COVID-19 Burnout Subject to the Dynamic Zero-COVID Policy in Hong Kong: Development and Psychometric Evaluation of the COVID-19 Burnout Frequency Scale

Examining the roles of self-compassion and self-control in managing work-family conflicts and preventing burnout during the pandemic: A three-wave longitudinal study in China

According to the Work/Family Border Theory, the pandemic-induced disruptions, such as widespread teleworking adoption, have blurred work and family boundaries. Meanwhile, the Work-Home Resources Model posited that the impact of such disruptions on work-family conflicts and mental health depends on individual resources. Building on previous research, this study hypothesised that self-compassion and self-control mitigate pandemic burnout by reducing work-family conflicts during pandemic. In particular, we proposed that the proactive nature of self-compassion motivates individuals to seek resources for managing work-family conflicts, while self-control translates this motivation into action through behavioural regulation and adaptive coping. Using a three-wave longitudinal design with 568 participants in China during heightened pandemic severity, the study revealed that both self-compassion and self-control were associated with lower pandemic burnout, mediated through reduced work-family conflict. The indirect effect of self-compassion on pandemic burnout via work-family conflicts was significant only for individuals with high or average self-control, emphasising the complementary role of both factors. Our findings underscore the protective value of self-compassion and self-control in navigating work-family conflicts during collective adversities, advocating for their incorporation in theoretical frameworks and practical intervention.

Reflections on the dynamic zero-COVID policy in China

The coronavirus disease 2019 (COVID-19) pandemic has posed a serious threat to global healthcare and economy. In order to curb its spread, China adopted the dynamic zero-COVID policy, aiming to diagnose and isolate cases and close contacts as soon as possible. However, there is a controversy about the impact of isolation measures on social order, including the economy, personal employment and public mental health. Therefore, this review discusses and analyzes in detail the advantages and challenges of implementing dynamic zero-COVID policy. Although this public health policy might cause a shock to the economy in the short term, China still achieved a continued healthy economic performance with stable unemployment and strong export growth. Moreover, the rates of infection and mortality in China were lower than those in the United States and the European Union. However, due to the high transmissibility and low pathogenicity of the Omicron variant and prolonged lockdown-induced psychological damage, people questioned the effectiveness and necessity of this policy. Now that China has adjusted its policy in a timely manner, but many problems still remain unsolved. Some practical suggestions in terms of mental health, vaccine development, drugs supply, and economic recovery are put forward at the end of our paper to minimize negative impacts and provide a reference for future efforts.

The COVID-19 burnout scale: development and initial validation

BACKGROUND

Research on the pandemic-related burnout has focused on work-related burnout especially among healthcare workers, but not in the general population.

AIM

To develop a valid and reliable instrument scale to measure pandemic-related burnout in the general population.

METHODS

We took several steps to develop the scale items and achieve content and face validity; literature review, panel of experts, calculation of content validity ratio, and cognitive interviews. We assessed structural and construct validity, and reliability of the COVID-19 burnout scale (COVID-19-BS).

RESULTS

Exploratory and confirmatory factor analysis identified three factors for the COVID-19-BS; emotional exhaustion, physical exhaustion, and exhaustion due to measures against the COVID-19. Cronbach's alpha coefficients for the three factors and the COVID-19-BS ranged from 0.860 to 0.921. Kaiser-Meyer-Olkin value was 0.945, and p-value for Bartlett test was <0.001. A significant positive correlation between the three factors and anxiety and depression indicated high concurrent validity. Cohen's kappa ranged from 0.848 to 0.957, while intraclass correlation coefficients ranged from 0.888 to 0.997.

CONCLUSIONS

Our findings indicate that the final 3-factor model with 13 items of COVID-19-BS is a brief, easy to administer, valid and reliable scale for assessing COVID-19-related burnout in the general public.

