Life Satisfaction during Forced Social Distancing and Home Confinement Derived from the COVID-19 Pandemic in Spain

Scoping review of the methodology of large health surveys conducted in Spain early on in the COVID-19 pandemic

Background

The use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population?

Objective

To describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic.

Methods

Scoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included.

Results

Sixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data.

Conclusions

Consistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.

Life Satisfaction Before and During COVID-19 Pandemic in Thailand

Objective: To investigate prevalence of life satisfaction in the Thai population before and during the COVID-19 epidemic, and factors associated with life satisfaction during the epidemic. Methods: Multistage sampling was used to draw a sample from the Thai population. A total of 3,115 Thai participants age 15 years or older from a nationally-representative longitudinal survey in 2019 and in 2021 were included in this study. The study applied the Scale with Life Satisfaction (SWLS) instrument to measure life satisfaction among the Thai population before and during the COVID-19 epidemic. Multiple regression analysis was used to investigate the association between life satisfaction and other variables. The follow-up survey response rate for individuals was 44.8%. Results: An average life satisfaction score during the COVID-19 epidemic (in 2021) was 22.4 which decreased from 25.5 before the COVID-19 epidemic (in 2019). More than one-third of the participants (36.5%) reported having less life satisfaction during the epidemic, which was nearly 20 percentage points higher than before the epidemic (17.7%). Controlling for life satisfaction in 2019, the analysis found statistical associations between demographic and economic characteristics and health-related behaviours, and life satisfaction during 2021. People in the older age cohorts (p ≤ 0.001), in a rural area (p ≤ 0.05), having higher education (p ≤ 0.001), still being employed (p ≤ 0.01) and becoming unemployed (p ≤ 0.01) had higher life satisfaction. The possibility of higher life satisfaction was also found in people who maintained good health (p ≤ 0.01), sufficient physical activity (p ≤ 0.001), and fruit and vegetable intake (p ≤ 0.01). People with income loss during the epidemic had lower life satisfaction (p ≤ 0.05). Conclusion: The findings suggest that policies and systems for resilience and social protection are needed for empowering individuals-especially the poor and vulnerable-to cope with crises, and improve health and wellbeing outcomes.

Health-Promoting Factors and Their Relationships with the Severity of Symptoms in Patients with Anxiety Disorders during the COVID-19 Pandemic

BACKGROUND

Anxiety disorders are one of the most common mental disorders in the modern world. The COVID-19 pandemic has led to the onset of many mental disorders in people who did not have them before. It can be suspected that in people who already had anxiety disorders before the pandemic, their quality of life has significantly deteriorated.

AIM

The aim of the study was to assess the relationships between life satisfaction, acceptance of illness, the severity of anxiety and depression symptoms and health behaviors in a group of patients diagnosed with anxiety disorders during the COVID-19 pandemic.

MATERIAL AND METHODS

The study was conducted in the period from March 2020 to March 2022. There were 70 people among the respondents, including 44 women aged 44.06 ± 14.89 years and 26 men aged 40.84 ± 16.72 years. All persons were diagnosed with generalized anxiety disorder. Patients with other co-occurring disorders were excluded, i.e., depression and signs of organic damage to the central nervous system, as were those with cognitive disorders that prevented the completion of the questionnaires. The following scales were used in the study: the Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS), Health Behavior Inventory (HBI) and Hospital Anxiety and Depression Scale (HADS). Spearman's rank correlation coefficient and the Mann-Whitney U test were used for statistical analyses.

