Coverage of Health Information by Different Sources in Communities: Implication for COVID-19 Epidemic Response

COVID-19 and mental health services in Sub-Saharan Africa: A critical literature review

BACKGROUND

The COVID-19 pandemic has wrought a profound impact on mental health in Sub- Saharan Africa, exacerbating existing disparities and rendering individuals undergoing treatment particularly susceptible. This comprehensive critical review delves into the scope, nature, and extent of COVID-19 impact on mental health services in Sub- Saharan Africa, while concurrently elucidating pivotal lessons and exemplary practices learnt from periods of lockdown.

METHODS

The methodology was guided by Jesson & Laccy's guide on how to conduct critical literature reviews. Articles were comprehensively sought through two academic databases (PubMed and Google Scholar), complemented by targeted searches on the WHO website and official public health websites of relevant Sub-Saharan African countries.

RESULTS

The investigation reveals a surge in mental health challenges, notably marked by a significant escalation in anxiety, depression, and post-traumatic stress disorder. Disruptions to care services, financial hardships, and the pervasive effects of social isolation further compound this escalation. The pre-existing inequalities in access to and quality of care were accentuated during this crisis, with marginalized groups encountering heightened impediments to essential services. In navigating this unprecedented challenge, communities emerged as integral agents in establishing supportive networks and implementing culturally sensitive interventions. Technology, such as telemedicine and online resources, played a pivotal role in bridging access gaps, particularly in remote areas. The synthesis of best practices for supporting mental health patients during lockdowns encompasses targeted interventions for vulnerable groups, including adolescents and pregnant women. Empowering communities through economic support and mental health literacy programs was identified as crucial. The integration of technology, such as the development of robust telemedicine frameworks, virtual training in curricula, and the utilization of digital platforms for interventions and public messaging, emerged as a cornerstone in addressing access disparities. Community engagement and resilience-building strategies gained prominence, emphasizing the necessity of collaboration between healthcare providers and communities. Promotion of peer support groups, home-based care, and the preservation of traditional healing practices were underscored as essential components.

CONCLUSION

The study underscores the need to adapt and optimize mental health services during emergencies. This entails prioritizing mental health within emergency response frameworks, exploring alternative service delivery methods, and fortifying data collection and research efforts.

Health Beliefs, Protective Behaviors, and Information-Seeking

BACKGROUND

The outbreak of COVID-19 caused severe damage to public health globally and served as a stark reminder of the potential for future pandemics. Promoting protective behaviors to prevent the spread of any contagious disease thus remains a priority. Although research has shown that health beliefs can affect protective behaviors, few studies have examined the role of information-seeking in this relationship.

OBJECTIVES

On the basis of the health belief model, this research focused on whether health beliefs affect personal protective behaviors through health information-seeking behaviors.

METHODS

This cross-sectional study with a causal-comparative design used an online questionnaire to investigate the Taiwanese public's health beliefs, protective behaviors, and information-seeking behaviors during the COVID-19 pandemic. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS

Between September 2021 and January 2022, 322 valid questionnaires were collected. The results revealed that the effects of two health beliefs-self-efficacy and perceived benefits-on handwashing, social distancing, practicing good cough etiquette, and keeping one's environment clean and well ventilated were partially mediated by the frequency of official information-seeking.

DISCUSSION

Results of this study support the regular and timely promotion of pandemic prevention measures through official sites. Promoting official information-seeking can help enhance protective behaviors.

COVID-19 information seeking and individuals' protective behaviors: examining the role of information sources and information content

BACKGROUND

Seeking COVID-19 information promotes individuals to adopt preventive behaviors, including wearing a mask, social distancing, staying away from risky places, and washing hands. This study aims to investigate which information and sources individuals relied on in seeking COVID-19 information and further examine their roles in individuals' adoption of preventive behaviors.

METHODS

Through a statistical analysis of 1027 valid responses from citizens in different Chinese cities in 2022 to the self-designed items in an online survey, this study identified individuals' preferred information sources and content on COVID-19. Regarding the information sources and content, the study used multiple regression analysis to examine their associations with individuals' preventive behaviors, and further applied fuzzy-set qualitative comparative analysis (fsQCA) to explore their configurations that increase the likelihood of individuals adopting preventive behaviors.

RESULTS

Individuals preferred information about the newest prevention and control policies, precautions and treatment, and symptoms from the sources of workplace and community, social media, and social live streaming services. Additionally, individuals' preventive behaviors were positively related to the workplace and community (β = 0.202, p <.001), social live streaming services (β = 0.089, p <.01), government department websites (β = 0.079, p <.05), television (β = 0.073, p <.05), and online news media (β = 0.069, p <.05), but were negatively associated with newspapers (β=-0.087, p <.05). Regarding information content, precautions and treatments (β = 0.211, p <.001), the newest prevention and control policies (β = 0.173, p <.001), symptoms (β = 0.152, p <.001), and official rumor-dispelling information (β = 0.082, p <.05) had a positive relationship with individuals' preventive behaviors. In addition, fsQCA results presented eight configurations that promote individuals to adopt preventive behaviors. The total coverage and solution consistency values were 0.869 and 0.987, respectively. Furthermore, COVID-19 information content, the sources of social media and interpersonal sources, and official news media played an essential role in increasing the likelihood of individuals adopting preventive behaviors.

CONCLUSIONS

Our findings demonstrated that individuals seek various COVID-19 information from multiple sources. The direct and degree of association of information sources and content with individuals' preventive behaviors vary from source to source and from content to content. Information sources and content could combinatorially promote individuals to adopt preventive behaviors through several configurations.

Beyond COVID-19: the impact of recent pandemics on medical students and their education: a scoping review

INTRODUCTION

Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students.

METHODS

This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis.

RESULTS

A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma.

CONCLUSION

This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.

Trust in information sources as a moderator of the impact of COVID-19 anxiety and exposure to information on conspiracy thinking and misinformation beliefs: a multilevel study

This study investigates the intricate relationship between exposure to information sources, trust in these sources, conspiracy and misinformation beliefs, and COVID-19 anxiety among 509 Omani citizens aged 11 to 50, representing 11 governorates. Employing structural equation modeling, we not only examine these associations but also explore how trust and COVID-19 anxiety act as moderating variables in this context. Additionally, we delve into demographic factors such as age group, educational level, gender, and place of residence (governorate) to discern potential variations.Our findings reveal that trust in health experts is inversely related to belief in conspiracy theories, while trust in health experts negatively correlates with exposure to conspiracy and misinformation. Intriguingly, trust in health experts exhibits divergent effects across governorates: it diminishes conspiracy and misinformation beliefs in some regions but not in others. Exposure to personal contacts and digital media, on the other hand, is associated with heightened beliefs in misinformation and conspiracy theories, respectively, in select governorates. These distinctions may be attributed to proximity to Muscat, the capital city of Oman, where various media outlets and policy-making institutions are situated. Furthermore, lower educational attainment is linked to greater belief in conspiracy and misinformation. Females reported higher levels of conspiracy theory beliefs and COVID-19 anxiety while no significant differences were detected in misinformation beliefs.This study sheds light on the intricate dynamics of misinformation and conspiracy theories in the context of COVID-19 in Oman, highlighting the pivotal roles of trust and COVID-19 anxiety as moderating factors. These findings offer valuable insights into understanding and addressing the spread of misinformation and conspiracy theories during a public health crisis.

Anxiety, depression, and stress prevalence among college students during the COVID-19 pandemic: A systematic review and meta-analysis

Background: Since the end of 2019, the coronavirus disease (COVID-19) outbreak rapidly became a pandemic. The psychological state of people during the COVID-19 pandemic has gained interest. Our aim was to study the prevalence of anxiety, depression, and stress in college students during the COVID-19 pandemic. Methods: A systematic search of Medline, Embase, Web of Science, and the Cochrane Library was conducted up to September 20, 2020. Reviewers independently assessed full-text articles according to predefined criteria. Stata14/SE was used to calculate the prevalence and 95% confidence intervals (CIs) of anxiety, depression, and stress among college students from different countries. A random effects model was adopted. The Egger test was used to determine publication bias. Results: A total of 280 references were retrieved, and 28 papers met our inclusion criteria, for a total of 436,799 college students. Thirteen studies involved non-Chinese college students, and 15 studies involved Chinese college students. The prevalence of anxiety, depression, and stress was 29% (95% CI, 19-25%), 37% (95% CI, 32-42%), and 23% (95% CI, 8-39%), respectively. Conclusion: The COVID-19 pandemic has had a negative psychological effect on college students, and the prevalence of anxiety, depression, and stress among Chinese college students is lower than among non-Chinese college students.