Profiles and predictors of mental health of university students in Hong Kong under the COVID-19 pandemic

This study investigated the mental health problems of university students in Hong Kong and related sociodemographic and psychosocial predictors under the pandemic. A total of 978 undergraduate students (mean age = 20.69 ± 1.61) completed an online questionnaire measuring sociodemographic factors, psychological morbidity, positive well-being, COVID-19 related stress and self-efficacy, and positive psychosocial attributes. Psychosocial risk factors included psychological morbidity, COVID-19 related stress, and difficulties encountered under the pandemic, whereas protective factors comprised pandemic related self-efficacy, positive psychological attributes, positive environmental factors, need satisfaction and positive perception toward service. Results showed that psychological morbidity in the participants was widespread, and it was related to sociodemographic factors, particularly family financial difficulties. While pandemic related stress positively predicted psychological morbidity and negatively predicted well-being indicators, COVID-19 self-efficacy showed an opposite effect. Besides, positive psychological attributes (resilience, emotional competence, and positive beliefs related to adversity) and environmental factors (healthy family functioning, peer support, and supportive community atmosphere) negatively predicted psychological morbidity and positively predicted well-being. Furthermore, need satisfaction and positive perception toward service were negatively associated with psychological morbidity and positively associated with well-being, while perceived difficulties showed an opposite effect.

Refraining from interaction can decrease fear of physical closeness during COVID-19

Perception of peripersonal space (PPS) and interpersonal distance (IPD) has been shown to be modified by external factors such as perceived danger, the use of tools, and social factors. Especially in times of social distancing in the context of the COVID-19 pandemic, it is vital to study factors that modify PPS and IPD. The present work addresses the question of whether wearing a face mask as a protection tool and social interaction impact the perception of IPD. We tested estimated IPD in pictures at three distances: 50 cm, 90 cm, and 150 cm in both social interaction (shaking hands) and without interaction and when the two people in the pictures wore a face mask or not. Data from 60 subjects were analyzed in a linear mixed model (on both difference in distance estimation to the depicted distance and in absolute distance estimation) and in a 3 (distance: 50, 90, 150) × 2 (interaction: no interaction, shake hands), × 2 face mask (no mask, mask) rmANOVA on distance estimation difference. All analyses showed that at a distance of 50 and 90 cm, participants generally underestimated the IPD while at an IPD of 150 cm, participants overestimated the distance. This could be grounded in perceived danger and avoidance behavior at closer distances, while the wider distance between persons was not perceived as dangerous. Our findings at an IPD of 90 cm show that social interaction has the largest effect at the border of our PPS, while the face mask did not affect social interaction at either distance. In addition, the ANOVA results indicate that when no social interaction was displayed, participants felt less unsafe when depicted persons wore a face mask at distances of 90 and 150 cm. This shows that participants are on the one hand aware of the given safety measures and internalized them; on the other hand, that refraining from physical social interaction helps to get close to other persons.

Predictors and moderators of COVID-19 pandemic fatigue in Hong Kong

BACKGROUND

Anti-pandemic fatigue has inevitably set in owing to the high intensity and prolonged presence of pandemic preventive measures. Globally, COVID-19 remains severe; however, pandemic fatigue may lead to less efficient viral control.

METHODS

A total of 803 participants residing in Hong Kong interviewed via telephone using a structured questionnaire. Linear regression was employed to test the corelates of anti-pandemic fatigue and the moderators that could potentially impact the appearance of fatigue.

RESULTS

When confounding effects of demographic factors (e.g., age, gender, educational attainment, and economic activity status) were avoided, daily hassles were found to be a core factor associated with anti-pandemic fatigue (B =0.369, SE =0.049, p = 0.000). For people with a higher level of pandemic-related knowledge and fewer obstacles brought about by preventive measures, the impact of daily hassles on pandemic fatigue weakened. Moreover, when pandemic-related knowledge was high, there was no positive association between adherence and fatigue.

