The effect of the COVID-19 pandemic on severe asthma care in Europe: will care change for good?

Background: The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods: In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results: 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions: Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.

The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?

Background The COVID-19 pandemic has put pressure on health-care services forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic, and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.

Emotional and behavioral responses to COVID-19: Explanations from three key models of personality

This review appraises evidence for the role of personality in COVID-19 related emotions and behaviors. Three key models of personality are considered: the Five-factor Model, HEXACO model, and Reinforcement Sensitivity Theory (RST). In line with personality research, more generally, most studies focus on the Five-Factor model. Key findings are that neuroticism is most associated with poor mental health, and extraversion is associated with a reluctance to socially isolate. Conscientiousness predicts compliance with safety guidelines but also with fewer prosocial behaviors, particularly stockpiling. Research within the HEXACO framework largely confirms these findings, especially for emotionality and mental health. The additional HEXACO Honesty-Humility factor is found to be associated with prosocial views and abstention from panic buying. Studies based on the Reinforcement Sensitivity Theory of personality indicate emotional conflict as people wish to stay safe while maintaining a sense of normality. Behavioral compliance is driven by activation in the Fight-Flight-Freeze System (FFFS;fear-related) and the Behavioral Inhibition System (BIS;anxiety-related). The Behavioral Approach System (BAS) is implicated in approach-driven behaviors such as avoiding infection. These findings have implications for health communications and post-pandemic support. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Coping with fibromyalgia during the COVID-19 pandemic: adjustment and wellbeing.

OBJECTIVE: Fibromyalgia syndrome (FMS) is a chronic condition with symptoms known to be exacerbated by stress. Individuals with FMS may be experiencing particular distress under Covid-19 pandemic-related lifestyle restrictions. The present study examined wellbeing, perceived symptom change and coping in individuals with and without FMS during pandemic-related social lockdown in the UK. DESIGN: Participants with a diagnosis of FMS (N = 390) and a general public sample with no FMS (N = 151) completed questionnaires at three time points. MAIN OUTCOME MEASURES: BBC Wellbeing Scale, Cognitive-Emotional Regulation Questionnaire measure of coping, perception of extent to which symptoms have worsened or improved over time. RESULTS: Contrary to expectations, FMS participants reported no worsening of symptoms and an increase in wellbeing over the study period. Non-FMS participants experienced worsening health symptoms and no change in wellbeing. Coping strategies involving positive reappraisal, refocussing and planning were positively associated with wellbeing in the FMS group. CONCLUSION: The unpredictable symptom profile in FMS, and the regular readjustment this necessitates, may support a form of resilience which has been adaptive during the pandemic. The results have implications for supporting people with FMS, and potentially other chronic conditions, especially at times of stress.

Vaccination Hesitancy and Conspiracy Beliefs in the UK During the SARS-COV-2 (COVID-19) Pandemic.

BACKGROUND: Conspiracy beliefs about vaccination along with vaccination hesitancy are threats to achieving population immunity during the SARS-COV-2 (COVID-19) pandemic. This longitudinal study aimed to clarify the association between these and non-monetary incentives to vaccination in the UK. METHOD: Data were collected at three points: (1) before and (2) after the development of a vaccine and (3) after the vaccination programme was underway. At Time 1, participants completed measures of general and COVID-19-specific concerns about vaccination and belief in conspiracy theories. At times 2 and 3, participants reported their intentions whether or not to have the SARS-CoV-2 vaccine. Those who were hesitant provided qualitative comments about what might change their decision. RESULTS: Vaccination hesitancy decreased between times 1 (54%) and 3 (13%). There were small effects of conspiracy beliefs on vaccine hesitancy, but only at time 1. Most concerns and reported incentives were related to safety, although at time 2, incentives included endorsement by trusted public figures. By time 3, only a minority of participants (N = 18) were adamantly against vaccination, stating that nothing would change their minds. CONCLUSION: Vaccination hesitancy declined in the UK during the course of the study. However, concerns about vaccine safety remained and could jeopardise the vaccination programme should any adverse effects be reported. Conspiracy beliefs seem to play only a minor role in hesitancy and may continue to decrease in importance with a successful vaccination programme. Understanding motivations behind vaccination hesitancy is vital if we are to achieve population immunity.