Assessing secondary school students' digital health literacy, information searching behaviours, and satisfaction with online COVID-19 information in Northern Ghana

Available evidence suggests that managing the complexities of health information and the behaviours associated with information search call for adequate digital health literacy (DHL). Students' ability to judge the relevance of health-related information largely affects their level of satisfaction with the information. The study assessed DHL, information searching behaviours, and the link between DHL and COVID-19 information. The cross-sectional study utilised the multi-stage sampling technique in the selection of 1392 secondary school students in the Northern Region of Ghana. A DHL questionnaire was used to survey the students. The students displayed inadequate level of DHL concerning the relevance of online information. Predictably, most of them had not searched for information in the past four weeks prior to the data collection. Search engine portals, websites of public bodies, and news portals were the predominant platforms used for information search. Majority of the participants reported not being satisfied with the information they found on the internet about coronavirus. A significant association between DHL levels and utilization of COVID-19 information platforms was identified, such that students who showed high levels of DHL used platforms which had reviewed/professional content compared to those with low levels of DHL. Advanced DHL may serve as a disincentive to the consumption of information from sources which are not credible. There is an urgent call for collaboration among the ministries/agencies responsible for education and health, telecommunication networks, and civil society organisations for interventions aimed at integrating DHL in schools..

Psychological consequences among veterans during the COVID-19 pandemic: A scoping review

Although there is an increasing number of studies reporting the psychological impact of COVID-19 on the general population and healthcare workers, relatively less attention has been paid to the veterans. This study aimed to review the existing literature regarding the psychological consequences of COVID-19 on veterans. A systematic search was conducted on PubMed, Embase, and the Cochrane Library from inception to December 3, 2022. A total of twenty-three studies were included with moderate-quality of evidence. Veterans experienced more mental health problems than civilians. The prevalence rates of alcohol use, anxiety, depression, post-traumatic stress disorder, stress, loneliness, and suicide ideation significantly increased during the pandemic, ranging from 9.6% to 47.4%, 9.4% to 53.5%, 8.6% to 55.1%, 4.1% to 58.0%, 4.3% to 39.4%, 15.9% to 28.4%, and 7.8% to 22.0%, respectively. The main risk factors of negative consequences included pandemic-related stress, poor family relationships, lack of social support, financial problems, and preexisting mental disorders. In contrast, higher household income and greater community interaction and support appeared to be resilience factors. In conclusion, the COVID-19 pandemic has increased adverse mental health consequences among veterans. Tackling mental health issues due to the COVID-19 pandemic among veterans should be a priority.

A longitudinal study on college students' depressive symptoms during the COVID-19 pandemic: The trajectories, antecedents, and outcomes

The ongoing COVID-19 pandemic is not only an immediate hazard but also a long-term risk to the development of depressive symptoms. However, it remains unclear how people's depressive symptoms change with the process of COVID-19. Further, there is also a paucity of research on the underlying antecedents and outcomes of depressive symptoms during this global health crisis. In this study, a longitudinal study was conducted in China and the data of 559 participants were collected from the outbreak period to the normalization period of the pandemic through self-report questionnaires. Depressive symptoms were longitudinally analyzed using Patient Health Questionnaire-9. Core variables involving society, family, individual cognition, and behaviors were studied as determinants or consequences. Latent growth curve model analyses indicated that college students had mild depressive symptoms at the initial stage of COVID-19 with a subsequent decreasing linear slope. Depressive symptoms were significantly predicted by college students' risk perception of COVID-19, social support, family functioning, and smartphone addiction tendency. Further, their depressive symptoms predicted the changes in smartphone addiction tendency and levels of hope. In conclusion, current findings can provide implications for future prevention and intervention of mental disorders to assist college students through such challenging times.

Understanding Information Processing and Protective Behaviors during the Pandemic: A Three-Wave Longitudinal Study

BACKGROUND

Few existing studies have examined information processing as an independent variable to predict subsequent information behaviors in a pandemic context, and the mechanism of subsequent information behavior processing following the initial or prior information behavior is unclear.

OBJECTIVE

Our study aims to apply the risk information seeking and processing model to explain the mechanism of subsequent systematic information processing in the context of the COVID-19 pandemic.

METHODS

A three-wave longitudinal online national survey was administered during the period of July 2020 to September 2020. Path analysis was conducted to test the relationships between prior and subsequent systematic information processing and protective behaviors.

RESULTS

One important finding was the key role of prior systematic information processing, as indirect hazard experience was found to be a direct predictor of risk perception (β = 0.15, p = 0.004) and an indirect predictor of protective behaviors. Another important finding was the central role of information insufficiency as a mediator/driving force in subsequent systematic information processing and protective behavior.

CONCLUSIONS

The study has made important contributions in that it extends the scholarship on health information behaviors by (a) highlighting that relevant hazard experience in risk information seeking and processing model should be expanded to include indirect experience, and (b) providing the mechanism of subsequent systematic information processing following prior information processing. Our study also provides practical implications on health/risk communication and protective behaviors' promotion in the pandemic context.

Exploring primary healthcare practitioners' experiences regarding the coronavirus disease 2019 (COVID-19) pandemic in KwaZulu-Natal, South Africa

BACKGROUND

The coronavirus disease 2019 (COVID-19) has spread rapidly around the world since the initial outbreak in Wuhan, China. With the emergence of the Omicron variant, South Africa is presently the epicentre of the COVID-19 pandemic in sub-Saharan Africa. Healthcare workers have been at the forefront of the pandemic in terms of screening, early detection and clinical management of suspected and confirmed COVID-19 cases. Since the beginning of the outbreak, little has been reported on how healthcare workers have experienced the COVID-19 pandemic in South Africa, particularly within a low-income, rural primary care context.

METHODS

The purpose of the present qualitative study design was to explore primary healthcare practitioners' experiences regarding the COVID-19 pandemic at two selected primary healthcare facilities within a low-income rural context in KwaZulu-Natal, South Africa. Data were collected from a purposive sample of 15 participants, which consisted of nurses, physiotherapists, pharmacists, community caregivers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. Audio recordings were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis.

RESULTS

Participants reported personal, occupational and community-related experiences related to the COVID-19 pandemic in South Africa. Personal experiences of COVID-19 yielded superordinate themes of psychological distress, self-stigma, disruption of the social norm, Epiphany and conflict of interest. Occupational experiences yielded superordinate themes of staff infections, COVID-19-related courtesy stigma, resource constraints and poor dissemination of information. Community-related experiences were related to struggles with societal issues, clinician-patient relations and COVID-19 mismanagement of patients.

CONCLUSION

The findings of this study suggest that primary healthcare practitioners' experiences around COVID-19 are attributed to the catastrophic effects of the COVID-19 pandemic with the multitude of psychosocial consequences forming the essence of these experiences. Ensuring availability of reliable sources of information regarding the pandemic as well as psychosocial support could be valuable in helping healthcare workers cope with living and working during the pandemic.

Information seeking, mental health and loneliness: Longitudinal analyses of adults in the UK COVID-19 mental health and wellbeing study

Information seeking has generally been seen as an adaptive response to the COVID-19 pandemic. However, it may also result in negative outcomes on mental health. The present study tests whether reporting COVID-related information seeking throughout the pandemic is associated with subsequently poorer mental health outcomes. A quota-based, non-probability-sampling methodology was used to recruit a nationally representative sample. COVID-related information seeking was assessed at six waves along with symptoms of depression, anxiety, mental wellbeing and loneliness (N = 1945). Hierarchical linear modelling was used to assess the relationship between COVID-related information seeking and mental health outcomes. Information seeking was found to reduce over time. Overall, women, older and higher socioeconomic group individuals reported higher levels of information seeking. At waves 1-4 (March-June 2020) the majority of participants reported that they sought information on Covid 1-5 times per day, this decreased to less than once per day in waves 5 and 6 (July-November 2020). Higher levels of information seeking were associated with poorer mental health outcomes, particularly clinically significant levels of anxiety. Use of a non-probability sampling method may have been a study limitation, nevertheless, reducing or managing information seeking behaviour may be one method to reduce anxiety during pandemics and other public health crises.

