Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia

Health and Wellbeing of Regional and Rural Australian Healthcare Workers during the COVID-19 Pandemic: Baseline Cross-Sectional Findings from the Loddon Mallee Healthcare Worker COVID-19 Study-A Prospective Cohort Study

BACKGROUND

Coronavirus 19 (COVID-19) has created complex pressures and challenges for healthcare systems worldwide; however, little is known about the impacts COVID-19 has had on regional/rural healthcare workers. The Loddon Mallee Healthcare Worker COVID-19 Study (LMHCWCS) cohort was established to explore and describe the immediate and long-term impacts of the COVID-19 pandemic on regional and rural healthcare workers.

METHODS

Eligible healthcare workers employed within 23 different healthcare organisations located in the Loddon Mallee region of Victoria, Australia, were included. In this cohort study, a total of 1313 participants were recruited from November 2020-May 2021. Symptoms of depression, anxiety, post-traumatic stress, and burnout were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Impact of Events Scale-6 (IES-6), and Copenhagen Burnout Inventory (CBI), respectively. Resilience and optimism were measured using the Brief Resilience Scale and Life Orientation Test-Revised (LOT-R), respectively. Subjective fear of COVID-19 was measured using the Fear of COVID-19 Scale.

RESULTS

These cross-sectional baseline findings demonstrate that regional/rural healthcare workers were experiencing moderate/severe depressive symptoms (n = 211, 16.1%), moderate to severe anxiety symptoms (n = 193, 14.7%), and high personal or patient/client burnout with median total scores of 46.4 (IQR = 28.6) and 25.0 (IQR = 29.2), respectively. There was a moderate degree of COVID-19-related fear. However, most participants demonstrated a normal/high degree of resilience (n = 854, 65.0%). Based on self-reporting, 15.4% had a BMI from 18.5 to 24.9 kgm2 and 37.0% have a BMI of 25 kgm2 or over. Overall, 7.3% of participants reported they were current smokers and 20.6% reported alcohol consumption that is considered moderate/high-risk drinking. Only 21.2% of the sample reported consuming four or more serves of vegetables daily and 37.8% reported consuming two or more serves of fruit daily. There were 48.0% the sample who reported having poor sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI).

CONCLUSION

Regional/rural healthcare workers in Victoria, Australia, were experiencing a moderate to high degree of psychological distress during the early stages of the pandemic. However, most participants demonstrated a normal/high degree of resilience. Findings will be used to inform policy options to support healthcare workers in responding to future pandemics.

Mental and social wellbeing trajectory during the pandemic for vulnerable populations

Objectives

We investigated changes over time in mental and social wellbeing indicators for vulnerable population subgroups during the pandemic. These groups were younger people, people with disabilities, low-income groups, unemployed, culturally, and linguistically diverse communities (CaLD), and Aboriginal and Torres Strait Islander peoples.

Methods

A series of four repeated population representative surveys were conducted in June 2020, September 2020, January 2022, and June 2022. Questions included items on psychological distress, financial hardship, social connection, and life satisfaction.

Results

For most groups, social connection and life satisfaction improved in 2022 relative to 2020. Psychological distress and financial hardship showed the opposite pattern, with some groups having worse results in 2022 relative to 2020. People without any vulnerability had better mental health and social wellbeing outcomes at each time point relative to the vulnerable population subgroups.

Conclusion

Pandemic-related policies had differential effects over time and for different population groups. Future policies and research need to closely monitor how they impact population subgroups, and the overall results clearly demonstrate the inequity in mental health and social wellbeing outcomes for vulnerable population cohorts.

Evaluation of the relationship between the fear of COVID-19 and mental status of female employees during the COVID-19 pandemic

BACKGROUND

The stress due to the COVID-19 pandemic has influenced the physical, mental, and social well-being of humans worldwide.

OBJECTIVE

To evaluate the relationship between the fear of COVID-19 and mental state of female employees during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted involving 726 participants. Data was collected using the Personal Information Form, fear of COVID-19 scale, and brief symptom inventory.

RESULTS

The fear experienced by women during the social isolation and quarantine period was associated with depression, anxiety, somatization, obsessive-compulsive disorder, interpersonal sensitivity, hostility, phobic anxiety and paranoid experiences.

CONCLUSION

Women, young people, the elderly and single individuals were most likely affected psychologically during the pandemic. Thus, interventions and psychological evaluations are recommended at an early stage to minimize this effect. Such interventions must be implemented considering the strategic planning and coordination of risk groups.

The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study

BACKGROUND

The COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries.

METHODS

Data were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption.

RESULTS

A total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50-59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%).

CONCLUSIONS

Smoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.

Fear of COVID-19, Stress and Coping Strategies among Nurses during the COVID-19 Pandemic's Second Wave: A Quasi-Intervention Study

Background

The COVID-19 pandemic and its related consequences caused a higher risk of mental health problems for nurses. Hence, this study aims to reduce the level of fear and stress related to the COVID-19 pandemic and promote active coping among Egyptian nurses.

Methods

This quasi-intervention study was conducted on 125 nurses working at Benha's University hospitals, who were selected by a systematic random sampling technique within the time interval of March 2021 to July 2021. The study was conducted using the fear of COVID-19 scale, the stress scale of depression, anxiety and stress scales, and the Brief (COPE) inventory scale.

Results

The mean ages of the studied nurses were 36.70 ± 9.50. Almost half of the studied nurses were males and married. Before the intervention, 47.2% of nurses had severe stress levels while 82.4% had a high level of fear of COVID-19. Experience years, type of department, and worries about vaccine side effects were the predictors of the fear of COVID-19. A significant difference (p = .000) was found between both mean stress and fear scores pre-intervention (15.27 ± 5.47 and 25.56 ± 6.13) and post-intervention (4.87 ± 2.14 and 11.92 ± 2.43). The most prevalent coping strategies among nurses before the intervention were self-distraction (5.03 ± 1.53), followed by behavioral disengagement and self-blaming. However, after the intervention, religion was found to be the utmost coping mechanism (6.12 ± 1.17), followed by positive reframing and acceptance.

Conclusion

The majority of the nurses in the study reported a significant fear of COVID-19, and around half of the nurses had severe stress as a result. After the intervention, the stress and fear scores were reduced by half or even less. Age, longer work experience, and worries about the vaccine were the predictors of fear of COVID-19. The coping strategies used after the intervention shifted toward active coping strategies. Clinical Trial Registration Number: 10-11-008-701.

Influence of gender identity on the adoption of religious-spiritual, preventive and emotion-focused coping strategies during the COVID-19 pandemic in Pakistan

BACKGROUND

Academic research has highlighted the gendered impacts and amplifications of gender disparities of COVID-19. Traditionally, Pakistan is a patriarchal society, where it is a parenthood norm to socialize specific gender social roles.

OBJECTIVES

The current research asserts that these normative gender roles may influence individuals throughout their life course, even during the COVID-19 pandemic. Therefore, the present study explored the influence of gender identity in adopting different coping strategies such as religious-spiritual, preventive, emotion-focused and non-constructive coping against the COVID-19 pandemic.

METHODS

Due to the lockdown in various areas of Pakistan, data were collected through an online questionnaire using Qualtrics. In a cross-sectional study, 955 respondents completed responses. Factors analysis and reliability analysis were run to ensure the scales' reliability, validity and robustness for different coping strategies. Multivariate linear regression analysis was used to find model fitness.

CONCLUSIONS

For theoretical explanation, the current study used social role theory that argues that each gender benefits differently from distinct coping behaviours. The findings highlighted that women were more likely to adopt most coping strategies, with the most significant difference in religious-spiritual coping and preventative coping strategies even in the presence of control variables such as level of education, household monthly income, family structure, marital status and family size. There was no gender difference in adopting non-constructive strategies. The empirical evidence suggested that females might be at an increased risk of stress due to the burden of unbalanced household-based social norms and care responsibilities. The current research also expanded the base of coping to religious-spiritual coping, emotion-focused coping and non-constructive coping.

