eHealth tools use and mental health: a cross-sectional network analysis in a representative sample

eHealth tools usage is vital for health care systems and increased significantly after the COVID-19 pandemic, which aggravated mental health issues. This cross-sectional study explored whether sociodemographic characteristics and mental health indices (stress and symptoms of anxiety and depression) were linked to the behavioral intention to use eHealth tools and eHealth tools usage in a representative sample from Poland using a network approach. Measurements were conducted in March 2023 among 1000 participants with a mean age of 42.98 (18-87) years, with 51.50% women. The measures included the behavioral intention to use eHealth tools (BI) based on the UTUAT2; eHealth tool use frequency (use behavior) including ePrescription, eSick leave, eReferral, electronic medical documentation (EMD), Internet Patient Account (IKP), telephone consultation, video consultation, mobile health applications, and private and public health care use; and the PSS-4, GAD-2, and PHQ-2. Furthermore, sociodemographic factors (sex, age, children, relationship status, education, and employment) were included in the research model. Network analysis revealed that mental health indices were weakly related to eHealth tools use. Higher stress was positively linked with mobile health application use but negatively linked to video consultation use. Use of various eHealth tools was intercorrelated. Sociodemographic factors were differentially related to the use of the eight specific eHealth tools. Although mental health indices did not have strong associations in the eHealth tools use network, attention should be given to anxiety levels as the factor with the high expected influence.

Revisiting the multidimensional interaction model of stress, anxiety and coping during the COVID-19 pandemic: a longitudinal study

Background

Although the Multidimensional Interaction Model of Stress, Anxiety and Coping (MIMSAC) has been known for years, there is a lack of research examining this theory longitudinally in stressful events. This study aims to revisit the MIMSAC among university students during the COVID-19 pandemic.

Methods

A prospective cohort study with the longitudinal design was performed during the first (W1, March 30–April 29, 2020) and second wave (W2, November 3–December 3, 2020) of the COVID-19 pandemic. A total of 216 university students with a mean age of 22 years (ranging from 20 to 36, M = 22.13, SD = 2.04) participated in the study. An online survey included Perceived Stress Scale, Coping Inventory for Stressful Situations, and Generalized Anxiety Disorder.

Results

Due to the MIMSAC, all variables changed substantially across W1 and W2, adapting to an unpredictable environment. Women scored higher than men in stress, anxiety, emotion- and avoidance-oriented coping styles. We found the indirect effect of emotion-oriented coping on the stress-anxiety relationship and task-oriented coping on the anxiety-stress interaction. Avoidance was not found as a mediator in the stress-anxiety interaction.

Conclusion

Emotion-oriented coping adversely affected mental health, increasing anxiety in response to stress during the COVID-19 pandemic. Task-oriented coping efficiently decreased stress in reaction to high anxiety, but only in men. Avoidance seems to be an ineffective coping style during the COVID-19 pandemic. Campus intervention programs should focus on reducing negative emotions and increasing the frequency of task-oriented coping strategies among university students.

Validation of the Brief Perceived Positive Lockdown Impact Scale PPLIS-4

BACKGROUND

Although research showed that positive aspects of the lockdown were perceived during the pandemic, there are no tools to test the positive impact of mandatory social isolation on life. The present study aims to validate a newly developed, brief, four-item perceived positive lockdown impact scale (PPLIS-4).

METHODS

A cross-sectional online survey study was formed among 4370 adults in three samples: Sample 1 consisted of university students from Poland and Ukraine, Sample 2 consisted of Polish university students under 26 (emerging adults), and Sample 3 consisted of Polish and Ukrainian adults above 25 (non-emerging adults). The standardized questionnaire was used for criterion validity to measure life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9).

RESULTS

The exploratory factor analysis (EFA) showed a one-factor solution in Sample 1 in Polish and Ukrainian university students. The confirmatory factor analysis (CFA) and confirmatory composite analysis (CCA) showed the one-factor structure appropriate for the PPLIS-4 among emerging and non-emerging adults. Criterion validity was also confirmed since the PPLIS-4 was positively related to the SWLS and negatively related to stress, anxiety, and depression.

CONCLUSIONS

The PPLIS-4 is a short but valid questionnaire to assess the positive aspects of lockdown. The PPLIS-4 can be used during the COVID-19 pandemic to measure some positive effects of changes in lifestyle as an aspect of resilience.