Health-Risk Behaviors, COVID-19 Preventive Behaviors, and the Impact of the COVID-19 Pandemic on the Working-Age Population of Bangkok, Thailand

Although studies have extensively discussed the effects of COVID-19 on global health behaviors, little is known about the extent of COVID-19 preventive behaviors and their negative effects on the working-age population of Bangkok, Thailand. Therefore, this study aimed to examine health-risk behaviors, COVID-19 preventive behaviors, and the impact of the COVID-19 pandemic among the Thai working-age population. An online cross-sectional survey was conducted among working-age adults through a self-administered questionnaire. Data were analyzed with descriptive statistics and stepwise multiple regression. Of the 313 Thai participants (227 females, 72.5%), 84.0% had high levels of health-risk behaviors for preventing COVID-19 infection, most respondents (89.1%) had high levels of knowledge about COVID-19, and most respondents (61.7%) had high levels of overall COVID-19 preventive behaviors. Stepwise multiple regression revealed that health-risk behaviors (β = 0.445), knowledge of COVID-19 (β = 0.148), gender (β = 0.145), and age (β = 0.133) were predictive of COVID-19 preventive behaviors. Additionally, most respondents (48.9%) had moderate overall effects from COVID-19. Based on our findings, these factors must be considered when implementing public policies to improve COVID-19 preventive behaviors among the currently employed working-age population. In addition, appropriate interventions must be established and evaluated for the pandemic's long-term effects.

Factors Predicting the Coronavirus Disease 2019 Preventive Behaviors of Older Adults: A Cross-Sectional Study in Bangkok, Thailand

The coronavirus disease 2019 (COVID-19) pandemic has affected the health behaviors of older adults. Thus, the factors predicting the COVID-19 preventive behaviors of older adults during the COVID-19 outbreak should be examined. Therefore, this study aimed to assess the COVID-19 preventive behaviors of older adults and explore the factors predicting these. A cross-sectional study was performed with 400 older adults who were selected using the cluster sampling technique. The associations of all variables in preventing COVID-19 infection with COVID-19 preventive behaviors were examined using stepwise multiple regression. The study results revealed that 70.8% of the study participants had high levels of COVID-19 preventive behaviors. Among these, self-efficacy in preventing COVID-19 infection (β = 0.224) showed the highest ability to predict COVID-19 preventive behaviors, followed by COVID-19 response efficacy (β = 0.171), knowledge about COVID-19 (β = 0.110), and gender (β = -0.102). Older adults adopted protective behaviors at the beginning of the COVID-19 pandemic. The predictors of these behaviors should be considered while designing and developing appropriate COVID-19 preventive behavior interventions, aimed at inducing behavioral modifications to reduce further infection with and spread of COVID-19.

Changes in dietary patterns among Bangladeshi adult population during the COVID-19 pandemic: A web-based cross-sectional study

Background

The home confinement induced by the COVID-19 pandemic affects individuals’ mental wellbeing and increases unhealthy behaviors, such as minimum to no physical activity, overeating, and substance use.

Objective

This study aimed to assess the changes in dietary patterns among the Bangladeshi adult population during the COVID-19 pandemic and identify their determinants.

Methods

This web-based cross-sectional survey was carried out from 10–17 December 2020 using an e-questionnaire based on Google Forms. A semi-structured e-questionnaire was forwarded to the participants – Bangladesh citizens aged above 18 years – through social media platforms and email in order to collect information about socio-demographic issues and multidimensional dietary patterns. From the initial 817 responses gathered through snowball sampling, 748 responses were retained. Bivariate and multivariate analyses were executed.

Results

The findings suggest that 50% of the participants reported a reduction in weight and physical activities, while approximately 52% experienced increased sleep time. One in three participants (31.4%) experienced a decrease in food buying capacity. The findings further indicate that women were 1.65 times more likely to reduce food consumption than men. Meanwhile, employed people were about 34% less likely to increase food consumption than their unemployed counterparts. People who were getting more than 6 h of sleep per day were nearly 61% less likely to increase food consumption than people who slept for less than 6 h per day. People struggling to buy food items were 2.31 times more likely to reduce food intake than people with no such limitations.

Conclusions

The study shows that COVID-19 has substantially affected Bangladeshi people’s common food consumption patterns. Being confined within the household, primarily due to countrywide lockdowns and ‘general holidays’, has affected both the dietary patterns and the financial wellbeing of people. Therefore, the concerned authorities should promote effective nutrition education and healthy dietary behaviors; meanwhile, financial support or incentives for people in need are also strongly advocated.

The Association Between COVID-19 Information Sources and Stigma Against Health Care Workers Among College Students: Cross-sectional, Observational Study

Background

The COVID-19 pandemic has triggered stigmatic attitudes against health care workers. Some forms of social media may play a role in disseminating stigmatizing messages.

Objective

We aimed to investigate the association between COVID-19 information sources and stigma against health care workers among college students during the pandemic.

Methods

A cross-sectional, observational study was conducted using a web-based platform in the Tohoku region of Japan. College students aged ≥20 years were asked to complete the questionnaire between August 18 and October 31, 2020. Stigma against health care workers was evaluated using a modified Japanese version of the Social Distance Scale. Participants were also asked to rate their perceived vulnerability to infection using the Japanese version of the Perceived Vulnerability to Disease scale.

Results

A total of 281 students from 8 colleges completed the web-based survey. There were 139 (49.5%) participants who used Twitter, 187 (66.5%) who used news websites, and 46 (16.4%) who used the websites of public health agencies as COVID-19 information sources. After adjusting for age, sex, department, and Perceived Vulnerability to Disease scores, the level of stigma did not differ between students who used Twitter and those who did not. Students who used the websites of public health agencies showed a significantly less stigmatic attitude than those who did not.

Conclusions

Fact-checking and directing visitors to credible information sources from public health agencies may have prevented the formation of stigmatic attitudes toward health care workers. An effective strategy to enable easy access to information provided by public agencies should be integrated into widespread web-based platforms.

An Integrated Approach to COVID-19 Preventive Behaviour Intentions: Protection Motivation Theory, Information Acquisition, and Trust

COVID-19 has been a global threat since November 2019 due to its high transmission rates and the issue of unwillingness to vaccinate. Effective risk management requires accurate health communication and public compliance with reccomended preventive behaviors. Therefore, we investigated predictors of COVID-19 preventive behavior intention based on Protection Motivation Theory (PMT) in addition to frequency of public's use of and trust in a group of COVID-19 related information sources. This cross-sectional study was conducted on 458 adults in Turkey with online survey. Results showed that all PMT components (except perceived susceptibility) accounted for 49% of the variance in protection motivation and there was relationship between information sources and protection motivation. Overall, our study findings suggested that being more informed and having confidence in the feasibility (self-efficacy) and effectiveness (response efficacy) of preventive behaviors may particularly help slow the disease spread.

Association of the time spent on social media news with depression and suicidal ideation among a sample of Lebanese adults during the COVID-19 pandemic and the Lebanese economic crisis

The main objectives were to associate between social media news consumption during these unstable times and depression, as well as suicidal ideation among a sample of Lebanese adults, in addition to associate between fear of Covid-19, depression and suicidal ideation. Secondary objectives aimed to check the mediating effect of depression in the association between time spent on social media to get the news and the presence of suicidal ideation. This is a cross-sectional study executed between April and May 2021. It involved 402 Lebanese citizens aged 18 years and above, selected randomly from all Lebanese districts. Having cancer (Beta = 0.20) or lung disease (Beta = 0.27), more fear of COVID-19 (Beta = 0.16), a higher time spent on social media for news (Beta = 0.13) and a higher household crowding index (Beta = 0.29) were significantly associated with more depression, whereas having a pet in the house (Beta = -0.13) and working in the medical field (Beta = -0.17) were significantly associated with less depression. Higher depression (aOR = 1.19) was significantly associated with higher odds of having suicidal ideation, whereas more fear of COVID-19 (aOR = 0.84) and older age (aOR = 0.96) were significantly associated with less odds of having suicidal ideation. Depression did not mediate the association between time spent on social media to get the news and suicidal ideation. This study showed that more time spent on social media reading the news is associated with higher depression but not suicidal ideation. Fear of Covid-19 is associated with more depression, but less suicidal ideation. Further studies are needed to identify the causality between social media news consumption, depression and suicidal ideation. Moreover, awareness campaigns should be organized to teach people how to consume social media news in a responsible way, without letting it affect their emotions directly, which may cause psychological disorders.

Immediate and delayed psychological effects of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China

BACKGROUND

The COVID-19 pandemic has greatly affected public health and wellbeing. In response to the pandemic threat of the coronavirus epidemic, several countries, including China, adopted lockdown and quarantine policies, which may cause psychological distress. This study aimed to explore the psychological impact of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China as well as the corresponding risk factors and protective factors.