Symptoms of post traumatic stress disorder and their relationship with the fear of COVID-19 and COVID-19 burden among health care workers after the full liberalization of COVID-19 prevention and control policy in China: a cross-sectional study

BACKGROUND

Over the past three years, the COVID-19 pandemic has brought an overwhelming impact on China's hospital system and health care workers, which can lead to post traumatic stress disorder (PTSD) symptoms. Previous research has shown that the COVID-19 pandemic had long-term adverse effects on the mental health of health care workers. Indeed, PTSD symptoms have emerged as one of the significant mental health issues for health care workers arising from the COVID-19 pandemic. Therefore, we conducted this cross-sectional survey to investigate the prevalence of PTSD symptoms in health care workers and its relationship with the fear of COVID-19 and the COVID-19 burden after the full liberalization of COVID-19 prevention and control policy in China.

METHODS

This study was conducted three years after the global COVID-19 pandemic (January 15 to January 16, 2023). This study was conducted via the Wenjuanxing platform and used the Chinese versions of the scales PC-PTSD-5, COVID-19 Anxiety Scale (FCV-19S), Social Support Scale, COVID-19 Stress Scale, GAD-2, and PHQ-2.

RESULTS

The prevalence of PTSD symptoms in health care workers was 24.3% (232/955). depression(P < 0.001), anxiety(P < 0.05), the fear of COVID-19(P < 0.001), and COVID-19 burden(P < 0.001) were highly correlated with PTSD symptoms in health care workers. Social support(P < 0.05) was a protective factor of PTSD symptoms.

CONCLUSIONS

This survey shows that PTSD symptoms were highly prevalent among Chinese health care workers after the COVID-19 pandemic. Governments and leaders of medical institutions should, through psychological interventions, address the current situation of PTSD symptoms among health care workers and develop targeted programs and strategies to reduce their psychological problems.

Age Differences in Psychological Distress After Multiple Disaster Exposures: The Effect of Multidimensional Negative COVID-19 Impacts

OBJECTIVE

This study examined how the multidimensional negative coronavirus disease (COVID-19) impacts contextualized the age differences in psychological distress following exposures to tornadoes and the COVID-19 pandemic.

METHODS

Data were from a 2-wave panel study conducted at T1 (October 2020-August 2021) and T2 (May-August 2022). Latent class analysis was conducted to explore the patterns of negative COVID-19 impacts based on a sample of 1134 at T1. Negative binomial regressions were performed to examine the age differences in psychological distress at T2, based on the working sample (N = 554), as well as the moderating effect of identified class membership, with baseline psychological distress controlled.

RESULTS

Three latent classes were identified: class 1 "low overall impacts," class 2 "moderate overall impacts with high emotional distress," and class 3 "severe overall impacts." Individuals ages 65 and over reported lower psychological distress at T2 relative to those ages 18-34 and 35-49. However, compared to people ages 18-34, 35-49, and 50-64, those ages 65 and over reported the greatest increases in T2 psychological distress if they had experienced moderate or severe overall COVID-19 impacts at T1.

CONCLUSION

There is a pressing need for mental health interventions that are tailored to multi-disaster scenarios and age-related differences in long-term disaster recovery.

Exploring the Impact of Covid-19-Related Perceptions on Psychological Distress and Quality of Life in an International Gastrointestinal Cohort Over Time Guided by the Common Sense Model

The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May-October 2020). Of those, 270 (32.5%) participants (85.2% female, mean age = 47.3 years) provided follow-up data (March-May 2021). Repeated-measures multiple analysis of variance and a cross-lagged panel model were used to test the study hypotheses. Gastrointestinal symptoms and COVID-19 perceptions at follow-up were strongly predicted by their baseline values, while illness perceptions were predicted by baseline gastrointestinal symptoms. Cross-lagged relationships indicated a reciprocal relationship between gastrointestinal symptoms and psychological distress. Moreover, gastrointestinal symptoms had substantial predictive utility, strongly predicting future gastrointestinal symptoms, and to a lesser extent, more negative illness perceptions, greater psychological distress, and greater use of adaptive coping strategies across time.

Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students' Mental Health

BACKGROUND

the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty.

METHODS

2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph.

RESULTS

our data highlighted the central roles of intolerance of uncertainty in students' anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems.

CONCLUSIONS

these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Path of fear: Experiences of health professionals in the fight against COVID-19

This study aimed to understand the expressions of fear in the journeys of health professionals who worked in the confrontation of coronavirus disease 2019 (COVID-19), in the city of Manaus, in the Brazilian Western Amazon. This is an exploratory qualitative study that adopts interpretive description as a method to generate informed knowledge responsive to the needs of the practice. We included 56 participants, comprising 23 health managers and 33 health workers (middle and higher level) of different professional categories. The results revealed three circles of experience: (1) knowledge and professional experience in dealing with the disease (unknown-known-experienced); (2) the growing proximity to death and loss (predicted-witnessed-suffered); and (3) the involvement and proximity to whatever affects the individual, their emotions, and personal transformations in the face of the threat (the collective, the neighbor, and oneself). Our results suggest that health professionals who worked during the COVID-19 pandemic in Manaus experienced insecurity, dread, and fear, illustrating the complexity of developing their activities in the front line of care and management during the different phases of the pandemic. A contribution of the study is precisely that of capturing this complexity, which suggests the impossibility of analyzing fear only in its simple manifestation, or in each circle of experience.

Understanding mental health conditions and key coping strategies utilized during major lockdowns in the Caribbean based on Google trends searches

The COVID-19 pandemic has prompted countries to implement extended Shelter in Place Orders (SIPOs) to restrict population movement and mitigate community spread. While these lockdown measures may be effective in containing the virus, they can substantially impact the population's well-being, potentially undermining their overall welfare. This study investigates whether major lockdowns implemented in the Caribbean produced differential changes in mental health among key English-Speaking Caribbean countries. More importantly, unlike past studies, we examine key coping strategies persons utilize during major lockdowns. Finally, this paper utilizes a novel near real-time high-frequency data source in Google Trends data analytics to assess mental health patterns and coping strategies among major Caribbean countries. Based on the results of difference-in-difference and event study models, we find positive and significant increases in searches for fear, depression, and suicide during key lockdown periods, which suggest negative mental health effects. Regarding coping strategies, searches for Zoom, learning, books, exercise, prayer, religion, and meditation increased, together with searches for addiction and marijuana. These results indicate the types of programs health administrators and policymakers can implement during lockdown periods to help local mental health communities, particularly among island communities.

Exposure to the COVID-19 news on social media and consequent psychological distress and potential behavioral change

Exposure to coronavirus disease 2019 (COVID-19) news pandemic is inevitable. This study aimed to explore the association between exposure to COVID-19 news on social media and feeling of anxiety, fear, and potential opportunities for behavioral change among Iranians. A telephone-based survey was carried out in 2020. Adults aged 18 years and above were randomly selected. A self-designed questionnaire was administered to collect information on demographic variables and questions to address exposure to news and psychological and behavioral responses regarding COVID-19. A multivariate logistic regression analysis was performed to assess the relationship between anxiety, fear, behavioral responses, and independent variables, including exposure to news. In all, 1563 adults participated in the study. The mean age of respondents was 39.17 ± 13.5 years. Almost 55% of participants reported moderate to high-level anxiety, while fear of being affected by COVID-19 was reported 54.1%. Overall 88% reported that they had changed their behaviors to some extent. Exposure to the COVID-19 news on social media was the most influencing variable on anxiety (OR 2.21, 95% CI 1.62-3.04; P < 0.0001), fear (OR 1.95, 95% CI 1.49-2.56; P < 0.0001), and change in health behaviors (OR 2.02, 95% CI 1.28-3.19; P = 0.003) in the regression model. The fear of being infected by the COVID19 was associated with the female gender and some socioeconomic characteristics. Although exposure to the COVID-19 news on social media seemed to be associated with excess anxiety and fear, it also, to some extent, had positively changed people's health behaviors towards preventive measures.

