Effects of Lifestyle Changes on the Mental Health of Healthcare Workers with Different Sense of Coherence Levels in the Era of COVID-19 Pandemic

Changes in hospital staff' mental health during the Covid‑19 pandemic: Longitudinal results from the international COPE-CORONA study

This longitudinal study aimed to explore anxiety and depressive symptoms, individual resources, and job demands in a multi-country sample of 612 healthcare workers (HCWs) during the COVID-19 pandemic. Two online surveys were distributed to HCWs in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) during the first (May-October 2020, T1) and the second (February-April 2021, T2) phase of the pandemic, assessing sociodemographic characteristics, contact with COVID-19 patients, anxiety and depressive symptoms, self-compassion, sense of coherence, social support, risk perception, and health and safety at the workplace. HCWs reported a significant increase in depressive and anxiety symptoms. HCWs with high depressive or anxiety symptoms at T1 and T2 reported a history of mental illness and lower self-compassion and sense of coherence over time. Risk perception, self-compassion, sense of coherence, and social support were strong independent predictors of depressive and anxiety symptoms at T2, even after controlling for baseline depressive or anxiety symptoms and sociodemographic variables. These findings pointed out that HCWs during the COVID-19 outbreak experienced a high burden of psychological distress. The mental health and resilience of HCWs should be supported during disease outbreaks by instituting workplace interventions for psychological support.

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic

Background

The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students.

Methods

A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13).

Results

Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (β = -0.28, p < 0.001), manageability (β = -0.19, p = 0.001)], female gender (β = 0.12, p = 0.015), and overall ARI (β = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (β = -0.19, p = 0.002), manageability (β = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (β = -0.15, p = 0.011), sex (β = 0.12, p = 0.015), and history of death in first-degree relatives (β = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (β = -0.26, p < 0.001), manageability (β = -0.13, p = 0.032), and comprehensibility (β = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH.

Conclusion

Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

Relationship between lifestyle changes due to the COVID-19 pandemic and depression: Nationwide population-based research using Community Health Survey data in South Korea

AIMS

This study evaluated the association between depression and lifestyle changes due to the COVID-19 pandemic and evaluated this association in patients with chronic diseases.

METHODS

Data were obtained from the 2020 Community Health Survey in South Korea. This study included 212,806 participants and perceived changes in life patterns (sleep, food, and exercise) after the COVID-19 outbreak were measured. People with hypertension or diabetes were categorized as patients with chronic diseases and depression was defined as a score of ≥10 on the Patient Health Questionnaire-9.

RESULTS

Compared with before the COVID-19 pandemic, increased or decreased sleep, the consumption of instant food, and decreased physical activity were associated with increased depression. Compared with the general population, patients with chronic diseases showed increased depression, with or without medication. Additionally, among patients with chronic diseases not taking medication, increased physical activity was associated with reduced depression, whereas reduced physical activity was associated with increased depression in both younger and older groups.

CONCLUSIONS

This study found that unhealthy lifestyle changes during the COVID-19 pandemic were associated with increased depression. Maintaining a certain lifestyle is important for mental health. Chronic disease patients need appropriate disease management, including physical activity.

Psychometric Evaluation of GHQ-12 as a Screening Tool for Psychological Impairment of Healthcare Workers Facing COVID-19 Pandemic

BACKGROUND

The General Health Questionnaire (GHQ) is a widely used tool, both in clinical and research settings, due to its brevity and easy administration. Researchers often adopt a dichotomous measurement method, considering a total score above or below a certain threshold. This leads to an extreme simplification of the gathered data and therefore to the loss of clinical details. In a multi-step evaluation study aimed at assessing health care workers' mental health during the Covid-19 pandemic, GHQ-12 proved to be the most effective tool to detect psychological distress compared to other scales adopted. These results led to deepen the understanding of GHQ-12 properties through a statistical study by focusing on items' properties and characteristics.

