Psychological Toll of the COVID-19 Pandemic: An In-Depth Exploration of Anxiety, Depression, and Insomnia and the Influence of Quarantine Measures on Daily Life

Representative national survey on drug use during the COVID-19 stay-at-home order in the USA

OBJECTIVES

This study explores the drug use behaviour in the US general population in the early days of the COVID-19 pandemic with a focus on the relationship between sociopsychological factors, mobility restrictions from March to June 2020 and mental health conditions.

DESIGN

A retrospective anonymous online survey representing a cross-section of the US population in 2020.

SETTING

A qualified panel of 500 000 Qualtrics participants stratified by gender, race, age and geographical region to represent the US population.

PARTICIPANTS

3340 participants voluntarily consented to respond.

MEASURES

Outcome measure for illicit and non-medical use of prescription drugs based on the National Institute on Drug Abuse-Modified Alcohol, Smoking and Substance Involvement Screening Test Level-2 Substance Use for Adult Questionnaire and predictor measures include self-reports of mobility behaviours, demographics and mental states using psychometrically validated scales.

RESULTS

χ2 tests showed that those who stayed home reported higher odds (p<0.05) of use across all 10 types of drugs. Logistic regression revealed that those with children at home, larger social circles, and pain, depression or trauma had higher odds, but older individuals and women had lower odds (p<0.05) of drug use.

CONCLUSIONS

Mobility restriction was a risk factor for drug use. Demographics and mental health conditions were important covariates, underscoring the need for further research on unintended consequences of infection control policies during national health crises.

Predicting sleep quality among college students during COVID-19 lockdown using a LASSO-based neural network model

BACKGROUND

In March 2022, a new outbreak of COVID-19 emerged in Quanzhou, leading to the implementation of strict lockdown management measures in colleges. While existing research has indicated that the pandemic has had a significant impact on sleep quality, the specific effects of containment measures on college students' sleep patterns remain understudied.

OBJECTIVE

This study aimed to understand the sleep quality of college students in Fujian Province during the epidemic and determine sensitive variables, in order to develop an efficient prediction model for the early screening of sleep problems in college students.

METHODS

A cross-sectional survey was conducted April 5-16, 2022 to survey college students in Quanzhou. A total of 4959 college students in Quanzhou were enrolled in this study. Descriptive analysis, univariate analysis, correlation analysis, and multiple regression analysis were used to explore the influencing factors regarding sleep quality. In addition, we constructed eight sleep quality risk prediction models to predict sleep quality.

RESULTS

A mean PSQI total score of 6.03 ± 3.21 and a sleep disorder rate of 29.4% (PSQI > 7) were obtained. Sleep quality, sleep latency, sleep efficiency, diurnal dysfunction, and PSQI score were all higher than the national norm (P < 0.05). A total of eight significant predictors finally identified by the LASSO algorithm was incorporated into prediction models. Through a series of assessments, we identified the artificial neural network model as the best model, achieving an area under curve of 73.8% an accuracy of 67.3%, a precision of 84.0%, a recall of 66.3%, and an F1 score of 69.3%. These performance indices suggest that the ANN model outperforms other models. It is noteworthy that the threshold probabilities for net benefit were found to be between 0.81 and 0.92 and the clinical impact curve confirmed that the models' predictions were particularly effective in identifying individuals with poor sleep quality when the threshold probability was set above 70%. These findings underscore the potential clinical utility of our models for the early detection of sleep disorders.

CONCLUSIONS

In Quanzhou, under COVID-19 quarantine management, the sleep quality of college students was affected to a certain extent, and their PSQI scores were higher than the national average in China. The artificial neural network model had the best performance, and it is expected to be used to provide early interventions to prevent sleep disorders.