RESULTS

In the Satisfaction in Life questionnaire, the respondents obtained an average score of 17.59 ± 5.74 points. In the AIS scale, the mean score obtained by the patients was 27.10 ± 9.65 points. In the overall Health Behavior Inventory (HBI), the average score was 79.52 ± 15.24 points. In the HADS questionnaire, probants obtained an average of 8.17 ± 4.37 points in the depression subscale and 11.55 ± 4.46 points in the anxiety subscale. In addition, there were significant negative correlations between life satisfaction (SWLS) and the severity of anxiety and depression (HADS). The lower the perceived quality of life, the significantly higher the anxiety and depressive disorders. The result obtained in the Health Behavior Inventory (HBI) as well as in the subscale of Prohealth Activities (PHA) was negatively associated with the severity of anxiety symptoms. Prohealth activities should therefore be developed to prevent anxiety disorders, as well as to promote positive mental attitudes. In the study, the average result obtained in the subscale of positive mental attitudes correlated negatively with both anxiety and depressive symptoms.

CONCLUSIONS

Life during the pandemic was assessed by patients as unsatisfactory. Health-promoting behaviors, and especially positive mental attitudes, may play a protective role in relation to anxiety and depressive symptoms in a situation of increased stress related to the COVID-19 pandemic in a group of patients with anxiety disorders.

Psychosocial and Health Effects of the COVID-19 Pandemic Experienced by Staff Employed in Social Welfare Facilities in Poland and Spain

The COVID-19 pandemic had a very significant negative impact on the physical and mental health of various professional groups. Therefore, the aim of this study was to assess the psychosocial and health effects of the COVID-19 pandemic experienced by staff employed in social welfare institutions in Poland and Spain. The study involved 407 people, including 207 from Poland and 200 from Spain (346 women and 61 men), working in social care facilities. The research tool was the authors' questionnaire consisting of 23 closed-ended, single- or multiple-choice questions. The study has indicated that the COVID-19 pandemic had negative health and psychosocial effects on employees of social welfare facilities. In addition, it has been shown that the severity of the psychosocial and health effects of the COVID-19 pandemic differed between the countries studied. Employees from Spain statistically significantly more often declared deterioration in most of the surveyed indicators, except for mood deterioration, which was experienced more by employees from Poland than their peers from Spain.

Parenting a Child with a Neurodevelopmental Disorder during the Early Stage of the COVID-19 Pandemic: Quantitative and Qualitative Cross-Cultural Findings

Research during the COVID-19 pandemic has shown a strong relationship between child symptoms, parental stress, and mental health challenges. The pandemic has changed family routines, worsening child symptomatology and parental burden. The aim of this study was to investigate how the magnitude of the perceived changes in child externalizing behavior, parental stress, and discontinuity of therapy-from before to during the COVID-19 pandemic-affected parental mental health during the pandemic. Moreover, we sought to compare these aspects cross-culturally between European countries and the USA. To these purposes, we asked Italian, Spanish, and U.S. parents of children with neurodevelopmental disabilities (NDD) to complete an online survey. Quantitative results showed that increased parental stress may have contributed to a worsening in parental psychological distress, regardless of culture. Moreover, they suggested an indirect effect of child externalizing behaviors on parents' psychological distress via parental stress. Qualitative analyses highlighted that the lack, or discontinuity, of therapeutic activities may have been one of the key contributors to parenting burden during the COVID-19 pandemic. Finally, qualitative results highlighted resilience factors that could have decreased the risk of psychological problems during the pandemic, such as a strong sense of parental efficacy and the ability to adapt to changing family dynamics.

Trajectories in life satisfaction before and during COVID-19 with respect to perceived valence and self-efficacy

Actions taken by governments to counteract the spread of the COVID-19 pandemic led to profound restrictions in daily lives, especially for adolescents and young adults, with closed schools and universities, travel restrictions, and reduction in social contacts. The purpose of the current study is to investigate the development of life satisfaction with assessments before and during the pandemic, including separate measurement occasions during a strict lockdown and when the implemented restrictions were relaxed again. Data are based on the German Personality Panel (GePP) with 1,920 young adults, assessed on four measurement occasions over a period of three years. Using latent change score modeling, we investigate the outbreak of the COVID-19 pandemic with respect to its perception as a critical life event over time. Further, we examine the influence of self-efficacy on change in life-satisfaction, as the belief in one's innate abilities has been shown to promote health related behavior and buffers against effects of negatively perceived critical life events. While average life satisfaction remained stable across time, we found a main effect of perceived positive valence and self-efficacy on latent change in life satisfaction at the within person level. Expressions of self-efficacy did not moderate the influence of the perception of the pandemic on self-reported life satisfaction. This study provides an important contribution to the recent COVID-19 literature as well as to the debate on stability and change of self-reported life satisfaction.

Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study

OBJETIVES

To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown.

DESIGN

Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation.

SETTING

Senior centres in the Region of Murcia (Spain).

PARTICIPANTS

The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet.

RESULTS

Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017).

CONCLUSION

The lockdown had a great negative impact on Spanish older women on mental well-being variables.

TRIAL REGISTRATION NUMBER

NCT04958499.

Anxiety, Worry, Life Satisfaction and Coping During the Acute VS Prolonged Pandemic Stress: Evidence From a Repeated Cross-Sectional Study

Objectives: The COVID-19 pandemic remains a continuous stressor worldwide. Our study aimed at comparing the data of waves from two lockdowns in Georgia, one in the acute stress phase (May 2020) and the other in the prolonged stress phase (December 2020).

Methods: In total, 750 and 716 individuals participated in the study with a repeated cross-sectional design. Sample equivalence was reached via controlling demographic variables. Anxiety, COVID-19 worry, and life satisfaction were measured along with coping behaviors and four coping styles—information-accessing/processing and action-planning (two problem-focused coping styles), and passive-submissive and avoidant (two emotion-focused coping styles).

Results: As pandemic prolonged, mental health indicators worsened, the action-planning style and behavioral coping decreased, while the information-accessing/processing style increased. The link between the COVID-19 worry and the action-planning coping style was strong in the acute stage and dissapeared in the prolonged stage. The individual context, namely, a history of coronavirus in the household, accounted for lower protective behaviors and higher information seeking in the prolonged phase.

Conclusion: The findings highlighted the importance of timing and general and individual contexts in coping with the pandemic.

Effects of Social Isolation Measures Caused by the COVID-19 Pandemic on Occupational Balance, Participation, and Activities' Satisfaction in the Spanish Population

The COVID-19 pandemic caused a lot of social and health chaos. Our main aim in this study was to examine the impact of the COVID-19 pandemic on occupational balance in the Spanish population, one year post the beginning of the pandemic compared with the pre-pandemic period. Data were collected among the Spanish population over 18 years of age by the Occupational Balance Questionnaire online survey; questions about satisfaction and performance of activities, and on the modification of routine and habits were asked. A total of 300 participants were included; 55.3% were female, with a mean age of 41.39 years. Significantly greater occupational imbalance was found in 1-year-post-confinement period of pandemic, as well as an increase in the difficulty of performance and a decrease in satisfaction with it. A greater number of the sample had modified their routines (p < 0.01), lost habits (p < 0.01), and did not resume habits (p < 0.01). In the analysis by age groups, differences were found in the variables related to habits and occupational balance. The social restriction measures negatively impacted occupational balance in the Spanish population. There was a decrease in occupational participation, increased difficulty in performance, decreased satisfaction in occupational performance, and modification of habits and routines.

The positive and negative effects of the COVID-19 pandemic on subjective well-being and changes in social inequality: Evidence from prefectures in Japan

This study aims to specify the effects of the COVID-19 pandemic on individual subjective well-being in Japan and to clarify the mechanism generating social inequality of subjective well-being during the crisis. Data were analyzed using fixed effects ordinary least squares (OLS) regression models from the Online Panel Survey of Social Stratification and Psychology in 2020 (SSPW2020-Panel), which was conducted in four waves in June 2020, September 2020, December 2020, and March 2021. The results reveal that COVID-19 spread in a prefecture had differential effects on subjective well-being in prefectures with high infection rates: positive effects for socially advantaged individuals and negative effects for socially disadvantaged individuals. In conclusion, social inequality in Japan, in terms of subjective well-being, has been widened by the COVID-19 pandemic during 2020.

