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Yu H, Huang W, Yang X, Yang H, Ma H, Zhang N. Longitudinal investigation of factors influencing mental health during centralized quarantine for COVID-19. Int Health 2024; 16:344-350. [PMID: 37584227 PMCID: PMC11062195 DOI: 10.1093/inthealth/ihad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/10/2023] [Accepted: 07/26/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Centralized quarantine was applied in response to the coronavirus disease 2019 outbreak. The present study aimed to investigate changes in psychological status of isolated individuals before and after quarantine. METHODS Between August 2020 and July 2021, 648 participants completed the following psychometric evaluations before and after centralized quarantine: 9-item Patient Health Questionnaire for depression, 7-item Generalized Anxiety Disorder for anxiety, the Chinese version of the Connor Davidson Resilience Scale for psychological resilience, the Chinese version of the Simplified Coping Style Questionnaire for coping style, Jiang's revised Chinese version of the Perceived Social Support Scale for social support and the Chinese version of the Impact of Events Scale for stress. RESULTS At the beginning of centralized quarantine, 83.2% (n=539) of participants had no depressive mood, 11% (n=71) had mild depressive mood and 5.8% (n=38) had moderate-severe depressive mood. At the end of quarantine, 80.8% (n=524) of participants had no depressive mood, 13% (n=84) had mild depressive mood and 6.2% (n=41) had moderate-severe depressive mood. At the beginning of the centralized quarantine, 86.7% (n=562) of participants had no anxiety, 9.6% (n=62) had mild anxiety and 3.7% (n=24) had moderate-severe anxiety. At the end of quarantine, 85.8% (n=556) of participants had no anxiety, 11.6% (n=75) had mild anxiety and 2.6% (n=17) had moderate-severe anxiety. After 2 weeks of centralized quarantine, anxiety (t=2.175, p<0.05), stress (t=7.453, p<0.01) and three stress subscale scores (p<0.01) decreased significantly; psychology resilience (t=-3.63, p<0.01), tenacity (t=-4.747, p<0.01), active coping style (t=-3.83, p<0.01) and support outside family (t=-3.07, p<0.05) all increased significantly. No significant change was observed in depression, strength, optimism, passive coping style or support inside family. Depression and anxiety scores associated significantly with resilience, stress, coping styles and social support scores. Anxiety (B=0.488, β=0.413, p<0.01), psychological resilience (B=-0.047, β=-0.203, p<0.01) and stress (B=1.475, β=0.167, p<0.1) scores before centralized quarantine were associated with depression after quarantine. Depression (B=0.323, β=0.422, p<0.01), psychological resilience (B=-0.022, β=-0.123, p<0.01) and stress (B=1.408, β=0.207, p<0.01) scores before quarantine also influenced anxiety levels after quarantine. A cross-lagged panel model indicated that depression, anxiety, resilience and stress scores at the first assessment were predictive of depression and anxiety levels at the second assessment. CONCLUSIONS Good mental health during centralized quarantine was associated with high scores of psychological resilience, impact of events, coping styles and social support and did not become worse in settings where adequate support was available.
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Affiliation(s)
- Haoran Yu
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenyan Huang
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Yang
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Yang
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Ma
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ning Zhang
- Department of Medical Psychology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Behera D, Bohora S, Tripathy S, Thapa P, Sivakami M. Perinatal depression and its associated risk factors during the COVID-19 pandemic in low- and middle-income countries: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02628-y. [PMID: 38376751 DOI: 10.1007/s00127-024-02628-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Perinatal depression significantly impacts maternal and child health, with further complexities arising during the COVID-19 pandemic. This review is the first to comprehensively synthesize evidence on the prevalence of perinatal depression and its associated risk factors in Low- and Middle-Income Countries (LMICs) during the pandemic period. METHODS The study protocol was registered in PROSPERO (CRD42022326991). This review followed the Joanna Briggs Institute (JBI) guideline for prevalence studies. A comprehensive literature search was conducted in six databases: PubMed, Scopus, Web of Science, PsycInfo, CINAHL, and ProQuest. Pooled prevalence estimates were computed for both prenatal and postnatal depression. Identified risk factors were summarized narratively. RESULTS A total of 5169 studies were screened, out of which 58 were included in the narrative review and 48 [prenatal (n = 36) and postnatal (n = 17)] were included in the meta-analysis. The pooled depression prevalence for prenatal women was 23% (95% CI: 19-27%), and for the postnatal women was 23% (95% CI: 18-30%). Maternal age, education, perceived fear of COVID-19 infection, week of pregnancy, pregnancy complications, and social and family support were identified as associated risk factors for depression. CONCLUSIONS Our review demonstrates an increased prevalence of perinatal depression during the COVID-19 pandemic in LMICs. It sheds light on the significant burden faced by pregnant and postnatal women and emphasizes the necessity for targeted interventions during the ongoing and potential future crisis.
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Affiliation(s)
- Deepanjali Behera
- School of Public Health, Kalinga Institute of Industrial Technology (KIIT) Deemed To Be University, Campus-5 (KIMS), Bhubaneswar, 751024, Odisha, India.
| | - Shweta Bohora
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Snehasish Tripathy
- Centre for Mental Health, Law and Policy, Indian Law Society, Pune, India
| | - Poshan Thapa
- School of Population and Global Health, McGill University, Quebec, Canada
| | - Muthusamy Sivakami
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
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Macaluso M, Rothenberg ME, Ferkol T, Kuhnell P, Kaminski HJ, Kimberlin DW, Benatar M, Chehade M. Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey. JMIR Public Health Surveill 2024; 10:e48430. [PMID: 38354030 PMCID: PMC10868638 DOI: 10.2196/48430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/20/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND With more than 103 million cases and 1.1 million deaths, the COVID-19 pandemic has had devastating consequences for the health system and the well-being of the entire US population. The Rare Diseases Clinical Research Network funded by the National Institutes of Health was strategically positioned to study the impact of the pandemic on the large, vulnerable population of people living with rare diseases (RDs). OBJECTIVE This study was designed to describe the characteristics of COVID-19 in the RD population, determine whether patient subgroups experienced increased occurrence or severity of infection and whether the pandemic changed RD symptoms and treatment, and understand the broader impact on respondents and their families. METHODS US residents who had an RD and were <90 years old completed a web-based survey investigating self-reported COVID-19 infection, pandemic-related changes in RD symptoms and medications, access to care, and psychological impact on self and family. We estimated the incidence of self-reported COVID-19 and compared it with that in the US population; evaluated the frequency of COVID-19 symptoms according to self-reported infection; assessed infection duration, complications and need for hospitalization; assessed the influence of the COVID-19 pandemic on RD symptoms and treatment, and whether the pandemic influenced access to care, special food and nutrition, or demand for professional psychological assistance. RESULTS Between May 2, 2020, and December 15, 2020, in total, 3413 individuals completed the survey. Most were female (2212/3413, 64.81%), White (3038/3413, 89.01%), and aged ≥25 years (2646/3413, 77.53%). Overall, 80.6% (2751/3413) did not acquire COVID-19, 2.08% (71/3413) acquired it, and 16.58% (566/3413) did not know. Self-reported cases represented an annual incidence rate of 2.2% (95% CI 1.7%-2.8%). COVID-19 cases were more than twice the expected (71 vs 30.3; P<.001). COVID-19 was associated with specific symptoms (loss of taste: odds ratio [OR] 38.9, 95% CI 22.4-67.6, loss of smell: OR 30.6, 95% CI 17.7-53.1) and multiple symptoms (>9 symptoms vs none: OR 82.5, 95% CI 29-234 and 5-9: OR 44.8, 95% CI 18.7-107). Median symptom duration was 16 (IQR 9-30) days. Hospitalization (7/71, 10%) and ventilator support (4/71, 6%) were uncommon. Respondents who acquired COVID-19 reported increased occurrence and severity of RD symptoms and use or dosage of select medications; those who did not acquire COVID-19 reported decreased occurrence and severity of RD symptoms and use of medications; those who did not know had an intermediate pattern. The pandemic made it difficult to access care, receive treatment, get hospitalized, and caused mood changes for respondents and their families. CONCLUSIONS Self-reported COVID-19 was more frequent than expected and was associated with increased prevalence and severity of RD symptoms and greater use of medications. The pandemic negatively affected access to care and caused mood changes in the respondents and family members. Continued surveillance is necessary.