METHODS

We examined the immediate (2-week) and delayed (2-month) impact of province-wide lockdown and personal quarantine on psychological distress in a national sample of 1390 Chinese residents.

RESULTS

No immediate impact of province-wide lockdown on psychological distress was observed, whereas personal quarantine increased individuals' anxiety, fear, and anger. Despite the lack of initial association, psychological distress increased among those in province-wide lockdown. Self-stigma and personal control both significantly moderated the association between lockdown and psychological distress, but in different directions. Those with higher self-stigma and lower personal control were more impacted by the lockdown. Government support moderated the impact of quarantine on psychological distress, but not that of lockdown.

CONCLUSIONS

The delayed effects of lockdown and quarantine on psychological distress were observed, and self-stigma, social support, and perceived control moderate the relationships. This study is the first to demonstrate the psychological costs of province-wide lockdowns on individuals' mental health, providing evidence of the need for mitigation strategies and timely public mental health preparedness in countries with recent outbreaks of COVID-19.

Reading habits of medical practitioners: Young doctors in Pakistan, a case study

Objective

This study attempted to investigate the reading preferences and habits among young Pakistani medical doctors. The reading time, preferred source of information, preferred medical journals, and ways of reading medical journals were explored.

Methods

A survey approach was used for data collection. The study participants were young medical professionals in Pakistan. An online survey was sent to more than 300 individuals through various physicians and their professional groups/bodies. A total of 155 responded to the questionnaire, and 128 of the questionnaires were considered worthy of data analysis.

Results

Among respondents, 40% read printed journals, 49% read online journals, 60% read case reports, and 55% read newspapers for 1–5 h per week. Continuing medical education was the preferred source of information, and the Pakistan Journal of Cardiology & Thoracic Surgery was the preferred medical journal. Reading the abstract and the conclusion was the preferred way of reading journal articles.

Conclusion

Young physicians are enthusiastic in participating in research activities and spending time gaining updated information. Physicians read articles methodically. Online sources of information are preferred over printed sources.

Modifiable Host Factors for the Prevention and Treatment of COVID-19: Diet and Lifestyle/Diet and Lifestyle Factors in the Prevention of COVID-19

Many studies have shown that the immune system requires adequate nutrition to work at an optimal level. Not only do optimized nutritional strategies support the immune system, but they also reduce chronic inflammation. Nutritional supplements that are recommended for patients with critical illnesses are thought to also be effective for the coronavirus disease 2019 (COVID-19) patients in the intensive care unit. Some studies have recommended fresh fruits and vegetables, soy, nuts, and antioxidants, such as omega-3 fatty acids, to improve immune system activity. Although nutritional status is considered to be an important prognostic factor for patients with COVID-19, there is to date no sufficient evidence that optimal nutritional therapies can be beneficial for these patients. Some have argued that the COVID-19 pandemic is a good opportunity to test the effectiveness of nutritional intervention for infectious diseases. Many researchers have suggested that testing the proposed nutritional approaches for infectious diseases in the context of a pandemic would be highly informative. The authors of other review papers concluded that it is important to have a diet based on fresh foods, such as fruits, vegetables, whole grains, low-fat dairy products, and healthy fats (i.e., olive oil and fish oil), and to limit the intake of sugary drinks as well as high-calorie and high-salt foods. In this review, we discuss the clinical significance of functional food ingredients as complementary therapies potentially beneficial for the prevention or treatment of COVID-19. We believe that our review will be helpful to plan and deploy future studies to conclude these potentials against COVID-19, but also to new infectious diseases that may arise in the future.

Mapping COVID-19 related research from Vietnam: a scoping review

INTRODUCTION

The situation of COVID-19 pandemic is becoming more complex. The research institutes should focus on the most important challenge related to this outbreak at the national level. We aim to realize this scoping review to map publications on COVID-19 in Vietnam in order to guide research priorities and policies in the country.

METHODS

This study was conducted at the Thai Binh University of Medicine and Pharmacy, from May to August 2020, according to the guidance for conducting systematic scoping review.

RESULTS

A total of 72 studies met the inclusion criteria. The most frequent publications were original articles (27.8%), followed by letter to editor/correspondence (26.4%). According to the research priorities for COVID-19 set by the WHO, 41.7% studies focused on control and prevention of COVID-19, but none of studies on personal protective equipment or protocol for healthcare workers' safety were conducted. 12.5% studies carried out a thorough investigation into epidemiology of the COVID-19 pandemic in Vietnam. Virology and genomics, natural history of the virus and its transmission in Vietnam were described by 18.1% papers. Only one study was conducted in terms of development for candidate therapeutics.

CONCLUSION

We call for national investigation on treatment against SARS-CoV-2 and protocol for medical staff protection. The government and academic institutions should work in collaboration with international stakeholders, including the WHO, to combat together the COVID-19.

Senior High School Students' Knowledge and Attitudes Toward Information on Their Health in the Kumasi Metropolis

The study examines senior high school students' understanding and attitudes toward information on their health in the Kumasi Metropolis. Multiple sampling techniques (convenient and simple random sampling techniques) were used in the study. A questionnaire was used to collect data from 391 respondents for the study. Frequencies and percentages were used to analyze the sociodemographic data. Again, the study used Pearson's correlation coefficient to show the degree of relationship between the level of knowledge of health information and attitudes toward seeking and sharing health information. The study found students' knowledge of the causes and symptoms of malaria, cholera, and Sexually Transmitted Infections (STIs) to be appreciably high as a result of readings from textbooks and health professionals. Again, the study found that the students preferred sharing their health information with friends than their parents and schools' authorities. The study further found that the major sources of students' health information included health professionals and textbooks. Lastly, even though some of the students claimed internet sources to their health information, it was not a major source to the student body at large. The study recommends strong health systems on the campuses of senior high schools as they have become communities on their own as a result of the emergence of the free senior high school program. The monitored positive peer-counseling group should also be encouraged by the schools' management and by extension the counseling units for the students to share views on themselves, particularly on health issues where they deem fit.

Promoting COVID-19 Vaccination Using the Health Belief Model: Does Information Acquisition from Divergent Sources Make a Difference?

As a promising approach to stop the escalation of the pandemic, COVID-19 vaccine promotion is becoming a challenging task for authorities worldwide. The purpose of this study was to identify the effective sources for disseminating information on the COVID-19 vaccine to promote individuals' behavioral intention to take the vaccine. Based on the Health Belief Model (HBM), this study illustrated the mechanism of how COVID-19 information acquisition from different sources was transformed into vaccination intentions via health beliefs. Using an online survey in China, the structural equation model results revealed that perceived benefits and cues to action were positively associated with COVID-19 vaccination intentions, and perceived barriers were negatively related to the intentions. However, perceived susceptibility and perceived severity had no significant relationships with the intentions. Moreover, the findings unveiled differences in the effects of acquiring information via multiple sources among traditional media, new media, and interpersonal interactions. Notably, new media and interpersonal interactions were more salient in promoting vaccination intention via health beliefs, compared with traditional media. The findings from this study will benefit health officials in terms of utilizing different information sources in vaccine programs.

The influence of fear of isolation on contact experience disclosure: Evidence from safety management of the COVID-19 pandemic

As the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to rage, disclosure of exposure to the virus is of great significance to safety management, especially considering the long latency of the disease. We conducted a survey based on terror management theory of 2,542 people in 71 cities, representing all provinces in mainland China. The results revealed that fear of being isolated influenced disclosure of exposure to the virus and that this influence was mediated by defensive impression management motivation. An inclusive climate buffered both the direct and the indirect effects of fear of isolation on disclosure behaviour via defensive impression management motivation. The implications of these findings for research and safety management during the COVID-19 pandemic are discussed.

COVID-19 Study on Scientific Articles in Health Communication: A Science Mapping Analysis in Web of Science

The COVID-19 pandemic continues to cause a collapse in the health systems and econo-mies of many countries around the world, after 2 years of struggle and with the number of cases still growing exponentially. Health communication has become as essential and necessary for control of the pandemic as epidemiology. This bibliometric analysis identifies existing contributions, jointly studying health communication and the pandemic in scientific journals indexed. A systematic search of the Web of Science was performed, using keywords related to COVID-19 and health communication. Data extracted included the type of study, journal, number of citations, number of authors, country of publication, and study content. As the number of scientific investigations has grown, it is necessary to delve into the areas in which the most impactful publications have been generated. The results show that the scientific community has been quick to react by generating an extraordinary volume of publications. This review provides a comprehensive mapping of contributions to date, showing how research approaches have evolved in parallel with the pandemic. In 2020, concepts related to mental health, mass communication, misinformation and communication risk were more used. In 2021, vaccination, infodemic, risk perception, social distancing and telemedicine were the most prevalent keywords. By highlighting the main topics, authors, manuscripts and journals since the origin of COVID-19, the authors hope to disseminate information that can help researchers to identify subsisting knowledge gaps and a number of future research opportunities.

