Mental health, social integration and support of informal caregivers during the second wave of the COVID-19 pandemic: A population-based representative study from Germany.

INTRODUCTION: The study analyzed mental health, social integration and social support of informal caregivers of individuals aged ≥60 years compared to non-caregivers during the second wave of the COVID-19 pandemic. METHODS: A quantitative, cross-sectional study was conducted with a sample drawn randomly from the nationally representative online panel forsa.omninet in Germany between March 4th and 19th 2021. In total, 3022 adults aged ≥40 years from Germany were questioned, including 489 adults providing informal care for adults aged ≥60 years between December 2020 and March 2021. Depressive (PHQ-9) and anxiety symptoms (GAD-7), loneliness (De Jong Gierveld Scale), social exclusion (Bude & Lantermann Scale) and social network support (Lubben's Social Network Scale) were measured. Adjusted OLS regression analyses and additional moderator analyses (moderators: perceived restrictions and danger of infection due to the COVID-19 pandemic) were conducted. RESULTS: Significant higher levels of depressive and anxiety symptoms and more social support were found among informal caregivers compared to non-caregivers. Loneliness and social exclusion did not differ between both groups. Perceived restrictions by the pandemic significantly moderated the association between informal caregiving and social support - social support was stronger among caregivers with higher levels of perceived restrictions by the pandemic. CONCLUSION: Informal caregivers are faced with worse mental health than non-caregivers during the pandemic, although their social support was stronger, in particular in dependence of higher levels of perceived restrictions by the pandemic. Thus, results indicate a need for an informal-care-specific policy and more professional support for informal caregivers during a health crisis.

Perceived Norms and Vaccination against COVID-19 among the General Adult Population in Germany: Results of a Nationally Representative Survey.

OBJECTIVE: to examine whether perceived norms are associated with vaccination against COVID-19 (also stratified by age group). STUDY DESIGN: nationally representative survey. METHODS: Data were taken from a sample of the general adult population (n = 3829, 16 to 94 years). Data collection took place from early July to early August 2021, and 3 different groups (1: not yet vaccinated and no intention to vaccinate against COVID-19; 2: not yet, but intended to vaccinate against COVID-19; 3: yes, at least one vaccination against COVID-19) were distinguished in the analyses. Data were adjusted for several sociodemographic and health-related factors. Perceived norms served as key independent variables (1: number of important friends and relatives who would like me to get vaccinated; 2: number of important friends and relatives who already have been vaccinated or still want to do so; 3: how your general practitioner (GP) thinks about Corona vaccination). RESULTS: Multiple logistic regression showed that, in particular, the number of important friends/relatives who would like an individual to get vaccinated is associated with the actual COVID-19 vaccination status among individuals aged 16 to 59 years. Interestingly, all 3 indicators for perceived norms are associated with the likelihood of COVID-19 vaccination status among individuals aged 60 years and over. CONCLUSIONS: Our study adds to the understanding of the association between perceived norms and COVID-19 vaccination status. This highlights potential pathways to increase vaccination rates to further combat the later stages of the pandemic.

Long-term care need, loneliness, and perceived social isolation during the COVID-19 pandemic: evidence from the German Ageing Survey.

BACKGROUND: There is a complete lack of studies focusing on the association between care degree (reflecting the long-term care need) and loneliness or social isolation in Germany. AIMS: To investigate the association between care degree and loneliness as well as perceived social isolation during the COVID-19 pandemic. METHODS: We used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. We used wave 8 of the German Ageing Survey (analytical sample: n = 4334 individuals, mean age was 68.9 years, SD: 10.2 years; range 46-100 years). To assess loneliness, the De Jong Gierveld instrument was used. To assess perceived social isolation, the Bude and Lantermann instrument was used. Moreover, the level of care was used as a key independent variable (absence of care degree (0); care degree 1-5). RESULTS: After adjusting for various covariates, regressions showed that there were no significant differences between individuals without a care degree and individuals with a care degree of 1 or 2 in terms of loneliness and perceived social isolation. In contrast, individuals with a care degree of 3 or 4 had higher loneliness (ß = 0.23, p = 0.034) and higher perceived social isolation scores (ß = 0.38, p < 0.01) compared to individuals without a care degree. DISCUSSION/CONCLUSIONS: Care degrees of 3 or 4 are associated with higher levels of both loneliness and perceived social isolation. Longitudinal studies are required to confirm this association.

Neighbourhood cohesion, loneliness and perceived social isolation prior and during the COVID-19 pandemic. Longitudinal evidence from the German Ageing Survey.

