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Mtenga SM, Mashasi I, Kisia L, Binyaruka P, Masanja H, Mohamed SF, Sanya RE, Mhalu G, Magembe G, Ramaiya K, Asiki G, Mair F, Bunn C, Gray CM. Socio-structural and direct health challenges related to illness management among patients with type 2 diabetes in Kenya and Tanzania during the COVID-19 pandemic: A qualitative inquiry. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0003876. [PMID: 40202987 PMCID: PMC11981119 DOI: 10.1371/journal.pgph.0003876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 01/26/2025] [Indexed: 04/11/2025]
Abstract
During COVID-19, people with type 2 diabetes (T2D) experienced increased vulnerability, including severe COVID-19 complications, disruptions in diabetes management, and social isolation. These aspects were heightened in many sub-Saharan African countries, such as Kenya and Tanzania, where healthcare systems already face critical challenges in coping with increasing non-communicable diseases (NCDs). Little is known about how people with T2D in these countries managed their diabetes or how the different approaches to COVID-19 control (Kenya imposed lockdown and curfew, whereas Tanzania adopted less strict measures) impacted their T2D management. This qualitative study aimed to compare the accounts of T2D patients in both countries to examine similarities and differences in the illness management challenges they faced during the COVID-19 pandemic.Semi-structured interviews were conducted with 52 patients (Kenya, n=22; Tanzania, n=30), and the transcripts were analyzed thematically. Despite different COVID-19 control measures, patients in both countries faced similar direct health challenges, such as difficulties accessing diabetic consultations and treatment, but they also experienced distinct socio-structural challenges. Direct health challenges included difficulties in accessing diabetic consultations and treatment, limited availability of diabetic medicine at health facilities and mental health distress. These were exacerbated by socio-structural challenges, many of which pre-dated COVID-19 but intensified during the pandemic. These included closure of diabetic clinics in Dar es Salaam, business instability, financial difficulties, health insurance challenges, higher food prices impacting patients' adherence to T2D dietary recommendations (in both countries), and price inflation of diabetic medicine and test kits (in Kenya). Together, these challenges led to patients practicing self-medication, missing doses and resulted in poor blood sugar control. People with T2D in Kenya and Tanzania have described similar illness management challenges. In both countries, future contingency planning is essential to ensure adequate routine management of T2D and to improve access to care in emergency situations. Affordable comprehensive health insurance, economic support, and psychosocial services are required to increase patient resilience and support the health and wellbeing of people with T2D.
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Affiliation(s)
- Sally Mmanyi Mtenga
- Health System Impact Evaluation and Policy Department, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Irene Mashasi
- Health System Impact Evaluation and Policy Department, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Lyagamula Kisia
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi Kenya
| | - Peter Binyaruka
- Health System Impact Evaluation and Policy Department, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Honorati Masanja
- Health System Impact Evaluation and Policy Department, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Shukri F. Mohamed
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi Kenya
| | - Richard E. Sanya
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi Kenya
| | - Grace Mhalu
- Health System Impact Evaluation and Policy Department, Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | | | - Gershim Asiki
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi Kenya
| | - Frances Mair
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
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Tran T, Joyce A, Nguyen H, Fisher J. Financial hardship and psychological distress during and after COVID-19 lockdowns in Victoria, Australia: a secondary data analysis of four repeated state-wide surveys. BMJ Open 2025; 15:e093336. [PMID: 40118488 PMCID: PMC11931936 DOI: 10.1136/bmjopen-2024-093336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 02/27/2025] [Indexed: 03/23/2025] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of individuals experiencing financial hardship and to examine the relationship between their experiences of financial hardship and psychological distress during and after the COVID-19 lockdowns. DESIGN This is a secondary analysis of data from four repeated state-wide surveys conducted in 2020 and 2022. SETTING Victoria, Australia. PARTICIPANTS AND OUTCOME MEASURES All Victorian residents aged 18 years and above were eligible. Psychological distress was assessed using the Kessler Psychological Distress Scale-6 Item version (K6), while financial hardship was assessed using a nine-item scale. Relationships between experiencing any form of financial hardship and experiencing high psychological distress (K6≥19) were evaluated using an autoregressive and cross-lagged model that used data from all four surveys. RESULTS A total of 2000, 2000, 2349 and 2444 individuals responded to surveys 1, 2, 3 and 4, respectively. The proportion of people experiencing at least one form of financial hardship increased from 23.5% in 2020 (the first year of the pandemic) to 38.5% in 2022 (the third year of the pandemic). The most vulnerable groups facing financial hardship included young people, Aboriginal & Torres Strait Islanders, individuals with disabilities and those with low income. The proportions of individuals experiencing high psychological distress followed a quadratic trajectory, with the peak occurring between the first and third years of the pandemic. Experiencing financial hardship was consistently associated with high psychological distress at each time point in this study. However, there was no evidence of a longitudinal relationship between financial hardship and high psychological distress. CONCLUSIONS The data from this study confirmed a significant increase in the proportion of individuals facing financial hardship among the adult population in Victoria from the first to the third year of the COVID-19 pandemic. This study does not ascertain a longitudinal effect of financial hardship on psychological distress during the pandemic. Further research is warranted to confirm this finding.