METHODS

GHQ-12 responses were analyzed using Item Response Theory (IRT), a suitable method for scale assessment. Instead of considering the single overall score, in which each item accounts equally, it focuses on individual items' characteristics. Moreover, IRT models were applied combined with the latent class (LC) analysis, aiming to the determination of subgroups of individuals according to their level of psychological distress.

RESULTS

GHQ-12 was administered to 990 health-care workers and responses were scored using the binary method (0-0-1-1). We applied the two-parameter logistic (2-PL) model, finding that the items showed different ways of responses and features. The latent class analysis classified subjects into three sub-groups according to their responses to GHQ-12 only: 47% of individuals with general well-being, 38% expressing signs of discomfort without severity and 15% of subjects with a high level of impairment. This result almost reproduces subjects' classification obtained after administering the six questionnaires of the study protocol.

CONCLUSIONS

Accurate statistical techniques and a deep understanding of the latent factors underlying the GHQ-12 resulted in a more effective usage of such psychometric questionnaire - i.e. a more refined gathering of data and a significant time and resource efficiency. We underlined the need to maximize the extraction of data from questionnaires and the necessity of them being less lengthy and repetitive.

The Mediating Role of Sense of Coherence and Striving for Work-Life Balance on Intention to Leave From Nurses' Burnout

High turnover and understaffing are significant issues plaguing the healthcare system. Some of the leading reasons of turnover include child-bearing and -rearing, stress related to working, and health concerns. With the onset of the coronavirus (COVID-19) pandemic, this problem of turnover worsened due to increased risk of infection and escalating workload. This study aimed to clarify and validate the effect of burnout on intention to leave among full-time nursing professionals and the structural relationship with sense of coherence (SOC) and striving for work-life balance (S-WLB). Secondary analyses of data obtained from a previous study was carried out; a hypothesized model was tested for goodness of fit and a final model was developed. Burnout directly affected intention to leave (P < .001). It also affected intention to leave through SOC and S-WLB (P < .01); SOC lessened the effect of burnout on S-WLB, therefore reducing its impact on intention to leave. Effective strategies need to be developed to improve the SOC and WLB of nurses to alleviate the effects of burnout and thus reduce the likelihood of turnover. Improving their ability to grasp and deal with emergencies and ambiguous situations, as well as providing emotional and tangible support can be other ways to retain nursing professionals.

Quality of therapy and mental health among occupational therapists during the COVID-19 pandemic

Introduction

The coronavirus disease of 2019 (COVID-19) has had a severe psychological impact on occupational therapists. Clarifying the mental health status of occupational therapists and its relationship with therapy quality is essential for maintaining the quality of care and patients' quality of life. Therefore, the present study aimed to investigate whether and how mental health problems are related to the quality of occupational therapy.

Methods

A nationwide cross-sectional online survey was conducted during Japan's second national state of emergency (January 2021). A total of 4,418 registered occupational therapists who were members of the Japanese Association of Occupational Therapists participated in this study. After screening for the exclusion criteria, data from 1,966 participants were analyzed.

Results

Path analysis showed that insufficient information provision by the workplace and increased workload were associated with depression, anxiety, and insomnia. Specifically, depression was associated with decreased therapy quality. Furthermore, one's therapy quality showed a strong positive correlation with colleagues' therapy quality.

Discussion

These results demonstrated a direct link between therapists' mental health conditions and therapy quality and suggested that decreased therapy quality might occur at the institutional rather than individual level. A reassessment of the support system and prompt detection and support for professionals with psychological symptoms may be the key to enhancing therapy quality and patients' quality of life. The present results contribute to the understanding of these relationships, considering the current pandemic context for occupational therapists.