Adaptation and Preliminary Validation of the Fear of Coronavirus Vaccination Scale in the Prospective Study among a Representative Sample of Polish, Israeli, Slovenian, and German Adults during the COVID-19 Pandemic

Although concerns about harm and side effects are among the most important factors determining vaccine hesitancy, research on the fear of vaccination is sparse. The purpose of this study is a validation the Fear of Coronavirus Vaccination Scale (FoCVVS), adapted from the Fear of COVID-19 Scale. A representative sample of 1723 young adults aged 20-40 from Poland, Israel, Slovenia, and Germany participated during two time-points of the third COVID-19 pandemic wave. The online survey included demographic variables and several well-being dimensions, including gender, vaccination status, fear of coronavirus (FoCV-19S), physical health (GSRH), life satisfaction (SWLS), and perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Exploratory factor analysis (EFA) was performed at T1, and confirmatory analysis (CFA) at T2. The second-order two-factor structure demonstrated the best fit and very good discriminant and convergent validation. The general factor of the FoCVVS included two subscales assessing the emotional and physiological symptoms of fear of vaccination. Unvaccinated people showed higher levels of fear of vaccination than those vaccinated. A vaccination status, fear of vaccination T1, and fear of COVID-19 T1 were significant predictors of fear of vaccination T2. Vaccination-promoting programs should be focused on decreasing fear and enhancing the beneficial effects of vaccination.

Associations of Work-Family Conflict with Family-Specific, Work-Specific, and Well-Being-Related Variables in a Sample of Polish and Ukrainian Adults during the Second Wave of the COVID-19 Pandemic: A Cross-Sectional Study

The conflict between work and family demands increased during the COVID-19 pandemic due to changes in lifestyle related to the lockdown. This study examines the associations between work-family conflict (WFC) and family-work conflict (FWC) with work-specific, family-specific, and well-being-related variables during the second wave of the COVID-19 pandemic. The results may be used in practice to improve the well-being of employees by adjusting home-based work and family areas of life to dynamic changes during the pandemic. The sample of 736 adults from Poland (53.26%) and Ukraine (46.74%), aged between 19 and 72 (M = 39.40; SD = 10.80), participated in the study. The cross-sectional study was performed using an online survey, including sociodemographic variables, measures of WFC, time pressure, remote work assessment (RWAS), physical health (GSRH), life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). This study showed numerous inter-group differences in all variables across the country, gender, relationship status, parenthood, caring for children under 12, and remote working status. A high WFC is more likely among Polish workers (than Ukrainian workers), people with a low level of self-perceived time pressure, and high symptoms of stress. Caring for children under 12, low self-perceived time pressure, and high stress can predict FWC. Various paths lead from perceived stress via WFC and FWC, physical health, anxiety, and depression to life satisfaction, as suggested by the structural equation modeling analysis. Parents of children under 12 and women are the most vulnerable groups for increased WFC, FWC, and worse mental health and well-being. Prevention programs should focus on reducing stress, anxiety, and work demands in these adult populations. A unique contribution to the existing knowledge revealed patterns of associations between WFC and FWC in relation to well-being dimensions in a cross-cultural context during the pandemic.

Network Analysis of Well-Being Dimensions in Vaccinated and Unvaccinated Samples of University Students from Poland during the Fourth Wave of the COVID-19 Pandemic

Although numerous studies investigated the predictors of vaccination intention and decision, little is known about the relationship between vaccination and well-being. This study compares the physical and mental health dimensions among vaccinated and unvaccinated people. In a cross-sectional online survey, 706 university students from Poland (mean age of 23 years, 76% of women) participated in this study during the fourth pandemic wave (November–December 2021). Standardized questionnaires with a Likert response scale were included in the survey to measure spirituality, exposure to the COVID-19 pandemic, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, anxiety, depression, and life satisfaction. Consistent with the fuzzy-trace theory, the unvaccinated sample was younger and scored significantly lower than the vaccinated group in exposure to COVID-19, perceived physical health, stress, coronavirus-related PTSD, fear of COVID-19, and depression, while higher in life satisfaction. The network analysis showed that mental health plays a crucial role in both groups, with the central influence of anxiety and stress on depression and life satisfaction. The message on vaccination to university students should focus on the benefits of vaccination in maintaining the status quo of good health and well-being. Campus prevention programs should primarily aim to reduce anxiety, stress, and negative emotions by teaching students coping strategies, relaxation techniques, and mindfulness.

