Psychosocial Correlates of Mental Health and Well-Being During the COVID-19: The Spanish Case

Ambulance Services Attendance for Mental Health and Overdose Before and During COVID-19 in Canada and the United Kingdom: Interrupted Time Series Study

BACKGROUND

The COVID-19 pandemic impacted mental health and health care systems worldwide.

OBJECTIVE

This study examined the COVID-19 pandemic's impact on ambulance attendances for mental health and overdose, comparing similar regions in the United Kingdom and Canada that implemented different public health measures.

METHODS

An interrupted time series study of ambulance attendances was conducted for mental health and overdose in the United Kingdom (East Midlands region) and Canada (Hamilton and Niagara regions). Data were obtained from 182,497 ambulance attendance records for the study period of December 29, 2019, to August 1, 2020. Negative binomial regressions modeled the count of attendances per week per 100,000 population in the weeks leading up to the lockdown, the week the lockdown was initiated, and the weeks following the lockdown. Stratified analyses were conducted by sex and age.

RESULTS

Ambulance attendances for mental health and overdose had very small week-over-week increases prior to lockdown (United Kingdom: incidence rate ratio [IRR] 1.002, 95% CI 1.002-1.003 for mental health). However, substantial changes were observed at the time of lockdown; while there was a statistically significant drop in the rate of overdose attendances in the study regions of both countries (United Kingdom: IRR 0.573, 95% CI 0.518-0.635 and Canada: IRR 0.743, 95% CI 0.602-0.917), the rate of mental health attendances increased in the UK region only (United Kingdom: IRR 1.125, 95% CI 1.031-1.227 and Canada: IRR 0.922, 95% CI 0.794-1.071). Different trends were observed based on sex and age categories within and between study regions.

CONCLUSIONS

The observed changes in ambulance attendances for mental health and overdose at the time of lockdown differed between the UK and Canada study regions. These results may inform future pandemic planning and further research on the public health measures that may explain observed regional differences.

Higher anxiety and perceived trauma among COVID-19 patients: a prospective comparative study

BACKGROUND AND PURPOSE

Psychiatric disorders such as anxiety, depression, and traumatic stress are not rare during infectious outbreaks, as the COVID-19 pandemic has posed a great concern to the general population. In this study, we aimed to investigate whether experiencing psychiatric symptoms during COVID-19 is the result of the burden of carrying an illness or the COVID-19 itself.

METHOD

Two hundred ten subjects and three different groups of participants (COVID-19 patients, university staff, and orthopedic patients) were recruited. They answered a demographic questionnaire, Yale-Brown Obsessive-Compulsive Scale (YBOCS) test for OCD symptoms, Impact of Event Scale-Revised (IES-R) for perceived trauma, Beck Anxiety Inventory (BAI) for anxiety, and Beck Depression Inventory (BDI) for depression assessments using phone or face-to-face interviews.

RESULT

At least one OCD symptom was observed in 85.7% of the subjects. However, there was no significant difference between the 3 groups (p = 0.2194). Perceived trauma was significantly higher among COVID-19 patients followed by university staff and orthopedic patients (23.73, 16.21, 11.51 mean IES-R scores respectively, p = 8.449e^-14). COVID-19 patients also showed higher anxiety (mean BAI score: 17.00) than the university staff and orthopedic patients' group (9.22 and 5.56 respectively) (p = 6.175e^-08). BDI score did not show much variation for depression, the mean score was 9.66, 9.49, and 6.7 for the COVID-19 patients, university staff, and orthopedic patients respectively, (p = 0.2735).

CONCLUSION

Perceived trauma and anxiety symptoms are significantly higher in COVID-19 patients and the symptoms of OCD and depression do not differ between COVID-19 and non-COVID-19 people, so the necessity of screening and following treatment of patients with COVID-19 should be kept in mind.

TRIAL REGISTRATION

IR.IUMS.FMD.REC.1399.761.

