Psychological distress among older adults during COVID-19 pandemic: Prevalence and associated factors

Impact of self-stigma of loneliness on psychological distress in older adults: mediation effect of relative deprivation and moderation effect of positive solitude

BACKGROUND

Self-stigma of loneliness is a major predictor of psychological distress among older adults, but its mechanism has not been further discussed. Drawing on classical relative deprivation theory and conceptualizing stigma model, this study aimed to examine the relationship between self-stigma of loneliness and psychological distress among older people and analyzed the mediation effect of relative deprivation and the moderation effect of positive solitude.

METHODS

The study applied a cross-sectional study design to conduct questionnaire survey by administrating the Stigma of Loneliness Scale (SLS), 6-item Kessler Psychological Distress Scale (K6), Relative Deprivation Questionnaire, and Positive Solitude Scale (PS) among 1179 Chinese older adults. The Pearson correlation analysis explored the correlation between variables and Model 4 in PROCESS examined the mediating effect of relative deprivation. The moderating effect of positive solitude in the mediation model was tested through Model 59.

RESULTS

The correlation analysis shows a significant and positive correlation between the stigma of loneliness, relative deprivation, and psychological distress (r = 0.530 ~ 0.714); while positive solitude is significantly and negatively correlated with the stigma of loneliness, relative deprivation, and psychological distress (r = -0.128 ~ -0.179). Additionally, relative deprivation plays a mediating role in the relationship between self-stigma of loneliness and psychological distress. Meanwhile, it is invalid of the moderating effect of positive solitude in the direct path, first half of and second half of the path in the mediation model.

CONCLUSIONS

Self-stigma of loneliness could both directly affect psychological distress in older people and indirectly through the role of relative deprivation. Furthermore, positive solitude does not significantly buffer the impact of self-stigma of loneliness on relative deprivation and psychological distress. As research findings suggested, it is conducive to reducing psychological distress in older adults by adopting appropriate interventions to diminish self-stigma of loneliness and relative deprivation.

Factors Associated with Loneliness and Psychological Distress in Older Adults During the COVID-19 Pandemic in Kazakhstan: A Cross-Sectional Study

Background and Objectives: In Kazakhstan, during the COVID-19 pandemic, older adults faced unique challenges, such as limited healthcare resources and prolonged periods of social isolation. The aim of our study was to evaluate the sociodemographic and health-related factors associated with loneliness and psychological distress in older adults during the COVID-19 pandemic in Kazakhstan. Materials and Methods: In this cross-sectional study, a total of 445 participants aged 60 and above were recruited from Kazakhstan during the COVID-19 pandemic. The Patient Health Questionnaire-4 (PHQ-4) was used to measure psychological distress, anxiety, and depression. Loneliness was assessed using the UCLA Loneliness Scale (UCLA-3). The sociodemographic and health-related variables of the tested participants were analyzed. Results: Mean values from the UCLA-3 (p < 0.001), PHQ-4 (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001) scores significantly differed between different categories of self-reported overall health. Significantly higher mean values were found in older adults with hypertension for UCLA-3 (p = 0.025), PHQ-4 (p = 0.001), anxiety (p = 0.001), and depression (p = 0.017); diabetes for UCLA-3 (p = 0.023), PHQ-4 (p = 0.029), and depression (p = 0.001); chronic heart failure for UCLA-3 (p = 0.005), PHQ-4 (p < 0.001), anxiety (p = 0.001), and depression (p < 0.001); cerebrovascular disease for UCLA-3 (p = 0.024), PHQ-4 (p = 0.002), anxiety (p = 0.001), and depression (p = 0.027); cardiovascular disease for UCLA-3 (p < 0.001), PHQ-4 (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001); dementia for anxiety (p = 0.046); being single for UCLA-3 (p = 0.009), PHQ-4 (p = 0.031), and depression (p = 0.028); other ethnic backgrounds for PHQ-4 (p = 0.004) and anxiety (p = 0.013); and living in an urban place for PHQ-4 (p = 0.043). Being single was shown to be a significant predictor for loneliness (OR 2.21; 95%CI 1.28-3.84), anxiety (OR 2.09; 95%CI 1.14-3.84), and depression (OR 4.23; 95%CI 1.95-9.15). Below-average (OR 5.79; 95%CI 1.09-30.90) self-reported overall health was shown to be a significant predictor of anxiety. Conclusions: Our study demonstrated that numerous sociodemographic and health-related factors were associated with loneliness, anxiety, and depression in older adults from Kazakhstan during the COVID-19 pandemic.