The Effect of Nurses' Death Anxiety on Life Satisfaction During the COVID-19 Pandemic in Turkey

The purpose of the study is to determine the effect of nurses' death anxiety on life satisfaction during the COVID-19 pandemic. This cross-sectional and correlational study was conducted with 411 nurses in Turkey. Data were collected online through Google Forms using a sociodemographic form, the Revised Death Anxiety Scale (RDAS), and the Satisfaction with Life Scale (SWLS). Percentages, means, Pearson's correlation analysis, and hierarchical linear regression models were used to analyze the data. The nurses' mean age was 28.11 (SD = 6.27) years. More than half of the nurses stated that there were COVID-19 patients in the clinic where they worked (56.0%) and that they were afraid to provide care to patients diagnosed with COVID-19 (54.5%). Their mean RDAS total score was 57.33 (SD = 16.20), indicating moderate death anxiety, and their mean SWLS total score was 2.58 (SD = 0.82), indicating a low level of life satisfaction. Sociodemographic variables accounted for 8.8% of the variance. Death anxiety was associated with life satisfaction (β =  - 0.118, p < 0.05). Model 3, which included all of the analyzed independent variables, explained 17% of the variance in life satisfaction (R² = 0.171, p < 0.001). This study showed that death anxiety adversely affects life satisfaction. Higher death anxiety among nurses was associated with lower satisfaction with life. Based on the findings, we recommend providing more psychological and communication support to nurses and implementing systematic physical and psychological evaluations of nurses to facilitate early intervention.

An evaluation of community satisfaction with the government's COVID-19 pandemic response in Aceh, Indonesia

Countries around the world are still struggling due to the COVID-19 pandemic. No exception with Indonesia, a developing country with the highest mortality rate and the lowest number of tests in Asia. Located in the northernmost, Aceh is one of the poorest provinces with a history of long-term conflict is not in the best condition to face a pandemic. This study's objective is to assess the local government's performance in responding to this pandemic according to the Acehnese community's level of satisfaction. Additionally, this study proposes a priority list for the local government to follow up on. A total of 529 respondents were collected within a week by the criteria of having internet access, being literate, and using WhatsApp messenger. The results show that the Acehnese are dissatisfied with the local government's performance in all districts or cities and at all stages, which include: anticipation, early detection, containment, control and mitigation, and elimination. Meanwhile, the top five priority recommendations are: conducting more rapid test and COVID-19 test; providing more test tools; performing detection; and inhibiting spread. These findings lead to many interpretations: lower trust towards the government, a poor health system, and potential influence on the political output. While vaccines are now being distributed in Aceh, the main focus is still to minimize spread and heal the sick. Looking at these results, the Aceh provincial government needs to work harder to improve both its performance and reputation with the Acehnese people.

Impact of the COVID-19 pandemic on depression, anxiety, loneliness, and satisfaction in the German general population: a longitudinal analysis

PURPOSE

Cross-sectional studies found high levels of depression and anxiety symptoms, and loneliness during the first wave of the COVID-19 pandemic. Reported increases were lower in longitudinal population-based findings. Studies including positive outcomes are rare. This study analyzed changes in mental health symptoms, loneliness, and satisfaction.

METHODS

Respondents of the German Socio-Economic Panel (N = 6038) were surveyed pre-pandemic (2017/2019) and during the first (June 2020) and second wave (January and February 2021) of the pandemic. Self-report screeners assessed depression and anxiety symptoms, loneliness, life and health satisfaction. Difference scores were analysed using ANCOVAs focusing on time, gender, age groups.

RESULTS

Depression and anxiety symptoms and health satisfaction increased from pre-pandemic to the first wave, but declined in the second pandemic wave. Loneliness increased and life satisfaction decreased during the first and the second wave of the pandemic. Young adults and women reported more distress and loneliness, even after controlling for pre-pandemic scores, education, and income. All effects remained stable when controlling for self-reported previous diagnosis of depression or region of residence.