Motivation of Teleworkers and Non-teleworkers in Times of COVID-19 in Spain: An Exploratory Study Using Non-parametric Analysis and Classification and Regression Trees

With the outbreak of COVID-19 in spring 2020, small, medium, and large companies were forced to cope with the unexpected circumstances. Faced by this health emergency, it was necessary to ensure that staff remained motivated and that they could continue to carry out their duties despite the obstacles. The main goal of this exploratory research was to characterize employees who teleworked and who did not, and their motivation during the lockdown. A total of 11,779 workers from different-sized companies in various sectors answered an ad hoc questionnaire. By using non-parametric comparisons and Classification and Regression Trees (CRTs), the results show differences in both the assessment of strategies put into practice by the companies and the level of motivation of teleworkers and non-teleworkers, with the latter being more highly motivated. Nonetheless, teleworkers assessed their companies’ strategies and the role of their managers and colleagues more positively. This research helps to understand how different sectors have dealt with the crisis, according to the degree of teleworking implemented in each sector, and to what extent the motivation of the employees has been affected. The analysis of the large amount of data obtained confirms the importance of the role of managers in sustaining the motivation of their subordinates in times of crisis. In this sense, it is necessary to develop managers’ competencies in order to develop and maintain relations of trust and support with their coworkers. On the other hand, it is necessary to foster employees’ sense of meaningfulness and responsibility at work in order to keep them motivated.

Mental, Physical and Socio-Economic Status of Adults Living in Spain during the Late Stages of the State of Emergency Caused by COVID-19

Research has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people's lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.

Health outcomes and psychosocial risk exposures among healthcare workers during the first wave of the COVID-19 outbreak

The aim is to describe the health and psychosocial risk factors of Spanish healthcare workers during the COVID-19 pandemic.

METHODS

A cross-sectional study by means of an online questionnaire (April-May 2020). The data comes from the database resulting from the COTS project "Working conditions, insecurity, and health in the context of the COVID-19 pandemic". The sample consisted of 1989 health care workers.

RESULTS

Women, young people (doctors and nurses) and the middle-aged (assistants) had poorer health and greater exposure to psychosocial risks. Geriatric assistants were the most-affected occupational group.

CONCLUSIONS

gender, occupation, and age are focuses of inequality in the exposure of health care workers to psychosocial risks.

Predictors of Psychological Distress and Coronavirus Fears in the First Recovery Phase of the Coronavirus Disease 2019 Pandemic in Germany

Objectives: While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic symptom levels and possible predictors of symptom levels in the pandemic's recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels. Methods: Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability factors, were administered through a national, cross-sectional online survey (n = 2160, mean age 42.7 years, 75% female), asking participants for their current symptom levels and their symptom levels prior to the COVID-19 pandemic. Results: Our findings show significantly elevated levels of depression, anxiety, somatic symptoms, and health anxiety in the recovery period compared to before the pandemic. The current prevalence rates based on self-reporting were 26.7% for depression, 24.5% for anxiety, and 29% for somatization. The strongest predictors of these symptom reports included domain-specific pre-existing symptom levels, neuroticism, biological COVID-19 risk factors, avoidance of illness information, and younger age. The most important predictors of COVID-19 fears were subjective COVID-19 risk perception, followed by pre-existing health anxiety, the number of biological COVID-19 risk factors, older age, neuroticism, avoidance of illness information and female gender. Discussion: These findings indicate the need for specific psychological programs to help individuals with enhanced psychological and biological vulnerability to cope better with the mental distress experienced during all phases of the ongoing COVID-19 crisis.

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.

Data-Driven Methodology for Coliving Spaces and Space Profiling Based on Post-Occupancy Evaluation through Digital Trail of Users

Sustainable spaces are those that are optimized, accessible, promote user experience and aim to reduce CO2 emissions while enhancing users’ well-being and comfort. The purpose of this paper is to present a methodology that was developed during the COVID-19 pandemic to understand and improve the use of coliving spaces based on remote Post-Occupancy Evaluation (POE) analysis of the digital trail generated by the users. Applying the POE methodology based on data collection from IT infrastructure enabled to identify opportunities to improve the future design of human-centered spaces. The residential market, design-wise traditional for centuries, is now facing a high-speed adaptation to the changing needs, accelerated by the COVID-19 crisis. New ways of living and shared spaces like Coliving are escalating. Technology is both an enabler of this shift in housing and the solution to operating and managing these new buildings. This paper demonstrates, through the case study of a Coliving space located in Madrid, Spain, the benefits of implementing data analysis of the digital trail collected from in-built IT systems such as smart locks, Wi-Fi networks and electric consumption devices. The conclusion is that analysing the available data from the digital infrastructure of coliving buildings can enable practitioners to improve the future design of residential spaces.