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Affiliation(s)
- Maurizio Macaluso
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Marc E Rothenberg
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Thomas Ferkol
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Pierce Kuhnell
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Henry J Kaminski
- Department of Neurology and Rehabilitation Medicine, George Washington University, Washington, DC, United States
| | - David W Kimberlin
- Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Benatar
- Department of Neurology, University of Miami, Miami, FL, United States
| | - Mirna Chehade
- Mount Sinai Center for Eosinophilic Disorders, Departments of Pediatrics and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Xiao W, Yang Y, Xiao H, Huang P, Wei D, Wu Y, Yu J, He JR, Qiu X. Impact of closed-off management due to COVID-19 rebound on maternal depression during pregnancy. BMC Pregnancy Childbirth 2024; 24:88. [PMID: 38287284 PMCID: PMC10823603 DOI: 10.1186/s12884-024-06285-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/21/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19. METHODS This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms. RESULTS Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted β: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms. CONCLUSIONS Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.
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Affiliation(s)
- Wanqing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yuting Yang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Huiyun Xiao
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yingfang Wu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jia Yu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
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Schwartz CE, Borowiec K, Li Y, Rapkin BD. Individual differences in the long-term impact of the pandemic: moderators of COVID-related hardship, worry, and social support. Qual Life Res 2024:10.1007/s11136-023-03573-0. [PMID: 38183562 DOI: 10.1007/s11136-023-03573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE Understanding people's response to the pandemic needs to consider individual differences in priorities and concerns. The present study sought to understand how individual differences in cognitive-appraisal processes might moderate the impact of three COVID-specific factors-hardship, worry, and social support-on reported depression. METHODS This longitudinal study of the psychosocial impact of the COVID-19 pandemic included 771 people with data at three timepoints over 15.5 months. Participants were recruited from panels of chronically ill or general population samples. Depression was measured by an item response theory validated depression index created using items from existing measures that reflected similar content to the Patient Health Questionnaire-8. COVID-specific factors of hardship, worry, and social support were assessed with items compiled by the National Institutes of Health. The Quality of Life Appraisal Profilev2 Short-Form assessed cognitive appraisal processes. A series of random effects models examined whether appraisal moderated the effects of hardship, worry, and social support on depression over time. RESULTS Over time the association between low social support and depression was greater (p = 0.0181). Emphasizing the negative was associated with exacerbated depression, in particular for those with low social support (p = 0.0007). Focusing on demands and habituation was associated with exacerbated depression unless one experienced greater hardship (p = 0.0074). There was a stronger positive connection between recent changes and depression for those people with higher worry scores early in the pandemic as compared to later, but a stronger positive correlation for those with lower worry scores later in the pandemic (p = 0.0015). Increased endorsement of standards of comparison, emphasizing the negative, problem goals, and health goals was associated with worse depression scores (all p < 0.0001). People who were younger, disabled, or had greater difficulty paying bills also reported worse depression (p < 0.0001, 0.0001, and 0.002, respectively). CONCLUSION At the aggregate level, COVID-specific stressors changed over the course of the pandemic, whereas depression and social-support resources seemed stable. However, deeper analysis revealed substantial individual differences. Cognitive-appraisal processes showed considerable variability across individuals and moderated the impact of COVID-specific stressors and resources over time. Future work is needed to investigate whether coaching individuals away from maladaptive cognitive-appraisal processes can reduce depression and lead to better overall well-being.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences and the Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bruce D Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Lin Y, Wu L, Ouyang H, Zhan J, Wang J, Liu W, Jia Y. Behavioral intentions and perceived stress under isolated environment. Brain Behav 2024; 14:e3347. [PMID: 38376043 PMCID: PMC10757889 DOI: 10.1002/brb3.3347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/09/2023] [Accepted: 11/20/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Isolation is a special environment that will affect the mental health and behavior of individuals. The current study was to explore the relationship between behavior intention (BI) and perceived stress in isolated environment during Shanghai Omicron pandemic. METHODS A cross-sectional study was conducted between April 8 and 14, 2022. Three self-reported questionnaires were used to evaluate quarantine duration, stress perception, and BI. A total of 1042 participants in Shanghai under quarantine at home were included by random sampling. Logistic regression and one-way variance analysis were used to determine the risk factors related to BI. RESULTS The finding implicated negative BI was more reported by the population of males, with lower educational background, with jobs, and youngers. A negative association existed between perceived stress and BI (B = -1.004, p = .003, OR = 0.367, 95% CI = .191-.703). The proportion of positive BI decreased with quarantined duration, whereas the negative BI seemed vibrate upward then downward. CONCLUSION There existed a significant effect of quarantined days on perceived stress with different BIs. High perceived stress was a risk factor of positive BI. This preliminary study has significance to understand the effect of compulsory measures on BI and for policies makers to take a psychosocial perspective to consider the effective pandemic intervention strategies.
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Affiliation(s)
- Ying Lin
- China Executive Leadership AcademyPudongShanghaiChina
| | - Lili Wu
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
| | - Hui Ouyang
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
| | - Jingye Zhan
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
| | - Jing Wang
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
| | - Weizhi Liu
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- Key Laboratory of Molecular Neurobiology of the Ministry of EducationNaval Medical UniversityShanghaiChina
| | - Yanpu Jia
- Laboratory for Post‐traumatic Stress Disorder, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
- The Emotion & Cognition Laboratory, Faculty of Psychology and Mental HealthNaval Medical UniversityShanghaiChina
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Roddy Mitchell A, Gordon H, Atkinson J, Lindquist A, Walker SP, Middleton A, Tong S, Hastie R. Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2343711. [PMID: 37976063 PMCID: PMC10656650 DOI: 10.1001/jamanetworkopen.2023.43711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023] Open
Abstract
Importance Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened by these disorders, yet their prevalence is unclear. Objective To conduct a systematic review and meta-analysis to determine the prevalence of 6 anxiety and related disorders among perinatal women in LMICs. Data Sources Embase, MEDLINE, PsycINFO, Cochrane Library, CINAHL, and Web of Science databases were searched from inception until September 7, 2023. Study Selection Studies conducted in World Bank-defined LMICs and reporting prevalence of generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, panic disorder, or adjustment disorder during the perinatal period (conception to 12 months post partum) using a validated method were included. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Study eligibility, extracted data, and risk of bias of included studies were assessed by 2 independent reviewers. Random-effects meta-analysis was used to estimate pooled point prevalence. Subgroup analyses were performed by specific anxiety disorder. Main Outcomes and Measures Main outcomes were prevalence estimates of each anxiety disorder, measured as percentage point estimates and corresponding 95% CIs. Results At total of 10 617 studies were identified, 203 of which met the inclusion criteria and reported the outcomes of 212 318 women from 33 LMICs. Generalized anxiety disorder was the most reported (184 studies [90.6%]) and most prevalent disorder at 22.2% (95% CI, 19.4%-25.0%; n = 173 553). Posttraumatic stress disorder was the second most prevalent (8.3%; 95% CI, 5.0%-12.2%; 33 studies; n = 22 452). Adjustment disorder was least prevalent (2.9%; 95% CI, 0.0%-14.1%; 2 studies; n = 475). The prevalence of generalized anxiety varied by country income status, with the highest prevalence among lower-middle-income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109), followed by low-income (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961) and upper-middle-income (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496) countries. Conclusions and Relevance These findings suggest that 1 in 5 women living in LMICs experience anxiety disorders during pregnancy and post partum. Targeted action is needed to reduce this high burden.