Post-COVID-19 syndrome, who at risk and why: an insight from Qatar 2022

Background

Despite the recovery from the COVID-19 pandemic, many people experience post-COVID-19 syndrome, which negatively impacts their health and function. This condition has become a significant public health problem that requires immediate attention.

Objective

To study the prevalence, clinical characteristics, and predictors of post-COVID-19 Syndrome in Qatar during 2022.

Methods

An analytic cross-sectional study was conducted among COVID-19 confirmed cases from January 2022 to July 2022 in Qatar. A simple random sample was employed to include (n = 588) participants from the list of cases and invited to participate in a telephone survey. The World Health Organization's standard case definition for PCS was adopted.

Results

Out of 368, the prevalence of post-COVID-19 syndrome was 43.2% (n = 159). Most PCS cases were females (67.9%; n = 108), married (73.6%; n = 117), and university and higher educational level (83.6%; n = 133). However, 78.7% (n = 125) reported poor to moderate levels of social support. Only 30.2% (n = 48) of PCS patients had a history of chronic diseases, and 5.7% (n = 9) required hospital admission during acute illness. Among PCS cases, the most commonly reported symptoms were fatigue (75.5%), followed by anxiety (49.1%), forgetfulness (46.5%), mood alteration (45.3%), and general weakness (39.6%). The logistic regression revealed that female gender (AOR: 2.58 95%CI: 1.58-4.225, p < 0.0001), university and high educational level (AOR: 2.2, 95%CI: 1.256-3.98, p < 0.006), poor level of social support (AOR: 2.45; 95%CI: 1.55-4.13; p < 0.002), were significant predictors for PCS.

Conclusion

Post-COVID-19 syndrome may go under-recognized. More efforts are needed to raise awareness and mobilize the resources to respond to this ongoing public health problem.

Monkeypox Emergence Post-COVID: Insight into Egyptian Older Adult's Awareness, Concern, and Mental Health

Aim: To identify Egyptian older adults' awareness, concerns, and mental health about the monkeypox outbreak. Background: In light of the ongoing COVID-19 pandemic, monkeypox disease is receiving more attention. The monkeypox virus outbreak has posed a global concern, especially to older adults with comorbidities. Natural disasters, and endemic affect older persons' mental health. Design: A cross-sectional descriptive design was followed. Methods: 254 older adults were recruited from three outpatient clinics using consecutive sampling using four tools. Results: 74.0% of older study participants were unaware of monkeypox. Gender, level of education, residence, worry about contracting monkeypox infection, and mental distress are predictors of awareness about monkeypox (p < .001). Worry of contracting monkeypox infection was common among female participants (p = .038), highly educated (p = .001), who had a low level of awareness and high level of mental distress (p = .001 for both). Conclusion: Awareness of monkeypox was associated with worry and mental distress. Gerontological nurses have a vital role in contacting older adults and providing care and education that decreases worry and preserves minds and feelings, improving their quality of life. Establishing a national strategic planning and crisis prevention framework to alleviate psychological distress and prevent mental health issues from deteriorating in this group is crucial.

"Be Your Own Doctor" Experiences of Patients With Transcatheter Aortic Valve Implantation During the Pandemic: A Qualitative Study

Background and Purpose: Although patients have had reduced access to healthcare institutions due to the COVID-19 pandemic and the related preventive measures, there is no current data on how the pandemic has affected patients who underwent transcatheter aortic valve implantation (TAVI), despite their need for close follow-up.This study investigated TAVI patients' experiences with self-care management during the pandemic. Methods: This study adopted a descriptive qualitative design. The sample consisted of 24 patients recruited using purposive sampling. Data were collected by telephone and analyzed using inductive content analysis. Results: The data were grouped under three themes: "vulnerability," "worsening of psychological condition," and "expectations." The most challenging self-care behaviors reported by TAVI patients were determined to be doing regular physical activity, managing their symptoms, complying with treatment, and attending regular check-ups. They also reported experiencing psychological problems such as fear, concern, and abandonment and stated a need for better communication and follow-up at home during the pandemic. Implications for Practice: The pandemic has more than ever demonstrated the importance of effective self-care for cardiovascular patients. Nurses should plan individualized interventions regarding the problems in self-care management that we identified in this study. In this regard, the use of secure digital applications such as telerehabilitation can be effective. Also, nurses should develop community-based and political initiatives to allow sustainable self-care management to be effectively implemented in special patient groups in extraordinary circumstances such as pandemics.