CONCLUSIONS

This study confirms that daily hassles can lead to anti-pandemic fatigue, which can be mitigated by improving the general public's understanding of the virus and developing more convenient measures.

Reduction in COVID-19 related resource loss and decline in prevalence of probable depression in Chinese adults: an application of the Conservation of Resource Theory

BACKGROUND

The levels of resource losses due to coronavirus disease 2019 (COVID-19) and mental distress may change during the pandemic period. Based on the Conservation of Resource (COR) Theory, this study investigated such changes and the mediation between survey time (Round 2 versus Round 1) and depression via resource losses.

METHODS

Two serial random population-based telephone surveys interviewed 209 and 458 Hong Kong Chinese adults in April 2020 and May 2021, respectively. Probable depression was defined as 9-item Patient Health Questionnaire (PHQ-9) score ≥ 10. The validated Conservation of Resources Scale for COVID-19 (CORS-COVID-19) scale was used to assess resource losses due to COVID-19. Multivariable logistic regression analysis, hierarchical logistic regression analysis, and structural equation modeling (SEM) was conducted to test the association, interaction, and mediation hypotheses, respectively.

RESULTS

The prevalence of probable depression declined from 8.6% to 1.0% over time, together with reductions in losses of financial resource (Cohen's d = 0.88), future control (Cohen's d = 0.39), social resource (Cohen's d = 0.60), and family resource (Cohen's d = 0.36) due to COVID-19. All the overall scale/subscales of the CORS-COVID-19 were positively and associated with probable depression [adjusted odds ratio (aOR) ranged from 2.72 to 42.30]. In SEM, the survey time was negatively associated with the latent variable of resource loss (β = - 0.46), which in turn was positively associated with probable depression (β = 0.73). In addition, the direct effect of survey time on probable depression was statistically non-significant (β = - 0.08), indicating a full mediation effect of resource losses.

CONCLUSIONS

The lessening of the resource losses might have fully accounted for the significant decline in probable depression from Month 3 to 15 since the first COVID-19 outbreak in Hong Kong, China. The level of depression might have increased during the first phase of the pandemic, but might decline in the later phases if resources losses could be lessened. All stakeholders should hence work together to minimize individuals' COVID-19-related resource losses to prevent depression in the general population, as COVID-19 might be lasting.

The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China

Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

Mental health concerns and network structures of psychological helpline help-seekers during the COVID-19 pandemic in China: Pandemic stage differences

BACKGROUND

The present study aimed to investigate the pandemic stage differences of mental health helpline help-seekers emotional responses, psychiatric symptoms, and related network structures during the COVID-19 pandemic in China.

METHODS

The data was collected by a large-scale psychological helpline in response to the COVID-19 pandemic in mainland China. Counselor-reported information about the help-seekers pandemic-related emotional responses and psychiatric symptoms were recorded. A total of 26,870 callers' data from February 28, 2020, to April 23, 2021, were collected in the present study. A linear probability model and network analysis were conducted to determine the differences in help-seekers mental health concerns and network structures between the pandemic (stage I, from February 28, 2020, to April 28, 2020, N = 9821) and the regular prevention and control period (stage II, from April 29, 2020, to April 23, 2021, N = 17,049).

RESULTS

Results revealed that anger, sadness, and obsession symptoms increased in stage II while symptoms of anxiety, somatization, and feelings of fear and stress were relieved. The network analysis results demonstrated both stage I and II networks centered on anxiety firmly. In stage II, the connection between anxiety and hypochondria and fear's strength centrality descended significantly.

LIMITATIONS

The mental health outcomes of callers only included the counselor-reported data.

CONCLUSIONS

The mental health concerns of helpline callers showed pandemic-related stage differences.

Risk communication and risk perception along with its influencing factors in Covid-19 disease: Focusing on the Extended Parallel Process Model

Introduction

Following the global spread of the Covid-19 infection, the Iranian government adopted measures to control the spread of the disease, but they were not applicable without the acceptance and interaction of the general population. This study used the Extended Parallel Process Model (EPPM) components to attempt to determine risk communication and risk perception along with its influencing factors in Covid-19 disease among the population of northwestern Iran.