Post-Traumatic Stress Disorder (PTSD) Among Algerian Cancer Patients: Validity of the Arabic DSM-5 PTSD Checklist (PCL-5) and Associated Factors

BACKGROUND

Cancer patients are at risk of post-traumatic stress disorder (PTSD) throughout their treatment journey due to serious challenges (e.g., complex surgical interventions, severe pain, and side effects from chemotherapy or radiation therapy). This may worsen patients' health and negatively impact their overall treatment journey and well-being. However, this area remains understudied in Algeria. Therefore, there is a need to understand the levels of PTSD symptoms and the associated factors among Algerian patients. To ensure accurate assessment and diagnosis, a validation study was conducted to confirm that the PTSD measurement instrument used was culturally appropriate for the Algerian context. The study's main objectives were to (i) determine the prevalence of PTSD among cancer patients in Algeria, (ii) validate the Arabic DSM-5 PTSD Checklist (PCL-5) among Algerian cancer patients, and (iii) explore the associations between demographic and clinical factors and PTSD among this population.

METHODS

The present study was cross-sectional and comprised 370 cancer patients. All participants were patients receiving treatment in oncology wards across various hospitals. All participants completed the PCL-5. Confirmatory factor analysis (CFA) was used to examine the factor structure of the PCL-5.

RESULTS

The PCL-5 was found to have a four-factor structure. Out of the 370 participants, 154 (41.6%) had PCL-5 scores below the cutoff of 31, indicating lower levels of PTSD symptoms; 216 participants (58.4%) had scores above this threshold, suggesting a likelihood of PTSD. Moreover, PTSD was significantly associated with patients' low educational attainment and more advanced stages of their disease.

CONCLUSIONS

The findings indicated moderate to high PTSD symptoms among cancer patients in Algeria. Moreover, the Arabic PCL-5 demonstrated good psychometric properties confirming that it is a reliable and valid tool for assessing PTSD symptoms among Algerian cancer patients.

Prevalence and correlates of severe anxiety among front-line nurses during and after the COVID-19 pandemic: a large-scale multi-center study

BACKGROUND

Nurses have been at the forefront of the battle against the COVID-19 pandemic, facing extended work hours and heightened stress, predisposing them to psychological distress. This study aims to investigate the prevalence and correlates of severe anxiety among frontline nurses in China during and after the COVID-19 pandemic.

METHODS

A large-scale multi-center survey was conducted from November to December 2022 and from April to July 2023. Data were collected using online surveys, covering demographic characteristics, job-related factors, anxiety, depression, and sleep disorders. Statistical analyses, including chi-square tests, t-tests, and logistic regression, were performed to assess the incidence and factors influencing severe anxiety.

RESULTS

The study included 816 nurses during the pandemic and 763 nurses after the pandemic. The prevalence of severe anxiety during the pandemic (52.3%) was significantly higher than after the pandemic (8.0%). Factors such as nursing title, night shift frequency, educational level, exercise frequency, COVID-19 infection status, economic pressure, and work pressure showed significant differences between the two periods. Binary logistic regression revealed associations between severe anxiety and factors such as night shift frequency, COVID-19 infection status, nursing title, depression, and sleep disorders. Receiver Operating Characteristic analysis demonstrated good predictive value for severe anxiety.

CONCLUSION

The study underscores the importance of understanding and addressing severe anxiety among frontline nurses during and after the COVID-19 pandemic. Future research should delve into long-term psychological effects and implement effective intervention measures to support nurses' mental health.

Associations between fear of COVID-19 and mental health in Ghana: A sequential mediation model

Introduction

Although the coronavirus disease 2019 (COVID-19) pandemic has ceased globally, individuals may still suffer from various psychological burdens in the post-COVID-19 era. The present observational cross-sectional study investigated how fear of COVID-19 can affect mental health through mediators including stress, perceived stigma, and preventive behaviors among young adults in Ghana.

Methods

A total of 635 participants aged between 18 and 29 years (mean age = 20.2 years [SD = 2.04]) were recruited to complete measures of COVID-19 fear, stress, perceived stigma, preventive behaviors, and mental health status from June to August 2022.