Changes in Mental Health during the COVID-19 Pandemic among Representative Sample of Young Adults from Germany, Israel, Poland, and Slovenia: A Longitudinal Study

The aim of this cross-national longitudinal study was to identify a change in mental health indicators: coronavirus-related post-traumatic stress disorder (PTSD), perceived stress, and fear of vaccination (FoVac). The first measurement (T1) took place in February 2021, and the second (T2) took place in May-June 2021. The sample consisted of 1723 participants across Germany, Israel, Poland, and Slovenia, between the age of 20 and 40 (M = 30.74, SD = 5.74). A paired-samples Student's t-test was used for testing the differences between T1 and T2. A repeated measures two-way ANOVA was performed to examine changes over time (T) and across the countries (C). A significant although small decrease at T2 was found for coronavirus-related PTSD, perceived stress, and FoVac. A significant main effect was found for T, C, and TxC for all variables, except the interaction effect for coronavirus-related PTSD and perceived stress. A medium effect size was found for coronavirus-related PTSD and FoVac across countries as well as perceived stress over time. A small effect size was revealed for coronavirus-related PTSD and FoVac over time, perceived stress across countries, and interaction for FoVac. A significant improvement in mental health was demonstrated across the four countries (particularly in Israel); however, there were still differences among each of them. Therefore, the cross-national context should be taken into consideration when analyzing the effects of the COVID-19 pandemic on mental health.

Changes in mental health during three waves of the COVID-19 pandemic: a repeated cross-sectional study among polish university students

BACKGROUND

Research indicates that mental health worsened during the Coronavirus crisis, in particular among women and university students. However, few longitudinal studies have so far investigated the changes in mental health outcomes across three subsequent waves of the COVID-19 pandemic. Therefore, this study aims to examine changes in mental health among university students.

METHODS

A total of 1,961university students from Poland, at mean age 23.23 years (SD = 3.16, 57.47% of women) were included in this repeated cross-sectional study across three waves of the COVID-19 pandemic: W1 (n = 657), W2 (n = 654), and W3 (n = 650). They completed the online survey with the Generalized Anxiety Disorder (GAD-7), Perceived Stress Scale (PSS-10), General Self-Rated Health (GSRH), and Satisfaction with Life Scale (SWLS), as well as sociodemographic variables.

RESULTS

The prevalence of people at high risk of anxiety and perceived stress, poorer physical health, and low life satisfaction changed significantly across three waves of the COVID-19 pandemic. The results of the two-way ANOVA showed that both the wave (W1<W2<W3) and gender (men<women) had a significant impact on the level of anxiety. Statistically significant changes in perceived stress were found between pandemic waves (W1>W2, W1>W3), and genders (men<women). Self-reported physical health significantly deteriorated in W3 compared to W1 and W2 (W1>W3, W2>W3), and was significantly worse in women than in men. The level of life satisfaction also decreased significantly in W3 (W1>W3, W2>W3), but did not differ between men and women. High GAD risk was presented two times more frequently among women and people who subjectively assessed their health as poor, three times more likely in participants dissatisfied with their lives, and seven times more probably in persons with high-stress levels.

CONCLUSIONS

The results of this study consistently indicate (using parametric and non-parametric statistical analysis) that there are significant differences in mental health problems across three waves of the COVID-19 pandemic. It suggests that pandemic waves should be considered in future review studies and meta-analyses. Furthermore, these findings indicate a potential role for prevention and intervention programs aimed at alleviating life satisfaction and subjective assessment of health and improving coping skills to reduce stress and anxiety.

Work engagement and financial satisfaction: The role of corporate volunteering and age

BACKGROUND: Work engagement and corporate volunteering increasingly draw the attention of researchers and practitioners because they significantly and positively contribute to individual and organizational outcomes. However, it is not clear whether employee age and financial satisfaction contribute to higher levels of employee engagement and volunteering. OBJECTIVE: The aim of this study was to investigate the mediating role of corporate volunteering between financial satisfaction and work engagement, and to explore work engagement and financial satisfaction relations with regard to age and corporate volunteering. METHODS: The study encompassed 1,109 multi-occupational employees of business and public sector in Poland. Work engagement (UWES), corporate volunteering and financial satisfaction measures were applied online. We investigated work engagement, corporate volunteering, and financial satisfaction interaction by means of two-way analysis of variance (ANOVA) and straightforward mediation analysis using PROCESS. RESULTS: Our results indicate the importance of corporate volunteering as a mediator between financial satisfaction and work engagement: employees participating in corporate volunteering had higher levels of financial satisfaction than those not participating. CONCLUSIONS: Firstly, corporate volunteering should be included in job design to increase work engagement; and secondly, organisations should increase employee financial satisfaction to facilitate corporate volunteering.

