The Effect of COVID-19 Outbreak on Older Adults' Hopelessness, Loneliness and Spiritual Well-Being in Turkey

Exploring Spiritual Needs and Loneliness Among Acutely Hospitalized Patients with Chronic Illnesses: An Observational Study Across Three Waves of the COVID-19 Epidemic in Taiwan

Background and Objectives: Spirituality and loneliness are widely recognized as important aspects of holistic healthcare. This observational study was conducted among hospitalized patients with chronic illnesses in a medical ward during three waves of the epidemic in Taiwan, from April 2022 to March 2023, to examine changes in spiritual needs and loneliness. Materials and Methods: These waves were classified as the first wave (outbreak period, April 2022 to July 2022); second wave (mitigation period, August 2022 to November 2022); and third wave (December 2022 to March 2023). The Spiritual Needs Scale and Loneliness Scale were used to assess changes in spiritual needs and loneliness of the enrolled patients across the different waves of the epidemic. Results: We found that the spiritual needs of the enrolled patients were higher during the outbreak period (F = 9.847, p < 0.001) compared to the other periods. In addition, loneliness was higher during the conclusion period (F = 45.764, p < 0.001) compared to the other two periods. Age (r = 0.261, p < 0.001) and the Charlson comorbidity index (r = 0.193, p < 0.01) were significantly positively correlated with spiritual needs. Furthermore, the number of daily confirmed COVID-19 cases (r = -0.392, p < 0.001) was significantly negatively correlated with loneliness. Conclusions: Hospitalized patients with chronic illnesses experienced heightened spiritual needs during the COVID-19 outbreak, while loneliness increased as the epidemic waned. The study's prospective observational design is a strength, but incorporating additional temporal measures between periods would have enhanced the findings.

Analysis of the relationship between self-neglect and spiritual well-being in older adults

This study was conducted to examine the relationship between self-neglect and spiritual well-being in older adults. This descriptive, cross-sectional and correlational study was conducted with 232 older adults. Data were collected using the "Elder Self-Neglect Scale (ESNS)" and "Spiritual Well-Being Scale (FACIT Sp-12)." It was found that 54% of the participants were female, 86% were married, 35% were primary school graduates, 66% lived in the district, 27% had hypertension, 54% had income equal to expenses, and 76% were retired. Mean ESNS total score of older adults was 102.83 ± 24.82 and mean FACIT Sp-12 total score was 33.73 ± 9.70. FACIT Sp-12 total score was found to be a significant negative predictor of the dependent variable ESNS total score (p < .05). In this study, it was determined that the spiritual well-being levels of older adults were above average and their self-neglect levels were low. It was determined that as the spiritual well-being levels of older adults increased, their self-neglect levels decreased.

Examination of Pandemic Awareness, Death Anxiety, and Spiritual Well-Being in Elderly Individuals

This study aimed to examine the relationships between the variables of pandemic awareness, death anxiety, and spiritual well-being and reveal whether the participants' perceptions of pandemic awareness, death anxiety, and spiritual well-being differed according to various sociodemographic characteristics. The study population is comprised of individuals aged 65 years and over in Edirne, Turkey. The data obtained from 449 people in the study were analyzed using various statistical methods. According to the results of the regression analysis performed in the study, the increase in the participants' pandemic awareness was found to reduce their death anxiety and increase their spiritual well-being statistically. Moreover, the increase in the participants' death anxiety statistically reduced their spiritual well-being.

A study on the determination of the factors affecting the happiness levels of older individuals during the COVID-19 pandemic in Turkish society

This study aims to determine the factors affecting the happiness levels of older individuals in Türkiye during the COVID-19 pandemic. The microdata set from the 2020 Life Satisfaction Survey conducted by the Turkish Statistical Institute was utilized, involving 1,863 individuals aged 60 and above. The relationship between happiness levels and various factors was investigated using the chi-square independence test, and the factors affecting happiness were further analyzed through generalized ordered logistic regression. According to the generalized ordered logistic regression model, participants in the 60-64 age group are 10.1% less likely to report happiness compared to those aged 65 and older. Men are 4.3% less likely than women to report happiness. Furthermore, individuals with no formal education and those with primary school education have a 14.4% and 9.4% higher likelihood of happiness, respectively, compared to university graduates. The literature on happiness demonstrates the relationship between different factors and happiness. This study determined that such factors as gender, age, educational status, source of happiness, health satisfaction, hope scale, and homeownership have an impact on the happiness levels of older individuals. The amount of societal support provided to older individuals can be an indicator of their level of happiness.