Results

Results from structural equation modeling found that (i) fear of COVID-19 was associated with stress and perceived stigma (standardized coefficients [βs] = 0.518 and 0.148, p-values < 0.001), (ii) stress and perceived stigma were associated with frequency of preventive behaviors (β = 0.173, p < 0.001 for stress; -0.100, p < 0.05 for perceived stigma), and (iii) preventive behaviors were associated with mental health status (β = 0.118, p < 0.01). Stress and preventive behavior (β = 0.009, 95%CI: 0.000, 0.003) and perceived stigma and preventive behavior (β = -0.007, 95%CI: -0.283, -0.020) were significant mediators in the association between fear of COVID-19 and mental health.

Discussion

The findings suggest that fear of COVID-19 may affect mental health through multiple pathways. Health professionals should provide comprehensive mental health interventions that address various influences regarding fear of COVID-19. Further research that examines the relationships between COVID-19-related variables and various health conditions is needed in the post-COVID-19 era to help develop different preventive and therapy measures.

Factors influencing sleep quality in healthcare workers: The mediating role of depression and anxiety symptoms

BACKGROUND

Numerous research has investigated the impact of depression and anxiety symptoms, occupational stress, work hours on sleep quality. Nevertheless, the interrelationships between these variables remain poorly understood.

OBJECTIVE

The objective of this study is to examine the factors that influence sleep quality, to elucidate the relationships between them and to examine the extent to which depressive and anxiety symptoms act as mediators in the aforementioned relationships.

METHODS

A cross-sectional survey was conducted to obtain information about medical personnel in Chongqing, China. The Depressive Symptom Scale, Anxiety Symptom Scale and Sleep Quality Scale developed by the Chinese Center for Disease Control and Prevention were used to assess the status of depression, anxiety and sleep quality, respectively. Structural equation modeling was employed to investigate the factors that influence sleep quality.

RESULTS

The detection rate of poor sleep quality among healthcare workers in Chongqing was 57.9%, analyzed by structural equation modeling, the direct effects of anxiety and depressive symptoms on sleep quality were -0.328, -0.221 and fully mediated the relationship between socio-economic status, weekly working hours and occupational tension and sleep quality. Social support, demands and payments had higher effects on sleep quality of -0.167, -0.176 respectively.

CONCLUSIONS

The factors affecting sleep quality were identified as weekly working hours, working age, socioeconomic status, and occupational tension. The sub-dimensions of occupational tension that played a decisive role were social support, demands, and payments. The association between the aforementioned variables and sleep quality was fully mediated by depression and anxiety symptoms.

The mediating effect of sleep quality on the relationship between social support and depressive symptoms among Chinese nurses during the omicron outbreak

BACKGROUND

The COVID-19 pandemic has led to increased depressive symptoms and diminished sleep quality among nurses. This study explores the relationships among social support, sleep quality, and depressive symptoms among Chinese nurses during the COVID-19 outbreak, with a focus on the mediating role of sleep quality.

METHODS

A cross-sectional study involving 2140 nurses was conducted from August to September 2022. The participants completed the Social Support Rating Scale, the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index. The data were analyzed via serial multiple mediation analysis with the PROCESS macro in SPSS.

RESULTS

Depressive symptoms affected an estimated 40.4% of the participants, with 69.2% reporting poor sleep quality. The present study revealed a significant negative correlation between social support and sleep quality and depressive symptoms (r = -0.229, p < 0.001; r = -0.322, p < 0.001, respectively). Furthermore, a substantial positive correlation was observed between sleep quality and depressive symptoms (r = 0.514, p < 0.001). Additionally, social support had a significant indirect effect on depressive symptoms through sleep quality (standardized effect = -0.0535, 95% CI = [-0.0648, -0.0424]). Sleep quality was found to mediate the relationship between social support and depressive symptoms in all subgroups, with variations based on years of experience, education levels, and hospital type.

CONCLUSION

Depressive symptoms were inversely associated with social support, which was moderated by sleep quality. Interventions targeting social support provision and sleep quality promotion are suggested for managing depressive symptoms among nurses during the COVID-19 pandemic.

Embracing impermanence: life events, fear of COVID-19 and psychological distress in the context of the postepidemic era: a moderated mediation model

OBJECTIVES

To investigate the relationships between life events and psychological distress in the postepidemic era as well as the effects of fear of COVID-19 (FCV-19) and impermanence on these relationships to enrich the study of the underlying psychological mechanisms of postepidemic psychological distress and to provide a theoretical basis for scientific prevention and intervention in individuals with psychological distress.