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.

The Mediating Role of Orthorexia in the Relationship between Physical Activity and Fear of COVID-19 among University Students in Poland

Previous research showed that the COVID-19 pandemic has a significant impact on the wellbeing and lifestyle of populations worldwide, including eating and physical activity (PA) patterns. The present study aims to examine the mediating effect of orthorexia on the relationship between PA and fear of COVID-19. A sample of 473 university students from Poland of a mean age of 22 years (M = 22.04, SD = 2.90, 47% of women) participated in the cross-sectional online survey study. Continuous variables were measured using the Fear of COVID-19 Scale (FCV-19S) and the Test of Orthorexia Nervosa (TON-17), while categorical variables divided participants into the physically active and inactive group regarding WHO criteria (150 min per week). Weak gender differences were found. Active people showed lower fear of COVID-19 and higher orthorexia scores than those inactive. Orthorexia was found as a suppressor variable, which increases the negative predictive value of PA on fear of COVID-19. The model of cooperative suppression explained 7% of FCV-19S. The mechanism of mediation showed that health-related behavior could help reduce fear of COVID-19, but caution is necessary for people with addictive behavior tendencies. Universities should support university students by offering programs focused on increasing healthy lifestyles and improving wellbeing.

Mental health prevalence and predictors among university students in nine countries during the COVID-19 pandemic: a cross-national study

The student population has been highly vulnerable to the risk of mental health deterioration during the coronavirus disease (COVID-19) pandemic. This study aimed to reveal the prevalence and predictors of mental health among students in Poland, Slovenia, Czechia, Ukraine, Russia, Germany, Turkey, Israel, and Colombia in a socioeconomic context during the COVID-19 pandemic. The study was conducted among 2349 students (69% women) from May-July 2020. Data were collected by means of the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Perceived Stress Scale (PSS-10), Gender Inequality Index (GII), Standard & Poor's Global Ratings, the Oxford COVID-19 Government Response Tracker (OxCGRT), and a sociodemographic survey. Descriptive statistics and Bayesian multilevel skew-normal regression analyses were conducted. The prevalence of high stress, depression, and generalized anxiety symptoms in the total sample was 61.30%, 40.3%, and 30%, respectively. The multilevel Bayesian model showed that female sex was a credible predictor of PSS-10, GAD-7, and PHQ-8 scores. In addition, place of residence (town) and educational level (first-cycle studies) were risk factors for the PHQ-8. This study showed that mental health issues are alarming in the student population. Regular psychological support should be provided to students by universities.

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.

Validation and Polish Adaptation of the Authorized Bratman Orthorexia Self-Test (ABOST): Comparison of Dichotomous and Continuous Likert-Type Response Scales

Purpose

Although research on orthorexia nervosa (ON) has developed in recent years, there exists a continuous need to develop valid tools to assess ON risk, according to strict diagnostic criteria. The present study aims to conduct Polish adaptation and validation of the Authorized Bratman Orthorexia Self-Test (ABOST), through a comparison of dichotomous and continuous Likert response scales.

Participants and Methods

This cross-sectional study involved 472 people with mean age of 27 years (ranging between 18 and 78 years, M = 26.88, SD = 10.40). The survey included demographic questions and measures of orthorexia (the ABOST and ORTO-15), eating disorders (EAT-26), body mass index (BMI), obsessive–compulsive disorder (OCI-R), anxiety (GAD-7), and depression (PHQ-9). The following statistical tests were performed to explore the psychometric properties of the ABOST: descriptive statistics, Student’s t-test, Pearson’s correlation, Cronbach’s α reliability, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).