Psychological distress in community-dwelling individuals living with severe and persistent mental illness

OBJECTIVES

To explore psychological distress levels, using the validated Kessler 6 (K6), as well as the relationship between demographics and K6 scores, and incidence of mental health crises in a cohort of community-dwelling people living with severe and persistent mental illness (SPMI).

METHODS

People living with SPMI taking antipsychotic or mood stabiliser medications were recruited from Australian community pharmacies between September 2020 and Februrary 2021 and completed an electronic survey, including the K6 scale. Pharmacists were interviewed and supplied written reports with details of the consultation when participants obtained 'very high' (⩾19/30) K6 scores. Records were reviewed and coded by an independent coder. Multivariate linear regression was used to determine predictors of K6 scores.

RESULTS

The median K6 score was 16/30 (IQR = 11,21; range = 6-30). Younger age, unemployment and multimorbid mental health diagnoses were significant predictors of higher K6 scores (p < .01; R2 = .24). Fifty-nine (39.3%) consumers scored ⩾19, of which 25/59 (42.4%) were reported to be exhibiting signs of psychological distress and none were experiencing mental health crises.

CONCLUSION

People living with SPMI have high levels of psychological distress as measured by the K6. Further work is needed to understand the prevalence, extent, precipitating factors and impact of psychological distress in people living with SPMI.

Disordered Social Media Use during COVID-19 Predicts Perceived Stress and Depression through Indirect Effects via Fear of COVID-19

The 2019 novel coronavirus disease (COVID-19) is a global threat that can have an adverse effect on an individuals' physical and mental health. Here, we investigate if disordered social media use predicts user stress and depression symptoms indirectly via fear of COVID-19. A total of 359 (timepoint 1 = 171, timepoint 2 = 188) participants were recruited via social media and snowball sampling. They completed an online survey that measured disordered social media use, fear of COVID-19, perceived stress, and depression symptomatology at two cross-sectional timepoints. We found that disordered social media use predicts depression indirectly through fear of COVID-19 at both timepoints. We also found that disordered social media use predicts perceived stress indirectly through fear of COVID-19, but only at timepoint 1. Taken together with previous research, our findings indicate that disordered social media use may lead to increased fear of COVID-19, which in turn may lead to poorer psychological wellbeing outcomes. Overall, there is evidence that the impact of the COVID-19 pandemic is affecting the physical, psychological, and emotional health of individuals worldwide. Moreover, this impact may be exacerbated by disordered use of social media.

Quality of life of a healthy polish population due to sociodemographic factors during the COVID-19 pandemic - a cross-sectional study

Introduction

The quality of life should be studied in every person, both among the sick and healthy. Sociodemographic factors affect the level of the perceived quality of life (QoL), and especially in the situation of the COVID-19 pandemic, which forced the enforcement of certain behaviours in society, such as social distancing, as well as introduced panic and fear for one's own health and life. The main aim of the study was to assess the quality of life in the group of people without the disease, to assess the impact of sociodemographic factors on QoL during the pandemic.

Material and method

3,511 healthy people were included in the study. The inclusion criteria of the study were: age of respondents over 18 years, no continuously administered medicaments, no diagnosed chronic diseases and no treatment in specialist clinics as well as lack of positive COVID-19 test in 4 weeks before the examination. The SF-36 questionnaire was used to assess the quality of life. The student's t-test and intergroup comparisons were used in 7 age groups. Factors such as age, gender, place of residence, education, civil status, employment status, smoking, and physical activity were assessed.

Results

The lowest average QoL level in the studied population was recorded in the Mental Component Summary (MCS) dimension (X = 47.9;Cl:47.6-48.3). A high correlation between age and the SF-36 spheres was noted in the following spheres: physical functioning (PF), role physical (RP), Physical Component Summary (PCS), and ILQ (p < 0.001). The highest chance of a better QoL in the PCS dimension among men was recorded in the 30-39 age group (OR = 3.65;Cl:1.13-11.79). In the group of people over 50 years of age living in the village, there was a greater chance of a better QoL in the PCS dimension in each age group. Practicing physical activity was significantly more often conditioned by a higher chance of developing a better QoL (p < 0.05). In the group of people ≥80 years of age, there was a greater than 4 times higher chance of developing a better quality of life in terms of MCS among physically active people (OR = 4.38;Cl:1.62-11.83).

Conclusion

With age, QoL decreases among people with disabilities. Men are more likely to assess their health better. A better QoL among women occurs at age 80 and later. A higher level of education often determined a significantly higher level of QoL felt. The practising of recreational physical activity and the lack of smoking habit determined a higher level of QoL more often. Smoking provided a greater chance of a better QoL in ILQ in the group of people ≥80 years.

The Relationship Between Fear of COVID-19 and Psychological Distress in Tour Guides: The Mediating Role of Job Insecurity and the Moderating Role of Psychological Resilience

Purpose

The COVID-19 has greatly affected the tourism industry in China, leading to an increase in psychological distress among tour guides. This study explores the mechanisms by which tour guides' fear of the COVID-19 affects psychological distress, using job insecurity as a mediating variable and psychological resilience as a moderating variable.

Patients and Methods

From August 11 to 30, 2022, 447 Chinese tour guides were invited online to fill in a questionnaire, and SPSS and Mplus tools were used for statistical analysis and hypothesis testing to conduct an empirical analysis of the relationship between COVID-19 fear and psychological distress.

Results

A total of 417 questionnaires (effective rate was 93.3%) were collected, among which female (n = 243) and male (41.7%) (n =174). The age concentration of participants was 46.5% between 26 and 35 years old, 9.1% under 25 years old, and 9.8% over 46 years old. Guides' fear of COVID-19 positively and significantly influenced psychological distress (β= 0.3051), and the relationship between fear of COVID-19 and psychological distress was mediated by job insecurity (β=0.196, 95% CI = 0.141, 0.255). In addition, psychological resilience significantly moderated the pathway from fear of COVID-19 to job insecurity and from fear of COVID-19 to guided psychological distress (β= 0.1371; β=0.116).

Conclusion

The diversion of fear of COVID-19 and job insecurity can alleviate the psychological distress of tour guides; strengthening their own psychological construction also helps to alleviate the effects of fear of COVID-19 on job insecurity and psychological distress. The findings of the study can provide theoretical support for the prevention and counseling of psychological problems of tourism employees in public health crises.

Effects of disaster-related traumatic events on worry about radiation and COVID-19: A decade after the Fukushima nuclear power plant accident

Community residents exposed to nuclear power plant (NPP) accidents have long-term worry about the effects of radiation. After the 2011 Fukushima NPP accident, those who experienced traumatic events during the Great East Japan Earthquake (GEJE) tended to have greater worry about radiation. Along with the prolonged worry about radiation, there may also be cognitive changes caused by the traumatic events. We hypothesized that if there were cognitive changes underlying the prolonged worry about radiation, those who experienced the traumatic events would tend to have greater worry about other issues unrelated to radiation. We examined the effects of the traumatic events during the GEJE on community residents' worry about radiation and COVID-19 a decade after the Fukushima NPP accident. Using the data of a longitudinal questionnaire survey following a random sample of 4900 community residents outside the evacuation zone in Fukushima, this study analyzed 774 responses (15.8%). The traumatic events consisted of (1) injury, (2) injury or death of a family member, and (3) the loss of a house or other property. We developed a mediation model drawing paths from the traumatic events to worry about radiation and COVID-19, including posttraumatic stress symptoms (PTSS) as a mediator, using structural equation modeling. The traumatic events directly affected worry about radiation. Although it did not directly affect worry about COVID-19, it did so indirectly through worry about radiation and PTSS. Traumatic events can increase trauma-related worry independently of PTSS and increase trauma-unrelated worry indirectly through trauma-related worry and PTSS.