METHODS

A survey of 504 adults (71.3% female; age M = 26.87, SD = 10.70) was conducted via the Social Readjustment Rating Scale, the FCV-19 Scale, the Impermanence Scale, the Anxiety Scale and the Depression Scale, and a structural equation model was established to explore the relationships between variables.

RESULTS

The present study revealed the following: (1) there is a significant positive correlation between life events and psychological distress; (2) FCV-19 completely mediates the relationship between life events and psychological distress; and (3) impermanence moderates the mediation, regulating the path by which life events affect FCV-19 and the path by which FCV-19 affects psychological distress.

CONCLUSIONS

In the postepidemic era, impermanence can effectively mitigate the impact of life events on FCV-19 and the impact of FCV-19 on psychological distress.

Sleep duration and pain during the COVID-19 pandemic with depression and chronic diseases as mediators

The bidirectional relationship between sleep duration and pain during the COVID-19 pandemic remains poorly understood. This study explores these interactions and the mediating roles of depression and chronic diseases using data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. A cross-sectional analysis was conducted on 15,979 participants aged 45 and older. Sleep duration was self-reported, and pain was assessed using validated anatomical charts. Depression symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and chronic diseases were self-reported. Personal activity during the pandemic was measured using the Personal Activity Score during COVID-19 (PAS-COVID-19). The results showed a significant association between deviations from optimal sleep duration and increased pain frequency. Participants with both shorter and longer sleep durations reported higher pain levels, with depression and chronic diseases acting as significant mediators. However, personal activity did not significantly mediate the association between sleep duration and pain. These findings underscore the complex interplay among sleep duration, pain, depression, and chronic diseases during the COVID-19 pandemic, emphasizing the importance of integrated interventions to manage these interconnected health issues.

Palestinian university students' perspectives on COVID-19 risk and remote learning during the pandemic: A qualitative photovoice study

BACKGROUND

The COVID-19 pandemic has triggered major changes worldwide, with repercussions on mental health and education. The present study primarily aimed to retrospectively explore undergraduate students' risk perceptions of COVID-19 and their experiences with remote learning during the pandemic, with an emphasis on their high school years.

METHODS

This qualitative photovoice study was conducted between 30 March and 4 May 2023. The target population of this study was first- and second-year undergraduate students who had been in high school during the pandemic. Maximum variation, snowball, and convenience sampling methods were used to recruit students. They were asked to share photos and provide comments in written or voice messages explaining their experiences during the pandemic. Voice messages were manually transcribed verbatim. A manual content analysis of these comments was performed to derive the codes and themes relevant to the study objectives.

RESULTS

Forty-seven students initially agreed to participate and signed an informed consent form. However, the final sample included 16 students (nine men and seven women). The content analysis revealed four themes that were identified as the main factors contributing to high school students' risk perceptions of COVID-19. The first theme was psychosocial factors related to the pandemic, including emotions, isolation and stress. The second focused on the mechanisms used to cope with the pandemic. The third theme included beliefs and behaviours that either increased or decreased COVID-19 risk. The final theme addressed schools' responses to COVID-19, including factors such as maintaining connections with schools, preventive measures and the transition to remote learning.

CONCLUSION

This study highlighted the extensive impact of the pandemic on Palestinian high school students, demanding instantaneous adaptation to ensure their safety and well-being while maintaining the quality of education. Remote learning has become an important strategy with opportunities and challenges for high school students.