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Affiliation(s)
- Alexandra Roddy Mitchell
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Hannah Gordon
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Jessica Atkinson
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anthea Lindquist
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Susan P. Walker
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anna Middleton
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Stephen Tong
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Roxanne Hastie
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
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Gómez-López ME, Aldrete-Cortez V, González-Carpinteiro A, Mendizábal-Espinosa R, Bobadilla L. The Emotional Experience of Mexican Women with SARS-CoV-2 during Pregnancy-A Qualitative Study. Healthcare (Basel) 2023; 11:2785. [PMID: 37893859 PMCID: PMC10606424 DOI: 10.3390/healthcare11202785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Pregnant women have been considered a high-risk group for SARS-CoV-2 infection; the impact of the disease on the health of a mother and her child is still being studied. The emotional impact of the pandemic on pregnant women has been extensively studied. Emotional distress is proposed as a perspective to explain the emotional manifestations in women during this stage as something common rather than pathological. The objective of this study was to explore the emotional experience of women who tested positive for SARS-CoV-2 towards the end of their pregnancy, during the first and second waves of COVID-19 in Mexico. A qualitative study was carried out: 18 pregnant women with COVID-19 were interviewed. A thematic analysis of the data was performed, resulting in 3 main themes and 14 subthemes. The COVID-19-infected mothers-to-be experienced mild to moderate emotional distress. It was more intense for those with comorbidities. This distress was aggravated during obstetrical complications and comorbidities, as well as during COVID-19 and postpartum. The emotional distress was appeased by both the perception of medical care and social support. The emotional distress of pregnant women with COVID-19 requires emotional support to reduce its impact.
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Affiliation(s)
| | - Vania Aldrete-Cortez
- Laboratory of Neuroscience and Cognitive Development, School of Psychology, Universidad Panamericana, Mexico City 03920, Mexico; (V.A.-C.); (A.G.-C.)
| | - Aline González-Carpinteiro
- Laboratory of Neuroscience and Cognitive Development, School of Psychology, Universidad Panamericana, Mexico City 03920, Mexico; (V.A.-C.); (A.G.-C.)
| | - Rosa Mendizábal-Espinosa
- Social Research Institute of London, University College London, London WC1E 6BT, UK;
- Nacer Temprano, Vivir en Grande, Civil Association, Tlalnepantla de Baz 54080, Mexico
| | - Liliana Bobadilla
- Hospital of Gynecology and Obstetrics “Dr. Luis Castelazo Ayala”, Instituto Mexicano del Seguro Social, Mexico City 01090, Mexico;
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Cai QY, Li X, Yang Y, Luo X, Luo SJ, Xiong J, He ZY, Chen Y, Mou YW, Hu JY, Yang S, Lan X, Liu TH. Rational use of drugs to alleviate adverse outcomes caused by COVID-19 quarantine in women with intrahepatic cholestasis of pregnancy. Front Med (Lausanne) 2023; 10:1122873. [PMID: 37608824 PMCID: PMC10441112 DOI: 10.3389/fmed.2023.1122873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/21/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose This study aimed to investigate the impacts of home quarantine on pregnancy outcomes of women with intrahepatic cholestasis of pregnancy (ICP) during the COVID-19 outbreak and whether the rational use of drugs will change these impacts. Methods This multi-center study was conducted to compare the pregnancy outcomes in women with ICP between the home quarantine group and the non-home quarantine group in southwest China. Propensity score matching was performed to confirm the pregnancy outcomes of the medication group and the non-medication group in women with ICP during the epidemic period. Results A total of 3,161 women with ICP were enrolled in this study, including 816 in the home quarantine group and 2,345 in the non-home quarantine group. Women with ICP in the home quarantine group had worse pregnancy outcomes, such as a growing risk of gestational diabetes mellitus A1, fetal growth restriction, pre-eclampsia, preterm delivery, and even stillbirth. Drug therapy could alleviate some adverse pregnancy outcomes caused by home quarantine, including pre-eclampsia, preterm delivery, and meconium-stained amniotic fluid. Conclusion COVID-19 quarantine would increase the incidence of ICP and lead to adverse pregnancy outcomes in women with ICP. The rational use of drugs reduced some obstetrical complications and improved partial pregnancy outcomes. Our findings suggested that the government and hospitals should enhance their management and life guidance for women with ICP and speed up developing home quarantine guidelines.
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Affiliation(s)
- Qin-Yu Cai
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Xia Li
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Yin Yang
- Department of Infection Controlling Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Luo
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shu-Juan Luo
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Xiong
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Zong-Yan He
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Yuan Chen
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Yi-Wei Mou
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Ji-Yuan Hu
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Shu Yang
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
| | - Xia Lan
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Tai-Hang Liu
- Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, China
- The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing, China
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10
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Yang H, Pan Y, Chen W, Yang X, Liu B, Yuan N, Zhang X. Prevalence of and relevant factors for depression and anxiety symptoms among pregnant women on the eastern seaboard of China in the post-COVID-19 era: a cross-sectional study. BMC Psychiatry 2023; 23:564. [PMID: 37550657 PMCID: PMC10405434 DOI: 10.1186/s12888-023-05059-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 07/28/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antenatal depression and anxiety symptoms may have negative consequences for both mothers and offspring, and upward trends in the prevalence of these symptoms were especially apparent during the COVID-19 epidemic. The purpose of this study was to evaluate the prevalence of and relevant factors influencing depressive and anxiety symptoms in Chinese pregnant women in the post-COVID-19 era. METHODS We conducted an online survey of 1,963 pregnant women in Jiangsu Province, using a cross-sectional design, and collected their general demographic data. The nine-item Patient Health Questionnaire 9 (PHQ-9) was used to evaluate depression symptoms, and the seven-item Generalized Anxiety Disorder 7 (GAD-7) was used to measure anxiety symptoms. RESULTS The prevalence of reported antenatal depressive symptoms, anxiety symptoms, and depression combined with anxiety symptoms was 25.2%, 27.9%, and 18.6%, respectively. Of the respondents, the prevalence of moderate to severe depression, and anxiety was 7.9% and 7.7%, respectively. Binary logistic regression analysis demonstrated that age, low level of education, rural area, unemployment, pregnancy complications, poor marital relationship, and fair household income were positively association with both depressive and anxiety symptoms (all P < 0.05). The proportion of women reporting anxiety symptoms in the third trimester was 1.91-fold higher than in first trimester. Parity was a relevant factor for depression and anxiety symptoms (all P < 0.05). CONCLUSIONS In the post-COVID-19 era, the prevalence of depression and anxiety symptoms in pregnant women was higher than expected, and it is vital to establish hospital, community, and family psychological health screening systems based on relevant factors and enhance early preventive measures.