Method

This cross-sectional study was conducted among the general population of the province. Demographic characteristics and extended parallel process model questionnaires were used to collect data, which was then analyzed based on descriptive (frequency, mean, standard deviation) and inferential statistics (t-test, analysis of variance, regression, chi-square) in SPSS-25 software.

Results

This study showed that 63.8% of the participants continually followed Covid-19 news, and 34% of participants used social media to get the news and warnings related to the Covid-19 pandemic. Among the domains of participants' risk perception for Covid-19 disease, the three domains of self-efficacy, response effectiveness and intention had the highest means compared with other domains. Significant correlations were found between risk perception and the dimensions of age, gender, marriage status, number of family members, place of residence, underlying disease, history of Covid-19, and family history of Covid-19 disease (p < 0.05). Multivariate linear regression analysis revealed that perceived sensitivity, perceived severity, self-efficacy, fear, defensive avoidance, intention, and behaviors were independent predictors of response efficacy (p < 0.001).

Conclusion

More than two years after the onset of the spread of Covid-19 disease, the risk perception of the disease among the study population was still insufficient in many areas. Risk of communication refers to the point of interaction between the government and the people, and the need to improve public trust in this issue is strongly felt.

Insomnia mediates the effect of perceived stress on emotional symptoms during the first wave of the COVID-19 pandemic in China

The outbreak of the 2019 coronavirus disease (COVID-19) has significant effects on stress, emotion and sleep in the general public. The aim of this study was to explore the relationship between perceived stress and emotional symptoms during the first wave of the COVID-19 pandemic in China and to further determine whether insomnia could serve as a mediator in this relationship. A total of 1178 ordinary citizens living in mainland China conducted anonymous online surveys. The 10-item Perceived Stress Scale, the Insomnia Severity Index, the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale were used to estimate perceived stress, insomnia, depression and anxiety symptoms, respectively. Of the 1171 valid respondents from 132 cities in China, 46.6 % and 33.0 % showed symptoms of depression and anxiety, respectively. Perceived stress and insomnia independently predicted the prevalence of emotional symptoms and were positively correlated with the severity of these emotional symptoms. The mediation analyses further revealed a partial mediation effect of insomnia on the relationship between perceived stress and emotional symptoms during the first wave of the COVID-19 outbreak in China. Our findings can be used to formulate early psychological interventions to improve the mental health of vulnerable groups, specifically those with insomnia, during the COVID-19 pandemic.

Reflection and Foresight on Personal Information Protection and Optimization in Public Health Emergencies in China-From the Perspective of Personal Information Collection during the Period of China's Dynamic-Zero COVID-19 Prevention and Control Policy

Public health emergencies threaten the overall public health security of the country. Based on the need to control the ways of infection, the collection and processing of personal information by the government have become an important part of epidemic prevention and control. However, personal information related to the epidemic is highly sensitive, which contains other personal information and even private information in addition to information on personal health. In the early days of China's response to the public health emergency of COVID-19, a great deal of non-desensitized information was transmitted in an unaccredited manner. With the implementation of epidemic prevention and control measures, the collection and processing of personal information in China have gradually transited from the initial disorder and chaos to the current orderly, legal, and effective situation, continuously optimizing the processing paths of personal information. Serious summary and reflection on the optimization path of China's epidemic-related information collection and processing methods by looking for a border at which the way and scope of personal information disclosure in future major public health emergencies are compatible with its purpose and role may help to improve the development of China's personal information protection legal system from a long-term perspective.

Family context as a double-edged sword for psychological distress amid the COVID-19 pandemic with the mediating effect of individual fear and the moderating effect of household income

Background

The COVID-19 pandemic drives psychological distress. Previous studies have mostly focused on individual determinants but overlooked family factors. The present study aimed to examine the associations of individual and family factors with psychological distress, and the mediating effect of individual fear and the moderating role of household income on the above associations.