Developing a cyberchondria severity scale to promote self-care among university students during COVID-19

Cyberchondria is a hybrid term signifying a state in which individuals compulsively search for health-related information online because of health distress or anxiety, further aggravating their worries. This study develops a Cyberchondria Severity Scale (CSS) to assess the current situation of university students. Exploratory factor analysis (EFA) was conducted using 145 valid questionnaires. Subsequently, a nationwide survey was conducted at various universities in Taiwan, and 802 questionnaires were used for confirmatory factor analysis (CFA). The EFA led to the development of a CSS for college students with four constructs: increased anxiety (α = 0.91), obsessive-compulsive hypochondria (α = 0.87), perceived controllability (α = 0.88), and online physician-patient interaction (α = 0.86), with a Cronbach's alpha of 0.92 and variance of 66.81%. The CFA indicated that item reliability ranged from 0.50 to 0.86, factor loadings ranged from 0.71 to 0.93, and the composite reliability for latent variables ranged from 0.83 to 0.90 (p < .001). The extracted average variance ranged from 0.46 to 0.60. There were significant differences in various dimensions: perceived controllability had the highest score and obsessive-compulsive hypochondria had the lowest (F3,2403=256.26, p < .001). Therefore, CSS has emerged as a reliable and valid measure. Future studies should explore the factors that influence cyberchondria, promote online health information searches, and enhance reading comprehension skills.

Psychometric characteristics of the Narcissistic Admiration and Rivalry Questionnaire (NARQ): Arabic version

Narcissists are characterized by confidence, fragility, a desire for social approval without showing interest in others, charm, self-assurance, arrogance, and aggression. This study assesses the psychometric properties of the Arabic version of the Narcissistic Admiration and Rivalry Questionnaire (NARQ) among Algerian students (N = 714). Confirmatory factor and Rasch analyses were used. The NARQ consists of 18 items addressing six narcissism subscales under two main dimensions: rivalry and admiration. The results showed good saturation of the items on the six subscales and the three sub-scales on each of the two main dimensions, revealing a modest but positive correlation between rivalry and admiration. Moreover, the results of the Rasch model demonstrated that the scale aligns with the data, confirming the validity of the scale. This study offers valuable perspectives on assessing narcissism among Arabic populations and enhances our comprehension of the traits linked to narcissistic personalities.

COVID-19-Related Post-Traumatic Stress Disorders Relation With Social Media Addiction Among University Students: Mediating Role of Fear of Missing Out

OBJECTIVE

Traumatic experiences and stressful life events have crippling outcomes on individuals' psychiatric disorders and are also frequently comorbid with addictive behaviors. This study aims to propose a mediation model to examine the association between coronavirus disease-2019 (COVID-19)-related post-traumatic stress disorder (PTSD) and social media addiction (SMA) among university students, and the mediating role of fear of missing out (FoMO).

METHODS

A cross-sectional study with 856 university students (mean age 19.2 years; 67.9% female) was conducted in China. The COVID-19-related PTSD scale, the FoMO scale, and the Bergen Social Media Addiction Scale were used, in addition to an online questionnaire addressing participants' sociodemographic information. Descriptive statistics and correlations were conducted with SPSS 21.0. The Structural Equation Model (SEM) with AMOS 21.0 was performed to assess the hypothesized mediation mode. The bootstrap with the 95% confidence interval (CI) was computed to test the significance of the mediating effect.

RESULTS

SEM demonstrated that COVID-19-related PTSD symptoms significantly and negatively influenced SMA (β=0.247, p<0.001), FoMO significantly and positively affected university students' SMA (β=0.341, p<0.001), and FoMO partially mediated the association between COVID-19-related PTSD symptoms and SMA. The mediation effect of FoMO was 0.176, with bootstrapping 95% CI=0.123, 0.235.

CONCLUSION

The main effects of COVID-19-related PTSD symptoms and FoMO on SMA among university students were identified, providing intervention strategies for mental health professionals on how to reduce the risk of SMA when confronting future traumatic events and public health crises.

Mediating effects of insomnia and resilience on COVID-19-related post-traumatic stress disorder and quality of life in adolescents

The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12-18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.

Psychometric properties of the Benign and Malicious Envy Scale: A cross-cultural study in the Arab Maghreb countries

BACKGROUND

The Benign and Malicious Envy Scale (BeMaS) is designed to assess the trait of envy and evaluate individual differences in people's tendency to experience benign or malicious envy towards superior comparison standards.