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Affiliation(s)
- Haidong Yang
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, P.R. China
| | - Yangyang Pan
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, P.R. China
| | - Wanming Chen
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, P.R. China
| | - Xu Yang
- Department of Psychiatry, Beijing Hui Long Guan Hospital, Peking University Hui Long Guan Clinical Medical School, Beijing, 100096, P.R. China
| | - Bin Liu
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, P.R. China
| | - Nian Yuan
- Science and Education Section, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, P.R. China.
| | - Xiaobin Zhang
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, P.R. China.
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11
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Zhu K, Wang S, Yue Y, Smith BA, Zhang ZF, Freudenheim JL, Niu Z, Zhang J, Smith E, Ye J, Cao Y, Zhang J, Hennessy DA, Lei L, Mu L. Disparities in insecurity, social support, and family relationships in association with poor mental health among US adults during the COVID-19 pandemic. Sci Rep 2023; 13:9731. [PMID: 37322075 PMCID: PMC10272217 DOI: 10.1038/s41598-023-35981-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on mental health. Identifying risk factors and susceptible subgroups will guide efforts to address mental health concerns during the pandemic and long-term management and monitoring after the pandemic. We aimed to examine associations of insecurity (concerns about food, health insurance, and/or money), social support, and change in family relationships with poor mental health and to explore disparities in these associations. An online survey was collected from 3952 US adults between May and August 2020. Symptoms of anxiety, depression, stress, and trauma-related disorders were assessed by the Generalized Anxiety Disorder 7-item scale, the Patient Health Questionnaire-9, the Perceived Stress Scale-4, and the Primary Care Post-Traumatic Stress Disorder Screen, respectively. Social support was measured by the Oslo Social Support Scale. Logistic regression was used and stratified analyses by age, race/ethnicity, and sex were performed. We found a higher prevalence of poor mental health among those who were younger, female, with lower socioeconomic status, and racial/ethnic minorities. Participants who were worried about money, health insurance, or food had higher odds of symptoms of anxiety (OR = 3.74, 95% CI: 3.06-4.56), depression (OR = 3.20, 95% CI: 2.67-3.84), stress (OR = 3.08, 95% CI: 2.67-3.57), and trauma-related disorders (OR = 2.93, 95% CI: 2.42-3.55) compared to those who were not. Compared to poor social support, moderate and strong social support was associated with lower odds of all four symptoms. Participants who had changes in relationships with parents, children, or significant others had worse mental health. Our findings identified groups at higher risk for poor mental health, which offers insights for implementing targeted interventions.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Siyi Wang
- Department of Psychology, Vassar College, Poughkeepsie, NY, USA
| | - Yihua Yue
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Beth A Smith
- Department of Psychiatry and Pediatrics, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | | | | | - Joshua Ye
- The Quarry Lane School, Dublin, CA, USA
| | - Ying Cao
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jie Zhang
- Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Dwight A Hennessy
- Department of Psychology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Jin Y, Murray L. Perinatal mental health and women's lived experience of the COVID-19 pandemic: A scoping review of the qualitative literature 2020-2021. Midwifery 2023; 123:103706. [PMID: 37167674 PMCID: PMC10150412 DOI: 10.1016/j.midw.2023.103706] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/27/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic resulted in global physical distancing restrictions and lockdown orders. Despite the clear documentation of increased mental distress amongst adult populations during the pandemic, there is limited evidence about the mental health challenges of people in the perinatal period (pregnancy, birth and postpartum). The aim of this review is to summarise the qualitative research about women's lived experience and emotional wellbeing during the COVID-19 pandemic. METHODS A comprehensive search strategy was developed. Twenty peer-reviewed qualitative research articles published in English from January 1, 2020, to December 15, 2021, were included. Data synthesis outlined the evidence from common themes in a narrative format. RESULTS Themes during pregnancy included: (1) information seeking: anxiety and fear; (2) experiencing isolation and disruptions to my social support; (3) 'Going it alone' in pregnancy care; (4) anticipatory grieving and despair; (5) finding 'silver linings' in social restrictions. One key theme during birth was "birthing in a crisis". Themes during postpartum included: (1) isolating 'Early motherhood is much like lockdown'; (2) breastfeeding: triumphs and tribulations; (3) facing disruptions during postpartum care; (4) 'Affecting us for years to come' - COVID-19 was not the only trauma; (5) 'silver linings' during postpartum care. CONCLUSIONS This review provides important insights into how experiences of isolation, decreased social support and adaptions to maternity services affect women's mental health. Maternity services should consider how perinatal mental health support may be integrated into the care of women who may still be required to isolate or have reduced visitors during their perinatal care. STATEMENT OF SIGNIFICANCE The restrictions and disruptions to maternity care due to the COVID-19 pandemic were likely to impact the mental health of women in the perinatal period (pregnancy, birth and postpartum). What is already known is that public health measures due to COVID-19 increased the prevalence of common perinatal mental disorders (CPMDs) and exacerbated common risk factors for CPMDs (i.e., poor social support). WHAT THIS PAPER ADDS The qualitative research with women in the perinatal period during the pandemic provides unique insights into how these events impacted perinatal mental and emotional health. In particular, the ways that global physical distancing measures and maternity care adaptations contributed to women's feelings of distress, isolation, and depression/despair. Silver linings such as more uninterrupted time with immediate family were also identified.
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Affiliation(s)
- Ying Jin
- School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
| | - Linda Murray
- School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
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13
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Dudeney E, Coates R, Ayers S, McCabe R. Measures of suicidality in perinatal women: A systematic review. J Affect Disord 2023; 324:210-231. [PMID: 36584713 DOI: 10.1016/j.jad.2022.12.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Suicide is a leading cause of death for perinatal women. Identifying women at risk of suicide is critical. Research on the validity and/or reliability of measures assessing suicidality in perinatal women is limited. This review sought to: (1) identify; and (2) evaluate the psychometric properties of suicidality measures validated in perinatal populations. METHODS Nine electronic databases were systematically searched from inception to January 2022. Additional articles were identified through citation tracking. Study quality was assessed using an adapted tool, and the psychometric properties of measures were reviewed and presented using a narrative synthesis. RESULTS A total of 208 studies were included. Thirty-five studies reported psychometric data on ten suicidality measures. Fifteen studies reported both validity and reliability data, 12 reported more than one type of validity, seven validated more than one measure and four only reported reliability. Nearly all measures primarily screened for depression, with an item or subscale assessing suicidal ideation and/or behaviours. Three measures were specifically developed for perinatal women, but only two were validated in more than one study. The Postpartum Depression Screening Scale (PDSS), suicidal thoughts subscale, was validated most frequently. LIMITATIONS Methodological differences and variability between the measures (e.g., suicidality construct assessed, number of items and administration) precluded direct comparisons. CONCLUSION Further validation of suicidality measures is needed in perinatal women. Screening for perinatal suicidality often occurs in the context of depression. The development of a standalone measure specifically assessing suicidality in perinatal women may be warranted, particularly for use in maternity care settings.