Factors Related to Mental Health of Foreign Care Workers in Long-Term Care Facilities in Japan during the COVID-19 Pandemic-A Comparative Study

This study aimed to evaluate the factors related to the mental health of foreign care workers in Japan's long-term care (LTC) facilities and compare their results with those of native care workers. We conducted a cross-sectional survey covering 80 LTC facilities across Japan between August and November 2021. The survey mainly included mental health, workload, reward, sense of coherence, loneliness, COVID-19-specific factors and sociodemographic variables. The results show that workload was a distinct feature associated with the mental health of foreign care workers (n = 172) when compared with those of native care workers (n = 154). In addition, we found that the relationship between cultural adaptation and mental health in a sample of foreign care workers was mediated by loneliness and sense of coherence (SOC). Finally, we found that reward, loneliness, SOC, and COVID-19-specific factors had significant impacts on the mental health of both foreign and native care workers. These findings highlight the importance of support measures from the workplace for foreign care workers. Workplace interventions that focus on workload, reward, and sense of coherence strategies are required to address mental health improvement and may still be of value in dealing with the continuing COVID-19 pandemic.

Gender differences in the association between lifestyle behaviors and mental health among psychiatrists in China

INTRODUCTION

Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors.

METHODS

Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors.

RESULTS

4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress.

CONCLUSIONS

The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.

The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: A prospective observational study

The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. The current study aimed at investigating the long-term relationship between SOC and psychopathological symptoms, and the impact of COVID-19-related rumination as its moderator. The prospective observational study assessed psychopathological symptoms and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic in an online panel (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathological symptoms and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. A model allowing for unidirectional coupling from SOC to psychopathological symptoms demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathological symptoms, whereby a stronger SOC was associated with a decrease in symptoms over time. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Our findings demonstrate that SOC is an important predictor and modulator of psychopathological symptoms during the COVID-19 pandemic, particularly in those respondents that ruminate about the pandemic.

Healthy lifestyle changes and mental health of healthcare workers during the COVID-19 pandemic in China

This study investigated lifestyle changes in physical activity, sleep, and diet among healthcare workers and their impact on their mental health during the COVID-19 pandemic in China. Healthcare workers (N = 589) completed an online survey about demographic and personal characteristics, working experiences, COVID-19-related stressors, lifestyle changes, and mental health (anxiety and depression) about three months after the lift of the lockdown policy in China. Lifestyle Changes (including changes in physical activity, sleep, and diet), Generalized Anxiety Disorder (GAD-7), and Depression (PHQ-9) were used to measure main outcomes. Of the participants, 39.7% (N = 234) had less physical activity, 36.0% (N = 212) slept less, and 41.8% (N = 246) ate healthier than before pandemic. Lower educational level, working within original hospitals, less physical activity and less sleep time was associated with increased anxiety. Working within original hospitals, less physical activity and an unhealthier diet was associated with increased depression. In summary, healthcare workers who became less healthy in lifestyles experienced a higher level of anxiety and depression symptoms during the COVID-19 pandemic. Strategies to promote healthy living and improve mental health among healthcare workers should be developed and implemented both during the ongoing COVID-19 pandemic and beyond.

A nationwide web-based survey of factors associated with depressive symptoms among Japanese workers

BACKGROUND

Precarious employment has affected mental health, and limited data are available on the association of low stress tolerance with depressive symptoms among Japanese workers.

AIMS

This study aimed to examine the relationship between stress tolerance and depressive symptoms among Japanese workers, including company employees, civil servants and self-employed persons in various industries.

METHODS

We conducted a nationwide cross-sectional study. From March 26 to April 6, 2020, we performed a web-based survey of Japanese workers. The questionnaire included questions on socioeconomic factors, the SOC scale that assesses stress tolerance, the CES-D, and the EQ-5D-5L. Multivariate regression analyses were performed to determine the factors associated with depressive symptoms.

RESULTS

We included 3,001 participants in the analysis. A high SOC score, adequate sleeping time and frequency of exercise were associated with higher depressive symptoms. Employment status and long working hours were not associated with depressive symptoms. Younger workers had lower SOC scores than older workers. An inverse correlation between the SOC score and CES-D score was found among Japanese workers.

CONCLUSIONS

Improving stress tolerance among younger workers is needed to prevent worsening mental health regardless of employment status for Japanese workers.