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Affiliation(s)
- Thach Tran
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew Joyce
- Centre for Social Impact, Swinburne University of Technology, Melbourne, Victoria, Australia
- Research & Impact, VicHealth, Melbourne, Victoria, Australia
| | - Hau Nguyen
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Fisher
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Zarei K, Hamilton-Moseley KR, Chen-Sankey J, Phan L, Ajith A, Hacker K, Jewett B, Choi K. Financial hardship during the COVID-19 pandemic and increased receipt of commercial tobacco discount coupons among US adults who use commercial tobacco. Tob Control 2024; 33:e151-e157. [PMID: 37339815 PMCID: PMC10730766 DOI: 10.1136/tc-2022-057814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Many individuals experienced financial hardship during the COVID-19 pandemic; yet commercial tobacco (CT) sales increased in the USA. We examined how experiencing financial hardships relates to increased CT discount coupon reception during the pandemic. METHODS A nationally representative sample of 1700 US adults who used CT during the 12 months prior to the survey were surveyed online during January to February 2021. Participants reported if they had received more discount coupons for various CT products during (compared with before) the pandemic. They also reported whether they experienced six different types of financial hardships since the pandemic, and the total number of hardships experienced was counted. Weighted multivariable logistic regressions were used to examine the associations between financial hardships and increased coupon reception, adjusting for demographics and CT product use. RESULTS During the first 10-11 months of the pandemic, 21.3% of US adults who used CT during the 12 months prior to the survey reported receiving more CT discount coupons. Experiencing financial hardship during the pandemic was associated with higher odds of receiving more coupons for all types of CT products: every additional count of financial hardship was associated with higher odds of increased reception of discount coupons for all CT products (adjusted odds ratios ranging from 1.13 to 1.23 across products). CONCLUSIONS Over one-fifth of US adults who used CT received more discount coupons during the pandemic. Those facing financial hardships had higher discount coupon reception, suggesting potential targeted marketing to financially vulnerable individuals by the tobacco industry.
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Affiliation(s)
- Kasra Zarei
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Kristen R Hamilton-Moseley
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Julia Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
- School of Public Health, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey, USA
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Lilianna Phan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kiana Hacker
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Bambi Jewett
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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Hendriksen PA, Kiani P, Koyun AH, Garssen J, Stock AK, Verster JC. Mood, Quality of Life, and Immune Fitness During the COVID-19 Pandemic of Young Adults in Germany. J Clin Med 2024; 13:6487. [PMID: 39518626 PMCID: PMC11546385 DOI: 10.3390/jcm13216487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 10/24/2024] [Accepted: 10/27/2024] [Indexed: 11/16/2024] Open
Abstract
Background: The COVID-19 pandemic has profoundly affected young adults' lives globally, including those in Germany. This study investigated mental health and quality of life during the pandemic, with a particular focus on mood. Immune fitness, the body's capacity to respond to health challenges (such as infections) by activating an appropriate immune response, was assessed as a physical health indicator. Methods: Data were collected from 317 participants, aged 18 to 35, via an online survey conducted between November 2021 and March 2022. Participants included 103 men (32.5%) and 214 women (67.5%), with a mean age of 25.5 years (SD = 4.1). Results: Compared to pre-pandemic levels, significant declines in mood, quality of life, immune fitness, and sleep quality were observed during the lockdown periods of the COVID-19 pandemic (p < 0.0125). The most pronounced effects were observed during the second lockdown, with declines extending into the second no-lockdown period for fatigue, depression, happiness, optimism, and immune fitness (p < 0.0125). Significant sex differences were found for the magnitude of mood effects (anxiety, depression, stress). No significant differences were found according to age or occupational status (student vs. work). Conclusions: The COVID-19 pandemic and associated lockdown periods had a significant negative effect on the mood, immune fitness, and well-being of young adults living in Germany.