Impact of the COVID-19 Pandemic on Higher Education: Characterizing the Psychosocial Context of the Positive and Negative Affective States Using Classification and Regression Trees

Our aim is to analyze the extent to which the psychosocial aspects can characterize the affective states of the teachers, administrative staff, and undergraduate and postgraduate students during the quarantine. A questionnaire was answered by 1,328 people from the community of the Universitat de Barcelona (UB), Spain. The survey was partially designed ad hoc, collecting indicators related to sociodemographic variables, the impact of COVID on the subjects or in their personal context, the psychosocial context of coexistence and perceived social support, characteristics related to the physical context during the quarantine, and labor conditions. Additionally, it included two validated instruments: the Survey Work-Home Interaction-Nijmegen for Spanish Speaking Countries (SWING-SSC) validated in Spanish and PANAS, the Positive and Negative Affect Schedule. Classification and Regression Trees (CART) were performed to identify which variables better characterize the participants' level of positive and negative affective states. Results according to groups showed that students are the ones who have suffered the most as a result of this situation (temporary employment regulation, higher scores in negative work-home and home-work interaction, lower scores in positive home-work interaction, and negative effects of teleworking). Additionally, they reported a higher mean score in interpersonal conflict and worse scores with regard to negative affective states. Based on sex, women were the ones whose environment was shown to be more frequently affected by the pandemic and who exhibited more negative effects of teleworking. In general terms, participants with the highest scores in negative affective states were those who perceived an increase in conflict and a high negative effect from work spilling over into their personal lives. On the contrary, participants with the highest levels of positive affective states were those with medium to low levels of negative home-work interaction, over 42.5 years old, and with medium to high levels of positive work-home interaction. Our results aim to help higher education to reflect on the need to adapt to this new reality, since the institutions that keep pace with evolving trends will be able to better attract, retain, and engage all the members of the university community in the years ahead.

Anxiety and Worries among Pregnant Women during the COVID-19 Pandemic: A Multilevel Analysis

Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.

Mental Well-Being of Chinese Immigrants in the Netherlands during the COVID-19 Pandemic: A Survey Investigating Personal and Societal Antecedents

The COVID-19 pandemic has profoundly impacted people’s lives worldwide, with negative consequences for mental health and well-being. Antecedents of mental health and well-being in times of COVID-19 have been underresearched, especially among minority groups. Therefore, an online survey was conducted investigating the personal and societal antecedents of mental well-being among Chinese immigrants in the Netherlands (N = 268). Constructs included perceived decrease of mental well-being and attitude toward the Netherlands as dependent variables and a range of potential antecedents as independent variables. Results show that participants judged the Chinese COVID-19 situation significantly more positively than the Dutch situation. Five antecedents of decreased mental well-being were found: financial concerns, social isolation, feelings of lost time, experienced racism, and distrust of Dutch COVID-19 information and figures. The antecedents of participants’ attitude toward the Netherlands were largely different: missing China, perceived difficulty of traveling to China, distrust of Dutch government measures, trust in Chinese government measures, and distrust of Dutch COVID-19 information and figures. Fear of the virus itself did not significantly affect either of the dependent variables. The results call for a broad perspective on factors associated with mental well-being and for special attention for minority groups in the societal dynamics.

Rethinking Strategies and Programs to Improve Physical and Emotional Well-being Among Healthcare Professionals: Facing the New Normalcy

Background

With the advent of coronavirus disease 2019 (COVID-19), a different perspective on the future of humanity has emerged that emphasizes the importance of building the capacities of healthcare providers in order to assist them with the heavy burden that these changes have placed on them both now and in the future. A reduction in the quality of life and the presence of prolonged fatigue are some of the most imminent problems that emerge among these professionals.

Objective

The aim of this study was to determine the effectiveness of a holistic intervention (workshop) for health science students aimed at developing skills that will enable them to obtain a better self-assessment of their quality of life, and prolonged fatigue.

Methods

Pre- and post-measures of quality of life, and prolonged fatigue were obtained from 130 health science students, including a group of 96 attendees (cases) of a 4-h wellness workshop and 34 students who did not attend (controls).

Results

Paired t tests indicated a significant improvement in nearly all dimensions related to quality of life, and prolonged fatigue in the case group who attended the workshop.

Conclusions

A comprehensive wellness strategy that utilizes a holistic approach can play an important role in improving and promoting essential skills to improve healthcare provider's self-assessment about the quality of life and reduce their prolonged fatigue. The critical importance of these needs has long been recognized, and this will also be crucial for addressing new challenges and emerging realities.