Health-Promoting Quality of Life at Work during the COVID-19 Pandemic: A 12-Month Longitudinal Study on the Work-Related Sense of Coherence in Acute Care Healthcare Professionals

(1) Background: During a pandemic, the wellbeing of healthcare professionals is crucial. We investigated the long-term association of the Work-related Sense of Coherence (Work-SoC) and the evolution of psychological health symptoms of acute care healthcare professionals during the first year of the COVID-19 pandemic. (2) Methods: This longitudinal observational study enrolled 520 multinational healthcare professionals, who completed an online survey every three months from April 2020 to April 2021. Mixed linear models examined the associations between Work-SOC and COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology. (3) Results: Healthcare professionals with a higher Work-SoC reported lower levels of COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology in April 2020 than healthcare professionals with an average or lower Work-SoC, but the levels increased to higher values in April 2021. Healthcare professionals with a lower Work-SoC reported higher levels of depressiveness and psychological trauma symptomatology in April 2020 but lower levels in April 2021. (4) Conclusions: Healthcare professionals with higher levels of Work-related Sense of Coherence might be protected against variations in psychological symptoms for about three months, but this protection seems to decrease as the pandemic continues, resulting in mental health deterioration. In contrast, healthcare professionals with a lower Work-SoC might be protected at later stages of the pandemic.

Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis

OBJECTIVE

The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.

METHOD

Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.

RESULTS

One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).

CONCLUSIONS

The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The global pandemic and changes in women's reproductive health: an observational study

OBJECTIVE

The COVID-19 global pandemic has led to the death of millions around the world and impacted the overall health of many people. In this article we aim to compare reproductive health indicators in the first 6 months of 2020 to the prior year, as well as explore stress and quality of life during this time.

METHODS

This retrospective observational study examined the menstrual cycles of 1159 women who were using a fertility tracking device to record their menstrual cycle and BBT data. We utilised a supplemental mobile application to administer a supplemental survey to collect data on stress and quality of life. Descriptive analyses were conducted with t-tests for two-group comparisons.

RESULTS

Study participants from 15 countries contributed to a total of 13,194 cycles. 23.1% (268/1159) responded to the survey focussed on assessing psychosocial distress. 44.4% (119/268) of the study participants reported that they had noticed a change in their menstrual cycle, temperature curve, or menstruation in the past 12 months. Cycle analysis found the average cycle length and pre-ovulation phase length was longer in the first 6 months of 2019, while the average days of menstruation was slightly longer in 2020.

DISCUSSION

Our findings indicate that menstrual cycle indicators changed only slightly in the first 6 months of 2020 but were still statistically significant. We were also able to understand that these study participants had some level of awareness of changes to their menstrual health.

Mental Health Crisis and Stress Coping among Healthcare College Students Momentarily Displaced from Their Campus Community Because of COVID-19 Restrictions in Japan

College students are one of the most affected groups by self-quarantine due to COVID-19, as they may live in loneliness and anxiety, increasing their risk of mental health crisis. This study aimed to identify risk factors for poor mental health and stress coping strategies among healthcare college students during the COVID-19 pandemic in Japan. A cross-sectional survey was conducted over 7 consecutive days starting on 28 April 2020 using a web-based questionnaire. The survey assessed socioeconomic characteristics and the General Health Questionnaire-12 score, self-reported health status, anxiety, and satisfaction with daily life, work, leisure, and new activities. Approximately 70% of 223 respondents had poor mental health. Less communication with friends was the main risk factor for mental health problems. Good health status and satisfaction with leisure and new activities were associated with reduced risk of mental health problems. Students with poor mental health tended to seek social support as a stress coping strategy. This study showed that the mental health of students declined during self-quarantine, and loneliness could be the major reason. There is a need for a new form of communication and learning that deals with the isolation and loneliness of students, especially for students living alone.

