or more; 0−12 scoring). The findings showed that psychological well-being increased after the tropical holiday. The GHQ-12 middle wave sum score differed from the wave 0 (p < 0.001) and wave 2 (p = 0.008) sum scores, with travelers reporting highest levels of well-being on their return, with evidence of a lasting improvement. TD was experienced by 71%, and it had a negative impact on psychological well-being only if experienced after travel.

Inducing wellbeing through staycation programs in the midst of the COVID-19 crisis

The COVID-19 pandemic aftermath has aggravated its traumatic effect to engender a mental health crisis. With increasingly worsened psychological wellbeing, it is the responsibility of tourism scholars and operators alike to explore how contemporary tourism offerings can enable individuals to rebuild hope and optimism through relishing tourism's restorative appeals amid rigid border lockdowns. However, it remains unclear whether tourists are able to restore themselves from staycation programs, since tourists have a tendency to favor a novel space, as opposed to a usual travel environment. To address this question, we relied upon a government-funded staycation campaign using a survey to assess a transformative process leading from travel motivation and restoration to fortifying psychological capital and wellbeing. Drawing on theories pertaining to attention restoration, psychological capital, and involvement, our findings unravel a travel transformative mechanism of staycation programs that build a linkage between travel motivation and favorable psychological outcomes amid adverse circumstances.

Evaluating the Effectiveness of a One-Week Multimodal Prevention Program for Slowing down and Stress Reduction Performed in a German Health Resort: Results of a Randomized Controlled Trial

BACKGROUND

Effective concepts are required to overcome the negative impact of daily stressful overwhelming. We investigated the effectiveness of a 1-week multimodal program for stress reduction.

METHODS

We performed a randomized controlled trial including adults with above-average stress level. The intervention consisted of health coaching, relaxation, physical activity, and balneotherapeutic elements. Individuals were randomized either to the intervention group (IG) or to one of the two control groups B and C. The main outcome was change in stress (Perceived Stress Questionnaire [PSQ], Screening Scale of Chronic Stress of the Trier Inventory for Chronic Stress [TICS-SSCS]) at 6 months post intervention; further outcomes were well-being (World Health Organization 5-Item Well-Being Index [WHO-5]) and health status (EuroQol visual analog scale [EQ-5D VAS]). Data were collected pre/post intervention as well as after 1, 3, and 6 months.

RESULTS

Data of 96 individuals (mean age 48.0 years, 74% female) were available for analyses. The IG improved overtime with -13.45 points for the PSQ and -6.44 points for the TICS-SSCS after 6 months. At 6-month follow-up the IG did not significantly differ from group B (PSQ: p = 0.2332; TICS-SSCS: p = 0.0805) or group C (PSQ: p = 0.0950; TICS-SSCS: p = 0.0607) when controlling for baseline (ANCOVA). Compared to group C, ANCOVA revealed significant differences in WHO-5 (p = 0.0292) and EQ-5D VAS (p = 0.0177) post intervention. At the 3- and 6-month follow-up and compared to group B, no substantial differences could be found for WHO-5 and EQ-5D VAS.

CONCLUSION

The results indicate that even a short-term multimodal program for stress reduction appears to set a positive trend towards less perceived and chronic stress.

A Conservation of Resources schema for exploring the influential forces for air-travel stress

Effective air-travel stress management is increasingly crucial in determining tourist satisfaction and travel choices, particularly in a time of intensive fear about virus, terrorism, and plane crashes. However, research about air-travel stress, particularly what and how various influential forces shape passenger stress levels, is still in its infancy. The current research proposes the adoption of Conservation of Resources (COR) theory as a holistic schema to identify through resource dynamics the potential influential forces for air-travel stress across leisure travel stages. The findings, based on surveying passengers at the gate of multi-country international and domestic airports, demonstrates the capability of COR schema to predict and explain the influences on air-travel stress from an array of personal and situational/trip-specific factors. The theoretical advances from COR-based cross-stage stress analyses, and the guidance for customized airline/airport stress-soothing service strategies are discussed.

Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness

It is well established that leisure vacations markedly improve well-being, but that these effects are only of short duration. The present study aimed to investigate whether vacation effects would be more lasting if individuals practiced meditation during the leisure episode. Meditation is known to improve well-being durably, among others, by enhancing the mental faculty of mindfulness. In this aim, leisure vacations during which individuals practiced meditation to some extent were compared with holidays not including any formal meditation practice as well as with meditation retreats (characterized by intense meditation practice) utilizing a naturalistic observational design. Fatigue, well-being, and mindfulness were assessed ten days before, ten days after, and ten weeks after the stays in a sample of 120 individuals accustomed to meditation practices. To account for differences in the experience of these stays, recovery experiences were additionally assessed. Ten days after the stay, there were no differences except for an increase in mindfulness for those practicing meditation. Ten weeks after the stay, meditation retreats and vacations including meditation were associated with greater increases in mindfulness, lower levels of fatigue, and higher levels of well-being than an "ordinary" vacation during which meditation was not practiced. The finding suggests that the inclusion of meditation practice during vacation could help alleviate vacations' greatest pitfall, namely the rapid decline of its positive effects.

Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

BACKGROUND

Older persons may suffer more from travel-related health problems because of ageing and underlying chronic disorders. Knowledge on who is more likely to have these health problems helps to tailor travel health advice more specifically. This study aimed to determine predictors of travel-related morbidity in older travellers by assessing their pre-travel characteristics and performance using physical and cognitive functioning tests.

METHODS

Multicentre prospective cohort study among older travellers (≥60 years) who consulted one of the participating Dutch travel clinics. Handgrip strength and cognitive performance were measured pre-travel. Participants completed questionnaires before departure and 1 and 4 weeks after return. A diary recorded health complaints during travel until 2-week post-travel.

RESULTS

In total, 477 travellers completed the study (follow-up rate of 97%). Participants' median age was 66 years. The most visited regions were South-East Asia (34%) and South Asia (14%). Median travel duration was 19 days. Polypharmacy (≥5 medications per day) was not uncommon (16%). The median Charlson Comorbidity Index (CCI) score was 0. Self-reported travel-related infectious diseases concerned primarily respiratory tract infections (21%) and gastroenteritis (10%) whereas non-infectious complaints were injuries (13%), peripheral edema (12%) and dehydration (3%). Medical assistance was sought by 18%, mostly post-travel from their general practitioner (87%). Self-reported physical and mental health-related quality of life significantly improved during and after travel. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone and social media use.

CONCLUSION

Older Dutch travellers are generally fit, well-prepared and suffer not only from common infectious health problems, but also from injuries. Travel improved their self-perceived health. The predictors could be used to identify the more at-risk older traveller and to decrease travel-related morbidity by optimizing pre-travel advice.

Health-Oriented Tourists and Sustainable Domestic Tourism

Health-oriented tourism has emerged as one of the fastest-growing niche tourism fields worldwide. Although there have been studies on the relationship between health and travel behavior, most have been from the perspective of travel motivation and have rarely examined the impact of travel on health. This study explores those travel elements that have a positive influence on health in the domestic health tourism industry, with health being viewed across three domains: psychological, physical, and social. A total of 28 health-contributing travel items reported by 862 package tour participants were analyzed. On the psychological health dimension, experiencing good feelings and escaping bad ones is important. On the physical wellness dimension, natural patterns of food intake during the day is strongly recognized, including the results of increased appetite and improved digestion. On the social health dimension, relationship improvements were experienced, along with a greater understanding of partner(s). These findings add to our understanding of traveler wellness, a significant step towards having the right information to enhance the quality of travel services, especially in the domestic health tourism industry.

Does Physical Activity during Alpine Vacations increase Tourists' Well-Being?

Physical activities have been proven to have an impact on general well-being in everyday life; however, literature lacks an analysis of the effects of physical activities in vacation settings. Thus, the study aimed at assessing the impacts of physical activity on well-being during vacation by taking a longitudinal approach. We utilized a pre-post within-subject design (n = 101) by testing vacationers prior to, during, and after their vacation in an alpine environment. Therefore, a series of eight linear mixed model analyses of co-variance was performed. The results suggested that the duration of a vacation and the amount of physical activity have a positive impact on the components of well-being, which was expressed by changes in the activation, elation, excitement, and calmness subscales of the Mood Survey Scale. Demographic patterns did not reveal any influences. Physical activity might be a marker for well-being, which influences people's everyday life and leisure time behavior by motivating them to engage in more physical activity. This research extends the existing literature by (1) proving the effects of vacations on well-being, (2) pointing out the effects of demographic predeterminations, and (3) gathering in-depth knowledge about the role of physical activity in changes to well-being.

[Impact of assisted vacations on female caregivers' burden]

Impact of assisted vacations on female caregivers' burden Abstract.

BACKGROUND

In everyday life, female caregivers experience various burdens due to their responsibilities and challenges. To relief and regenerate from the stressful daily routine, assisted vacations may be a viable option. Previously, there were no empirical findings available that focus on requirements and expectations of female caregivers. Neither do they provide information about the organisation nor do they provide information about the implementation of assisted vacations.