Health Beliefs in Association with Behaviors in Compliance with COVID-19 Public Health Guidelines: A Cross-sectional Study

This study investigated the preventive health behaviors against the COVID-19 outbreak in Turkey according to the health belief model. The relationships between perceived susceptibility, severity, benefits, barriers, and preventive health behaviors were examined. 1401 participants consisting of 992 (70.8%) females and 409 (29.3%) males participated in an online survey. Independent groups t-test, hierarchical regression analysis and Process Macro were used for analyses. The findings showed that women perceived higher levels of severity of the disease and the benefits of preventive health behaviors than men. Men perceived more barriers to preventive health behaviors. The levels of anxiety and preventive health behaviors of women were higher than men. In regression analysis, male gender and perceived barriers were found as risk factors for preventive health behaviors. However, female gender, perceived severity, and benefits were protective factors for preventive health behaviors. People with low and moderate anxiety levels were more likely to comply with preventive health behaviors.

The Comparison of China and Iran Response to COVD-19 Pandemic: Lessons Learn for Health Policy

Currently, despite the change in the course of diseases, attention to infectious diseases and their integration has decreased. The prevalence of remerging infectious diseases has led to the need for appropriate preparation programs. There are still problems in controlling infectious diseases with the outbreak of coronavirus. The outbreak of the disease affected many countries in a short period. Therefore, by examining the actions of the two countries, it is possible to gain appropriate experiences in dealing with infectious diseases. This study was conducted using a gray literature review to examine all applied actions for the response to COVID-19 epidemics and their impacts on the prevalence of this disease in China and Iran. Examination of the documents shows that disease prevention is the most critical action, and we have witnessed a decrease in the number of patients with this disease by the introduction of prevention policies. The implementation problems of quarantine programs were meeting the basic needs of the people and continuing to implement this program. The issue of education was also one of the leading problems.

A Situation Assessment of Community Health Workers' Preparedness in Supporting Health System Response to COVID-19 in Kenya, Senegal, and Uganda

Background:

Coronavirus disease (COVID-19) caused socio-economic disruptions across the globe. The pandemic disrupted the health system (HS) calling for reengineering in response to high infection rates, deaths, and resultant containment measures. To deal with COVID-19 and promote resilience, community health workers (CHWs) were engaged across countries.

Objective:

Assess the preparedness of CHWs in supporting health system response in prevention and management of COVID-19 in Kenya, Senegal, and Uganda.

Methods:

A mixed methods design study involving national and subnational jurisdictions in the 3 countries. Key informant interviews were conducted with policy actors (16) and health care workers (24) while in-depth interviews involved CHWs (14) and community members (312) subjected to survey interviews.

Results:

Most (>50%) households survived on <USD 100/month during COVID-19 announced in March 2020 through national TV (57%), FM (42%), and radio station (27%). Community members interactions with CHWs increased during the pandemic through home visits as health educators, basic counseling providers and distributors of pandemic information tools, personal protective equipments, and social support commodities. The CHWs faced challenges during pandemic prevention and management including lack of: protective gear, salary, refresher courses, and identification tools; limited supervision and training; hostile reception during home visits; misconception and politicking about the pandemic. To effectively support prevention and manage of COVID-19, priority needs for CHWs were identified namely: provision of resources, protective gear, transport reimbursement, stipends, identification cards, and tools for recording and reporting; empowerment with adequate skills, trainings on provision of psychosocial support, first aid, and sensitization on policies.

Conclusion:

COVID-19 linked disruptions to optimal functioning of HS necessitated engagement of CHWs in the pandemic prevention and management. Findings underscore the important role CHWs play in supporting HS during crisis like COVID-19 to mitigate disruptions and stabilize the system for effective response. The CHWs can improve resilience of social and HS during unplanned disruptions for optimal functioning and attainment of universal health care. Policy makers should develop structured mechanisms for engaging CHWs while committing resources to address challenges that affect seamless synergy between health and CHWs Systems.

Comparison of anxiety levels of hospitalized COVID-19 patients, individuals under quarantine, and individuals in society

PURPOSE

This study aims to compare the anxiety levels of COVID-19 patients, individuals under quarantine, and healthy individuals in society.

DESIGN AND METHODS

This cross-sectional study was conducted from May 25, 2020 to June 25, 2020 in a city located in the northwest of Turkey. The data were collected using a personal information form, the Beck Anxiety Scale, administered in face-to-face interviews, and online questionnaires. The data were analyzed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and logistic regression analyses.

FINDINGS

The anxiety level of individuals under quarantine (Median: min-max = 1: 0-55) was significantly lower statistically compared to that of the rest of the society (Median: min-max = 6: 0-63) and hospitalized COVID-19 patients (Median: min-max = 5: 0-42) (p = 0.0001). Female gender, being 61 years of age and older, having psychiatric and chronic illnesses, and experiencing disrupted sleep patterns were determined to be the factors associated with high levels of anxiety.

PRACTICE IMPLICATIONS

This study found that society in general and hospitalized COVID-19 patients had high anxiety levels. The study results can be useful for creating training and population-based screening programs to control the anxiety of individuals under quarantine, hospitalized COVID-19 patients, and the rest of the society during the pandemic. Additionally, the finding from this study on groups at risk for anxiety will provide important data for future research on this subject and for the planning of health services offered to these groups.

Knowledge, practice and psychological symptoms among medical laboratory staff during COVID-19 pandemic in Nepal: An online based survey

Introduction

Despite several attempts to control COVID-19, there was a continuous rise in the number of cases, and this has left questions unanswered on the availability of health resources in Nepal. Here, we tried to assess the level of knowledge, practice and psychological symptoms among medical laboratory staff.

Methods

An online survey was conducted in February 2021. A total of 301 completely filled responses were used to assess knowledge, practice and psychological distress. R-language software was used for data analysis and p-value less than 0.05 was considered statistically significant.

Results

Of the total 301 respondents, 180 (59.8%) were male and 121 (40.2%) were female. The average score of knowledge obtained in this study was 32.4 ± 5.7 on a 56-point scale. Knowledge level was significantly different among age-groups (p-value – 0.034). The average practice score obtained was 2.25 ± 0.91 on a 4-point scale. More than one psychological distress symptom was observed in nearly half (41.5%) of the participants.

Conclusion

We conclude that medical laboratory staff in Nepal has satisfactory levels of knowledge and practice and, larger number of them has psychological distress. The study recommends further improvement in an effective information flow system, regular training, social security and psychological support.

Control and Prevention of the COVID-19 Epidemic in China: A Qualitative Community Case Study

Background

Cross-infection among residents in communities is one of the most critical reasons for the rapid spread of the COVID-19 epidemic. The COVID-19 epidemic has been well controlled within Chinese communities, which has made important contributions to the country's fight against it.

Methods

In this study, a qualitative case study design, with mixed methods applied to data collection and analysis, was employed to explore epidemic prevention measures taken by a Chinese community, namely Mulin, during the pandemic.

Results

The Mulin community established an integrated plan for epidemic prevention, including the prevention of the invasion of COVID-19, the prevention of cross-infection within the community, gaining the residents' trust and support, and providing the residents with convenient services.

Conclusion

In the present work, the Mulin community was taken as a typical case study, and qualitative methods were employed to comprehensively summarize the practice and experience of the community's epidemic prevention. Mulin's practices could shed light on how communities in other countries, especially developing countries with large populations, can prevent the spread of COVID-19.

Media use, positive and negative emotions, and stress levels of adults during COVID-19 pandemic in Turkey: A cross-sectional study

AIM

This study was conducted to determine media use, positive and negative emotions, and stress levels of adults during the COVID-19 pandemic.

BACKGROUND

Using media tools in the pandemic process has impacted the mental health of individuals. As the COVID-19 outbreak is a new disease fear, anxiety and stress about this situation can cause strong emotions in adults.

METHODS

The research was carried out using a cross-sectional design. The sample consisted of 1541 adults. The Positive and Negative Emotion Scale, and the Perceived Stress Scale were used to collect the data.