PURPOSE: To investigate the longitudinal association between neighbourhood cohesion and loneliness as well as perceived social isolation prior and during the COVID-19 pandemic (stratified by sex). METHODS: Longitudinal data were taken from a nationally representative sample (German Ageing Survey) of inhabitants aged 40 years and over in Germany prior (wave 6: year 2017) and during the COVID-19 pandemic (wave 8: November 2020 until February 2021; n = 6688 observations, mean age was 67.4 years). The De Jong Gierveld tool was used to measure loneliness and the Bude and Lantermann tool was used to measure perceived social isolation. Neighbourhood cohesion was assessed based on different items. RESULTS: FE regressions showed that decreases in closeness of contact with neighbours were associated with increases in loneliness and perceived social isolation levels among men, but not women. In contrast, decreases in different indicators of involvement in neighbourhood activities were associated with increases in loneliness and perceived social isolation levels among women, but not men. CONCLUSION: Changes in neighbourhood factors are differently associated with loneliness and perceived social isolation among middle-aged and older women and men. Gender-specific efforts to avoid loneliness and social isolation are, therefore, needed.

Are informal caregivers more likely to believe in conspiracy theories during the COVID-19 pandemic?: Findings of a representative study from Germany.

OBJECTIVES: This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age. METHODS: The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4th and 19th March 2021 and the questions referred to the time between December 2020 and March 2021. RESULTS: No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers. CONCLUSION: Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing.

Social support for informal caregivers of spouses and parents(-in-law) aged 60 years and older during the COVID-19 pandemic: Findings from a representative German Online Survey.

OBJECTIVES: We analyzed whether spousal and adult child caregivers of older adults differed from each other and from non-caregivers in terms of the social support available to them during the COVID-19 pandemic, whether available support differed by gender, and whether the perception of pandemic restrictions moderated these differences. METHODS: Participants (≥40 years) were randomly drawn from the population-based German online panel forsa.omninet. Between 4 th and 19 th March 2021, 2520 non-caregivers, 337 adult child caregivers and 55 spousal caregivers were questioned about social support, perception of pandemic restrictions, health and sociodemographic information. Adjusted regression analyses and moderator analyses were conducted. RESULTS: Adult child caregivers had higher social support from family and friends than non-caregivers, and more support from friends than spousal caregivers. Spousal caregivers had less social support from friends compared to both groups. The perceived restrictions of the pandemic moderated the differences in support from family and friends between spousal caregivers and non-caregivers, and the differences between spousal and adult child caregivers in support from friends. Gender moderated the difference in support by friends between caregiving and non-caregiving wives and sons(-in-law). DISCUSSION: Informal caregivers seemed to have a supportive informal network during the pandemic. However, spousal caregivers only had similar levels of support as adult child caregivers if they strongly perceived restrictions of the pandemic, and had the lowest support level of all three groups - in particular from friends. Thus, spousal caregivers may benefit most from support actions, and these should focus on their wider social network.

Predictors of Loneliness among Homeless Individuals in Germany during the COVID-19 Pandemic.

PURPOSE: The aim of the study was to identify the frequency of loneliness and to examine the factors associated with loneliness among homeless individuals in Germany during the COVID-19 pandemic. METHODS: Data were taken from the 'national survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic'. The data collection took place from 26th July to 17th September 2021 (the analytical sample included n = 491 observations). The well-established UCLA-3 tool was used to quantify loneliness. Independent variables included sex, age, marital status, the existence of children and pets, level of education, country of origin, duration of homelessness, alcohol and drug consumption, mental health concerns and concerns regarding COVID-19 illness. Multiple logistic regressions were used to examine the predictors of loneliness. RESULTS: The frequency of loneliness was 41.7% for the total sample. Multiple logistic regression analysis stratified by gender showed that a higher likelihood of loneliness was associated with being born in Germany, being middle aged (40 to 49 years compared to 18 to 29 years), having mental health problems and a short period of homelessness (1 month compared to longer periods) among women. In men, a higher likelihood of loneliness was associated with a higher fear of COVID-19 and a short period of homelessness. CONCLUSIONS: Our study revealed a high frequency rate of loneliness among homeless individuals. The study results highlight the associations between some explanatory variables (i.e., the duration of homelessness and mental health problems). Identifying the factors associated with loneliness may help to adequately address the problems of homeless individuals at risk of loneliness. Longitudinal studies are required to confirm our findings.

[Use of and Attitudes toward Tests for the Detection of SARS-CoV-2 and Corresponding Antibodies: Results of a Nationally Representative Survey in Late Summer 2021]. / Inanspruchnahme von und Einstellungen zu Tests zum Nachweis von SARS-CoV-2 und entsprechenden Antikörpern. Ergebnisse einer bevölkerungsrepräsentativen Befragung im Spätsommer 2021.