AIM

The aim of the study was to collect data concerning the attitudes and expectations of female caregivers about assisted vacations to identify positive effects and elements.

METHODS

Ten problem-centered interviews with female caregivers, a group interview with four staff members of a supplier of assisted vacations, and one expert interview with the management of the supplier were operated. To analyse the gathered data the qualitative content analysis by 13-2Gläser & Laudel was conducted (2010).

RESULTS

A specific anamnesis beforehand the assisted vacations, a continuous development of trust and relationships as well as a professional proactive support and take-over of nursing activities can help female caregivers to enjoy restful and relieving holidays. Six identified conditions contribute to experience a recreative assisted vacation.

CONCLUSIONS

Staff members who accompany assisted vacations get lots of information about family caregivers. This could be used for ongoing support of family caregivers after the assisted vacations to reduce their burden.

Short Vacation Improves Stress-Level and Well-Being in German-Speaking Middle-Managers-A Randomized Controlled Trial

Stress in the work place has a detrimental effect on people's health. Sufficient recovery is necessary to counteract severe chronic negative load reactions. Previous research has shown that vacationing for at least seven consecutive days provided an efficient recovery strategy. Yet, thus far, the effects of short vacations and the mode of vacation (whether at home or in a new environment) have rarely been studied. We investigated the immediate and long-term effects of a short vacation (four nights) on well-being and perceived stress and whether the mode of vacation impacted on these results. Data was obtained from 40 middle managers (67.5% men and 32.5% women). The intervention group (n = 20) spent a short vacation in a hotel outside their usual environment. The control group (n = 20) spent their vacation at home. Results indicated that one single short-term vacation, independent of the mode, has large, positive and immediate effects on perceived stress, recovery, strain, and well-being. Strain levels decreased to a greater extent in the intervention group compared to the control group. The effects can still be detected at 30 days (recovery) and 45 days (well-being and strain) post-vacation. Encouraging middle management employees to take short vacations seems to be an efficient health promotion strategy; environmental effects seem to play a minor role.

Psychological Resources and Self-rated Health Status on Fifty-year-old Women

Objectives

The aim of the study is to expand knowledge about predictors of the self-rated health and mental health in fifty-year-old women. The study exploring links between self-rated mental/health and optimism, self-esteem, acceptance of the changes in physical look and some sociodemographic factors.

Methods

Participants in this study were 209 women aged 50 to 59. A single-items measures of self-rated health and mental health were used. Self-esteem was measured through the Rosenberg Self-Esteem Scale; optimism through the OPEB questionnaire; acceptance of the changes in physical look was rated by respondents on a seven-point scale. Participants were also asked about weight loss attempts, the amount of leisure time, and going on vacation during the last year.

Results

Predictors of the self-rated mental health in women in the age range of 50 to 59 were: acceptance of the changes in physical look, self-esteem and optimism. Predictors of the self-rated health were: optimism and acceptance of the changes in physical look.

Conclusion

Optimism and acceptance of the changes in physical look seem to be important factors that may impact subjective health both physical and mental of women in their 50s. The role of the leisure time and vacation in instilling the subjective health requires further investigation.

The treatment experience questionnaire: development and validation of a questionnaire assessing the individual's emotional, perceptual, and cognitive reactions to alternative, physical, and dental treatments

BACKGROUND

The aim of this study was to develop and validate a questionnaire designed to assess the patient's affective, cognitive, and perceptual state during treatment administration.

METHODS

362 individuals (214 females, 148 males, mean age 54.6 years) with predominantly musculoskeletal or dental problems participated in the study. Patients responded to the questionnaire immediately following a treatment. The questionnaire included items of 9 proposed scales devised to assess mood, psychological tension, sleepiness, mental absorption, treatment appraisal, perceived cooperation during treatment administration, perceived somatosensory intensity of treatment as well as negative and positive bodily sensations during treatment. Treatments were administered in 2 spa centers, a clinic for physical medicine and rehabilitation and a clinic for dentistry. Treatments investigated were among others dental treatment, massage, packs, baths, relaxation training, exercise, and acupuncture.

RESULTS

The proposed scales were confirmed. Scales had adequate to good reliability and validity. All scales significantly distinguished between treatments.

CONCLUSION

The devised questionnaire has adequate properties to assess patients' experiences during treatment administration.

The relationship between nature-based tourism and autonomic nervous system function among older adults

BACKGROUND

Nature-based tourism has recently become a topic of interest in health research. This study was aimed at examining relationships among nature-based tourism, stress, and the function of the autonomic nervous system (ANS).