RESULTS

The Positive Emotion Scale mean scores were lower (p < 0.05) for those people whose daily media use time was more than 4 h and who followed the developments about COVID-19 through the media once a day. It was found that those with daily media use of more than 4 h/day had higher Perceived Stress Scale scores than those with lower use (p > 0.05).

CONCLUSION

This study concluded that the use of media in adults increased during the COVID-19 outbreak and that media use was associated with positive and negative emotions and stress levels. Health professionals should assess the effect of the COVID-19 outbreak on mental health in various community groups and develop interventions to prevent negative consequences of increased media use.

New media platform's understanding of Chinese social workers' anti-epidemic actions: an analysis of network public opinion based on COVID-19

Research on social public opinion of new media is currently an important interdisciplinary topic in the international academic community. Under the background of COVID-19, the major public health event of in China, this research took social workers as the research object who worked during the period of epidemic prevention and control. It referred to the international research on public opinion and selected 63 related hotly discussed articles and public comments on the WeChat public platform, the new Chinese Internet media. Moreover, the research conducted text mining on related public opinion with the 5 W communication model from public opinion evolution, text content, communication media, audiences, and public opinion influence, and used grounded theory building a development model of the generation of network public opinion. It also put forward the development needs of social work in the aspects of community resilience, social work practice, lack of public health social workers, and big data warning, etc., and pointed out that social work lacks its proper structural status in China's public health system and emergency management system.

The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

COVID-19 was declared a pandemic in March 2020, resulting in many countries worldwide calling for lockdowns. This study aimed to review the existing literature on the effects of the lockdown measures established as a response to the COVID-19 pandemic on the mental health of children and adolescents. Embase, Ovid, Global Health, PsycINFO, Web of Science, and pre-print databases were searched in this PRISMA-compliant systematic review (PROSPERO: CRD42021225604). We included individual studies reporting on a wide range of mental health outcomes, including risk and protective factors, conducted in children and adolescents (aged ≤ 19 years), exposed to COVID-19 lockdown. Data extraction and quality appraisal were conducted by independent researchers, and results were synthesised by core themes. 61 articles with 54,999 children and adolescents were included (mean age = 11.3 years, 49.7% female). Anxiety symptoms and depression symptoms were common in the included studies and ranged 1.8-49.5% and 2.2-63.8%, respectively. Irritability (range = 16.7-73.2%) and anger (range = 30.0-51.3%), were also frequently reported by children and adolescents. Special needs and the presence of mental disorders before the lockdown, alongside excessive media exposure, were significant risk factors for anxiety. Parent-child communication was protective for anxiety and depression. The COVID-19 lockdown has resulted in psychological distress and highlighted vulnerable groups such as those with previous or current mental health difficulties. Supporting the mental health needs of children and adolescents at risk is key. Clinical guidelines to alleviate the negative effects of COVID-19 lockdown and public health strategies to support this population need to be developed.

Association between contact with a general practitioner and depressive symptoms during the COVID-19 pandemic and lockdown: a large community-based study in Hangzhou, China

OBJECTIVES

To determine the association of general practitioner (GP) contact with depressive symptoms during the COVID-19 pandemic and lockdown in China.

DESIGN

In April 2020, a follow-up survey was conducted on the basis of a baseline survey conducted between October 2018 and May 2019.

SETTING

The survey was embedded in the Stanford Wellness Living Laboratory-China (WELL China) study, an ongoing prospective community-based cohort study during 2018-2019.

PARTICIPANTS

The survey was conducted by telephone interview among 4144 adult urban residents participating in the WELL China study at baseline. We collected information on sociodemographic characteristics, depressive symptoms and GP contact during the lockdown period (February to March 2020).

PRIMARY AND SECONDARY OUTCOME MEASURES

Depressive symptoms were measured using the WHO-Five Well-being Index, comprising five questionnaire items that briefly indicate psychological well-being. Logistic regression models were applied to assess the association between GP contact and depressive symptoms.

RESULTS

In total, 3356 participants responded to the survey; 203 were excluded owing to missing data on depressive symptoms, leaving 3153 participants in the present study. During lockdown, 449 participants had GP contact. GP contact was significantly negatively associated with prevalent depressive symptoms (OR, 0.67; 95% CI 0.51 to 0.89; p<0.01) and incident depressive symptoms (OR 0.68; 95% CI 0.51 to 0.93; p<0.05). Stratified analysis showed a significant negative association between depressive symptoms and GP contact in individuals who were 45-64 years old (p<0.01), had a middle or high education (p<0.01) and had self-reported non-communicable diseases (p<0.05).

CONCLUSIONS

Contact with GPs during the COVID-19 pandemic and lockdowns may have a negative association with depressive symptoms in community-dwelling populations. Given the possibility of further surges in COVID-19 infections, GPs' contact in the community should be enhanced.

Risk perceptions of COVID-19 and its impact on precautionary behavior: A qualitative study

OBJECTIVE

The controlling of the COVID-19 pandemic is influenced by the precautionary behavior of the community, and such behavior is frequently related to individuals' risk perception. The current study aimed to explore risk perceptions and precautionary behavior in response to COVID-19.

METHOD

Qualitative in-depth interviews by telephone were undertaken with 26 participants from three affected cities in an initial stage of the disease outbreak, from May 3 to June 5, 2020. The method of analyzing data was inductive. The results were analyzed using interpretation, categorizing, and thematic analysis.

RESULTS

The perception of risk is influenced by numerous individual, community, and cultural factors; these perceptions act as triggers for precautionary behavior, with a tendency to deny risks or react with exaggeration in terms of the precautionary reactions related to COVID-19. The thematic analysis produced two major categories: 1) risk perception and 2) precautionary behavior. The analysis provides essential insight into risk perception and precautionary behavior.

CONCLUSION

The risk perceptions and patterns of precautionary behavior could be unreliable, unhealthy, and culturally affected, which would influence the effectiveness of pandemic control measures. Further investigations with more data and including risk perception and precautionary behavior in the national response plan for emergency and crisis are highly recommended.

PRACTICE IMPLICATIONS

A greater understanding and ongoing assessment of COVID-19 risk perception could inform policymakers and health professionals who seek to promote precautionary behavior. This could also facilitate early interventions during pandemics.

Lessons for Workforce Disaster Planning from the First Nosocomial Outbreak of COVID-19 in Rural Tasmania, Australia: A Case Study

The identification and announcement of the COVID-19 pandemic has been a global issue. Disaster preparedness for internal and external threats is inherent within health care environments and requires agile thinking and swift remediation. Nosocomial infection is a risk for recipients of care, especially in hospital settings, which has implications for workforce planning. The aim of this case study was to examine the community response to the internal disaster of the first nosocomial COVID-19 outbreak within an Australian rural health care environment. A critical discourse analysis method was adopted to generate and analyse data collected from three different media platforms during a six-week period. Four main themes were distilled: actions and intent, loss, well-being and recognising choice, and community action. Phase two of the study interrogated these themes to expose the power positioning of speakers and their relationships to the audiences. Strengthening communication with local communities within health care environments must be a priority in any future rural workforce disaster preparedness planning. Maintenance of trust with health service provision and delivery in rural communities is imperative. The inclusion of a robust communication plan within any risk management strategy that meets the needs of the local users of health services is mandatory.

Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic is an international public health threat, and people's participation in disease-related preventive behaviours is the key to controlling infectious diseases. This study aimed to assess the differences in adopting preventive behaviours among populations to explore potential individual and household factors and inequalities within families.

METHODS

This online survey was conducted in April 2020. The directional stratified convenient sampling method was used to select 4704 participants from eight provinces in eastern, central, and western China. The questionnaire included demographic information, household variables, and five target prevention behaviours. The chi-squared test, binary multilevel model, and Mantel-Haenszel hierarchical analysis were used for data analysis in the study.

RESULTS

Approximately 71.2% of the participants had appropriate outdoor prevention, and 32.9% of the participants had indoor protection in place. Sharing behaviours (P < 0.001) and education level (P < 0.001) were positively associated with adopting preventive measures. The inhibiting effect of household crowding and stimulating effect of high household income on preventive behaviours were determined in this study. Household size was negatively associated with living area (β = -0.057, P < 0.05) and living style (β = -0.077, P < 0.05). Household income was positively associated with age (β = 0.023, P < 0.05), and relationship with friends (β = 0.053, P < 0.05). Vulnerable groups, such as older adults or women, are more likely to have inadequate preventive behaviours. Older adults (OR = 1.53, 95% CI 1.09-2.15), women (OR = 1.37, 95% CI 1.15-1.64), and those with more than 2 suspected symptoms (OR = 1.85, 95% CI 1.07-3.19) were more likely to be affected by the inhibiting effect of household crowding, while the stimulating effect of high household income was limited in these groups.