Hospital Resilience in Three COVID-19 Referral Hospitals in Brazil

Health crises, such as the COVID-19 pandemic, challenge health systems in demonstrating resilience-the ability to cope with change, manage challenges, and adapt in order to retain their effectiveness. Understanding how such challenges affect and produce reactions in those involved in this response is extremely important. This study evaluated resilience in three referral hospitals in the city of Recife, Pernambuco, Brazil-one public, one private, and one philanthropic hospital-by examining the coping activities adopted by the nursing staff working on the COVID-19 frontline. A multiple case study was carried out, using a qualitative approach, triangulating data from direct observations, document analysis, and interviews with 21 nursing professionals working in management and care provision. Data were collected from April to October 2020. The interviews were transcribed and analyzed based on the resilience categories defined by Blanchet (2017): absorption capacity, adaptive capacity, and transformative capacity. Four themes were considered relevant to the objectives of this study: institutional support, access to personal protective equipment (PPE), work relationships, and fear and mental health. Adaptive capacity was demonstrated concerning the four themes analyzed, absorption capacity was demonstrated in two themes, and no transformative capacity was identified. The study highlighted that the health crisis was challenging for all the hospitals studied, regardless of their legal-administrative status. No differences were observed among them in terms of resilience.

Lost time: Perception of events timeline affected by the COVID pandemic

The need to remember when a past event occurred, is often an everyday necessity. However, placing events in a timeline is seldom accurate and although to some extent modulated by event saliency, on average we are less accurate in remembering a timeline for events happening in the distant past compared to more recent events. 277 participants took part in an online study during May 2022 in which they were asked to state the year in which a number of events took place. The events' occurrences ranged from 2017 to 2021, with participants choosing one date from the 2016-2022 range. In addition, they completed 4 questionnaires aimed at quantifying their State Boredom; Depression, Anxiety & stress; resilience; and level of activity during the lockdown periods of the COVID pandemic. As expected, the findings showed more errors for distant events than those in 2020, but surprisingly we found a large error for estimating the timing of events that occurred in 2021 matching in the extent to those 3 to 4 years earlier. The findings show that participants were less able to recall the timeline of very recent events coinciding with COVID lockdowns. This increased error in perception of event timeline correlated positively with reported levels of depression & anxiety as well as physical and mental demands during the pandemic, but negatively correlated with measures of resilience. Although measures of boredom showed significant correlations with reported depression & anxiety and physical/mental load, they did not correlate with errors in the perception of the event timeline for 2021. The findings are consistent with poor perception of event timeline reported previously in prison inmates. It is likely that an accurate perception of an event timeline relies on a collection of life events such as birthdays, holidays, travels, etc., anchoring our experiences in the time domain, which was largely absent during COVID restrictions.

Understanding volunteer motivations and concerns in coaching and officiating basketball: implications for sport policy

Sport participation and volunteering can make important contributions to good health. Sporting organisations need volunteers to deliver their participation opportunities and for many years the sector has faced challenges to volunteer recruitment and retention, especially due to the increased bureaucratic and compliance demands in operating community sports clubs. As sporting organisations pivot to adapt to COVID-safe sport we can learn about their experiences to inform volunteer recruitment and retention policies and practices. This research examined volunteer intentions and motivations in coaching and officiating in basketball and explored factors influencing their decision to return to COVID-safe basketball. Data was collected via an online survey that drew on theoretical frameworks of volunteer motivations (i.e. modified Volunteer Functions Inventory VFI) in sport as well as sport policies related to COVID-safe guidelines for return to sport. Data was collected in Victoria Australia during July 2020 before basketball had the chance to return from the first Australian-wide COVID-19 lockdown. Volunteers had positive intentions to return to basketball following COVID-19 restrictions because it was fun, to help others, or because friends/family were involved. Volunteers were most concerned that others will not comply with COVID-safe policies particularly around isolating when feeling unwell (95%), but also reported concerns about the inconveniences of some COVID-safe policies introduced to return to organised sport (e.g. social distancing, density limits, and enforcing rule changes). Understanding these volunteer intentions, motivations and factors influencing the decision to return to COVID-safe basketball can help inform recruitment and retention strategies to support volunteers in sport. Practical implications for sport policy and practice are discussed.

Factors Associated with Job Stress and Their Effects on Mental Health among Nurses in COVID-19 Wards in Four Hospitals in Korea

Increased workload during the COVID-19 pandemic has threatened nurses' mental health. This study aimed to identify factors associated with job stress in COVID-19 nurses compared to other nurses. Nurses were recruited from four hospitals in Republic of Korea in November 2020. The general sociodemographic questionnaire, job stress, anxiety (GAD-7), and depression (PHQ-9) were used to conduct an online survey. Stepwise multiple regression analysis was used to identify the factors associated with job stress. A total of 290 participants were analyzed: 122 in the dedicated ward and 168 in the nondedicated ward nurse groups. Job stress, anxiety, and depression were higher in nurses dedicated to COVID-19 (4.19 ± 0.59, 5.98 ± 3.92, and 6.97 ± 4.47, respectively) than in the nondedicated group (3.92 ± 0.72 (p = 0.001), 4.98 ± 4.20 (p = 0.042), and 5.92 ± 4.36 (p = 0.047), respectively). Among COVID-19 nurses, job stress levels were higher in 30-39 year olds than in 20-29 year olds (3.71 ± 0.43 vs. 4.04 ± 0.54, p = 0.006) and in non-smokers compared with smokers (3.85 ± 0.49 vs. 3.38 ± 0.53, p = 0.24). Anxiety (β = 0.34, standard error (SE) = 0.01, p < 0.001) and clinical experience of 5-10 years (β = 0.23, SE = 0.10, p = 0.004) were associated with job stress. These findings can be applied when devising response strategies for infectious diseases and developing psychological and organizational intervention programs for alleviating job stress in nurses.

Menstrual cycle symptomatology during the COVID-19 pandemic: The role of interoceptive sensibility and psychological health

The literature on the COVID-19 pandemic has shown the importance of investigating its impact on mental health during this sensitive period, also in relation to the female menstrual cycle. To this end, interceptive sensibility has emerged as a fundamental construct for studying the mind-body interaction among psychosomatic and pain symptoms, particularly through the distinction between two attentional styles (namely, a "mindful" and a "non-mindful" sensibility). The aim of the following study is to verify the role of mental health and interoceptive sensibility on menstrual symptoms in women of childbearing age, during the pandemic, as well as to identify the specific contribution of the existing dimensions of interoceptive sensibility in the prediction of symptoms' severity. Data were collected through an online survey, for which 5294 women responded on demographic information, menstrual history, symptoms' disturbance, and completed the Italian versions of the GHQ-12 and the MAIA. The analyses showed that symptoms were strongly correlated to either the GHQ-12 and the MAIA subscales Noticing, Emotional Awareness, Trusting and Not-Worrying. This result was further verified via a hierarchical regression, which revealed that the same interoceptive dimensions and mental health strongly predicted the intensity of menstrual symptoms (R² = 0.177, ΔR² = 0.143) compared to other considered dimensions (R² = 0.180, ΔR² = 0.002). Results are partially in line with the premises but suggest that mental health has a strong impact on the experience of the menstrual cycle and that only a few interoceptive dimensions may be relevant in explaining the severity of menstrual symptoms. It is here suggested that noticing internal bodily signals and being aware of emotional states might become dysfunctional if not reconciled with a good ability to self-regulate internal states, but may rather contribute to the perpetuation of the 'vicious cycle' of heightened affective and attentional reactions to interoceptive sensations.

Exploring Loneliness, Fear and Depression among Older Adults during the COVID-19 Era: A Cross-Sectional Study in Greek Provincial Towns

BACKGROUND

With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression.

OBJECTIVE

To explore the presence and severity of depression in older adults in Greek provincial towns during the pandemic and to explore any possible relationships with loneliness and fear.

METHODS

A convenience sample of 200 participants aged >65, completed a socio-demographic form, the Revised UCLA Loneliness Scale, the Geriatric Depression-15 Scale (GDS-15) and the COVID-19 Fear Scale (FCV-19S). Data were collected from April to May 2022.