CONCLUSION

Increases and decreases in mental health symptoms and health satisfaction showed little variation. Of concern are the strong increases of loneliness and decreased life satisfaction being important targets for interventions. Main risk factors are young age and female gender.

Implications of COVID-19 Mitigation Policies for National Well-Being: A Systems Perspective

The ongoing COVID-19 crisis and measures aimed at curbing the pandemic have a widespread impact on various aspects of well-being, such as housing, social connections, and others. Moreover, COVID-19 does not affect all population groups equally. This study analyzes the impact of major COVID-19 non-pharmaceutical interventions (NPIs) on a set of national well-being indicators from the most recent version of the OECD Well-Being Framework. Using causal loop diagrams (systems maps), we consider direct and indirect effects of these policies on various components of the national well-being system. Our results show that business closures directly and/or indirectly impact more national well-being components than any other policy. The most affected national well-being components by all policies are life satisfaction, perceived health, and prevalence of depressive symptoms. In addition, we specify how the impact of the anti-pandemic measures differs for various population strata, using the degree of income and employment loss as key stratifying variables. Our insights can be helpful to identify and promote measures that can alleviate the adverse effects of the COVID-19 crisis on the national well-being.

Satisfaction with life among university students from nine countries: Cross-national study during the first wave of COVID-19 pandemic

Background

A cross-sectional study was performed to examine life satisfaction differences between university students from nine countries during the first wave of the COVID-19 pandemic. A cross-national comparison of the association between life satisfaction and a set of variables was also conducted.

Methods

Participants in the study were 2349 university students with a mean age of 23 years (M = 23.15, SD = 4.66). There was a predominance of women (69.26%) and individuals studying at the bachelor level (78%). The research was conducted between May and July 2020 in nine countries: Slovenia (n=209), the Czech Republic (Czechia)(n=308), Germany (n=267), Poland (n=301), Ukraine (n=310), Russia (n=285), Turkey (n=310), Israel (n=199), and Colombia (n=153). Participants completed an online survey involving measures of satisfaction with life (SWLS), exposure to COVID-19, perceived negative impact of coronavirus (PNIC) on students' well-being, general self-reported health (GSRH), physical activity (PA), and some demographics (gender, place of residence, level of study). A one-way ANOVA was used to explore cross-national differences in life satisfaction. The χ² independence test was performed separately in each country to examine associations between life satisfaction and other variables. Bivariate and multivariate logistic regressions were used to identify life satisfaction predictors among a set of demographic and health-related variables in each of the nine countries.

Results

The level of life satisfaction varied between university students from the nine countries. The results for life satisfaction and the other variables differed between countries. Numerous associations were noted between satisfaction with life and several variables, and these showed cross-national differences. Distinct predictors of life satisfaction were observed for each country. However, poor self-rated physical health was a predictor of low life satisfaction independent of the country.

Conclusions

The association between life satisfaction and subjective assessment of physical health seems to be universal, while the other variables are related to cross-cultural differences. Special public health attention should be focused on psychologically supporting people who do not feel healthy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12288-1.

Psychological Factors, Leisure Activities, and Satisfaction during the COVID-19 Pandemic: A Cross-Sectional Study in Eleven Spanish-Speaking Countries

The COVID-19 pandemic has affected the lives of millions of people worldwide. This study aimed to analyze the effects of several psychological factors (self-esteem, self-control, and emotional stability) over lifestyle-related variables (time spent on leisure activities) and the levels of satisfaction (family, friends, work, and leisure satisfaction) experienced during the COVID-19 outbreak. Data for this article were retrieved as part of a cross-sectional international study conducted in eleven Spanish-speaking countries between March and September 2020. The analyses were conducted using the responses of 9500 persons (65.95% women, 34.05% men). Structural equation modeling was used to test the direct and indirect effects of the psychological variables on satisfaction variables mediated by the time engaged in leisure activities. Our model indicated that psychological factors significantly predicted the amount of time spent in leisure activities and satisfaction. Overall, results indicate that self-esteem is a relevant psychological factor to consider in the development of psychological interventions directed at promoting healthy lifestyles. Nevertheless, further research is needed to validate the direction of the associations found in this study.