Methods

We conducted a population-based cross-sectional survey on Chinese adults in Hong Kong from February to March 2021 (N = 2,251) to measure the independent variables of anti-epidemic fatigue, anti-epidemic confidence, individual and family members' fear of COVID-19, and family well-being (range 0-10), and the dependent variable of psychological distress (through four-item Patient Health Questionnaire, range 0-4).

Results

Hierarchical regression showed that anti-epidemic fatigue was positively (β = 0.23, 95% CI [0.18, 0.28]) while anti-epidemic confidence was negatively (β = -0.29, 95% CI [-0.36, -0.22]) associated with psychological distress. Family members' fear of COVID-19 was positively (β = 0.11, 95% CI [0.05, 0.16]) while family well-being was negatively (β = -0.57, 95% CI [-0.63, -0.51]) associated with psychological distress. Structural equation model showed that individual fear mediated the above associations except for family well-being. Multi-group analyses showed a non-significant direct effect of anti-epidemic confidence and a slightly stronger direct effect of family well-being on psychological distress among participants with lower incomes, compared to those with higher incomes.

Conclusion

We have first reported the double-edged effect of family context on psychological distress, with the positive association between family members' fear of COVID-19 and psychological distress fully mediated by individual fear and the negative association between family well-being and psychological distress moderated by income level. Future studies are warranted to investigate how the contagion of fear develops in the family and how the inequality of family resources impacts family members' mental health amid the pandemic.

COVID-19-Related Burnout and Intention of Fully Vaccinated Individuals to Get a Booster Dose: The Mediating Role of Resilience

Because an annual COVID-19 booster vaccine appears to be required to control the pandemic, identifying the factors that influence individuals' decision to receive a booster dose is critical. Thus, our goal was to quantify the influence of COVID-19-related burnout on vaccination intention and to investigate the role of resilience in mediating the link between burnout and intention. We conducted a cross-sectional study with a convenience sample during October 2022. We used the COVID-19 burnout scale and the Brief Resilience Scale. The study sample included 1256 people who had received their primary COVID-19 vaccination. Among the participants, 34.1% reported being very likely to be vaccinated with a booster dose. COVID-19-related burnout was found to be inversely connected with vaccination intention. Moreover, our results suggested that resilience not only had a positive direct effect on vaccination intention but also mediated the relationship between burnout and vaccination intention. Although our study had limitations, such as a convenience sample and information bias, we demonstrate the critical role of resilience in reducing the impact of COVID-19-related burnout on the vaccination intention. Policymakers should develop and implement initiatives to address the issues of COVID-19-related burnout and enhance booster adoption by strengthening psychosocial resources such as resilience.

'Dynamic zero-COVID' policy and viral clearance during an omicron wave in Tianjin, China: a city-wide retrospective observational study

OBJECTIVE

To report how the Chinese mainland battled its first omicron wave, which happened in Tianjin, a metropolis with 14 million residents. We also sought to better understand how clinical features affected the timing of viral clearance.

DESIGN

A retrospective study of the omicron wave in Tianjin between 8 January 2022 and 3 March 2022.

SETTING

Except for the first cases on 8 January, all the omicron cases were identified through PCR mass testing in the residential communities. Residential quarantine and serial PCR mass testing were dynamically adjusted according to the trends of new cases.

PARTICIPANTS

All the 417 consecutive PCR-positive cases identified through mass screening of the entire city's 14 million residents. 45.3% of the cases were male, and the median age was 37 (range 0.3-90). 389 (93%) cases had complete data for analysing the correlation between clinical features and the timing of viral clearance.

MAIN OUTCOME AND MEASURE

Time to viral clearance.

