Socio-ecological determinants of distress in Filipino adults during COVID-19 crisis

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Exploring the associations between resilience and psychological well-being among South Africans during COVID-19

Resilience pertains to an individual's ability to withstand, adapt, and recuperate from adversity and stress. As the world grapples with unprecedented challenges such as the COVID-19 pandemic, understanding the relationship between resilience and psychological well-being becomes essential. Preliminary observations suggest that those with a higher resilience tend to have better psychological well-being, indicating a possible symbiotic relationship between the two. This study was structured using a cross-sectional survey design. A convenience sampling technique was employed, including 631 respondents in South Africa. Data collection took place between June 11 and July 9, 2022, facilitated through a Google Forms questionnaire. This questionnaire encompassed various instruments, namely a biographical questionnaire, the CD-RISC 10, the WHO Well-being Index, the FACIT-Sp-12, and the PMHS. The findings from the collected data highlighted a strong correlation between resilience and overall well-being during the COVID-19 pandemic. This elevation in resilience can be instrumental in augmenting psychological well-being. As such, interventions or programs aimed at enhancing individual and community well-being might benefit from incorporating elements that bolster resilience, especially during periods of global adversity.

Health Behavior and Attitudes During the COVID-19 Pandemic Among Vulnerable and Underserved Latinx in the Southwest USA

The COVID-19 pandemic highlighted deep-rooted health disparities, particularly among Latinx immigrants living on the Mexico-US border. This article investigates differences between populations and adherence to COVID-19 preventive measures. This study investigated whether there are differences between Latinx recent immigrants, non-Latinx Whites, and English-speaking Latinx in their attitudes and adherence to COVID-19 preventive measures. Data came from 302 participants who received a free COVID-19 test at one of the project sites between March and July 2021. Participants lived in communities with poorer access to COVID-19 testing. Choosing to complete the baseline survey in Spanish was a proxy for being a recent immigrant. Survey measures included the PhenX Toolkit, COVID-19 mitigating behaviors, attitudes toward COVID-19 risk behaviors and mask wearing, and economic challenges during the COVID-19 pandemic. With multiple imputation, ordinary least squares (OLS) regression was used to analyze between-group differences in mitigating attitudes and behaviors toward COVID-19 risk. Adjusted OLS regression analyses showed that Latinx surveyed in Spanish perceived COVID-19 risk behaviors as more unsafe (b = 0.38, p = .001) and had stronger positive attitudes toward mask wearing (b = 0.58, p = .016), as compared to non-Latinx Whites. No significant differences emerged between Latinx surveyed in English and non-Latinx Whites (p > .05). Despite facing major structural, economic, and systemic disadvantages, recent Latinx immigrants showed more positive attitudes toward public health COVID-19 mitigating measures than other groups. The findings have implications for future prevention research about community resilience, practice, and policy.

Community resilience across Australia towards natural hazards: an application of the Conjoint Community Resiliency Assessment Measurement

Natural hazards can turn into disasters when not managed well. An important part of disaster risk reduction is to understand how well communities are prepared for natural hazards and how well they can cope with and recover from shocks in the long term. This research assesses self-reported community resilience and asks what makes a community resilient, using Australia as a case study. It reports on an Australian-wide online survey which included questions related to the Conjoint Community Resiliency Assessment Measurement, a subjective indicator, as well as questions about risk perception, well-being, and self-efficacy. Community resilience was found to be moderately high but scores for community leadership and preparedness were low. Perceived community resilience was positively correlated with age and those with high scores for self-efficacy and well-being. There was, as expected, an inverse relationship between reliance on external support during natural hazards and self-efficacy. The results complement previous studies which used different measures of community resilience.

The double-edged impact of Internet use on mental health outcomes among Filipino university students: the mediating role of online social support

Introduction

Evidence supports both the positive and negative effects of Internet use on mental health outcomes, but it remains unclear on the role of online social support in this relationship. This study examined the link between daily hours of general Internet use and bidimensional mental health (BMMH) through the pathway of online social support (OSSS).

Methods

Drawing from a sample of 247 Filipino university students, this cross-sectional study tested two simple mediation models that considered mental wellbeing and psychological distress as outcome variables.

Results

Findings show that the total effect of Internet use is positive and negative for mental wellbeing and psychological distress, respectively. Online social support mediated the favorable effects of Internet use on BMMH outcomes. However, the introduction of OSSS as a mediator yielded residual direct effects with opposing signs for both models. The resultant inconsistent mediation in the models signifies the double-edged impact of Internet use on mental health, with favorable effects transmitted through online social support.