OBJECTIVE

This study aimed to examine the factor structure of the BeMaS in Arab culture through exploratory and confirmatory factor analysis and to ensure the measurement equivalence of the benign and malicious envy scale across three countries in the Arab Maghreb region (Algeria, Tunisia, and Morocco).

METHODS

The study was conducted on a sample of 1047 students from various universities across three countries, Algeria (n = 401), Tunisia (n = 289), and Morocco (n = 357), and implemented a cross-sectional study design. The study involved individuals aged 18-64 (M = 22.00, SD = 4.79). Most were females (64.4 %, n = 674), with substantial male representation (35.6 %, n = 373). All participants completed the Arabic BeMaS.

RESULTS

The confirmatory factor analysis results indicated that the Arabic BeMaS has a two-factor structure for the total sample and each subsample. However, some modifications were necessary in the Tunisian sample. The overall results suggest that the two-factor structure of the BeMaS is valid and reliable in the Arab context. At the same time, differences between the three groups suggest cultural differences despite similarities in language, geographic proximity, and shared customs and traditions. Additionally, the results highlight the need for further research into envy, particularly within Arabic culture. Religious and cultural traditions may significantly influence how envy is experienced and perceived, making such cultural differences important to investigate.

CONCLUSION

In summary, this study contributes to our measurement of Envy in the Arab context by validating BeMaS and highlighting the importance of cultural factors in measuring and explaining envy. However, further research is needed to deepen our understanding of this complex emotion in different cultural and social contexts.

The relationship between corona disease anxiety and sleep disturbances and suicidal ideation in medical staff: The mediating role of resiliency and cognitive flexibility: A cross-sectional study

Background and Aims

Medical staff have experienced anxiety, sleep disturbances, and suicide due to the COVID-19 epidemic. Thus, this study examined the relationship between corona disease anxiety, sleep problems, and suicidal ideation in medical staff and how resiliency and cognitive flexibility mediate it.

Methods

This descriptive-analytical cross-sectional study examined medical staff. In 2022, participants were affiliated with Hamadan University of Medical Sciences, Iran educational and treatment centers. Sampling was done at primary COVID-19 treatment centers. Data was collected using validated instruments. Ethics were observed during data collecting.

Results

Path analysis was employed to test hypotheses. Analysis showed significant positive relationships between Corona disease anxiety and sleep disturbances (p = 0.001, β = 0.438) and suicidal ideation (p = 0.001, β = 0.310). Conversely, negative and significant associations were identified between resiliency and cognitive flexibility with sleep disturbances and suicidal ideation.

Conclusions

The study illustrates how medical staff's psychological health is linked to COVID-19. High Corona disease anxiety causes sleep disturbances and suicidal thoughts. Resilience and cognitive flexibility modulated Corona disease anxiety, sleep problems, and suicidal thoughts. The comprehensive study focuses on medical staff mental health issues, suggesting targeted solutions.

Burnout increased among university students during the COVID-19 pandemic: a systematic review and meta-analysis

Generally, university students are at risk of burnout. This likely was exacerbated during the COVID-19 pandemic. We aimed to investigate burnout prevalence among university students during the COVID-19 pandemic and examine its distribution across countries, sexes, fields of study, and time-period. PubMed, EMBASE, PsycINFO, World Health Organization's Global COVID-19 database, Scopus, Epistemonikos, ERIC and Google Scholar were searched (protocol: https://doi.org/10.17605/OSF.IO/BYRXW ). Studies were independently screened and extracted. Random-effects meta-analysis was performed. Study quality was appraised, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We identified 44 primary studies comprising 26,500 students. Global prevalence rates were 56.3% for high emotional exhaustion (EE), 55.3% for high cynicism (CY) and 41.8% for low personal accomplishment (PA). Prevalence of EE, CY, and PA domains varied significantly across fields of study, countries and WHO and World Bank regions, but not sex. All studies demonstrated good internal validity, although substantial heterogeneity existed between studies. The certainty of evidence was rated as moderate. Considering its potentially severe consequences, burnout is a significant public health concern. The development and implementation of evidence-based localized interventions at organizational and individual levels are necessary to mitigate burnout.