RESULTS

The average age of participants was 76.6 years and 35.5% of the participants presented depressive symptoms (mean prevalenceof depression 5 ± 3.7). A moderate to low level of loneliness (mean value 39 ± 11.3) and a moderate level of COVID-19 fear (mean value 18.9 ± 6.5) were also experienced. Higher levels of loneliness were found among participants with lower perceived health status and among those participants registered in Primary Health and Social Care (PHSC) services. Loneliness was positively correlated with depression (r = 0.7, p < 0.001), and increased loneliness and depression were associated with an increase in fear of COVID-19 (r = 0.2, p = 0.01 for both).

CONCLUSIONS

During the pandemic, older adults experienced loneliness, fear of COVID-19 and depression which were positively associated with each other. It is imperative to develop PHSC policies that are aimed at addressing the mental health problems of the older population, which have been caused by the COVID-19 pandemic, through developing their resilience, offering psychological support and promoting social connections.

Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability

Background

COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress.

Objective

This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak.

Methods

This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress.

Results

This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030).

Conclusion

These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.

COVID-19: Factors Associated with the Psychological Distress, Fear and Resilient Coping Strategies among Community Members in Saudi Arabia

(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been non-existent in Saudi Arabia. Therefore, this study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies among the general population in Saudi Arabia. (2) Methods: A cross-sectional study was conducted in healthcare and community settings in the Saudi Arabia using an anonymous online questionnaire. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used to assess psychological distress, fear and coping strategies, respectively. Multivariate logistic regressions were used, and an Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported. (3) Results: Among 803 participants, 70% (n = 556) were females, and the median age was 27 years; 35% (n = 278) were frontline or essential service workers; and 24% (n = 195) reported comorbid conditions including mental health illness. Of the respondents, 175 (21.8%) and 207 (25.8%) reported high and very high psychological distress, respectively. Factors associated with moderate to high levels of psychological distress were: youth, females, non-Saudi nationals, those experiencing a change in employment or a negative financial impact, having comorbidities, and current smoking. A high level of fear was reported by 89 participants (11.1%), and this was associated with being ex-smokers (3.72, 1.14-12.14, 0.029) and changes in employment (3.42, 1.91-6.11, 0.000). A high resilience was reported by 115 participants (14.3%), and 333 participants (41.5%) had medium resilience. Financial impact and contact with known/suspected cases (1.63, 1.12-2.38, 0.011) were associated with low, medium, to high resilient coping. (4) Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress along with medium-high resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers to provide specific mental health support strategies for their current wellbeing and to avoid a post-pandemic mental health crisis.

Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model

Introduction

Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD).

Objective

To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico.

Material and methods

Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured.

Results

The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (β = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (β = 0.077, p < 0.01) and alcohol (β = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (β = 0.121, p < 0.01, and β = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (β = 0.024, p < 0.01, and β = 0.025, p < 0.01, respectively).

Conclusion

This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.

Distress of tertiary education students in Australia during the COVID-19 pandemic

OBJECTIVE

This project sought to characterize levels of distress in Australian tertiary education students during the COVID-19 pandemic.

METHODS

Advertisements were placed on multiple participant recruitment and student run websites associated with various tertiary institutions. Level of overall distress was assessed with the K-10 so that comparisons could be made with previous research. A total of 1072 tertiary education students 18 years or older participated in the study.

RESULTS

70.9% of tertiary education students studying in Australia displayed elevated levels of psychological distress during the pandemic, with 23.01% of the sample reporting extreme levels of distress.

CONCLUSIONS

More tertiary education students experienced severe distress during the COVID-19 pandemic than adults in the general population, as well as before the pandemic.

IMPLICATIONS

Services are needed to help tertiary education students cope with elevated levels of distress associated during the COVID-19 pandemic.

"The usual challenges of work are all magnified": Australian paediatric health professionals' experiences during the COVID-19 pandemic

Background

The COVID-19 pandemic has significantly increased stress and strain on health professionals. With a focus on paediatric cardiac care, this study explored health professionals' concerns about COVID-19, perceptions of the impact of pandemic on healthcare, and experiences of psychological stress.

Methods

Paediatric health professionals working at a large quaternary hospital in Australia were invited to complete a survey between June 2020 and February 2021. Demographic factors, clinical role characteristics, and anxiety and depressive symptoms were assessed. Qualitative data on experiences and perceived effects of the pandemic on paediatric cardiac care were also collected.

Results

228 health professionals (152 nurses, 37 medical doctors, 22 allied and mental health professionals, 17 medical research and administrative staff) participated in the survey (54.4% response rate, 85% women). Half the sample (52.2%) endorsed 'moderate' to 'extreme' worry about COVID-19 and 38% of participants perceived healthcare services as adversely impacted by the pandemic to a 'great' or 'very great' extent. Almost one in five health professionals reported anxiety (18%) and 11% reported depressive symptoms indicative of a need for clinical intervention. Six themes were identified in the qualitative data: (1) Concern about the consequences of visitor restrictions and disrupted patient services, (2) Intensified strain on healthcare workers, (3) Feelings of fear and loss, (4) Social isolation and disconnection, (5) Adapting to change, and (6) Gratitude.

Conclusion

Timely, tailored policies, supports, and interventions are needed to address health professionals' mental health needs during and beyond the pandemic, to minimize the far-reaching impact of situational stressors.

Validation of the Chinese version of the COVID-19 Phobia Scale among Chinese college students

Background and objective

Different languages and versions of the COVID-19 Phobia Scale (C19P-S) have been developed and tested in several countries. Chinese college students are a large vulnerable group and are susceptible to psychological problems during the COVID-19 pandemic. However, no studies had yet examined the reliability and validity of the C19P-S in China among college students group. This study aims to evaluate the COVID-19-related phobia of Chinese college students and examine the reliability and validity of this scale.

Methods

A total of 1689 Chinese college students participated in this study from April 27 to May 7, 2022. They finished the online questionnaire including demographic information and C19P-S. Cronbach's alpha and split-half reliability were used to examine the internal consistency of the scale. Confirmatory factor analysis was further used to examine the scale's construct validity. Convergence validity was also confirmed.

Results

This scale in Chinese had high reliability and validity. The Cronbach's alpha and split-half reliability of the total scale were 0.960 and 0.935, respectively. The construct validity-related indicators of the total scale met the standards (RMSEA = 0.064, IFI = 0.907, TLI = 0.906, and CFI = 0.907). Regarding the subscales, the composite reliability (CR) and average variance extracted (AVE) also met the cutoff values (CR > 0.7 and AVE >0.5). Comparison between gender groups showed that total and subscale scores between male and female students differed significantly.

Conclusion

The Chinese version of the C19P-S was appropriate for evaluating phobic symptoms among Chinese college students. Therefore, this tool could be used to evaluate the mental health of college students in the future.

No fear: Willingness of smartphone activated first responders to assist with cardiac arrest during the COVID-19 pandemic

Aim

To understand the fear and willingness to respond of smartphone activated first responders during the COVID-19 pandemic.

Methods

We invited smartphone activated first responders registered with the GoodSAM application in Victoria, Australia to take part in an online survey in November 2020. We assessed willingness to respond to an alert and provide CPR during the pandemic and administered the Fear of COVID-19 Scale questionnaire. Regression analysis was conducted to investigate associations between occupation, clinical training, and years of clinical experience with willingness to respond and fear of COVID-19.

Results

The survey response rate was 5.1%. Responders (n = 348) had a median age (interquartile range) of 46 years (33-55). Most (67%) were aged 30-59 years and 43% were female. Responders spanned several occupations including paramedics (12.6%), registered nurses (14.7%), and non-clinical individuals (21.8%). Most (92%) reported they would feel comfortable responding to a GoodSAM alert during the pandemic. Almost all (>95%) reported they would provide CPR. About 20% reported being afraid of COVID-19 but only 3.2% reported they had a high-level of fear of COVID-19. The odds of paramedics being willing to respond to an alert was reduced by 73% during the pandemic (OR 0.27, 95% CI 0.11 to 0.69). No other associations were found with willingness or fear of COVID-19.

Conclusion

Although willingness was high and fear of COVID-19 was low, some smartphone activated first responders were less willing to respond to an alert during the pandemic. These findings may inform future pandemic planning and decision-making around pausing first-responder programs.

