Exploring the influence of self-efficacy and autonomy on outdoor recreation behaviors during the COVID-19 pandemic

Outdoor Recreation (OR) provides the benefits of physical activity and traditional leisure placed in an outdoor environment. Motivation, self-efficacy, and autonomy can increase depending on the physical and social environment. This study explored the relationship between self-efficacy and autonomy on OR behaviors and identified barriers and facilitators to OR during the COVID-19 pandemic. Survey information was collected from 995 U.S. adults (93.6% white, 64.0% female) regarding OR behaviors, changes in OR during COVID-19, and OR self-perceptions. Significant positive correlations existed between autonomy and self-efficacy (r = 0.138, p < 0.01), and self-efficacy and pre/post pandemic OR behaviors 2020 (r = 0.158, p < 0.01), (r = 0.129, p < 0.01) respectively. Qualitative data implied barriers and facilitators to OR as: social, mental health, and increased or changed OR/physical activity. Implications from this research are beneficial to OR and health professionals to promote overall physical and mental well-being for OR participants.

Dementia inpatients with and without COVID-19: Clinical needs, care and outcomes

Background: Dementia is the most common pre-existing condition related to coronavirus deaths. COVID-19 itself causes high rates of neuropsychiatric co-morbidities, including delirium. In addition, infection control measures in hospitals and changes in patient flow have drastically altered the care provided to patients with dementia. Some of the emergency measures mainly affected COVID-19 positive patients, whereas others had an impact on all. The difference in dementia care and health outcomes between patients with and without coronavirus is not well characterised. Methods: This project examined these differences by leveraging the National Audit of Dementia (NAD) data framework. A tailor-made questionnaire was composed of the relevant items from the NAD and additional items - demographic data, details of care provided, health and discharge outcomes. The sample included 100 patients with dementia admitted to the Stoke Mandeville Hospital during April-July 2020. This was composed of all dementia patients who tested positive for COVID-19 during admission (n=25) and a control sample of those who did not (n=75). Statistical analysis: Analysis involved a combination of student's t, binomial, and Chi-squared statistical tests, applied to numerical, two-answer categorical, and multiple-answer categorical data respectively. Where appropriate, false discovery rate correction was applied to account for multiple comparisons. P-values of <0.05 were treated as representing significant differences between the groups. Results and Conclusions: Demographics of COVID-positive dementia inpatients were different, with more males (48% vs. 27% of COVID-negative) and more patients coming from residential care (40% vs. 19%). During admission, COVID-positive patients experienced higher rates of new neurological signs and delirium, but fewer formal assessments of cognition were carried out. On the other hand, COVID-positive inpatients received better functional assessments and comprehensively documented ward-care. While the mortality rate for these patients was much higher (48% vs. 8%), if discharged, this was better coordinated. Distinct clinical needs of COVID-19 dementia inpatients need to be taken into account in the planning of routine, and crisis, hospital care.