Changes in Stress, Coping Styles, and Life Satisfaction between the First and Second Waves of the COVID-19 Pandemic: A Longitudinal Cross-Lagged Study in a Sample of University Students

In this study, we aimed to explain the interplay mechanism between stress, life satisfaction, and coping styles among university students. A cohort study was performed during the first (wave 1; W1) and second (wave 2; W2) waves of the Coronavirus disease 2019 (COVID-19) pandemic. The total sample included 231 university students, of which 59.31% were women. The Satisfaction with Life Scale (SWLS), Perceived Stress Scale (PSS), and Coping Inventory for Stressful Situations (CISS) were included in one online survey. Stress, emotion-oriented, and avoidance-oriented coping styles increased from W1 to W2 of the COVID-19 pandemic, while life satisfaction and task-oriented coping decreased. The partial mediation effect of all three coping styles during W1 and W2 (in a cross-sectional approach) on the relationship between perceived stress and life satisfaction was confirmed in this study. The task-oriented and avoidance-oriented coping styles can play a mediating role in the reciprocal relationship between life satisfaction and perceived stress during W1 and W2 of the pandemic. There were no mutual interactions between stress and life satisfaction from a longitudinal approach. Coping styles changed subsequently due to stressful environmental changes related to lockdown during the COVID-19 pandemic. Having a wide range of coping strategies from which to choose during an unstable situation should help manage stress and well-being.

Mental Health and Psychological Wellbeing during the COVID-19 Lockdown: A Longitudinal Study in the Balearic Islands (Spain)

Confining the entire population to a lockdown after the outbreak of SARS-CoV-2 was an unprecedented measure designed to protect the health of those living in Spain. The objective of the present study is to assess the evolution of mental health and psychological wellbeing during lockdown. To do this, we carried out a longitudinal study, via an online survey over the eight weeks of lockdown (weekly assessments). Sociodemographic variables were recorded, along with data related to COVID-19, psychological wellbeing (anxiety, depression, psychotropic drugs, consultations made to improve mood or anxiety), life satisfaction, and self-perceived health. A total of 681 individuals participated in the study, 76.8% were women; the mean age was 43 years old (SD = 12.7). Initially, high scores were reported for anxiety, depression, and the number of consultations to improve mood, but these decreased significantly over the study period. The reverse seems to be true for life satisfaction, perceived good health, and intake of psychotropic drugs. We also identified groups whose psychological wellbeing was more susceptible to the effects of lockdown. Women, those worried about their jobs after the pandemic, and those afraid of being infected were the most affected individuals. More generally, after the initial negative effect on psychological wellbeing, various indicators improved over the lockdown period.

The Professional and Psycho-Emotional Impact of the COVID-19 Pandemic on Medical Care-A Romanian GPs' Perspective

The aim of this study was to assess the psycho-emotional impact and the adjustment degree of Romanian general practitioners (GPs) in the coronavirus disease 2019 (COVID-19) pandemic context. With a cross-sectional design, the study included 677 GPs to whom a validated questionnaire based on different items targeting three factors was sent: burden of prevention, presence of stress symptoms, and adjustment to pandemic. The burden of prevention and the adjustment effort to the pandemic were felt significantly more by female doctors and by GPs working in associated offices. The case definition quality, the support received, the professional life changes, and the stress symptoms proved to be the main predictors for the adjustment to pandemic. The adjustment measurement questionnaire can be used in further studies to identify the most supportive public health practices in difficult epidemiological contexts.