RESULTS

Tianjin initiated the 'dynamic zero-COVID' policy very early, that is, when daily new case number was ≈0.4 cases per 1 000 000 residents. Daily new cases dropped to <5 after 3 February, and the number of affected residential subdivisions dropped to ≤2 after 13 February. 64% (267/417) of the cases had no or mild symptoms. The median interval from hospital admission to viral clearance was 10 days (range 3-28). An exploratory analysis identified a feature cluster associated with earlier viral clearance, with HRs of 3.56 (95% CI 1.66 to 7.63) and 3.15 (95% CI 1.68 to 5.91) in the training and validation sets, respectively.

CONCLUSIONS

The 'dynamic zero-COVID' policy can suppress an omicron wave within a month. It might be possible to predict in advance which cases will require shorter periods of isolation based on their clinical features.

Assessing COVID-19-related health literacy and associated factors among school teachers in Hong Kong, China

Objectives

The coronavirus disease 2019 (COVID-19) pandemic developed rapidly, with changing guidelines, misinformation, inaccurate health information and rumors. This situation has highlighted the importance of health literacy, especially among educators. The aims of this study were (i) to assess COVID-19-specific health literacy among school teachers in Hong Kong and (ii) to examine its association with demographic factors, self-endangering work behaviors (i.e., work intensification, work extensification and work quality reduction), secondary burnout symptoms (i.e., exhaustion related to work and psychosomatic complaints), the level of knowledge of COVID-19- or pandemic-related information and the level of confusion about COVID-19-related information.

Methods

A self-report survey was administered to 366 Hong Kong school teachers from April 2021 to February 2022. COVID-19-specific health literacy was measured using the HLS-COVID-Q22 instrument. Other instruments, including self-endangering work behavior scales (i.e., extensification of work, intensification of work and work quality reduction) and two dimensions of the Burnout Assessment Tool (i.e., psychosomatic complaints and exhaustion) were also used for assessment. Data were analyzed using an independent samples Student's t-test, analysis of variance, correlation analysis and adjusted multilinear regression models.

Results

The results showed that 50.8% of school teachers had sufficient health literacy, 38.3% had problematic health literacy and 10.9% had inadequate health literacy. The HLS-COVID score did not vary by sex, but varied according to the type of school, the number of working hours per week and the number of students attending the school. Teachers with sufficient health literacy scored significantly lower for two types of self-endangering work behavior-intensification of work (p = 0.003) and work quality reduction (p = 0.007)-than those with insufficient health literacy. After excluding those who had already been vaccinated, respondents with sufficient health literacy felt more positive about COVID-19 vaccination than those with insufficient health literacy (t[180] = 4.168, p < 0.001). In addition, teachers with sufficient health literacy felt more informed (p < 0.001) and less confused (p < 0.001) about COVID-19-related information than those with insufficient health literacy. Multiple linear regression analysis revealed that age (β = 0.14, p = 0.011) and the number of teaching hours per week (β = -0.206, p < 0.001) were significant predictors of the HLS-COVID score.

Conclusions

The findings of this study may serve as a guide for addressing health literacy gaps among school teachers.

The impact of media on children during the COVID-19 pandemic: A narrative review

Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative review has searched the scientific literature in the field focusing on children. A non-systematic literature review was conducted in May 2022. Various databases were employed to conduct the document research for this paper, such as "Google Scholar", "PubMed", "Web of Science". Keywords for the search included "screen time", "media", "digital use", "social media", "COVID-19", "pandemic", "lockdown", "children", "effect of media on children during COVID". It was found that both children and adolescents seem to have used technologies to confront struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media use can have positive effects on children depending on usage and monitoring by the parents.