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Affiliation(s)
- Elizabeth Dudeney
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK.
| | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Rose McCabe
- Centre for Mental Health Research, School of Health and Psychological Sciences, University of London, UK
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14
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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15
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Manaka M, Sasano N, Chikazawa S, Sasaki A. Review of the Depression Rate among Pregnant Women during the COVID-19 Pandemic. Health (London) 2023. [DOI: 10.4236/health.2023.151003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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16
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Wu Y, Ye R, Wang Q, Sun C, Ji Y, Zhou H, Chang W. Association of COVID-19 Lockdown during the Perinatal Period with Postpartum Depression: Evidence from Rural Areas of Western China. HEALTH COMMUNICATION 2022; 37:1488-1495. [PMID: 35172658 DOI: 10.1080/10410236.2022.2036425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 lockdown has posed unique challenges to postpartum women, but its association with postpartum depression is not well understood in the Global South. This study aims to evaluate the association between COVID-19 lockdown and postpartum depression in rural areas of western China. A multi-stage random cluster sampling method was used to select a cohort of pregnant and postpartum women with infants aged 0-6 months. We conducted an in-person survey before the COVID-19 lockdown and a phone survey right after the lockdown ended. We used multivariate regression models to evaluate the association between lockdown and postpartum depression. Subgroup analysis was performed to explore the role of social support. The overall prevalence of postpartum depression was 13.3%. Postpartum women who experienced the lockdown were less likely to be depressed than those who did not (adjusted odds ratio (aOR) = .43, 95% confidence interval (CI) = [.27, .70]). Lockdown was negatively associated with postpartum depression among postpartum women with low level of social support (aOR = .30, 95% CI = [.18, .51]). COVID-19 lockdown was associated with lower likelihood of postpartum depression, potentially due to increased support from family. Future research is needed to explore targeted interventions to prevent postpartum depression among women from migrant worker families in rural China.
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Affiliation(s)
- Yuju Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Ruixue Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Qinagzhi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Chang Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Yadong Ji
- Communication Studies, North Central College
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Wei Chang
- Harvard Chan School of Public Health, Harvard University
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17
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Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1405-1421. [PMID: 35912813 DOI: 10.1177/10547738221112748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.
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18
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Zhang J, Yuan H, Xu L, Yi C, Tang W. The impact of COVID-19 on the mental health of pregnant women in Shanghai, China. Front Public Health 2022; 10:938156. [PMID: 36276386 PMCID: PMC9583156 DOI: 10.3389/fpubh.2022.938156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/14/2022] [Indexed: 01/25/2023] Open
Abstract
Background COVID-19 has dramatically impacted people's health, especially mental health. This study aimed to compare the psychological status of pregnant women before and after the COVID-19 outbreak. Methods Participants were recruited (from September 29, 2019, to November 5, 2020) and screened by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7). The study participants were categorized into three groups based on two turning-points: January 23, 2020, when China initiated a locked-down strategy, and May 11, 2020, when Shanghai started to ease the COVID-19 measures. Multivariable logistic regression was used to determine the factors associated with depression and anxiety in pregnant women. We used enter method for variable selection; only variables with P <0.10 were included in the final model. Results We recruited 478 pregnant women. After the outbreak, the depression rate (PHQ-9 ≥ 5) increased by 12.3% (from 35.4 to 47.7%), and the anxiety rate (GAD-7 ≥ 5) was stable (13.3 vs. 16.2%). The multivariable logistic regression results further confirmed that the odds of depression in pregnant women increased 81% after the outbreak (aOR = 1.81, 95%CI: 1.16-2.84). However, the median depression scale score was still statistically higher after the pandemic situation was stable (5.0 vs. 4.0) compared to the outbreak period. Conclusion The depression rate increased among pregnant women after the outbreak and was not recovered after the ease of COVID-19 measures in Shanghai. Health institutes should pay attention to the long-term influence of the pandemic.
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Affiliation(s)
- Jiali Zhang
- Fenglin Community Health Service Center, Shanghai, China
| | - Hualong Yuan
- Fenglin Community Health Service Center, Shanghai, China
| | - Liping Xu
- Fenglin Community Health Service Center, Shanghai, China
| | - Chuntao Yi
- Fenglin Community Health Service Center, Shanghai, China
| | - Weiming Tang
- Guangdong No. 2 Provincial People's Hospital, Guangzhou, China,The University of North Carolina at Chapel Hill Project-China, Guangzhou, China,*Correspondence: Weiming Tang
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Ahmed M, Amin F, Taj A, Durrani N. Antenatal anxiety and depression: Frequency and correlates during the COVID-19 pandemic in Pakistan. J Family Med Prim Care 2022; 11:6407-6415. [PMID: 36618208 PMCID: PMC9810941 DOI: 10.4103/jfmpc.jfmpc_911_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Context Mental health ailments like anxiety and depression are common during the antenatal period. Uncertainty during COVID-19 pandemic has markedly increased its prevalence in the general population. Pregnancy, being emotionally and physically exhausting, makes mothers more susceptible to developing mental disorders like anxiety and depression. Aims To investigate prevalence and associated risk factors of antenatal anxiety and depression among women in Karachi, Pakistan. Settings and Design This cross-sectional study was conducted in the department of obstetrics and gynecology during May 2020 till May 2021. Methods and Material The study explored anxiety, depression, and associated factors in pregnant women attending antenatal clinics at a tertiary care hospital located in Karachi, Pakistan, during the COVID-19 pandemic by using the hospital anxiety and depression scale (HADS) as a screening tool. Statistical Analysis Data was entered in SPSS version 21 for statistical analysis. Results A total of 390 patients were enrolled in the study with mean age of 28.06 ± 4.52 years. Mean week of pregnancy at the time of enrolment into the study was 32.7 ± 3.1. Prevalence of anxiety and depression was 46.7% and 33.1%, respectively. On multivariable analysis, polyhydramnios was a risk factor of anxiety, whereas low income and unplanned pregnancy were substantially linked to depression. Fear of visiting doctor was a common risk factor for both anxiety and depression. Conclusion In a catastrophe like the COVID-19 pandemic, attempts to address heightened anxiety during antenatal visits will undoubtedly benefit maternal and fetal mental health. As a response, strategies to manage high anxiety symptoms should be taken into consideration.
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Affiliation(s)
- Marium Ahmed
- Department of Family Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan,Address for correspondence: Dr. Marium Ahmed, Department of Family Medicine, Liaquat National Hospital, Stadium Road, Karachi, Pakistan. E-mail:
| | - Faridah Amin
- Department of Community Health Department, The Indus Hospital Network, Karachi, Pakistan
| | - Aisha Taj
- Department of Obstetrics and Gynecology, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Noureen Durrani
- Department of Publication, Liaquat National Hospital and Medical College, Karachi, Pakistan
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20
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Hu M, Conway M. Perspectives of the COVID-19 Pandemic on Reddit: Comparative Natural Language Processing Study of the United States, the United Kingdom, Canada, and Australia. JMIR INFODEMIOLOGY 2022; 2:e36941. [PMID: 36196144 PMCID: PMC9521381 DOI: 10.2196/36941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/13/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022]
Abstract
Background
Since COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020, the disease has had an unprecedented impact worldwide. Social media such as Reddit can serve as a resource for enhancing situational awareness, particularly regarding monitoring public attitudes and behavior during the crisis. Insights gained can then be utilized to better understand public attitudes and behaviors during the COVID-19 crisis, and to support communication and health-promotion messaging.