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Affiliation(s)
- Pauline A. Hendriksen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; (P.A.H.); (P.K.); (J.G.)
| | - Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; (P.A.H.); (P.K.); (J.G.)
| | - Anna Helin Koyun
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, D-01307 Dresden, Germany; (A.H.K.); (A.-K.S.)
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; (P.A.H.); (P.K.); (J.G.)
- Danone Global Research & Innovation Center, Uppsalalaan 12, 3584 CT Utrecht, The Netherlands
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, D-01307 Dresden, Germany; (A.H.K.); (A.-K.S.)
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands; (P.A.H.); (P.K.); (J.G.)
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, D-01307 Dresden, Germany; (A.H.K.); (A.-K.S.)
- Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne, VIC 3122, Australia
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Aggarwal S, Tabassum H, Agarwal P, Grover A, Singh R. Beyond Barriers: Addressing Challenges and Opportunities of People with Disability During the Pandemic. Indian J Community Med 2024; 49:579-587. [PMID: 39291115 PMCID: PMC11404413 DOI: 10.4103/ijcm.ijcm_49_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/19/2024] [Indexed: 09/19/2024] Open
Abstract
People with disabilities often experience worse health outcomes than ordinary people because of multiple barriers to accessing healthcare. These inequalities are particularly exposed during the pandemic, indicating an urgent need to strengthen health systems, so that they are inclusive and responsive to the needs of these people during crises. These people are particularly affected by changes in routine services because of diversion of healthcare staff and facilities to respond to the pandemic, e.g., rehabilitation and medications. The combination of these factors substantially imparts negative impacts on their functioning and well-being. Health services research can help address the challenges of maintaining continuity of care during crises as well as addressing systematic inequalities in the health sector that marginalize people with disabilities even during noncrisis times. Therefore, research is needed to understand the health service design and to identify strategies to maximize active participation from this population.
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Affiliation(s)
- Sumit Aggarwal
- Department of Descriptive Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Heena Tabassum
- Non-Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Pragati Agarwal
- Department of Descriptive Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Ashoo Grover
- Department of Delivery Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Ravinder Singh
- Non-Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
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Siddique AB, Hosen MS, Akter H, Hossain SM, Al Mamun M. Assessment of knowledge, attitudes, and practices regarding cardiovascular diseases (CVDs) among older individuals of rural Bangladesh: findings from a face-to-face interview. Front Public Health 2024; 12:1336531. [PMID: 38855451 PMCID: PMC11157036 DOI: 10.3389/fpubh.2024.1336531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Cardiovascular diseases (CVDs) stand as the foremost contributor to global mortality, claiming roughly 17.9 million lives each year, constituting 32.1% of total fatalities. Their impact is notably profound in economies such as Bangladesh, exacting a substantial economic burden. Consequently, grasping the landscape of knowledge, attitudes, and practices is essential for timely identification and prevention strategies. Methods This cross-sectional study, carried out between January and May 2023 in the rural regions of Zirani, Savar Upazila, Dhaka, Bangladesh, utilized convenient sampling and conducted face-to-face interviews using a semi-structured questionnaire. It encompassed socio-demographic factors, as well as knowledge, attitudes, and practices concerning CVDs. Data analysis employed descriptive statistics, chi-square tests, and regression analyses, utilizing both the R programming language and SPSS (Version 26). Result A total of 424 participants aged 60 years and above were included. The majority were male (60.8%), and the mean age was 71.21 ± 9.21 years, 57.3% were between 60 and 70 years old. Factors such as education, monthly family income, high blood pressure, diabetes, and non-smoking. Were significantly associated with higher knowledge, attitudes and practices scores. Conclusion This study illuminates CVD-related KAP among rural Older Individuals in Bangladesh, revealing significant associations between factors such as education, monthly family income, high blood pressure, and non-smoking, with higher scores in knowledge, attitudes, and practices regarding cardiovascular health. These insights underscore the importance of addressing socio-economic factors and health behaviors in developing targeted interventions for the prevention and management of cardiovascular diseases in this demographic.