The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults

The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.

Emotional eating in relation to psychological stress during COVID-19 pandemic: a cross-sectional study in faculty of medicine, Tanta University, Egypt

BACKGROUND

Stress, anxiety, and depression resulting from the COVID-19 pandemic as well as subsequent restrictive measures had a negative impact on eating behaviors. This study aimed to determine the emotional eating behaviors and the perceived stress level and to assess the relation between them among adults in the faculty of medicine during the late period of lockdown during the COVID-19 pandemic.

METHODS

This was a cross-sectional study among 580 persons from the faculty of medicine, at Tanta University, Egypt conducted over a period of one month during the last period of partial lockdown (October 2020). A self-administered structured questionnaire consisted of five parts used in the study (sociodemographic factors, COVID-19-related parameters, nutrition-related information during the pandemic, emotional eating scale, and perceived stress scale).

RESULTS

More than two-fifths of students, employees, and staff (45.2%, 45.5%, and 44.2%, respectively) stated that their weight increased as a result of the lockdown. 50.8% of students, 42.5% of employees, and 54.6% of staff were in the moderate emotional eating groups. Similarly, the majority of students, employees, and staff reported moderate levels of stress(84%, 80.8%, and 76.1% respectively). The total emotional eating score was positively correlated with the total perceived stress scores (r = 0.13, p = 0.001*).

CONCLUSION

COVID-19 pandemic, particularly during the period of lockdown, had a negative impact on individuals' psychological stress levels and levels of emotional eating behaviors.

The effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women

This study was carried out to determine the effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. This study was conducted online between June and September 2021. Women aged 21-65 years were invited to participate in the study via social media. A total of 396 women comprised the sample for this study. Data were collected the Fear of COVID-19 Scale, and the Health-seeking Behavior Scale. Data were evaluated using descriptive statistics, parametric tests and regression analysis. As a result of the study, 11.1 percent of women were found to have had a Pap smear test during the pandemic period. Fear of COVID-19 was determined to have a positive and significant effect on online health-seeking behavior (t = 7.915, p < .001), professional health-seeking behavior (t = 4.503, p < .001), traditional health-seeking behavior (t = 6.037, p < .001), and general health-seeking behavior(t = 8.390, p < .001) while it did not have any effect on having a Pap smear test (p > .05). This study showed that although the fear of COVID-19 positively affected health-seeking behaviors in women, the rates of gynecological examination and Pap smear test rates were low during the pandemic.

Resilience as a protective factor on the quality of life (QoL) of Indian nursing students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic negatively impacted the quality of life of individuals around the world, including health care professionals. There has been little research that examines the role of resilience concerning the impact of COVID-19 on the quality of life of nursing students. This study aimed to determine how resilience influenced the quality of life among nursing students during the COVID-19 pandemic.

METHODS

A cross-sectional research design was adopted for this study. A total of two hundred sixty-eight nursing students from three universities, South India responded in the web-based survey. Data was collected using self-reported questionnaires in June 2021.

RESULTS

Our findings revealed that the participants' resilience was normal, which had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. The COVID-19 impact on QoL significantly differed with year of education (F = 3.087; p < 0.02) and university (F = 6.697, p < 0.001). Bivariate analysis revealed significant inverse relationships between the impact of COVID-19 on quality of life with resilience (r = -0.259; p < 0.001) and perceived knowledge on COVID-19(r = -0.168; p < 0.006).

CONCLUSION

In our study, we found that resilience had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. Therefore, it is important to promote students' resilience and improve their quality of life during stressful situations.

The experience of COVID-19 among people with depression: Impact on daily life and coping strategies

BACKGROUND

The prevalence of depression symptoms among U.S. adults increased dramatically during the early months of the COVID-19 pandemic. We sought to understand the impact of the pandemic on people with a history of depression.

METHODS

In June 2020, a national sample of 5023 U.S. adults, including 760 reporting past/current diagnoses of depression, completed survey measures related to the COVID experience, coping, anxiety, depression, and PTSD.

RESULTS

After adjusting for sociodemographic characteristics, a history of depression increased the odds of negative effects of pandemic on multiple aspects of life: routines, access to mental health treatment, alcohol use, prescription painkiller use, and other drug use. Those with a history of depression also scored significantly higher on the PHQ-8, GAD-7, and PDS-5 (all ps < 0.0001). Greater use of adaptive coping strategies was significantly associated with lower scores, and greater use of maladaptive strategies with higher scores. Individuals reporting a history of depression reported greater use of both adaptive and maladaptive strategies.

CONCLUSIONS

Adaptive coping strategies appear to be protective and help regulate symptomatology, suggesting that particular focus during the clinical encounter on developing tools to promote well-being, alleviate stress, and decrease perceptions of helplessness could mitigate the effects.

An evaluation of the introduction of telehealth for remote antenatal and postnatal contacts in Bangladesh and Lao People's Democratic Republic during the COVID-19 pandemic

From 2020, COVID-19 spread rapidly around the globe and continues to have a major impact on health system functioning, with a disproportionate impact on low- and middle-income countries (LMIC). Reduced service utilisation and coverage of essential childbirth interventions is likely impacting maternal and newborn morbidity and mortality. Telehealth has been identified as an important tool in the continued provision of essential healthcare services. The aim of this study was to explore the experience and impact of implementing telehealth services for the provision of remote antenatal (ANC) and postnatal (PNC) contacts in regions of Bangladesh and Lao People's Democratic Republic through 100 semi-structured interviews with health service leaders and providers, and childbearing women who organised, provided, or were the recipients of ANC and PNC telehealth during the COVID-19 pandemic response. The findings showed that a sudden pivot from face-to-face to telehealth services posed both health system and provision of care challenges. Health systems lacked funding to support telehealth and the infrastructure needed for service changes; however, some were able to work with key maternal child health departments within Ministries of Health to find the resources to implement the services. Health providers found telehealth beneficial during the pandemic response but identified a lack of training, guidance, and support as a barrier to changing practice. Childbearing women reported being fearful of accessing care at health services due to COVID-19, and whilst they appreciated the telehealth contacts, many continued to prefer face-to-face delivery of ANC and PNC care. Telehealth, however, was a good alternative in a time when face-to-face care was not possible. Considerations for post-pandemic broader implementation or scale-up of telehealth for routine antenatal and postnatal maternity care provision include the need for further research on issues such as accessibility, acceptability, quality of care, and sustainability of service provision.

The Relationship Between Social Interaction and Anxiety Regarding COVID-19 in Japanese Older Adults

While previous studies suggest that women have higher anxiety than men regarding COVID-19, underlying mechanisms remain unclear. This study tries to explain the mechanisms by gender difference in social interaction based on a theory of social amplification of risk framework (SARF). We surveyed older adults in Japan regarding their anxiety regarding COVID-19, as well as the frequencies of their direct and indirect social interaction in July 2020 (N = 1,587, aged 78-99 years). To explore the way in which gender and anxiety regarding COVID-19 were mediated by these two types of social interactions, MODEL4 of SPSS's Process MACRO was applied to the data. We found that older women interacted more directly and indirectly with others than did older men. And, direct social interaction was negatively and related, but indirect social interaction was positively related to older adults' anxiety regarding COVID-19. Furthermore, direct social interaction was related to older women's low anxiety regarding COVID-19, whereas indirect social interaction was related to older women's high anxiety regarding COVID-19. The findings of our study suggest that the degree of anxiety regarding COVID-19 among older women may be dependent upon the types of social interaction they have with others.

'Caring for the helpers': factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic

BACKGROUND

Western studies have found that nurses are likely to experience both positive and negative emotions in their job, as a helping profession [professional quality of life (ProQoL)] during the coronavirus disease 2019 (COVID-19) pandemic, and that psychosocial and work-related variables (e.g. pandemic-related stressors, interpersonal and organizational support, coping strategies) are associated with such outcomes. However, relevant studies on nurses in the Asian context are limited.