Objective
The aim of this study was to compare public attitudes toward the 2020-2021 COVID-19 pandemic across four predominantly English-speaking countries (the United States, the United Kingdom, Canada, and Australia) using data derived from the social media platform Reddit.
Methods
We utilized a topic modeling natural language processing method (more specifically latent Dirichlet allocation). Topic modeling is a popular unsupervised learning technique that can be used to automatically infer topics (ie, semantically related categories) from a large corpus of text. We derived our data from six country-specific, COVID-19–related subreddits (r/CoronavirusAustralia, r/CoronavirusDownunder, r/CoronavirusCanada, r/CanadaCoronavirus, r/CoronavirusUK, and r/coronavirusus). We used topic modeling methods to investigate and compare topics of concern for each country.
Results
Our consolidated Reddit data set consisted of 84,229 initiating posts and 1,094,853 associated comments collected between February and November 2020 for the United States, the United Kingdom, Canada, and Australia. The volume of posting in COVID-19–related subreddits declined consistently across all four countries during the study period (February 2020 to November 2020). During lockdown events, the volume of posts peaked. The UK and Australian subreddits contained much more evidence-based policy discussion than the US or Canadian subreddits.
Conclusions
This study provides evidence to support the contention that there are key differences between salient topics discussed across the four countries on the Reddit platform. Further, our approach indicates that Reddit data have the potential to provide insights not readily apparent in survey-based approaches.
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Affiliation(s)
- Mengke Hu
- Department of Biomedical Informatics University of Utah Salt Lake City, UT United States
| | - Mike Conway
- Department of Biomedical Informatics University of Utah Salt Lake City, UT United States
- School of Computing & Information Systems University of Melbourne Carlton Australia
- Centre for Digital Transformation of Health University of Melbourne Carlton Australia
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21
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Cantisano LM, Gonzalez-Soltero R, Blanco-Fernández A, Belando-Pedreño N. ePSICONUT: An e-Health Programme to Improve Emotional Health and Lifestyle in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159253. [PMID: 35954601 PMCID: PMC9368425 DOI: 10.3390/ijerph19159253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022]
Abstract
The use of information and communication technologies in the health field is known as eHealth. Nowadays, the application of technological and digital tools for maintaining/improving physical and mental health is experiencing an exponential boom. These tools have been perceived as a powerful support for face-to-face therapies and lifestyle changes. Nevertheless, there is not enough scientific research that analyses the impact and consequences of eHealth interventions. More studies are needed to validate its application. Therefore, the aim of this study was to evaluate the impact of eHealth tools in a programme called ePSICONUT. This programme was created to promote healthy lifestyle habits in university students. The sample consisted of 16 university students from the Dominican Republic aged 18−24 years (x¯ = 20.69; s = 1.74). ePSICONUT was developed in 12 weeks and its impact was analyzed by comparing the initial and the final psychological and lifestyle tests results, which were completed online by the participants. Results reported that the professionally supervised use of eHealth tools was associated with better psychological well-being, lees anxiety and depression, and better lifestyle habits (such as diet quality), even in stressful and changing situations such as the COVID-19 pandemic circumstances. However, more studies are needed to validate and promote the use of eHealth-based intervention programmes.
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Affiliation(s)
- Luisa Marilia Cantisano
- School of Psychology, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santiago De Los Caballeros 51000, Dominican Republic;
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Rocio Gonzalez-Soltero
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Correspondence: (R.G.-S.); (N.B.-P.)
| | - Ascensión Blanco-Fernández
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Noelia Belando-Pedreño
- Faculty of Sports Sciences, Department of Physical Activity and Sport, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Correspondence: (R.G.-S.); (N.B.-P.)
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22
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Depression in pregnant and postpartum women during COVID-19 pandemic: systematic review and meta-analysis. Obstet Gynecol Sci 2022; 65:287-302. [PMID: 35754363 PMCID: PMC9304439 DOI: 10.5468/ogs.21265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) emerged as a global pandemic in March 2020 and caused a big crisis, especially the health crisis. Pregnant and postpartum women experienced significant physical, social, and mental changes that put them at higher risk for several conditions during the pandemic. This study aimed to report the prevalence of depression in pregnant and postpartum women during the COVID-19 pandemic. Eligible studies were identified using several databases. Prevalence analysis was conducted using MedCalc ver. 19.5.1. This systematic review and meta-analysis was registered in PROSPERO on July 12, 2021 with registration number CRD42021266976. We included 54 studies with 95.326 participants. The overall prevalence of depression was 32.60% among pregnant and postpartum women during the COVID-19 pandemic. The rate was higher among pregnant women (31.49%) compared to postpartum women (27.64%). The prevalence of depression among pregnant and postpartum women increased during the COVID-19 pandemic.
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23
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Hao C, Jin F, Hao C, Zhang X, Xie L, Zhang Y, Liu X, Ni X, Li W. Evaluation of the Effects on Uninfected Pregnant Women and Their Pregnancy Outcomes During the COVID-19 Pandemic in Beijing, China. Front Med (Lausanne) 2022; 9:842826. [PMID: 35646987 PMCID: PMC9131041 DOI: 10.3389/fmed.2022.842826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background People's lifestyles may have changed during the COVID-19 pandemic, which may have a profound impact on pregnant women and newborns. This study aims to assess the effects of the COVID-19 pandemic on uninfected pregnant women and their newborns, including potential environmental factors. Methods We retrospectively analyzed the pregnancy complications of 802 cases in the pandemic group and 802 controls in the pre-pandemic group in a matched nested case-control study, and evaluated the association with sociodemographic features, lifestyles, and other factors in 311 pregnant women with adverse pregnancy outcomes. Results Compared to the pre-pandemic group, the rates of anemia, vaginitis, shoulder dystocia, and adverse pregnancy outcomes such as preterm birth were increased in the pandemic group. After controlling for the covariates, we observed a higher risk of adverse pregnancy outcomes in the pandemic group. Pregnant women with adverse pregnancy outcomes had an increased rate of anemia and vaginal candidiasis. Conclusion COVID-19 pandemic has profound effects on adverse pregnancy outcomes, suggesting the importance of ensuring regular prenatal checkups and keeping a healthy lifestyle.