Behavioral Immune System Responses to Coronavirus: A Reinforcement Sensitivity Theory Explanation of Conformity, Warmth Toward Others and Attitudes Toward Lockdown.

Behavioral immune system (BIS) describes psychological mechanisms that detect cues to infectious pathogens in the immediate environment, trigger disease-relevant responses and facilitate behavioral avoidance/escape. BIS activation elicits a perceived vulnerability to disease (PVD) which can result in conformity with social norms. However, a response to superficial cues can result in aversive responses to people that pose no actual threat, leading to an aversion to unfamiliar others, and likelihood of prejudice. Pathogen-neutralizing behaviors, therefore, have implications for social interaction as well as illness behaviors and responses to health communications. In this study, we investigate how PVD influences conformity, attitudes to other people and to lockdown regulations through the lens of the Reinforcement Sensitivity Theory (RST). RST describes personality in terms of biologically-driven approach and avoidance motivations which support personal goals. Participants from the United Kingdom public (N = 605) completed an RST personality questionnaire and then read either (a) coronavirus morbidity-mortality statistics and current United Kingdom government lifestyle regulations, (b) just the regulations (as presented in most government publicity materials), or (c) no information at all. They all completed the Perceived Vulnerability to Disease scale to assess BIS-relevant Germ Aversion and Perceived Infectability, followed by questions measuring social conformity, warmth toward others and attitudes toward lockdown measures. Significantly lower PVD scores were observed in the no-information condition, with the other conditions showing no difference. In terms of RST, approach behaviors related to goal-drive persistence work alongside fear in explaining conformity to social norms. Reward related approach behaviors partially explained warmth toward others, indicating that social rewards gained through interaction continue to be strong drivers of behavior. We found no role for RST traits in attitudes toward lockdown. Overall, coronavirus-related behavior is not driven purely by fear, but also by social and/or protection goals regulated by approach motivation. This study presents new insights into public perceptions of coronavirus and government regulated lifestyle restrictions, helping to explain social behaviors in terms of biologically driven mechanisms. Such understanding is vital if we are to successfully motivate public behavior to constrain spread of the virus.

Coronavirus (COVID-19) in the United Kingdom: A personality-based perspective on concerns and intention to self-isolate.

Objectives Public behaviour change is necessary to contain the spread of coronavirus (COVID-19). Based on the reinforcement sensitivity theory (RST) framework, this study presents an examination of individual differences in some relevant psychological factors. Design Cross-sectional psychometric. Methods UK respondents (N = 202) completed a personality questionnaire (RST-PQ), measures of illness attitudes, concerns about the impact of coronavirus on health services and socio-economic infrastructures, personal safety, and likelihood of voluntary self-isolation. Results Respondents most concerned were older, had negative illness attitudes, and scored higher on reward reactivity (RR), indicating the motivation to take positive approach action despite prevailing worry/anxiety. Personal safety concerns were highest in those with negative illness attitudes and higher fight-flight-freeze system (FFFS, reflecting fear/avoidance) scores. Results suggest people are experiencing psychological conflict: between the urge to stay safe (FFFF-related) and the desire to maintain a normal, pleasurable (RR-related) life. Ways of ameliorating conflict may include maladaptive behaviours (panic buying), reflecting reward-related displacement activity. Intended self-isolation related to FFFS, but also low behavioural inhibition system (related to anxiety) scores. Older people reported themselves less likely to self-isolate. Conclusions Interventions need to consider individual differences in psychological factors in behaviour change, and we discuss relevant literature to inform policy makers and communicators. Statement of contribution What is already known on this subject? Reinforcement sensitivity theory (RST) personality systems can influence perception of persuasive health messages. However, there is limited evidence for their direct effects on health concerns and behaviours, and none relating to specific infectious diseases. What does this study add? Reward reactivity (RR) is associated with concern about impact of coronavirus on the NHS and other social infrastructures, indicating the motivation to take positive-approach action despite worry/anxiety. Personal safety concerns are related to fight-flight-freeze system traits (FFFS, reflecting fear/avoidance). Intended self-isolation related to FFFS, but also low behavioural inhibition system (related to anxiety) scores. Older people reported themselves less likely to self-isolate. Results suggest psychological conflict: between the urge to stay safe (FFFF-related) and the desire to maintain a normal, pleasurable life (RR-related). Ways of ameliorating conflict may include maladaptive behaviours (panic buying), reflecting reward-related displacement activity.