Factors related to perceived stress during the COVID-19 epidemic context among the general population in China: A cross-sectional nationwide study

Assessing stress among community health workers due to COVID-19 related work: A comparative study from Vietnam

BackgroundCommunity health workers (CHWs) involved in COVID-19 response might be at increased risk of stress, though evidence remains absent.ObjectiveTo assess the effects of COVID-19 related work on stress and identified factors associated with the risk of deteriorating to severe stress among CHWs in Vietnam.MethodsUsing a nation-wide survey among 979 CHWs involved in COVID-19 response, we applied multivariable logistic regression to estimate the risk of deteriorating to high stress levels between before the epidemic (average June-December 2019) and at its peak (January-March 2021). Stress levels were measured using the Perceived Stress Scale (PSS-10).ResultsMedian stress levels among CHWs increased from 10 (IQR = 7-16) before COVID-19 to 15 (IQR = 11-19) on the PSS-10 during the COVID-19 outbreak. The proportion of CHWs with low stress levels decreased from 67.6% to 42.2% (p-value <0.001), while the proportion of CHWs with moderate and high stress levels increased 1.8 and 4.2-fold, respectively. Less sleep and poor sleep quality, working in unfavorable work environments, and being involved in daily high-risk SARS-CoV-2 exposure activities were associated with an increased risk of deterioration to high stress levels.ConclusionsWe found a substantial increase in stress levels among CHWs in Vietnam that is probably due to their COVID-19 related work; the observed 2 and 4-fold increase in CHWs suffering from moderate and high stress levels, respectively, is particularly worrisome. Targeted support for CHWs is crucial to ensure the sustainability of health interventions during COVID-19 and future epidemics.

The negative impact of loneliness and perceived stress on mental health during two-month lockdown in Shanghai

BACKGROUND

Shanghai undergone COVID-19 lockdown for 2 months in 2022, affecting >25 million population. We aim to find changes in mental health during Shanghai lockdown and if mental health was associated with Shanghai lockdown, loneliness, and perceived stress.

METHODS

We conducted two cross-sectional online surveys in China, which were before and at the end of Shanghai lockdown (survey 1 in January 2022, N = 1123; survey 2 in June 2022, N = 2139). Participants reported mental health, loneliness, and perceived stress through the 12-item General Health Questionnaire (GHQ-12), the short-form UCLA Loneliness Scale (ULS-8), and the 10-item Perceived Stress Scale (PSS-10). We compared data between survey 1 and 2. We ran a multiple linear regression model to investigate the impact of Shanghai lockdown, loneliness and perceived stress on mental health.

RESULTS

There's an increase in the proportion of lonely people during Shanghai lockdown (49.77 % to 65.26 %). During Shanghai lockdown, the proportion of lonely people (68.97 % VS. 61.35 %, p < 0.001) and risk for mental health conditions (50.50 % VS. 43.27 %, p < 0.001) were higher among residents in Shanghai than outside Shanghai. Shanghai lockdown (b = 0.556, p = 0.02), higher ULS-8 (b = 0.284, p < 0.001) and higher PSS-10 (b = 0.365, p < 0.001) were associated with higher GHQ-12.

LIMITATIONS

Participants reported their mental health status during Shanghai lockdown retrospectively.

CONCLUSION

Shanghai lockdown had psychological impacts not only on residents in Shanghai but also outside Shanghai. Addressing loneliness and perceived stress accommodated to the lockdown situation should be considered.

Impact of training on primary care physicians' management of depression and anxiety disorders in rural China

BACKGROUND

Primary care physicians (PCPs) in rural township health centers are the most easily accessible doctors to the residents in rural China, which covers 35% of the population. High prevalence of depression was reported among rural left-behind elderly and children as many workers had migrated to urban cities.

AIM

This study explored mental health care provision by PCPs in rural China and the association with their training background.

METHODS

Rural township health centers in both developed and less developed counties of Zhejiang Province, China were chosen as the study sites. A total of 697 PCPs completed questionnaires between December 2019 and January 2020, and the number of valid questionnaires was 673, with a valid response rate of 79.3%.

RESULTS

The rural PCPs reported a median range of seeing 1 to 5 mental health patients per week. Over two-thirds (68.2%) of the respondents had never received any training on treating common mental health disorders (depression and anxiety) while 20.3% received at most 2 days of training; 6.4% received 3 to 20 days of training; and 5.1% received over 20 days of training. PCPs with mental health training were significantly associated with better mental health care in terms of confidence and practice characteristics (e.g. having patients who brought up mental health issues, providing follow-up), while years of practice made a difference in practice but not confidence.