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Affiliation(s)
- Abu Bakkar Siddique
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
- International Centre for Research, Innovation, Training and Development (ICRITD), Savar, Dhaka, Bangladesh
- AMR Reference Laboratory (Research), Bangladesh Livestock Research Institute, Savar, Dhaka, Bangladesh
- Health and Environmental Epidemiology Laboratory (HEEL), Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Md. Shohag Hosen
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Hasna Akter
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Syed Mujakkir Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Md. Al Mamun
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
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Hossen MT, Shuvo SD, Mazumdar S, Hossain MS, Riazuddin M, Roy D, Mondal BK, Parvin R, Paul DK, Adnan MM. Determinants of anxiety and depression among type 2 diabetes mellitus patients: A hospital-based study in Bangladesh amid the COVID-19 pandemic. Glob Ment Health (Camb) 2024; 11:e13. [PMID: 38390250 PMCID: PMC10882174 DOI: 10.1017/gmh.2024.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/14/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Anxiety and depression are common psychological disorders in patients with type 2 diabetes mellitus (T2DM), which was upsurging worldwide amid the COVID-19 pandemic. This study aimed to explore factors associated with anxiety and depression among T2DM patients in Bangladesh during the COVID-19 pandemic. A cross-sectional study was conducted among T2DM patients using face-to-face interviews. Anxiety and depressive symptoms were measured using the CAS and PHQ-9 scales. Outcomes were assessed including sociodemographic, lifestyle, anthropometric, and challenges of getting routine medical and healthcare access-related questions. The prevalence of anxiety and depressive symptoms were 29.8% and 22.7%, respectively. Regression analysis reported that males older than 50 years, illiterate, unemployed or retired, urban residents, below the recommended level of moderate to vigorous physical activity (MVPA), low dietary diversity score (DDS) and obese respondents were associated with higher odds of anxiety and depressive symptoms. Moreover, respondents with transport difficulties, unaffordable medicine, medicine shortages, close friends or family members diagnosed with COVID-19 and financial problems during COVID-19 had higher odds of anxiety and depressive symptoms than their counterparts, respectively. Our study suggests providing psychological support, such as home-based psychological interventions, and highlighting policy implications to ensure the well-being of T2DM patients in Bangladesh during the pandemic.
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Affiliation(s)
- Md Toufik Hossen
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sanaullah Mazumdar
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Sakhawot Hossain
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Riazuddin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Deepa Roy
- Department of Mathematics, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Bappa Kumar Mondal
- Department of Food Fortification, Nutrition International, Dhaka, Bangladesh
| | - Rashida Parvin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Dipak Kumar Paul
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
| | - Md Moshiuzzaman Adnan
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
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Haffejee F, Maharajh R, Sibiya MN. Exploring the Lived Experiences of Vulnerable Females from a Low-Resource Setting during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7040. [PMID: 37998271 PMCID: PMC10671480 DOI: 10.3390/ijerph20227040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
The onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.
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Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Rivesh Maharajh
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Umlazi 4031, South Africa;
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Wan J, Liu L, Chen Y, Zhang T, Huang J. Psychological resilience matters in the relationship between the decline in economic status and adults' depression half a year after the outbreak of the COVID-19 pandemic. Front Psychiatry 2023; 14:1239437. [PMID: 37743994 PMCID: PMC10513423 DOI: 10.3389/fpsyt.2023.1239437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Background/objective The outbreak of COVID-19 in China since 2019 has had a significant impact on the mental health of people in Hubei Province during the three-year pandemic period. Therefore, studying the prevalence of depression among the population of Hubei Province since the pandemic is of great significance. Methods Based on opportunity and stress theory, we collected provincial-level data from Hubei (N = 3,285) to examine the impact of declining economic status on depressive symptoms and to investigate the moderating effect of psychological resilience during the period of economic adjustment. Results We used propensity score matching to estimate the treatment effect of economic status decline on depression severity and confirmed the moderating effect of psychological resilience. We found that the more that an individual's economic status declines, the more severe that his or her depressive symptoms become. Specifically, each unit decrease in economic status is associated with an increase of approximately 0.117 units in depression level. In addition, our results indicated that psychological resilience significantly moderated the relationship between economic decline and depression (-0.184*). Conclusions and implications Our study confirms the role of economic status in depressive symptoms. Compared with traditional research on the relationship between economic status and mental illness, this paper expands the research regarding the two in the context of a major public health emergency. Furthermore, we suggest ways to improve people's mental health following the pandemic.