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Affiliation(s)
- Chongyi Hao
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.,MOE Key Laboratory of Major Diseases in Children, Beijing, China.,Rare Disease Center, National Center for Children's Health, Beijing, China.,Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Feng Jin
- Shunyi Women's and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Chanjuan Hao
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.,MOE Key Laboratory of Major Diseases in Children, Beijing, China.,Rare Disease Center, National Center for Children's Health, Beijing, China.,Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaofen Zhang
- Shunyi Women's and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Limin Xie
- Shunyi Women's and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Yawei Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuanshi Liu
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.,MOE Key Laboratory of Major Diseases in Children, Beijing, China.,Rare Disease Center, National Center for Children's Health, Beijing, China.,Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xin Ni
- Beijing Children's Hospital, Capital Medical University, Beijing, China.,Shunyi Women's and Children's Hospital of Beijing Children's Hospital, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Wei Li
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.,MOE Key Laboratory of Major Diseases in Children, Beijing, China.,Rare Disease Center, National Center for Children's Health, Beijing, China.,Beijing Children's Hospital, Capital Medical University, Beijing, China
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24
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Kuipers YJ, Bleijenbergh R, Van den Branden L, van Gils Y, Rimaux S, Brosens C, Claerbout A, Mestdagh E. Psychological health of pregnant and postpartum women before and during the COVID-19 Pandemic. PLoS One 2022; 17:e0267042. [PMID: 35421171 PMCID: PMC9009654 DOI: 10.1371/journal.pone.0267042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 01/02/2023] Open
Abstract
Background The COVID-19 pandemic is likely to influence psychological health of pregnant and postpartum women. Methods We conducted a non-concurrent cross-sectional study among 1145 women living in the Dutch-speaking part of Belgium, 541 pregnant and 604 postpartum women. We measured psychological health with the Whooley questions, Generalized Anxiety Disorder 2-item (GAD-2) and the Edinburgh Postnatal Depression Scale (EPDS) and compared the scores of pregnant and postpartum women before and during the COVID-19 pandemic. Results No differences were observed in the Whooley, GAD-2 or EPDS scores among pregnant women. The postpartum total GAD-2 scores before vs during the pandemic showed significant differences. Controlling for confounders, we observed a small main positive effect of having an infant during time of COVID-19 (F(1.13) = 5.06, p.025, d.27). The effect was significantly larger for women with (a history of) perinatal psychological problems (F(1.12) = 51.44, p < .001, d.82). Emotional support was significantly related to GAD-2 scores of postpartum women during the pandemic (F(1.90) = 35.54, p < .001). Postpartum women reported significant higher effects of the pandemic on their behavior compared to pregnant women (p.034). Conclusion The COVID-19 pandemic seems to have a positive effect on postpartum women during the first year postpartum, in particular for women with (a history of) perinatal psychological problems and for those women who experienced emotional support. The findings suggest that less external stimuli caused by lockdown restrictions might have a positive effect on postpartum women’s emotional wellbeing. The sample consisted of white, educated women in a relationship and information regarding the extent of exposure to adverse COVID-19 consequences was lacking. We relied on self-selection and self-report. The postpartum pandemic sample was small.
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Affiliation(s)
- Yvonne J. Kuipers
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland
- * E-mail:
| | - Roxanne Bleijenbergh
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Laura Van den Branden
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Yannic van Gils
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Sophie Rimaux
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Charlotte Brosens
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Astrid Claerbout
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
| | - Eveline Mestdagh
- Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
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25
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Musiimenta A, Tumuhimbise W, Atukunda EC, Ayebaza S, Kobutungi P, Mugaba AT, Asasira J, Mugyenyi GR, Katusiime J, Zender R, Pinkwart N, Haberer JE. Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies. Digit Health 2022; 8:20552076221086769. [PMID: 35401999 PMCID: PMC8984853 DOI: 10.1177/20552076221086769] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/09/2021] [Accepted: 02/16/2022] [Indexed: 01/29/2023] Open
Abstract
Background The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time. Objectives This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis. Methods We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants' characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges. Results Among 50 women, the median age was 28 years (interquartile range 24-34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support. Conclusion SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.
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Affiliation(s)
- Angella Musiimenta
- Mbarara University of Science and
Technology, Uganda,Angels Compassion Organization, Uganda,Angella Musiimenta, Department of
Information Technology, Mbarara University of Science and Technology, P.O. Box
653, Mbarara, Uganda.
| | | | | | | | | | - Aaron T Mugaba
- Mbarara University of Science and
Technology, Uganda,Angels Compassion Organization, Uganda
| | | | | | | | | | | | - Jessica E Haberer
- Harvard Medical School, USA,Massachusetts General
Hospital Center for Global Health, USA
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26
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Giner L, Vera-Varela C, de la Vega D, Zelada GM, Guija JA. Suicidal Behavior in the First Wave of the COVID-19 Pandemic. Curr Psychiatry Rep 2022; 24:1-10. [PMID: 35080711 PMCID: PMC8790944 DOI: 10.1007/s11920-022-01312-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Since the declaration of the COVID-19 pandemic, there have been numerous social changes to try to contain the spread of the disease. These sudden changes in daily life have also changed the way we relate to others, in addition to creating a climate of uncertainty and fear. Therefore, the objective of this review is to compile published data of the consequences of suicidal behavior in the first months from the onset of the pandemic. RECENT FINDINGS The analysis reflects a concern about issues related to suicide since the beginning of the pandemic. A large number of online surveys have been released and have provided data on relatively large populations. The percentage of the population with suicidal ideation in that period seems to be approximately 5-15%. Many studies associate suicidal ideation with being young, female, and presence of sleep problems. Surveys of healthcare workers do not seem to indicate a higher prevalence of suicidal ideation compared to the general population. The incidence of suicide attempts seen in emergency departments did not seem to change, while the number of visits for other issues, unrelated to suicide, did decrease. The few studies on completed suicide do not indicate an increase in incidence in these first 6 months since March 2020, when the WHO declared the start of the pandemic. It does not seem that there have been major changes in the figures related to suicidal behavior in the studies from the first wave of the COVID-19 pandemic, although it is still too early to know the consequences it will have long term. The social and economic damages resulting from the pandemic will certainly take a long time to recover.
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Affiliation(s)
- Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain.
| | | | - Diego de la Vega
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain ,Unidad de Hospitalización de Salud Mental. Unidad de Gestión Clínica de Salud Mental del Hospital Virgen Macarena. Servicio Andaluz de Salud, Seville, Spain
| | - Giovani M. Zelada
- Internal Medicine/Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Julio A. Guija
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain ,Instituto de Medicina Legal Y Ciencias Forenses de Sevilla, Seville, Spain
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27
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Krampe H, Danbolt LJ, Haver A, Stålsett G, Schnell T. Locus of control moderates the association of COVID-19 stress and general mental distress: results of a Norwegian and a German-speaking cross-sectional survey. BMC Psychiatry 2021; 21:437. [PMID: 34488667 PMCID: PMC8419811 DOI: 10.1186/s12888-021-03418-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An internal locus of control (LoC I) refers to the belief that the outcome of events in one's life is contingent upon one's actions, whereas an external locus of control (LoC E) describes the belief that chance and powerful others control one's life. This study investigated whether LoC I and LoC E moderated the relationship between COVID-19 stress and general mental distress in the general population during the early months of the COVID-19 pandemic. METHODS This cross-sectional survey study analysed data from a Norwegian (n = 1225) and a German-speaking sample (n = 1527). We measured LoC with the Locus of Control-4 Scale (IE-4), COVID-19 stress with a scale developed for this purpose, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. RESULTS The association between COVID-19 stress and general mental distress was strong (r = .61 and r = .55 for the Norwegian and the German-speaking sample, respectively). In both samples, LoC showed substantial moderation effects. LoC I served as a buffer (p < .001), and LoC E exacerbated (p < .001) the relation between COVID-19 stress and general mental distress. CONCLUSIONS The data suggest that the COVID-19 pandemic is easier to bear for people who, despite pandemic-related strains, feel that they generally have influence over their own lives. An external locus of control, conversely, is associated with symptoms of depression and anxiety. The prevention of mental distress may be supported by enabling a sense of control through citizen participation in policy decisions and transparent explanation in their implementation.