Time-series COVID-19 policymaker analysis of the UAE, Taiwan, New Zealand, Japan and Hungary

There are two types of policy analysis: socioeconomic analysis and public policy outcome analysis. The socioeconomic analysis is used for understanding the relationship between COVID-19 incident and mortality and building effective governance. There are two types of policy outcome analysis: general policy analysis and time series policy analysis. This paper is a policy outcome analysis of COVID-19, not a policy analysis. This paper examines COVID-19 policy outcome analysis of five countries such as the UAE, Taiwan, New Zealand, Japan and Hungary. Two policy outcome analysis tools are used in this paper such as scorecovid to generate a snapshot list of sorted scores and time-series hiscovid to identify when policymakers made mistakes for correcting mistakes in the near future policy update. Scores in both tools are based on the population mortality rate: dividing the number of COVID-19 deaths by the population in millions. The lower the score, the better the policy. The higher the score, the more deaths that make people unhappy. COVID-19 death is the most unfortunate event in life and is caused by policy. The introduced time-series policy analysis tool, hiscovid discovered ten facts of five countries. Discovered ten facts will be detailed in this paper. Visualization of policy outcomes over time will play an important role in mitigating the COVID-19 pandemic.

Fatigue, sleep quality and mental health symptoms in Brazilian women during the COVID-19 pandemic: longitudinal study

To assess the impact of the COVID-19 pandemic on the variables of sleep quality, fatigue, anxiety, and depression in healthy Brazilian women. Longitudinal observational study conducted through an online questionnaire with women in 2020 and 2021. The Pittsburgh Sleep Quality Index, the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale were used. The data were analyzed descriptively and the comparison between the data obtained in the first and second evaluation was performed using the McNemar test. A logistic regression was applied to test the association between the variables that showed a significant difference. A total of 235 women responded to the questionnaires. There was a significant increase in fatigue between the two moments (p < 0.05). In the first assessment, depression (OR: 2.39; 95% CI: 1.14-4.99), anxiety (OR: 2.68; 95% CI: 1.37-5.22) and sleep quality (OR: 4.01; 95% CI: 1.71-9.67) were associated with fatigue. In the second assessment, depression (OR: 2.93; 95% CI: 1.19-7.18) and anxiety (OR: 2.69; 95% CI: 1.27-5.71) were associated with fatigue. There was an impact on biopsychosocial aspects during the COVID-19 pandemic, with worsening of fatigue symptoms within a 6-month interval. In addition, fatigue was associated with symptoms of depression and anxiety, and worse sleep quality in the first year of the pandemic, remaining associated with symptoms of depression and anxiety in the second year of the pandemic in the country.

Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale

Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.

Teachers' Well-Being and Associated Factors during the COVID-19 Pandemic: A Cross-Sectional Study in Hong Kong, China

School teachers have faced many challenges due to the coronavirus disease-2019 (COVID-19) pandemic and public health-related containment measures. Recent studies have demonstrated high levels of stress and mental health issues among school teachers. To better understand teacher well-being and inform practices to support them in the face of the ongoing pandemic, we aimed to assess perceived stress, well-being and associated factors among school teachers in Hong Kong, China. For this cross-sectional study, we employed a self-reported questionnaire to assess teacher well-being as an indicator of mental health. Drawing on quantitative data obtained from 336 teachers in Hong Kong from April 2021 to February 2022, we assessed workloads, work-related sense of coherence, perceived stress, secondary burnout symptoms (i.e. intensification of work and exhaustion related to work situation), self-endangering work behaviours and satisfaction with work. Bivariate and multivariate analyses were performed to examine the associations between well-being, demographic and work characteristics. A high percentage (87.6%) of teachers had high levels of perceived stress, which was positively associated with extensification of work (r = 0.571, p < 0.01), intensification of work (r = 0.640, p < 0.01) and exhaustion related to work situation (r = 0.554, p < 0.01). A multilinear regression model adjusted for age and gender was computed to detect predictors of teachers' well-being index values (F(12, 296) = 41.405, p < 0.001, R² = 0.627). A higher WHO-5 score was associated with (1) higher teaching hours (B = 0.235, 95% CI = 0.093, 0.413, p = 0.002); (2) higher work-related sense of coherence (B = 2.490, 95% CI = 0.209, 4.770, p = 0.032); (3) higher work satisfaction (B = 5.410, 95% CI = 2.979, 7.841, p < 0.001); (4) lower level of exhaustion related to work situations (B = -9.677, 95% CI = -12.279, -7.075, p < 0.001); and (5) lower level of psychosomatic complaints (B = -4.167, 95% CI = -6.739, -7.075, p = 0.002). These findings highlight the critical need to allocate more attention and resources to improve the mental health of school teachers in Hong Kong. The findings can also inform the development of psychological and organisational interventions and support mechanisms for teachers during the prolonged COVID-19 pandemic and in preparation for future stressful scenarios. Safeguarding the well-being and mental health of teachers is important for improving the quality of teaching and learning environments and the mental health of school students.