Discussion

Findings highlight the importance of online social support as a pathway to harness the positive effects of Internet on mental health. Recommendations to improve online social support for students are discussed herein.

The Association between Resilience and Psychological Distress during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

This study examined the association between resilience and psychological distress in healthcare workers, the general population, and patients during the COVID-19 pandemic. We searched the PubMed, Web of Science, PsycInfo, Science Direct, and Nursing and Allied Health databases. Included articles examined healthcare workers (e.g., physicians and nurses), the general population, and patients during the COVID-19 pandemic. Studies of exposure to other infectious diseases related to epidemics or pandemics (e.g., SARS and MERS) were excluded. This study was performed following the Cooper matrix review method and PRISMA guidelines, followed by a meta-analysis of study results using R version 4.1.2. A random effect model was used for the pooled analysis. This study was registered with PROSPERO (registration No. CRD42021261429). Based on the meta-analysis, we found a moderate negative relationship between overall resilience and psychological distress (r = -0.42, 95% confidence interval [CI]: -0.45 to -0.38, p < 0.001). For the subgroup analysis, a moderately significant negative relationship between overall resilience and psychological distress was found among healthcare workers (r = -0.39, 95% CI: -0.44 to -0.33, p < 0.001), which was weaker than in the general population (r = -0.45, 95% CI: -0.50 to -0.39, p < 0.001) and in patients (r = -0.43; 95% CI: -0.52 to -0.33; p < 0.001). This association was robust, although the heterogeneity among individual effect sizes was substantial (I2 = 94%, 99%, and 74%, respectively). This study revealed a moderate negative relationship between resilience and psychological distress in healthcare workers, the general population, and patients. For all these populations, interventions and resources are needed to improve individuals' resilience and ability to cope with psychological distress during the COVID-19 pandemic and in future disease outbreaks.

Perceived stress during COVID-19: Community resilience three years before the pandemic as a protective factor

Research indicates that stress increased across the globe after the outbreak of the COVID-19 pandemic. Community resilience has been suggested as a central protective factor for stress related to disasters and emergency crises. This study examined the contribution of community resilience reported three years prior to the onset of the COVID-19 pandemic, together with related worries and personal risk factors, to perceived stress among Israeli adults following the first wave of COVID-19 in Israel. We performed a two-period 3-year longitudinal study (Period 1 [P1]: July-September 2017; Period 2: [P2] May-June 2020). The final sample included 578 participants. Participants completed a community resilience self-report questionnaire during P1 as well as measures regarding perceived stress and COVID-19 worries during P2. Using linear hierarchical regression, we tested the additional explanatory effect of community resilience and found it to be negatively associated with perceived stress. While health-related worries were not significantly associated with perceived stress, worries related to the functioning of governmental and health institutions regarding the COVID-19 pandemic were significantly associated with perceived stress. Additionally, being single, living in a smaller residence and income reduction during the pandemic predicted higher perceived stress. The current study highlights the potential buffering role of community resilience in protecting against COVID-19 stress. Assessing community resilience may help identify vulnerable groups, and focusing on community building may be an effective strategy to mitigate stress in future disasters.

Difference between Minorities and Majorities in the Association between COVID-19-Related Stress and Psychological Distress: A Socio-Ecological Perspective and the Moderating Role of Parenthood

This study introduces a socio-ecological perspective of differences in psychological distress between the Palestinian minority and Jewish majority citizens of Israel during lockdown due to COVID-19. The study examines the association between COVID-19-related stress and psychological distress, and the moderating effect of parenthood. Online questionnaires, completed by 1934 participants (1391 Jews, 552 Palestinians; 1306 parents, 637 without children; 54.86% female, 45.13% male; M age = 40.38, SD = 13.77) assessed COVID-19-related stressors and depression, anxiety, and stress. The Palestinian minority showed a higher level of COVID-19-related stress and psychological distress than the Jewish majority. Parenthood showed a moderating effect on the association between COVID-19-related stress and distress for the Jewish majority but not the Palestinian minority. The results emphasize the significance of considering social status when seeking to understand the differences between minorities and majorities in terms of distress and resilience during pandemic events, and the need for cultural sensitivity and awareness when issuing instructions in such circumstances. Additionally, the results highlight the potential role of parenthood as a resilience factor, depending upon social status.