CONCLUSIONS

Training is the key determinant of the practice of mental health care by the PCPs in rural China. Our findings have implications for national policy to target two-thirds of rural PCPs who received no mental health training.

More Positive Emotion, Less Stress Perception?

Purpose

Shanghai, a mega-city with a population of 25 million, was becoming the first city in mainland China to erupt in the Omicron pandemic. The pandemic and the quarantine measures of whole city static management brought out big challenges for the population. This study sought to examine the psychological impact of such quarantine measures.

Methods

A cross-sectional study was conducted in China between April 8 to April 14, 2022. The survey contained inventories of stress perception, emotion states, duration of quarantine, and demographic characteristics. A total of 1,051 participants in Shanghai who were quarantined at home were included by random sampling.

Results

We found moderate-to-mild perceived stress (3.248±1.936) and emotion states (3.453±2.094). Individuals with high negative emotions had high levels of perceived stress. Specifically, the population aged 30-49, female, with higher household income, staying with the elderly or children, were more likely to report high stress and negative emotion. Hierarchical regression and the further path analysis indicated that emotion states partially mediated the relationship between quarantined days at home and perceived stress.

Conclusion

There was a moderate-to-mild level of perceived stress and emotion when quarantined at home for an average of 20 days in Shanghai. The present findings implicated more positive emotion then less stress perception at the same duration of quarantine. It was suggested to consider the measures taken to construct positive emotions for the public to overcome negativity and bring out a virtuous circle to thrive, if the quarantine has to be continued for preventing the pandemic.

Perceived COVID-19-related stress drives home gardening intentions and improves human health in Taiwan

The COVID-19 pandemic has added a layer of mental health problems and perceived stress. Home gardening is considered a good method to reduce perceived stress. The current research evidence is insufficient to understand the relationship and influencing factors between the intentions, behaviors, and benefits of home gardening during short-term COVID-19 events. Although the duration from the onset to stabilization of the outbreak lasted for only 1.5 months from May to June 2021 throughout Taiwan, the significant pandemic changes might have affected the perceived stress along with the intentions, behaviors, and benefits of home gardening. This study explored the relationship between pandemic stress and home gardening through online snowball sampling because of the strict social distancing regulations. A total of 1455 non-follow-up and internet questionnaires throughout Taiwan were collected during the wave onset, peak, easing, and stabilization stages. The questionnaire included questions on personal information, perceived pandemic stress, gardening intentions, gardening behaviors, and gardening benefits. This study showed that perceived stress increased from the pandemic onset to its peak, and decreased from the peak to stabilization stages. Home gardening intentions and behaviors also revealed similar trends. Higher pandemic-perceived stress directly increased home-gardening intentions and indirectly promoted home-gardening behaviors and benefits. Our findings indicated that home gardening is a positive element in reducing perceived stress. Lower gardening intentions and behaviors were observed when the high perceived stress was removed. This study suggests that home gardening was a valuable strategy for staying close to nature and obtaining multiple benefits during the peak pandemic period. Providing small-scale gardening activities and spaces is appropriate for obtaining gardening benefits and avoiding space abandonment after the pandemic. Providing seeds, seedlings, tools, knowledge, online home gardening programs, and small residential and food gardens is a valuable strategy for obtaining multiple benefits during the peak of the pandemic.

Online Emotional Support Accompany Group Intervention and Emotional Change of the Public During the COVID-19 Pandemic: A Multi-Period Data Analysis From China

COVID-19 has made it difficult to adopt traditional face-to-face psychological intervention under this situation because of the blocked down and social distancing, which brings big psychological crisis to the public among the global. To explore the emotional change of the public in China at the outburst of the pandemic at different phases, to establish an online working platform and create a new model of an online intervention to hold public emotions under pandemic, and test its effectiveness, so to give advisement for government emergency management system. We established an online organization to work for this program ad innovated a model of online group counseling with online emotional support accompany group (OESAG) right after the outburst of a pandemic. We analyzed 53 OESAGs from February 10 to April 9, including 555 application forms, 253 feedback from members, and 139 feedback from group leaders by using NVivo and SPSS to explore the evolution and characteristics of public emotion during COVID-19 and the effectiveness of OESAG. Our results showed that the emotional changes of members ranged from shock to depression to positive. The public's emotions swiftly changed from stress, anxiety, and isolation, to the hope of returning to work or finding a job during the pandemic with the help of OESAG. OESAG has effectively regulated the negative emotions of members by conducting psychological crisis intervention to provide members a space to communicate with each other, especially the female and frontline staff. Policy makers can set up an online systematic psychological crisis intervention system as soon as possible to make up for the lack of psychological assistance in the emergency management system.