Family Communication as a Mediator between Family Resilience and Family Functioning under the Quarantine and COVID-19 Pandemic in Arabic Countries

The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as a mediator of the relationship between family resilience and family functioning under the quarantine and coronavirus pandemic in Algeria and Iraq. This study was conducted among individuals in Iraq and Algeria (N = 361). The respondents completed the Family Communication Scale (FCS), Walsh Family Resilience Questionnaire (WFRQ), and Family Functioning Scale (FFS). Structural equation modeling (SEM) with the bootstrapping method was used to conduct the mediated effects of family communication. Using the bootstrapping method in SEM, family resilience and communication significantly affected family functioning (coefficient = 0.808). Moreover, the direct effect and indirect effect (via family functioning) of family resilience on family functioning were both significant, with coefficients of 0.682 and 0.126. In addition, numerous groups from Iraq and Algeria have been analyzed as a sample and have shown no differences in the relationships between family resilience, family communication, and family functioning. In conclusion, the results showed that family communication mediated the relationship between family resilience and family functioning. Moreover, the type of this mediation seemed to be partial because of the significant direct relationship between family resilience and family functioning. According to the findings, healthcare providers should consider improving family resilience and communication to achieve good family functioning.

Psychometric Properties of the Perceived Collective Family Efficacy Scale in Algeria

The Perceived Collective Family Efficacy Scale is a tool utilized to assess the effectiveness of a family as a functioning system. The scale has a single-factor structure with good validity and reliability. However, there is a shortage of psychometric evidence of the scale in an Arab context. This study aimed to assess the psychometric properties of the Perceived Collective Family Efficacy Scale among Algerian students. A cross-sectional study was conducted to recruit 300 students from Algerian universities. The students completed the 20-item Perceived Collective Family Efficacy Scale, Arabic version, to measure their beliefs regarding collective efficacy within families. Confirmatory factor analysis (CFA) and the Rasch model were employed to assess the psychometric properties and unidimensionality of the scale. Both CFA and Rasch findings supported the single-factor structure for the Perceived Collective Family Efficacy Scale. Specifically, the CFA indicated that the data aligned with a one-dimensional model. The Rasch analysis revealed favorable indicators of unidimensionality for the scale. Moreover, a thorough examination of the Principal Component Analysis of the Rasch residuals confirmed the existence of a single dimension, which is consistent with the original structure of the Perceived Collective Family Efficacy Scale. These findings provide scientific evidence for the validity and unidimensional nature of the Perceived Collective Family Efficacy Scale. Specifically, the satisfactory psychometric properties findings indicate that the Perceived Collective Family Efficacy Scale could be applied in an Arab context (i.e., in Algerian). The scale's unidimensional structure underscores its effectiveness in measuring beliefs in collective efficacy within families. These results enhance our understanding of family dynamics and provide a reliable measurement tool for assessing family efficacy in similar cultural contexts.

Psychological Effect of the COVID-19 Pandemic on Nursing Students: Palestinian Perspective

Introduction

COVID-19 has had an important effect on nursing students, with some having their clinical practice cancelled or suspended and others suffering from the virus.

Objective

The purpose of this study was to assess the psychological status in terms of stress, anxiety, and depression of nursing students during COVID-19 pandemic.

Methods

The study was cross-sectional, carried out by a convenience sample of 320 participants of nursing students between May and June 2020. Data collection was performed by "Depression Anxiety Stress-21 Scale" (DASS-21).

Results

The results revealed that 78 (24.3%) of participants reported stress; 121 (37.8%) reported anxiety; and 72 (22.5%) reported depression. Also, grade and socioeconomic status had statistically significant effect on anxiety, stress, and depression. In addition, age had statistically significant effect on depression, place of residence had statistically significant effect on anxiety, and gender had statistically significant effect on stress.

Conclusion

The study confirmed an alarming number of nursing students who experienced anxiety, stress, and depression. This study serves as an evidence concerning nursing students' mental health issues as a consequence of the COVID-19 pandemic.