Vulnerability and resilience of older adult toward stress during COVID- 19 pandemic in RAS Al-Khaimah, UAE

In addition to heightened physical health risks, older persons may face mental health and social well-being potential risks as a result of coronavirus disease 2019 (COVID-19). The ability to adapt effectively to adversity, or resilience, may be a key aspect in successful aging. However, the measurement and correlates of resilience in the older adults have received insufficient attention. This study aims to assess the vulnerability and resilience of older adult toward stress during COVID-19 pandemic in RAS Al Khaimah, UAE. A cross-sectional descriptive study. The sample was recruited from two primary health care centers that introduce homecare services to older adults, namely Julphar and RAS Al- Khaimah health care centers. From the period of September 2021 to January 2022. 168 community-dwelling older adults registered in the mentioned primary health centers who were aged 60 years and older, were able to communicate, and who agreed to participate in the study. An electronic questionnaire for data collection, which was distributed to participants via publicly available online resources and the WhatsApp application. 

Prevalence and correlates of COVID-19-related traumatic stress symptoms among older adults: A national survey

Coronavirus pandemics increase the incidence of posttraumatic stress disorder (PTSD), which requires intensive treatment and is related to several long-term psychiatric disorders. Older adults are particularly vulnerable to COVID-19 and hence trauma symptoms. It is not known what is the prevalence of trauma symptoms relating to COVID-19 specifically among older adults nor what may be the markers for the emergence of trauma symptoms. The aim of the present research was to estimate the prevalence, and identify correlates of, traumatic stress symptoms attributable to COVID-19 among older adults in the UK. A cross-sectional survey that assessed COVID-19-related trauma symptoms and demographics was conducted with a sample of 3012 adults aged 60 years and older who were representative of the UK population. Data were analysed descriptively and using multiple/logistic regression. 36.5% of the sample (n = 1100) reported experiencing clinically meaningful traumatic stress symptoms that could lead to as many as 27.4% of the sample going on to develop PTSD. Women and younger older adults were particularly likely to experience clinically meaningful symptoms of traumatic stress. Work is urgently required to prepare services to address what may be substantial numbers of older people presenting with PTSD in the future.

The Assessment of the Severity of COVID-19-Related Anxiety Symptoms in Participants of the University of the Third Age in Poland: A Cross-Sectional Study among Internet Survey Respondents

Introduction: Fear of infection with SARS-CoV-2 has become widespread. All over the world, since the very beginning of the pandemic, older adults have been considered one of the groups at highest risk of SARS-CoV-2 infection and death due to COVID-19. The aim of the study was to evaluate the severity of anxiety symptoms related to COVID-19 in the older adults who are participants of the Universities of the Third Age in Poland. Material and methods: The study included participants of the University of the Third Age in Poland. A total of 296 persons were enrolled, including 258 women and 38 men. The study was a diagnostic survey, conducted with the use of the following validated psychometric scales: General Anxiety Disorder-7 (GAD-7), Short Health Anxiety Inventory (SHAI), and State-Trait Anxiety Inventory (STAI). Results: In two scales (STAI and SHAI), the mean scores demonstrated mild symptoms indicative of anxiety disorders in the older respondents. Women and men did differ significantly in terms of the scores obtained in STAI X-1 and STAI X-2. Single respondents differed significantly from divorced ones in terms of STAI X-1 scores. Moreover, widows/widowers differed significantly from divorced ones in terms of STAI X-2, and GAD-7 scores. Respondents declaring their financial status as average differed significantly from those declaring their financial status as good in terms of: STAI X-1, STAI X-2, SHAI, and GAD-7 scores. Conclusions: The subjective experience of anxiety symptoms associated with fear of contracting COVID-19 was increased due to the ongoing pandemic, but was not significantly high in the analysed population of older people. COVID-19-related anxiety was significantly more common in lonely individuals and in those of worse financial status. Women and men differed significantly in terms of perceived state anxiety and trait anxiety measured by STAI. More studies addressing COVID-19-related anxiety in older people participating in the Polish Universities of the Third Age are needed to determine a more accurate distribution of this phenomenon in Poland.