Sudden Changes and Their Associations with Quality of Life during COVID-19 Lockdown: A Cross-Sectional Study in the French-Speaking Part of Switzerland

The lockdown due to the COVID-19 pandemic has led to various sudden changes in a large number of individuals. In response, the question of how individuals from different social and economic strata cope with those changes has arisen, as well as how much they have affected their mental well-being. Choosing strategies that cope with both the pandemic and the well-being of the population has also been a challenge for different governments. While a large number of studies have investigated the mental health of people from different populations during the COVID-19 pandemic, few have explored the number and type of changes experienced during lockdown by the general population, alongside their relationships with health-related quality of life (HRQoL). To fill this research gap, an observational cross-sectional study on those associations was conducted in the French-speaking part of the Swiss general population. Data were collected from 431 participants during the first four weeks of lockdown due to COVID-19. Multivariate regressions were used to identify the sociodemographic profile of the population that experienced different types and numbers of changes during this period, the association of those changes with the HRQoL-mental and physical-and infection beliefs, and the perception of the governmental measures. We show that the more changes people experienced, the lower their mental HRQoL; however, adherence to governmental measures has helped people to cope with the imposed changes, even though the number of unexpected and unwished changes have strained their mental HRQoL. The low-income population experienced financial difficulties and changes in their food intake more frequently, while dual-citizenship or non-Swiss individuals declared conflictual situations more frequently. Sport practice had a positive association with mental HRQoL; nevertheless, a decrease in sport practice was frequently reported, which correlated with a lower mental HRQoL. Risk perception of COVID-19 increased with lower physical HRQoL score, which supports the efficiency of governmental communication regarding the pandemic. Our results support that government measures should be accompanied by effective and targeted communication about the risk of infection, in order to encourage all strata of the general population to follow such measures and adapt to the changes without unduly affecting their mental health. The usage of such tools might help to reduce the impact of policy-imposed changes on the mental HRQoL of the general population, by inducing voluntary changes in informed and engaged populations.

"At Least until the Second Wave Comes…": A Twitter Analysis of the NHS and COVID-19 between March and June 2020

In the UK, tweets around COVID-19 and health care have primarily focused on the NHS. Recent research has identified that the psychological well-being of NHS staff has been adversely impacted as a result of the COVID-19 pandemic. The aim of this study was to investigate narratives relating to the NHS and COVID-19 during the first lockdown (26 March–4 July 2020). A total of 123,880 tweets were collated and downloaded bound to the time period of the first lockdown in order to analyse the real-time discourse around COVID-19 and the NHS. Content analysis was undertaken and tweets were coded to positive and negative sentiments. Five main themes were identified: (1) the dichotomies of ‘clap for carers’; (2) problems with PPE and testing; (3) peaks of anger; (4) issues around hero worship; and (5) hints of a normality. Further research exploring and documenting social media narratives around COVID-19 and the NHS, in this and subsequent lockdowns, should help in tailoring suitable support for staff in the future and acknowledging the profound impact that the pandemic has had.

Reliability and Validity of General Health Questionnaire-12 in Chinese Dental Healthcare Workers During the COVID-19 Pandemic

BACKGROUND

The General Health Questionnaire-12 (GHQ-12) is a widely used instrument to assess mental health status. However, little is known about its applicability in Chinese healthcare workers. This study aimed to evaluate the reliability and validity of the GHQ-12 in Chinese dental healthcare workers.

METHODS

Dental healthcare workers participated in the first occupational survey in China conducted by the Chongqing Stomatological Association from February 2021 to March 2021 by filling out GHQ-12. The reliability and validity of GHQ-12 were then tested.

RESULTS

A total of 3,020 valid electronic questionnaires were acquired. The positive detection rate of self-reported mental health status was 23.80% (719/3,020). The Cronbach's α coefficient of the GHQ-12 was 0.892, and the Cronbach's α coefficient was 0.877-0.888 after the deletion of individual items, and the split-half reliability was 0.843. The correlation coefficient between the item-total score ranged from 0.465 to 0.762 (P<0.05). The exploratory factor analysis found 2 common factors with a factor load of 0.564-0.818. The confirmatory factor analysis showed that the factor load on the specified items was 0.480-0.790.

CONCLUSIONS

The two-factor model of GHQ-12 featured good reliability and validity, which could be used to assess the mental health status of Chinese dental healthcare workers.