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Affiliation(s)
- Jun Wan
- School of Economics and Resource Management, Beijing Normal University, Beijing, China
| | - Lin Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yue Chen
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Tianchen Zhang
- College of Letters and Science, University of Wisconsin, Madison, WI, United States
| | - Jun Huang
- School of Sociology, Central China Normal University, Wuhan, China
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Sarkar S, Arakelyan S, Choa E, Poghosyan H. The role of financial security in loneliness or sadness among Medicare-enrolled cancer survivors during the COVID-19 pandemic. J Geriatr Oncol 2023; 14:101507. [PMID: 37216846 PMCID: PMC10123351 DOI: 10.1016/j.jgo.2023.101507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION This study aims to estimate the relative decreased rate of financial security and increased rate of loneliness or sadness during the COVID-19 pandemic and investigate the association between financial security and loneliness or sadness among Medicare beneficiaries with a cancer history. MATERIAL AND METHODS We examined population-based, cross-sectional data from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 survey. The study cohort included 1,632 Medicare beneficiaries (aged ≥65 years) with self-reported cancer history. The outcome was feelings of loneliness or sadness, and the independent variable was financial security during the 2020-2021 winter surge of COVID-19. We conducted weighted descriptive statistics, a cross-tabulation analysis, and multivariable logistic regression analyses. RESULTS Overall, 18.8% of cancer survivors reported increased feelings of loneliness or sadness and 11.2% reported decreased financial security during the 2020-2021 winter surge of COVID-19. Cancer survivors who reported decreased financial security had 93% higher odds of increased feelings of loneliness or sadness compared to those who reported feeling more or about the same financial security (Adjusted odds ratio [AOR] = 1.93; 95% Confidence Interval [CI] 1.25-3.01; p <0.004). DISCUSSION Decreased financial security and increased feelings of loneliness or sadness were prevalent among cancer survivors. Additional screenings and interventions beyond what are currently available are needed to ease the socioeconomic vulnerabilities experienced by cancer survivors.
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Affiliation(s)
| | - Stella Arakelyan
- Advanced Care Research Centre, Centre for Population Health Sciences, Usher Institute, Edinburgh University, Edinburgh, UK.
| | | | - Hermine Poghosyan
- Yale University School of Nursing, Orange, CT, USA; COPPER Center, Yale School of Medicine, New Haven, CT, USA.
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Dubey S, Das S, Ghosh R, Dubey MJ, Chakraborty AP, Roy D, Das G, Dutta A, Santra A, Sengupta S, Benito-León J. The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia. J Alzheimers Dis Rep 2023; 7:119-128. [PMID: 36891252 PMCID: PMC9986710 DOI: 10.3233/adr-220090] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023] Open
Abstract
Background Cognitive postscripts of COVID-19, codenamed as 'cognitive COVID' or 'brain fog,' characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. Objective We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Methods Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer's disease, five with vascular dementia, three with Parkinson's disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Results Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue (p = 0.001) and depression (p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke's Cognitive Examination (p = 0.001) scores also significantly worsened. Conclusion The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., 'second hit' like infection/dysregulated immune response, and inflammation). 'Brain fog' is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. 'FADE-IN MEMORY' (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Shambaditya Das
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College, and
Hospital, Burdwan, West Bengal, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampur Mental
Hospital, Berhampur, West Bengal, India
| | - Arka Prava Chakraborty
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Dipayan Roy
- Department of Biochemistry, All India Institute of Medical
Sciences (AIIMS), Patna, Bihar, India
- Indian Institute of Technology (IIT), Madras,
Tamil Nadu, India
- School of Sciences, Indira Gandhi National Open
University, New Delhi, India
| | - Gautam Das
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ajitava Dutta
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Arindam Santra
- Department of Neuromedicine, Bangur Institute of
Neurosciences (BIN), Kolkata, West Bengal, India
| | - Samya Sengupta
- Department of General Medicine, Apollo Gleneagles
Hospital, Kolkata, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital “12 de
Octubre”, Madrid, Spain
- Centro de Investigación Biomódica en Red Sobre
Enfermedades Neurodegenerativas (CIBERNED), Madrid,
Spain
- Department of Medicine, Complutense University,
Madrid, Spain
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