Results

The ABOST using a five-point Likert scale for responses demonstrated good psychometric properties. The CFA goodness-of-fit indices confirmed the one-factor solution. Positive correlations were found between the ABOST and the ORTO-15, EAT-26, OCI-R, GAD-7, and PHQ-9. Women scored higher in the ABOST than men, while BMI was unrelated to the ABOST.

Conclusion

The ABOST using the Likert scale provides a reliable and valid instrument to assess ON risk, as indicated by the face, structural, and convergent validity results. However, more research in various countries is needed, in order to verify the results of this study.

A Comparison of Depression and Anxiety among University Students in Nine Countries during the COVID-19 Pandemic

The mental health of young adults, particularly students, is at high risk during the COVID-19 pandemic. The purpose of this study was to examine differences in mental health between university students in nine countries during the pandemic. The study encompassed 2349 university students (69% female) from Colombia, the Czech Republic (Czechia), Germany, Israel, Poland, Russia, Slovenia, Turkey, and Ukraine. Participants underwent the following tests: Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7), Exposure to COVID-19 (EC-19), Perceived Impact of Coronavirus (PIC) on students' well-being, Physical Activity (PA), and General Self-Reported Health (GSRH). The one-way ANOVA showed significant differences between countries. The highest depression and anxiety risk occurred in Turkey, the lowest depression in the Czech Republic and the lowest anxiety in Germany. The χ2 independence test showed that EC-19, PIC, and GSRH were associated with anxiety and depression in most of the countries, whereas PA was associated in less than half of the countries. Logistic regression showed distinct risk factors for each country. Gender and EC-19 were the most frequent predictors of depression and anxiety across the countries. The role of gender and PA for depression and anxiety is not universal and depends on cross-cultural differences. Students' mental health should be addressed from a cross-cultural perspective.

Development and Validation of the Test of Orthorexia Nervosa (TON-17)

This study aims to develop and validate a new self-report questionnaire to measure orthorexia nervosa (ON). Based on a current review of the scientific literature and interviews with people at risk of orthorexia, 40 items were selected to test orthorexia nervosa (TON-40). A total sample of 767 individuals (M = 26.49, SD = 9.66, 56.98% women) participated in the study. The exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and composite construct analysis (CCA) were performed to find an appropriate model of sufficient reliability and validity and stable construction. Convergent validation was performed regarding the correlation of the TON-17 with another measure of ON (ORTO-15), eating disorders (the EAT-26 and DEAS), healthy behavior (the HBI), quality of life (the Brief WHOQOL), physical health (the GRSH), anxiety (the GAD-7), depression (the PHQ-9), and obsessive-compulsive disorder (the OCI-R). Gender, Body Mass Index (BMI), and the medical reasons for a restrictive diet were also examined. As a result of the structural analyses, the number of items was reduced from 40 to 17. The best fit indices of the TON-17 were found for the hierarchical bi-factor model, with three lower-order factors (Control of food quality, Fixation of health and healthy diet, and Disorder symptoms) and one general higher-order factor (Orthorexia). According to the 95th percentile method of estimation, the prevalence of ON was 5.5% for the TON-17 total score. The TON-17 scale and subscales showed good psychometric properties, stability, reliability, and construct validity. The TON-17 indicated a positive relationship with the ORTO-15, EAT-26, DEAS, HBI, OCI-R, GAD-7, and PHQ-9. TON-17 can be considered as a useful tool for assessing the risk of ON.

Ability to initiate relationships and sense of loneliness mediate the relationship between low self-esteem and excessive internet use

The purpose of the study was to identify possible mechanisms underlying the relationship between low self-esteem and excessive Internet use in a non-clinical sample of young adults. Basing on the theoretical framework and results of existing studies we hypothesized that the association between self-esteem and excessive Internet use will be serially mediated by the ability to initiate contact with others and sense of loneliness. The study sample consisted of 506 participants (60% women) aged between 18 and 35 years (mean = 19). The following questionnaires were administered: the Rosenberg Self-Esteem Scale, the UCLA Loneliness Scale, the Interpersonal Competence Questionnaire and the Excessive Internet Use Scale. The last measure was prepared by authors for the purpose of the study. Serial mediation analysis was conducted. In line with our hypotheses the link between low self-esteem and excessive Internet use was found to be sequentially mediated by the capability to initiate social contacts and chronic loneliness. Difficulty in engaging in social interaction leading to the sense of loneliness may explain the link between low self-esteem and excessive Internet use. These results may help to design early intervention programs.