METHODS

Three hundred and twenty-two older adults living in Taichung City, Taiwan, were selected as participants. Data were collected by a face-to-face survey that included measures of the frequency of participation in domestic and international nature-based tourism and the stress and ANS function of these participants. The data were analyzed using a path analysis.

RESULTS

The results demonstrated that the frequency of participation in domestic nature-based tourism directly contributed to ANS function and that it also indirectly contributed to ANS function through stress reduction.

CONCLUSIONS

Domestic nature-based tourism can directly and indirectly contribute to ANS function among older adults. Increasing the frequency of participation in domestic nature-based tourism should be considered a critical element of health programs for older adults.

Effects of a social cognitive theory-based hip fracture prevention web site for older adults

The purposes of this study were to develop a Social Cognitive Theory-based, structured Hip Fracture Prevention Web site for older adults and conduct a preliminary evaluation of its effectiveness. The Theory-based, structured Hip Fracture Prevention Web site is composed of learning modules and a moderated discussion board. A total of 245 older adults recruited from two Web sites and a newspaper advertisement were randomized into the Theory-based, structured Hip Fracture Prevention Web site and the conventional Web sites groups. Outcomes included (1) knowledge (hip fractures and osteoporosis), (2) self-efficacy and outcome expectations, and (3) calcium intake and exercise and were assessed at baseline, end of treatment (2 weeks), and follow-up (3 months). Both groups showed significant improvement in most outcomes. For calcium intake, only the Theory-based, structured Hip Fracture Prevention Web site group showed improvement. None of the group and time interactions were significant. The Theory-based, structured Hip Fracture Prevention Web site group, however, was more satisfied with the intervention. The discussion board usage was significantly correlated with outcome gains. Despite several limitations, the findings showed some preliminary effectiveness of Web-based health interventions for older adults and the use of a Theory-based, structured Hip Fracture Prevention Web site as a sustainable Web structure for online health behavior change interventions.

An Investigation of the Role of Non–Work-Time Behavior in Buffering the Effects of Work Strain

OBJECTIVE

In this exploratory study, we investigated the extent to which common leisure time behaviors, which generate positive feelings of fulfillment and personal reward, are significant in alleviating work-induced stress between successive work periods. We tested the hypotheses that such activities increase recovery from stress directly, and also by improving sleep quality, thereby alleviating maladaptive outcomes from work strain.

METHOD

An on-line survey study was completed by a heterogeneous sample of 314 workers in diverse occupations, in good health.

RESULTS

Non-work-time behaviors play a significant role in mediating maladaptive outcomes from work strain. Multivariate analysis of these relationships indicates both direct and indirect effects, the latter being associated with mediating sleep quality. Respondents reporting higher levels of active leisure activities, exercise, and creative (hobby) and social activity, reported significantly better sleep, recovery between work periods, and lower chronic maladaptive fatigue symptomology.

CONCLUSION

Active and fulfilling non-work-time behaviors are more significant in maximizing recovery from work strain than is commonly recognized. This effect is arguably due to the downregulation of stress-induced brain arousal, and stimulation of the pleasure-reward brain neurophysiology. Consistent recovery from work strain between work periods may represent a crucial factor in avoiding work-related "loss spirals" leading to maladaptive health outcomes, which can be particularly relevant to workers in inherently stressful occupations.

Combined Inpatient Rehabilitation and Spa Therapy for Breast Cancer Patients

The present study investigated the changes of quality of life, mood, and the tumor marker CA 15-3 associated with a 3-week inpatient breast cancer rehabilitation program incorporating spa therapy. One hundred forty-nine women, 32 to 82 years, participated in the study 3 to 72 months after breast cancer surgery. Quality of life (QoL, EORTC QLQ-C30), anxiety, and depression (HADS) were measured 2 weeks before, at the end, and 6 months after rehabilitation; CA 15-3 at the beginning, end, and at 6 months follow-up. Patients received an individualized rehabilitation program incorporating manual lymph drainage, exercise therapy, massages, psychological counseling, relaxation training, carbon dioxide baths, and mud packs. Quality of life and mood improved significantly, the greatest short-term improvements found for mood-related aspects of quality of life, the most lasting improvements found for physical complaints (eg, fatigue). Also, the tumor marker CA 15-3 declined significantly to follow-up. Patient characteristics, as well as the time since surgery, moderated rehabilitation outcome to a limited extent. Older patients, nonobese patients, patients with a greater lymphedema, and patients with an active coping style showed slightly greater improvements. Hot mud packs inducing hyperthermia did not affect CA 15-3. In conclusion, the combination of inpatient rehabilitation with spa therapy provides a promising approach for breast cancer rehabilitation.