OBJECTIVE

This study examined the psychosocial correlates of three indicators of ProQoL, i.e. compassion satisfaction, secondary traumatic stress (STS), and burnout, among nurses during the fifth wave of the COVID-19 pandemic in Hong Kong.

METHOD

Nurses in Hong Kong (N = 220) working in hospitals and community settings during the COVID-19 pandemic were recruited between 24 May and 27 June 2022 through nursing associations to complete an online survey measuring the aforementioned psychosocial variables.

RESULTS

Hierarchical regression results found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer ProQoL (i.e. lower compassion satisfaction; higher STS and burnout) (β from 0.16, p > .05, to 0.44, p > .001). In addition, COVID-19-related worries/uncertainties and emotional processing were associated with higher STS (β from 0.21 to 0.23, p < .01), whereas insufficient organizational support for communication with the healthcare system was associated with higher burnout (β = 0.12, p < .05).

CONCLUSIONS

Our findings identified the important psychosocial determinants in ProQoL among nurses in Hong Kong and provide recommendations for services supporting the mental health of these nurses. Providing workshops for nurses to train their skills in coping with COVID-19-related uncertainties, worries, and stressors from the clinical work environment, in using adaptive coping strategies (e.g. positive reframing), and in soliciting emotional support from important others could facilitate their ProQoL. Moreover, the provision of organizational support through timely and transparent communication with the healthcare system could reduce STS in nurses.

Albatineh A, Ridha FM, Hammoud SM, Elsadek HM, Rahman MA. Coping strategies to overcome psychological distress and fear during COVID-19 pandemic in Kuwait

Background

The COVID-19 pandemic has detrimental effects on both physical and psychological well-being of community people worldwide. The purpose of this research was to determine coping strategies and the factors associated with psychological distress and fear among adults in Kuwait during the COVID-19 pandemic.

Results

Participants with good-excellent mental health perception had significantly lower prevalence of reporting high psychological distress, while those identified as patients as used health services in the past 4 weeks had significantly higher prevalence of reporting high psychological distress. On the other hand, individuals born in the same country of residence, whose financial situation was impacted by COVID-19 had significantly lower prevalence of reporting high levels of fear from COVID-19. Those with an income source, with co-morbidities, tested negative to COVID-19, being frontline or essential worker, reported medium to high psychological distress and had significantly higher prevalence of high levels of fear of COVID-19.

Conclusions

Mental health services should be provided in addition to the existing services in primary healthcare settings, so that the impact of ongoing pandemic on psychological wellbeing of people in Kuwait can be addressed.

Psychological Distress, Fear and Coping Strategies among Hong Kong People During the COVID-19 Pandemic

The COVID-19 pandemic contributed to potential adverse effects on the mental health status of a wide range of people. This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Hong Kong. A cross-sectional online survey was conducted among general population in Hong Kong. Psychological distress was assessed using the Kessler Psychological Distress Scale; level of fear was evaluated using the Fear of COVID-19 scale; and coping strategies were assessed using the Brief Resilient Coping Scale. Multivariable logistic regression was used to identify key factors associated with these mental health variables. Of the 555 participants, 53.9% experienced moderate to very high levels of psychological distress, 31.2% experienced a high level of fear of COVID-19, and 58.6% showed moderate to high resilient coping. Multivariable logistic regression indicated that living with family members, current alcohol consumption, and higher level of fear were associated with higher levels of psychological distress; perceived stress due to a change in employment condition, being a frontline worker, experiencing 'moderate to very high' distress, and healthcare service use to overcome the COVID-19 related stress in past 6 months were associated with a higher level of fear; and perceived better mental health status was associated with a moderate to high resilient coping. This study identified key factors associated with distress, fear and coping strategies during the pandemic in Hong Kong. Mental health support strategies should be provided continuously to prevent the mental impact of the pandemic from turning into long-term illness.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-021-02338-7.

Psychometric evaluation of Korean version of COVID-19 fear scale (K-FS-8): A population based cross-sectional study

COVID-19-related fear negatively affects the public's psychological well-being and health behaviours. Although psychological distress including depression and anxiety under COVID-19 is well-established in literature, research scarcely evaluated the fear of COVID-19 with a large sample using validated scale. This study aimed to validate a Korean version of fear scale(K-FS-8) using an existing fear scale(Breast Cancer Fear Scale; 8 items) and to measure the fear of COVID-19 in South Korea. A cross-sectional online survey was conducted with 2235 Korean adults from August to September 2020. The Breast Cancer Fear Scale was translated from English into Korean using forward-backward translation, and then face validity was assessed. Patient Health Questionnaire-4 and Primary Care Post-Traumatic Stress Disorder Screen for DSM-5 were used for assessing convergent validity of K-FS-8, and item response theory analysis was also conducted to further validate the K-FS-8. This study confirmed the validity and reliability of the K-FS-8. The validity of the scale was confirmed by convergent validity, known-group validity and item response theory analysis, and internal consistency was also examined(Cronbach's α coefficient = 0.92). This study also identified that 84.6% participants had high COVID-19 fear; whilst 26.3%, 23.2% and 13.4% participants had high risk of post-traumatic stress disorder, depressive and anxiety symptoms, respectively. The K-FS-8 showed the acceptability measuring the fear of COVID-19 in the Korean population. The K-FS-8 can be applied to screen for fear of COVID-19 and related major public health crises identifying individuals with high levels of fear in primary care settings who will benefit from psychological support.

COVID-19: Psychological distress, fear, and coping strategies among community members across the United Arab Emirates

BACKGROUND

The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally.

OBJECTIVES

We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE.

METHODS

We conducted a cross-sectional online survey across the UAE during November 2020. Adults aged ≥18 years, living in the UAE who were able to respond to an online questionnaire in English or Arabic were considered eligible to participate in the study. We used standard validated tools to measure psychological distress, fear and coping. Kessler Psychological Distress Scale [K10] was used to assess psychological distress, Fear of COVID-19 Scale [FCV-19S] was used to assess the level of fear, and Brief Resilient Coping Scale [BRCS] was used to assess the coping strategies.

RESULTS

A total of 417 individuals participated in this study with a mean age of 29 [± 10.7] years. More than half of the participants experienced high to very high levels of psychological distress [55%] and a quarter experienced high levels of fear of COVID-19 [23.3%] with almost a third of them [36.2%] having low resilient coping. About 37.4% of the participants had work-related mental health impacts and 32.4% were perceived to have moderate to a great deal of distress due to a change of employment status during the pandemic. One in ten participants [9.4%] reported increased smoking. Increased smoking [AOR 8.66, 95% CIs 1.08-69.1,], increased alcohol drinking [AOR 2.39, 95% CIs 1.05-5.47] and higher levels of fear of COVID-19 [AOR 2.93, 95% CIs 1.83-4.67] were associated with moderate to very high levels of psychological distress. Being female [AOR 1.82, p = 0.030], having a pre-existing mental health condition [AOR 9.88, 95% p = 0.027], engaging in high-risk behaviors such as increased smoking [AOR 21.14, p = 0.003], increased alcohol drinking [AOR 1.48, p = 0.359] in the previous four weeks, and higher levels of fear of COVID-19 [AOR 4.18, p <0.001] were associated with moderate to very high levels of psychological distress. Also, being a smoker [AOR, 0.840, p = 0.011], and having a high level of fear [AOR 0.372, p = 0.001] were found to be associated with low resilient coping.

CONCLUSION

Community members in the UAE are at a higher risk of psychosocial distress and fear during the COVID-19 pandemic. Thus, healthcare providers and policymakers would need to be more alert to provide specific mental health support strategies for their wellbeing.

Mediating Effects of Copying Style on the Relationship between Parenting Style and Adversity Quotient of Nursing Students

Background

Nursing is known as a stressful job; nursing students as the future workforce particularly require the adversity quotient (AQ) in order to successfully overcome difficulties and setbacks encountered amid their studies and in their future workplaces.

Aim

To explore the relationship among parenting style, coping styles, and AQ, and investigate the mediating effects of coping style on the relationship between parenting style and AQ among nursing students.