Experience of the COVID-19 pandemic in Wuhan leads to a lasting increase in social distancing

On 11th Jan 2020, the first COVID-19 related death was confirmed in Wuhan, Hubei. The Chinese government responded to the outbreak with a lockdown that impacted most residents of Hubei province and lasted for almost three months. At the time, the lockdown was the strictest both within China and worldwide. Using an interactive web-based experiment conducted half a year after the lockdown with participants from 11 Chinese provinces, we investigate the behavioral effects of this 'shock' event experienced by the population of Hubei. We find that both one's place of residence and the strictness of lockdown measures in their province are robust predictors of individual social distancing behavior. Further, we observe that informational messages are effective at increasing compliance with social distancing throughout China, whereas fines for noncompliance work better within Hubei province relative to the rest of the country. We also report that residents of Hubei increase their propensity to social distance when exposed to social environments characterized by the presence of a superspreader, while the effect is not present outside of the province. Our results appear to be specific to the context of COVID-19 and are not explained by general differences in risk attitudes and social preferences.

COVID-19 pandemic fatigue and its sociodemographic and psycho-behavioral correlates: a population-based cross-sectional study in Hong Kong

Pandemic fatigue is a growing public health concern of the lingering COVID-19 pandemic. Despite its widespread mass media coverage, systematic empirical investigations are scarce. Under the Hong Kong Jockey Club SMART Family-Link Project, we conducted online and telephone surveys amid the pandemic in February to March 2021 to assess self-reported pandemic fatigue (range 0-10) in Hong Kong adults (N = 4726) and its associations with sociodemographic and psycho-behavioral (high vs low to moderate) variables. Data were weighted by sex, age, and education of the general population. Binary logistic regression models yielded adjusted odds ratios (aORs) for high pandemic fatigue (score ≥ 7) for sociodemographic and psycho-behavioral variables. 43.7% reported high pandemic fatigue. It was less common in older people (55-64 years: aOR 0.56, 95% CI 0.39-0.82; 65 + years: 0.33, 0.21-0.52) versus age group 18-24 years, but more common in those with tertiary education (1.36, 1.15-1.62) versus secondary or below. High pandemic fatigue was positively associated with depressive symptoms (aOR 1.83, 95% CI 1.55-2.17), anxiety symptoms (1.87, 1.58-2.20), loneliness (1.75, 1.32-2.31), personal fear of COVID-19 (2.61, 2.12-3.23), family fear of COVID-19 (2.03, 1.67-2.47), and current alcohol use (1.16, 1.00-1.33), but negatively associated with self-rated health (0.79, 0.68-0.92), personal happiness (0.63, 0.55-0.72), personal adversity coping capability (0.71, 0.63-0.81), family adversity coping capability (0.79, 0.69-0.90), family well-being (0.84, 0.73-0.97), family communication quality (0.86, 0.75-0.98), and frequent home exercise (0.82, 0.69-0.96; versus less frequent). We first used a single-item tool to measure COVID-19 pandemic fatigue, showing that it was common and associated with worse mental health, lower levels of personal and family well-being and alcohol use.