Measurement and community antecedents of positive mental health among the survivors of typhoons Vamco and Goni during the COVID-19 crisis in the Philippines

The present study examined the measurement and antecedents of positive mental health in people who concurrently experienced two disasters of different nature (i.e., typhoons and COVID-19 crisis), focusing on the survivors of typhoons Vamco and Goni that hit the Philippines in November 2020, during the COVID-19 pandemic. First, we investigated the psychometric properties of Mental Health Continuum-Short Form (MHC-SF), a well-validated measure of positive mental health dimensions (i.e., emotional, social, and psychological well-being) by: 1) comparing the structural validity of three measurement models including a single-factor, bifactor, and three-factor solutions of positive mental health; 2) looking into the criterion validity through correlating the MHC-SF subscales with relevant measures; and 3) calculating for item reliability. Second, we examined the mediating role of social responsibility in the positive influence of community resilience on the three dimensions of positive mental health. Using 447 participants, with ages ranging from 18 to 70 years old, confirmatory factor analysis showed that compared to the single-factor and the bifactor models, the intercorrelated three-factor model of MHC-SF has the best model fit and most stable factor loadings. MHC-SF subscales correlated with relevant measures indicating criterion validity and yielded excellent internal consistency for all subscales. Additionally, results showed that social responsibility mediated the positive impact of community resilience on emotional, social, and psychological well-being of Filipinos in times of great adversities. The findings were discussed within the context of extreme weather events and the COVID-19 crisis in the Philippines, highlighting implications on disaster preparedness and mental health policies at the community level.

The mediating role of psychological distress on the link between socio-ecological factors and quality of life of Filipino adults during COVID-19 crisis

Anchored on the Ecological Systems Theory, this study aimed to determine how psychological distress operates as an underlying mechanism in the impact of socio-ecological factors on the quality of life of Filipino adults during coronavirus disease 2019 (COVID-19) crisis. A cross-sectional online survey was conducted to assess perceptions of 401 adults on socio-ecological factors (i.e., safety at home, trust in public institutions, and financial difficulties), psychological distress, and quality of life during the early phase of COVID-19 community quarantine in the Philippines. Using latent variable path analysis, all three socio-ecological factors have significant direct effects on both psychological distress and quality of life. More importantly, the proposed model was confirmed in terms of a significant partial mediation of psychological distress on the impact of safety at home, trust in public institutions, and financial difficulties on the quality of life of Filipino adults. The study offers novel insights into the role of psychological distress as an underlying mechanism that operates on the influence of socio-ecological factors on the quality of life of adults during a global health crisis. Implications on psychological interventions and policies in preventing mental health problems vis-à-vis improving Filipinos' quality of life during the COVID-19 pandemic are discussed.

Measuring mental well-being among frontline nurses during the COVID-19 crisis: Evidence from Saudi Arabia

In the days of the COVID-19 pandemic, frontline nurses providing care to different communities face are particularly vulnerable to the mental health threats of the crisis. The objective of this study was to examine the structural validity, convergent validity, and reliability of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in professional nurses amidst the COVID-19 crisis in Saudi Arabia. Data were collected from 413 nurses in Saudi Arabia using a cross-sectional online survey. Consistent with the original version, results of the confirmatory factor analysis revealed a unidimensional structure of the WEMWBS. Support for convergent validity was found as the WEMWBS significantly correlated with measures of burnout and compassion satisfaction. In terms of reliability, all WEMWBS items yielded high internal consistencies suggesting that the 14 items were robust indicators of mental well-being. In response to the challenges of the COVID-19 crisis, the current study offers a psychometrically sound instrument that can be utilized in screening the mental well-being of nurses in the days of a public health crisis. Preserving the positive aspect of mental health among frontline healthcare workers and promoting quality of care for communities requires a contextualized measurement tool that efficiently assesses mental well-being.

Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics

Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind's survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups' beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals' willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups' beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people's trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals' willingness to adopt such preventative measures.

Older Adults' Experiences and Adaptation Strategies during the Midst of COVID-19 Crisis: A Qualitative Instrumental Case Study

BACKGROUND

This study aimed to validate one of the propositions of the Need-Threat Internal Resiliency Theory.

METHODS

This study used an instrumental case study of five participants to qualitatively explore older adults' experiences and adapting strategies during the coronavirus disease 2019 (COVID-19) crisis. We selected participants based on parameters and conducted in-depth interviews of 15-30 minutes. The transcribed responses were then analyzed using a phenomenological holistic description.

RESULTS

Five major themes emerged to explain and describe the various experiences of coping with COVID-19, known as internal resiliency, developed by the older adult participants in response to the perceived threat from this crisis.

CONCLUSION

These findings showed that older adult participants had established internal resiliency in response to changes caused by the COVID-19 crisis, resulting in adaptation and coping with the situation, consistent with one proposition of the Need-Threat Internal Resiliency Theory.