CONCLUSIONS

Inequalities in COVID-19 prevention behaviours exist between families and inadequate adoption of prevention by vulnerable groups are noteworthy. This study expands the research perspective by emphasizing the role of household factors in preventive behaviours and by focusing on family inequalities. The government should use traditional media as a platform to enhance residents' public health knowledge. Targeted additional wage subsidies, investments in affordable housing, financial support for multigenerational households, and temporary relocation policies may deserve more attention. Communities could play a critical role in COVID-19 prevention.

Access to Epidemic Information and Life Satisfaction under the Period of COVID-19: the Mediating Role of Perceived Stress and the Moderating Role of Friendship Quality

The present study mainly focused on college students amidst the COVID-19 outbreak and aimed to develop and examine a moderated mediation model between access to epidemic information and life satisfaction. Friendship quality as a moderator, and perceived stress as a mediator. A sample of 1032 college students participated in this study and completed questionnaires regarding access to epidemic information, perceived stress, friendship quality, and life satisfaction. Findings indicated that 1) access to epidemic information was strongly related to life satisfaction; 2) perceived stress acts as a mediator in the positive relationship between access to epidemic information and life satisfaction; 3) friendship quality moderated the relationship between access to epidemic information and perceived stress as well as perceived stress and life satisfaction, and such that there was a stronger association between access to epidemic information and perceived stress for college students with high friendship quality. But the relationship between perceived stress and life satisfaction became weaker for college students with high friendship quality. The results illuminate the mechanism to theoretical and practical implications for improving college students' life satisfaction during the pandemic.

Assessing the Level of Awareness of COVID-19 and Prevalence of General Anxiety Disorder among the Hail Community, Kingdom of Saudi Arabia

BACKGROUND

The COVID-19 pandemic has caused a major public health problem around the world. Therefore, the aim of the study was to assess the awareness and prevalence of General Anxiety Disorder (GAD) with regard to COVID-19 among the Hail community, in the Kingdom of Saudi Arabia, in order to help health authorities to effectively control the pandemic.

METHODS

A cross-sectional online survey was completed by 412 participants living in Hail, Saudi Arabia. The questionnaire assessed demographic characteristics, knowledge, attitudes, and practices for the prevention of COVID-19, as well as psychological feelings in terms of GAD as an impact of the COVID-19 pandemic.

RESULTS

The study found that most of the respondents demonstrated good knowledge, attitudes, and practice for COVID-19 prevention. The elderly and employed demonstrated significant positive attitudes and practices (p < 0.05). Participants with a positive attitude were almost two and a half times (OR = 2.4; 95% CI: 1.54-3.99) more likely to have good practices. Additionally, the rural respondents were less likely (OR = 0.45; 95% CI: 0.21-0.96) to have a positive attitude. Married participants were more than one and a half (OR = 1.60; 95% CI: 1.04-2.44) times more likely to have a positive attitude. The prevalence of GAD was 21.8% and was significantly increased among participants with inadequate knowledge (OR = 2.01; 95% CI: 1.25-3.22), females (OR = 1.92; 95% CI: 1.19-3.09), individuals with chronic diseases (OR = 1.71; 95% CI: 1.02-2.86), and non-Saudi participants (OR = 2.44; 95% CI: 1.02-5.85).

CONCLUSIONS

Ensuring a sufficient combination of relatively good levels of knowledge, positive attitudes, and desired practices serves as a good approach to preventing the spread of COVID-19. However, the increased prevalence of GAD requires the attention of policymakers. Therefore, a great emphasis should be placed on health awareness campaigns, with a focus on misconceptions and the provision of counseling.

Public psychological distance and spatial distribution characteristics during the COVID-19 pandemic: a Chinese context

The COVID-19 pandemic is a public health emergency, which continues to have a significant impact on the functioning of society and the public’s daily life. From the perspective of psychological distance (PD), this study used descriptive, differential, and spatial autocorrelation analysis methods to explore the cognitive distance, emotional distance, expected distance and behavioral distance of the Chinese public in relation to the COVID-19 pandemic. An analysis of 4042 valid sample data found that: (1) The event emotional distance and subject emotional distance were both furthest from the event and subject psychological distance dimensions, and anger about the event was the strongest. (2) The government was the most appealing subject in the process of pandemic prevention and control, but at the same time, the public’s sense of closeness to the government was also lower than that of the other three subjects, e.g., medical institutions. (3) Different pandemic regions showed significant differences in PD. Mean scores of PD in each risk region were as follows: High-risk regions > medium-risk regions > low-risk regions. (4) From a global perspective, no spatial autocorrelation was found in PD. However, from a local perspective, high-value regions (provinces with distant PD) are mainly concentrated in the southern regions (Guizhou, Guangxi, Hainan, Jiangxi), and low-value regions (provinces with close PD) are mainly concentrated in North China (Shanxi, Hebei, Beijing). Combined with the relevant conclusions, this paper put forward policy recommendations.

The impact of the COVID-19 pandemic on physical and mental health in the two largest economies in the world: a comparison between the United States and China

The broad impact of the COVID-19 on self-reported daily behaviors and health in Chinese and US samples remains unknown. This study aimed to compare physical and mental health between people from the United States (U.S.) and China, and to correlate mental health parameters with variables relating to physical symptoms, knowledge about COVID-19, and precautionary health behaviors. To minimize risk of exposure, respondents were electronically invited by existing study respondents or by data sourcing software and surveys were completed via online survey platforms. Information was collected on demographics, physical symptoms, contact history, knowledge about COVID-19, psychologic parameters (i.e. IES-R; DASS-21), and health behaviors. The study included a total of 1445 respondents (584 U.S.; 861 China). Overall, Americans reported more physical symptoms, contact history, and perceived likelihood of contracting COVID-19. Americans reported more stress and depressive symptoms, while Chinese reported higher acute-traumatic stress symptoms. Differences were identified regarding face mask use and desires for COVID-19 related health information, with differential mental health implications. Physical symptoms that were possibly COVID-19 related were associated with adverse mental health. Overall, American and Chinese participants reported different mental and physical health parameters, health behaviors, precautionary measures, and knowledge of COVID-19; different risk and protective factors were also identified.

Psychological distress experienced by self-quarantined undergraduate university students in Lebanon during the COVID-19 outbreak

INTRODUCTION

Quarantine, although essential during contagious outbreaks, has been correlated with poor psychological outcomes in the general population. Such outcomes include low mood, suicide, and post-traumatic stress symptoms. Studies have mostly looked at the mental health of general citizens, healthcare workers, or infected survivors, with limited research targeting university students. This study aimed to understand the psychological distress experienced by self-quarantined undergraduate university students in Lebanon during the COVID-19 outbreak.

METHODS

Undergraduate students enrolled at the American University of Beirut were invited to participate in a 47-item online questionnaire. 73 participants completed the questionnaire. Demographic data, data about COVID-19 exposure, stressors during quarantine, understanding the rationale, compliance, and difficulties associated with quarantine, and levels of psychological distress were analysed.

RESULTS

75.3% of the participants were considered as having a high risk of developing acute stress. Undergoing quarantine for more than 14 days, having a chronic medical illness, inadequate access to supplies, and fear of infection were all significantly associated with an increased risk of acute stress.

CONCLUSION

Despite being a necessary preventive measure during infectious disease outbreaks, quarantine can be associated with negative psychological effects, particularly in undergraduate students. Providing preventive and effective interventions is of utmost necessity.KEY POINTSDuring COVID-19, three-quarter of students had high risk for acute stress.Females had higher odds of high-risk acute stress compared to males.Having a chronic medical condition was associated with high risk acute stress.Long quarantine and lack of supplies were associated with high risk acute stress.Providing interventions to protect the mental health of students is necessary.