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Affiliation(s)
- Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lars Johan Danbolt
- Practical Theology, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Centre for Psychology of Religion, Innlandet Hospital Trust, Ottestad, Norway
| | - Annie Haver
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
- Faculty of Social Sciences, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Gry Stålsett
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Modum Bad Psychiatric Center, Vikersund, Norway
| | - Tatjana Schnell
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway.
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
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28
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Xu K, Zhang Y, Zhang Y, Xu Q, Lv L, Zhang J. Mental health among pregnant women under public health interventions during COVID-19 outbreak in Wuhan, China. Psychiatry Res 2021; 301:113977. [PMID: 34020217 PMCID: PMC8088032 DOI: 10.1016/j.psychres.2021.113977] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 04/25/2021] [Indexed: 12/21/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has become a pandemic. As the first city struck by the COVID-19 outbreak, Wuhan had implemented unprecedented public health interventions. The mental health of pregnant women during these anti-epidemic controls remains unknown. A total of 274 pregnant women living in Wuhan during the COVID-19 outbreak took part in our investigation online. The data on mental health conditions were evaluated using Edinburgh Postnatal Depression Scale (EPDS), Self-Rating Anxiety Scale (SAS), Chinese Perceived Stress Scale (CPSS), and Pittsburgh Sleep Quality Index (PSQI). We also collected the information on physical health status and precautionary measures against COVID-19. The prevalence of depression, anxiety, stress, and poor sleep quality was 16.1%, 13.9%, 42.7%, 37.6%, respectively. Comparing to SAS, PSQI score in pregnant women who participated in the survey after April 8 (date of Wuhan reopening), those data collected before April 8 were significantly higher. High levels of stress, severe health concerns over the fetus, and poor hygienic practices were negatively associated with mental health conditions. In conclusion, a large proportion of pregnant women reported psychological symptoms during the epidemic, which negatively related to the severe health concerns over fetus and poor hygienic practices. More psychological support during the epidemic would promote maternal mental well-being.
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Affiliation(s)
- Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Ya Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Qiao Xu
- Maternal and Child Health Hospital of Jianghan District, 50 Machangjiao Rd, Wuhan, Hubei, China
| | - Lan Lv
- Maternal and Child Health Hospital of Jianghan District, 50 Machangjiao Rd, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China.
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29
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Esteban-Gonzalo S, Caballero-Galilea M, González-Pascual JL, Álvaro-Navidad M, Esteban-Gonzalo L. Anxiety and Worries among Pregnant Women during the COVID-19 Pandemic: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6875. [PMID: 34206849 PMCID: PMC8297358 DOI: 10.3390/ijerph18136875] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 01/19/2023]
Abstract
Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.
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Affiliation(s)
- Sara Esteban-Gonzalo
- Psychology Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - María Caballero-Galilea
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
| | - Juan Luis González-Pascual
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
| | - Miguel Álvaro-Navidad
- Obstetrics and Gynecology Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Obstetrics and Gynecology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Laura Esteban-Gonzalo
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Iyengar U, Jaiprakash B, Haitsuka H, Kim S. One Year Into the Pandemic: A Systematic Review of Perinatal Mental Health Outcomes During COVID-19. Front Psychiatry 2021; 12:674194. [PMID: 34248710 PMCID: PMC8264436 DOI: 10.3389/fpsyt.2021.674194] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
Obstetric guidelines have rapidly evolved to incorporate new data and research on the novel coronavirus disease (COVID-19), with data on perinatal mental health building over the last year. Our aim in the present manuscript is to provide a systematic review of mental health outcomes in pregnant and postpartum women during the COVID-19 pandemic in the context of neonatal and obstetric guidelines addressing symptoms and complications of COVID-19 during pregnancy, mother-to-neonate transmission, Cesarean-section delivery, neonatal prematurity, maternal/neonate mortalities, maternal-neonatal separation, and breastfeeding. We summarize data from 81 mental health studies of pregnant and postpartum women and underscore protective and risk factors identified for perinatal mental health outcomes amidst the COVID-19 pandemic. Data reviewed here suggest increased psychological symptoms, especially depressive and anxiety symptoms, in pregnant and postpartum women during COVID-19. Our systematic review integrates the most current obstetric and neonate guidelines, along with perinatal mental health outcomes associated with COVID-19, highlighting the best available data for the care of women and their neonates amidst the current COVID-19 pandemic.
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Affiliation(s)
- Udita Iyengar
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), London, United Kingdom
| | - Bhavisha Jaiprakash
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), London, United Kingdom
| | - Hanako Haitsuka
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Sohye Kim
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, United States
- Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States
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Zhang L, Zhu S, Yao H, Li M, Si G, Tan X. Study on Factors of People's Wearing Masks Based on Two Online Surveys: Cross-Sectional Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3447. [PMID: 33810355 PMCID: PMC8036546 DOI: 10.3390/ijerph18073447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 12/15/2022]
Abstract
(1) Background: To analyze factors of people's wearing masks based on two online surveys, and to explore whether living area factor or quarantine status could have an impact on mask-wearing. (2) Methods: Chi-square test and logistic regression analysis were used to explore the influence of different factors on people's behavior of mask-wearing in the present study. R3.6.2 was used for data cleaning, SPSS 26.0 was used to conduct corresponding statistical analysis, and a two-sided p-value less than 0.05 was considered to be statistically significant. (3) Results: According to our study, the proportion of participants who wore face masks was higher than 90.0% in both surveys. Single factor analysis showed that the proportion of people wearing face masks raised with the increase of people's education, age, and monthly income (Yuan) in both surveys. People who lived in rural areas were less likely to wear masks. Mask-wearing rate was lower in the isolated individuals than in the non-isolated ones. (4) Conclusions: Masks-wearing is one of the effective measures for COVID-19 pandemic prevention and control. After the Chinese government made wearing face masks mandatory in public places, most residents in China had developed the habit of wearing masks, contributing to the high rate of masks-wearing in China. However, people in rural areas need to raise their awareness of wearing masks. Meanwhile, the mask-wearing of the isolated individuals needs to be enhanced.
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Affiliation(s)
| | | | | | | | | | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan 430071, China; (L.Z.); (S.Z.); (H.Y.); (M.L.); (G.S.)
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Wang H, Liang L, Du C, Wu Y. Implementation of Online Hospitals and Factors Influencing the Adoption of Mobile Medical Services in China: Cross-Sectional Survey Study. JMIR Mhealth Uhealth 2021; 9:e25960. [PMID: 33444155 PMCID: PMC7869921 DOI: 10.2196/25960] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/27/2020] [Accepted: 01/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background Online hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection. Objective In this study, we built a hypothesis model based on the Unified Theory of Acceptance and Use of Technology (UTAUT) in order to analyze the factors that may influence patients’ willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed. Methods A cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors. Results Out of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (P=.048) and education level (P=.04) affected people’s willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients’ willingness to use online hospitals. Conclusions The goal of our research was to determine the factors that influence patients’ awareness and willingness to use online hospitals. Currently, the public’s awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.
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Affiliation(s)
- Huanlin Wang
- West China Hospital, Sichuan University, Sichuan, China
| | - LanYu Liang
- West China Hospital, Sichuan University, Sichuan, China
| | - ChunLin Du
- West China Hospital, Sichuan University, Sichuan, China
| | - YongKang Wu
- West China Hospital, Sichuan University, Sichuan, China
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