Loneliness, Spiritual Well-Being, Anxiety, Depression, and Attitude to Death of Gastrointestinal Cancer Patients Treated with Rumor Resection

Gastrointestinal cancer (GIC) patients with tumor resection may experience surgical complications, economic burden, and weakened social connection, which could lead to adverse psychological status. Thus, this study aimed to explore multidimensional psychological status of these patients, encompassing loneliness, spiritual well-being, anxiety, depression, and attitudes to death. Totally, 210 GIC patients with tumor resection and 50 healthy controls (HCs) were enrolled to complete the University of California Los Angeles loneliness (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), hospital anxiety and depression scale-anxiety/depression (HADS-A/D), and death attitude profile-revised (DAP-R) scales. UCLA-LS score was increased (P < 0.001), while FACIT-Sp score was decreased (P < 0.001) in GIC patients than HCs. Additionally, HADS-A score (P < 0.001), anxiety rate (P < 0.001), moderate to severe anxiety rate (P < 0.001), HADS-D score (P < 0.001), depression rate (P < 0.001), and moderate to severe depression rate (P = 0.011) were all elevated in GIC patients versus HCs. Concerning attitude to death, DAP-R scores for fear of death (P < 0.001) and death avoidance (P < 0.001) were increased, and the scores for neutral (P < 0.001) and approach (P = 0.010) acceptance were declined in GIC patients than HCs. Notably, female sex, unmarried status, and drinking history were independently linked with increased UCLA-LS score, but gastric cancer was independently associated with decreased UCLA-LS score (all P < 0.050). Neoadjuvant therapy was independently related to anxiety (P = 0.012). Female sex was independently correlated with depression (P = 0.006). In conclusion, GIC patients with tumor resection experience loneliness, anxiety, depression, and reduced spiritual well-being. They tend to fear and avoid, rather than accept death.

The mediating role of COVID-19 anxiety on the relationship between quality of life and spiritual well-being, and hopelessness: A study on cancer patients

OBJECTIVES

The coronavirus pandemic has caused concern in the community, especially in patients. Spirituality, hopelessness, and quality of life have an impact on the management of the process in cancer patients during these crisis periods. To investigate COVID-19 anxiety's mediating role in hopelessness' relationships with the quality of life and spiritual well-being among cancer patients.

METHODS

This study used a cross-sectional design to collect data from cancer patients using self-administered questionnaires. The study recruited 176 cancer patients receiving treatment at a university hospital. The participants completed measures of spiritual well-being, COVID-19 anxiety, hopelessness, and quality of life. Following preliminary analyses, a mediation model was analyzed using the PROCESS macro for SPSS, with the bootstrap method applied (model 4).

RESULTS

The results showed that spiritual well-being was negatively associated with COVID-19 anxiety and hopelessness, and positively associated with the quality of life. COVID-19 anxiety was associated positively with hopelessness, and negatively with the quality of life. Moreover, COVID-19 anxiety mediated the relationship between hopelessness, spiritual well-being, and quality of life.

SIGNIFICANCE OF RESULTS

This study provides evidence for COVID-19 anxiety's mediating role in the relationship between spiritual well-being and quality of life and hopelessness among cancer patients. The findings suggest that interventions aimed at reducing COVID-19 anxiety may be effective in reducing hopelessness among cancer patients, by promoting higher levels of spiritual well-being and improving quality of life.

COVID-19 pandemic impact on mental health in a large representative sample of older adults from the Lombardy region, Italy

BACKGROUND

We aimed to assess the prevalence of depressive and anxiety symptoms, hopelessness and insomnia in the older adults before and during the COVID-19 pandemic identifying subgroups at higher risk of mental distress.

METHODS

Within the Lost in Lombardy project, a web-based cross-sectional study was conducted on a representative sample of 4400 older adults aged 65 years or more from the Lombardy region recruited between November 17th and 30th 2020.

RESULTS

The prevalence of depressive symptoms increased by +112 % during the pandemic, anxiety symptoms by +136 %, insufficient sleep by +12 %, unsatisfactory sleep by +15 %. Feelings of hopelessness were more frequent among women compared to men and increased with increasing age. A worsening in each of the four specific mental health outcomes was more frequently observed in women (OR = 1.50, depression; OR = 1.31, anxiety; OR = 1.57, sleep quality; OR = 1.38, sleep quantity), in subjects who decreased their physical activity during the pandemic (OR = 1.64, depression; OR = 1.48, anxiety; OR = 2.05, sleep quality; OR = 1.28, sleep quantity), and with increasing number of pre-existing chronic diseases. The use of at least one psychotropic drug - mostly antidepressants/anxiolytics - increased by +26 % compared to pre-pandemic.

LIMITATIONS

Pre-pandemic symptoms were retrospectively reported during the Covid pandemic. Potential information and recall bias should not be ruled out.

CONCLUSIONS

If confirmed by future longitudinal studies, our findings could support evidence-based health and welfare policies on responding to this pandemic and on how to promote mental health and wellbeing, should future waves of infection emerge.