Is the mental health of young students and their family members affected during the quarantine period? Evidence from the COVID-19 pandemic in Albania

WHAT IS KNOWN ON THE SUBJECT?: Mental health is deteriorated during the quarantine period. Mental health status is affected by the quarantine even after the end of it and for an extended period. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Depression levels among nursing/midwifery students during the quarantine period are high. Depression levels among students' family members during the quarantine period are high. Those who are not satisfied with COVID-19 prevention measures and those who believe that COVID-19 and quarantine can cause problems on health, have elevated levels of depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Provision of mental health services during the quarantine period should be a priority for the healthcare system. Offering mental health first aid training and support can improve the mental health status of students and their family members. ABSTRACT: Introduction The use of quarantine method has a significant impact on mental health status. Aim This study aimed to assess the levels of depression among bachelor and master university students (nurses/midwives) and their family members' during the quarantine period of COVID-19 pandemic. Method A cross-sectional study was conducted in Vlora University, Albania. Patient Health Questionnaire (PHQ-9) was used. Institutional e-mails of all active students were used for their recruitment. Results In total, 863 students and 249 family members participated in the study. The mean PHQ-9 score was 6.220 (SD = 5.803) and 6.280 (SD = 5.857) for students and family members, respectively. Being unsatisfied with COVID-19 prevention measures, beliefs that COVID-19 infection and quarantine process can cause problems on their health status were the key factors for students to be screened positive for mental problems in multiple regression analysis. For parents, the last two factors were found to contribute significantly. Discussion Our findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members. Broader population studies are necessary to safeguard these results. Implications for Practice Provision of mental health services during the quarantine period is of paramount significance. Mental health first aid training and support could benefit both students and their parents significantly. Additionally, follow-up services after the end of quarantine are recommended.

Anxiety and depression levels of the general population during the rapid progressing stage in the coronavirus disease 2019 outbreak: a cross-sectional online investigation in China

OBJECTIVE

The outbreak of COVID-19 has major impacts on the psychological health of the public. This study aimed to investigate the anxiety and depression levels of the general population during the rapid progressing stage of COVID-19 pandemic in China and to explore the associated factors.

DESIGN AND SETTING

A cross-sectional online survey.

PARTICIPANTS

2651 Chinese people.

MEASURES

The Hospital Anxiety and Depression Scale was used to measure their psychological health. A structured questionnaire collected possible associated factors, including sociodemographic characteristics, health information, contact history-related information, experience and perceptions, knowledge and education and adopted precautions. Multiple linear regression was conducted to explore the factors associated with anxiety and depression.

RESULTS

The mean score of anxiety and depression was 4.35 and 4.38, respectively. The rates of people with anxiety and depressive symptoms (with >7 score in the subscale) were 14.15% and 17.35%, respectively. Participants without political party membership, with contact history of COVID-19, going out or gathering, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher risks of infection, lower knowledge and poorer health presented higher anxiety and depression levels. Moreover, those who were females, married, lived alone and wore mask were more anxious; whereas people who were younger, experienced public health crisis, did not take precautions (regular work-rest, exercise) had higher depression level.

CONCLUSIONS

During the rapid progressing stage of COVID-19 pandemic in China, one-seventh and one-sixth respondents presented anxiety and depression symptoms, respectively. The risk factors for anxiety and depression included the following: without political party membership, with contact history of COVID-19, going out or gathering, wearing masks, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher susceptibility, lower knowledge and poorer health status. Extensive information and psychological support should be provided to improve the mental health of the general population.

Risk Perception and Behavioral Response to COVID-19: A Survey of University Students and Staff in the Iraqi Kurdistan Region

This study explores the risk perceptions and behavioral responses of university academics and students toward the COVID-19 pandemic. All universities in Iraqi Kurdistan were invited to take part in a self-administered online survey; 976 individuals ultimately completed it. The survey included eight main questions about personal risk perception and behavioral response to COVID-19 based on a five- or nine-point ordinal scale. A high percentage of the respondents perceived it as highly unlikely they were at risk of getting infection (26.9%), serious illness (29.7%), and death (41.7%). The percentage of the respondents who applied protective measures frequently or always was high for most protective behavior types, except for wearing masks, wearing gloves, and avoiding touching the face. There was a significant (P < .001) weak positive correlation between risk perception and protective behaviors. The respondents followed protective behavior measures reasonably, but the frequency of undertaking some important protective behaviors was relatively low.

Illness uncertainty among patients with COVID-19 in the Mobile Cabin Hospital

Aims

To investigate the status and influencing factors of illness uncertainty among patients with coronavirus disease 2019 (COVID‐19) in the mobile cabin hospital.

Design

A cross‐sectional study.

Methods

114 patients with COVID‐19 admitted to a mobile cabin hospital in Wuhan, Hubei Province, in February 2020 were enrolled by a convenience sampling method. The Chinese version of the Mishel Illness Uncertainty Scale (MUIS) was used to assess patients’ degree of illness uncertainty, and multiple regression analysis was used to explore the influencing factors.

Results

The average total score of MUIS (Chinese version) was 52.22 ± 12.51, indicating a moderate level of illness uncertainty. The dimension unpredictability turned out to have the highest mean score: 2.88 ± 0.90. The multiple stepwise regression analysis showed that female (t = 2.462, p = .015), monthly family income not less than RMB 10,000 (t = −2.095, p = .039), and disease duration of 28 days or more (t = 2.249, p = .027) were independent influencing factors of illness uncertainty.

Conclusion

Patients with COVID‐19 are at a moderate level of illness uncertainty. Medical staffs should pay more attention to female patients, patients with lower monthly family income, patients with the prolonged disease, and take targeted interventions to help them reduce illness uncertainty.

Impact

Facing the brand new and unknown infectious disease, patients confirmed of COVID‐19 suffer from immense physical and psychological stress, where illness uncertainty is a major stressor that troubles patients. The present study surveys illness uncertainty among patients with COVID‐19 in the mobile cabin hospital with results revealing a moderate level. Study results will benefit nurses in any setting where care for patients with COVID‐19 is provided, public policymakers and future researchers.

When COVID-19 enters in a community setting: an exploratory qualitative study of community perspectives on COVID-19 affecting mental well-being

OBJECTIVE

The COVID-19 pandemic has resulted in an increased level of anxiety and fear among the general population related to its management and infection spread. Considering the relevance of present circumstances, we explored perceptions and attitudes of community members towards their mental well-being during the COVID-19 pandemic.

SETTING

We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan.

PARTICIPANTS

In-depth interviews were conducted with community members including, young adults, middle-aged adults and older adults of both genders. Study data were analysed manually using the thematic analysis technique.

PRIMARY OUTCOME

The primary outcome is assessing community perception towards their mental well-being amidst the COVID-19 pandemic.

RESULTS

A total of 27 in-depth interviews were conducted, between May and June 2020. Three overarching themes were identified: (1) impact of COVID-19 on the mental health of the general communities; (2) current coping mechanisms to adapt to the new reality and (3) recommendations to address the mental health of communities. Generally, community members underwent increased anxiety and fear due to the contagious nature of the virus. Alongside, social, financial and religious repercussions of the pandemic have also heightened psychological distress among community members. However, community members were able to point out some of the coping mechanisms such as getting closer to God, connecting with family, participating in mental health sessions and resetting lives by indulging in diverse activities. Simultaneously, they also recommended the need for remote mental health services for elders and continuous efforts by the government to address the mental health needs of the community.

CONCLUSION

COVID-19-associated mental health consequences have hit every individual in society. The study finding has the potential to guide the development of context-specific innovative mental health programmes to overcome the pandemic repercussions.

Health literacy, resilience and perceived stress of migrants in Israel during the COVID-19 pandemic

OBJECTIVE

To examine perceived stress in migrants guided by Bornstein's Specificity Principle in Acculturation Science (BSPAS) theoretical framework.

DESIGN

Using a cross-sectional study, we recruited English-language migrants (n = 411) living in Israel to respond to an online questionnaire during the COVID-19 pandemic, from 3 April to 16 May 2020.

MAIN OUTCOME MEASURES

The dependent variable comprised the Perceived Stress Scale (PSS) scores, which attained an internal consistency of 0.91 in this sample.

RESULTS

PSS scores were related to lower age (p < 0.0001), being single (p = 0.0095), not possessing high (p = 0.0069) or medium resilience (p = 0.0002), reporting below average SES (p = 0.0196), being "extremely" worried about getting COVID-19 (p < 0.0001), and having high health literacy (p = 0.0007). Additionally, the interaction between health literacy and resilience (p < 0.0001) showed that migrants with high resilience and high health literacy had the lowest perceived stress; and migrants with low resilience and high health literacy had the highest perceived stress.

CONCLUSIONS

Interventions are needed to assist migrants during the COVID-19 pandemic. The optimal intervention will aim to address the psychological distress while increasing both health literacy and resilience.