Methods

The study employed a cross-sectional and correlational design. A convenience sampling method was used to recruit nursing students (n = 158 valid) from a higher education institute in Macao SAR. Four measuring instruments were used, including (1) The Demographic Information Form, (2) The Adversity Quotient Scale, (3) The Simplified Coping Style Questionnaire, and (4) The Chinese Version of the Parental Styles Scale.

Results

The associations only existed between negative mother-parenting styles, negative coping styles and AQ, passive mother-parenting styles and passive copying (r = -0.166, 0.276, 0.266, 0.232, 0.229, 0.186, 0.207, P < 0.05); there is no statistically significant correlation between father parenting style and the score of AQ, negative coping style, and positive coping style at all. The obtained model fitting index: χ2/df = 1.191, RMSEA = 0.035, SRMR = 0.0305, TLI = 0.991, CFI = 0.997, indicating that the fitting indices of the model are all within the acceptable range, and there is a significant mediating effect of coping styles on the relationship between mother parenting styles and AQ of Macao nursing students.

Conclusions

Coping styles play an important role in mediating the relationship between parenting styles, particularly, mothering styles and AQ of Macao nursing students. Special attention should be paid to cultivating students' positive coping strategies in order to mediate the negative mothering styles and to enhance their AQ for better adapting to the challenges faced by them in school and in future working places and social environments.

Highlighting Effects of Flipped Learning on Mental Health through Metaverse: Moderating Impact of e-learning and Cyber Resilience

Objectives: A metaverse refers to a virtual-reality platform in which users can interact with computer- generated environment, to socialize. It has really enhanced the internet-based and online education. The current study aimed to evaluate the effect of flipped learning on mental health through metaverse. There is a huge potential for expanding learning and knowledge through metaverse, and educational institutions worldwide are evolving to incorporate this concept. To explore the effects of flipped learning on mental health through the metaverse, the study examined the moderating influence of e-learning and cyber resilience by adopting interactive methods in the context of China. Methods: The study employed a quantitative design by conducting surveys from students in Chinese educational institutions. A sample of 350 questionnaires was distributed among the students, out of which 324 complete questionnaires were obtained for further analysis. Results: The findings showed a significant effect of flipped learning on mental health through metaverse. It also exposed the significance of the moderating effect of cyber resilience. In contrast, the moderating effect of e-learning was found to be insignificant between flipped learning through metaverse and students' mental health in Chinese educational institutions. Conclusion: The study provides insightful and practical guidelines for China's education and cybersecurity departments.

Association between COVID-19 pandemic declaration and depression/anxiety among U.S. adults

BACKGROUND

Although studies have investigated the impact of the COVID-19 on mental health, few studies have attempted to compare the prevalence of depression/anxiety symptoms among U.S. adults before and after the COVID-19 pandemic declaration. We examined the prevalence and association between depression/anxiety symptoms and COVID-19 pandemic declaration among U.S. adult population and subgroups.

METHODS

A nationally representative cross-sectional study of the Health Information National Trends Survey (HINTS 5, Cycle 4) assessing health-related information and behaviors in U.S. adults aged ≥18 years from February through June 2020. The primary dependent variable was current depression/anxiety derived from Patient Health Questionnaire-4. The main independent variable was responses before and after the COVID-19 pandemic declaration in addition to sexual identity heterosexual identity, /race/ethnicity and rural-urban commuting areas. Covariates were sociodemographic factors, and health risk behaviors. Weighted percentages, multivariable logistic regression, and Chi-square tests were used to establish the prevalence and association between current depression/anxiety and the independent variables and covariates.

RESULTS

A total of 3,865 participants completed the survey and included 35.3% of the participants before the COVID-19 pandemic declaration. Most of the sample were aged 50-64 years [33.0%]; males [51.0%]; and non-Hispanic Whites [70.1%]). The post-pandemic declaration included participants, aged 35-49 years [27.0%]; females [52.6%]; and non-Hispanic Whites [59.6%]). The prevalence of depression/anxiety was higher after the COVID-19 pandemic declaration (32.2%) than before the declaration (29.9%). Higher risks of depression/anxiety symptoms after the declaration were associated with being a sexual minority ([adjusted odds ratio] AOR, 2.91 [95% confidence interval (CI), 1.38-6.14]) and having fair/poor general health (AOR, 2.91 [95% CI, 1.76-4.83]). The probability of experiencing depression/anxiety symptoms after the declaration was highest among homosexuals/lesbians/gays (65.6%) compared to bisexuals (39.6%), and heterosexuals (30.1%).

CONCLUSIONS

In this study, young adults, non-Hispanic Whites, and those with fair/poor general health had a higher burden of depression/anxiety symptoms after the pandemic declaration. The development of psychological support strategies to promote wellbeing during the pandemic may reduce psychological distress in the population, especially among at-risk populations.

The psychometric properties and gender invariance of the Italian version of the Perceived Vulnerability to Disease Questionnaire (I-PVDQ) during the COVID-19 pandemic

BACKGROUND

The Perceived Vulnerability to Disease Questionnaire (PVDQ) measures beliefs associated with personal susceptibility to infectious diseases and behaviors or perceptions in the presence of potential risk of pathogen transmission. Given the onset of the Severe Acute Respiratory Syndrome Coronavirus 2 global pandemic, otherwise known as the COVID-19 pandemic, the construct being measured may function differently based on affective, behavioral, and cognitive changes along with the need to change norms and lifestyles in a global context. The present study aims to test the psychometric properties and the gender invariance of the Italian adaptation of the PVDQ to confirm that the scale can be used with Italian-speaking people, and that it functions effectively during a pandemic.

METHODS

A total of 509 participants filled out an online questionnaire including the Italian version of the I-PVDQ (I-PVDQ) and several measures of psychological constructs. Reliability and factor analyses (single and multigroup) were conducted. Bayesian correlation tests and Bayesian independent sample t-tests were used to assess the validity of I-PVDQ.

RESULTS

Exploratory factor analysis supported the two-factor structure of the I-PVDQ, and factor loadings loaded appropriately onto perceived infectability (PI) and germ aversion (GA). In terms of invariance, the scale showed configural, metric, scalar, and strict invariance across genders. Decisive evidence in favor of correlation with the measure of COVID-19 related fears for both PI and GA was found. There was strong evidence for observed correlations with COVID-19 related constructs such as intolerance to uncertainty, psychological inflexibility, resilience, stress, and anxiety. Women showed higher GA than men, while there were no gender differences in PI.

CONCLUSIONS

Taken together, these results suggest that the I-PVDQ confirms the psychometric properties of the original version and that can be used to detect PVD when it is affected by environmental circumstances since its functioning is preserved during a pandemic.

Virtual Behavioral Intervention to Promote Healthy Lifestyle Behaviors: A Feasibility RCT during COVID-19 Pandemic

BACKGROUND

the COVID-19 pandemic has had a substantial impact on human health, affecting many lifestyle behaviors such as physical activity, sedentary behavior, dietary habits and sleep.

PURPOSE

to assess the feasibility of six sessions of a virtual behavioral intervention to promote healthy lifestyle practices during a stay-at-home advisory phase of the COVID-19 pandemic.

METHODS

A participant-blinded randomized controlled trial was performed through a virtual platform setting. Participants were randomly assigned into two groups. They were assigned to a motivational interviewing (MI) intervention or attention group, with pre- and postintervention assessments. The MI treatment consisted of six sessions (twice each week). The same number of virtual structured sessions were provided for the attention group, and they provided brief advice to promote healthy lifestyles. The study was conducted from April to June 2020.

RESULTS

The feasibility outcomes indicated that 39 of the 50 participants (78%) completed the trial. The dropout rate was 21.7% for the attention group and 22.2% for the intervention group. Participating in MI had a significant positive interventional effect on physical activity level, distress and fear of COVID-19.

CONCLUSIONS

It is feasible to deliver behavioral change interventions virtually. Further, MI can be used as a useful strategy for the favorable promotion of a healthy lifestyle.

TRIAL REGISTRATION

NCT05392218 (26/05/2022).