OBJECTIVE: There is a lack of knowledge regarding utilization of and attitudes towards tests for the detection of SARS-CoV-2 in Germany. Our work aimed to reduce this gap. METHODS: Data were taken from a nationally representative online survey (August 24th to 3rd September 2021, n=3,075; mean age: 44.5 years). Utilization of and attitudes toward Covid-19-tests were quantified in detail. RESULTS: In sum, 79.1% of respondents had already undergone an appropriate test to detect SARS-CoV-2 test (mainly rapid antigen testing at rapid testing centers and self-testing) or an antibody test. With the exception of a PCR test, Covid-19 tests were rarely perceived as uncomfortable. Respondents were most likely to prefer a rapid antigen test in a rapid testing center. The main reasons for using self-testing as well as rapid antigen testing at rapid testing centers were (i) protection of others, (ii) for their own health precautions, and (iii) traveling. The main reasons for not using self-testing/rapid antigen testing at the workplace/training center were: (i) already vaccinated against Covid-19/recovered from Covid-19, followed by (ii) the home office workplace, and (iii) a lack of perceived benefit. Nearly 80% were somewhat or very satisfied, with access to testing at the workplace/training center and rapid testing centers. CONCLUSION: Our work described the use of and aspects of attitudes toward tests for the detection of SARS-CoV-2 in Germany in late summer 2021. At that time, such test offers were already used quite often and were predominantly perceived as not being very unpleasant. The protection of other individuals was one of the main reasons for the use of such tests. Future research in this area is desirable (e. g., among the oldest old and in times when free-of-charge testing is no longer offered).

[Attitudes Toward Influenza Vaccination in Fall/Winter 2021: Results of the COSMO Study]. / Einstellung zur Grippeimpfung im Herbst/Winter 2021: Ergebnisse der COSMO-Studie.

AIM OF THE STUDY: There is a lack of knowledge about attitudes to influenza vaccination in Germany in 2021/2022. Based on the COSMO survey ("COVID-19 Snapshot Monitoring"), the aim of this study was to shed some light on this topic. METHODS: Wave 49 (August 10 and 11, 2021) of the COSMO survey (n=967; Germany-wide non-probabilistic quota sample; 18 to 74 years). RESULTS: This year, about one-third of respondents (and health care workers) plan to get a flu shot, and among the at-risk group of people aged 60 and older (up to 74 years in our sample), more than half. Correlates (such as gender: women with a lower likelihood of a planned flu shot) were identified. CONCLUSION: Physicians should inform women in particular about the advantages of influenza vaccination, especially during the pandemic, and communicate data on the proven protective effect of influenza vaccination as convincingly as possible (e. g., using existing brochures).

Utilization of internet for religious purposes and psychosocial outcomes during the COVID-19 pandemic.

BACKGROUND: Prior to the COVID-19 pandemic, research findings pointed towards an alleviating effect of religion on depressive symptoms and loneliness. However, it is not clear whether such a relationship persisted when worships were mostly held as online events. Consequently, this study investigates the link between religion-related internet utilization, particularly for online worships, depressive symptoms, and loneliness during the lockdown period. METHODS: Data were derived from a representative sample of German individuals aged 40 years and above, which was conducted in June and July 2020. Utilization of internet for religious purposes was treated as a dichotomous variable. RESULTS: Regarding bivariate analysis, individuals that used the internet for religious purposes were significantly older, and more likely to be female or to live in an urban setting. Furthermore, they had significantly more severe depressive symptoms. According to multiple linear regression, internet usage for religious purposes was both associated with more depressive symptoms, R² = .30, F(11, 3367) = 113.01, ß = 0.39, p = .050, and higher loneliness levels, R² = .09, F(11, 3367) = 25.75, ß = 2.24, p = .025. CONCLUSIONS: It seems possible that the alleviating effect of religion on depressive symptoms and loneliness did not hold during the COVID-19 pandemic, which may imply that online worships are not perfect replacements for traditional worships in terms of their social and health benefits.

Health-related quality of life in seven European countries throughout the course of the COVID-19 pandemic: evidence from the European COvid Survey (ECOS).

PURPOSE: To investigate health-related quality of life (HRQoL) over the course of the COVID-19 pandemic in seven European countries and its association with selected sociodemographic as well as COVID-19-related variables. METHODS: We used longitudinal data from nine quarterly waves collected between April 2020 and January 2022 (sample size per wave ranging from N = 7025 to 7300) of the European COvid Survey (ECOS), a representative survey of adults in Germany, United Kingdom, Denmark, Netherlands, France, Portugal and Italy. HRQoL was measured using the EQ-5D-5L. The association of self-reported COVID-19 infection, perceived health risk from COVID-19, selected sociodemographic variables and the COVID-19 stringency index with HRQoL was analyzed by logistic and linear fixed effects regressions. RESULTS: On average across all nine waves, the proportion of respondents reporting any problems in at least one of the EQ-5D dimensions ranged between 63.8% (Netherlands) and 71.0% (Denmark). Anxiety/depression was the most frequently affected EQ-5D dimension in four countries (Portugal: 52.0%; United Kingdom: 50.2%; Italy: 49.2%; France: 49.0%), whereas pain/discomfort ranked first in three countries (Denmark: 58.3%; Germany: 55.8%; Netherlands: 49.0%). On average across all nine waves, the EQ-VAS score ranged from 70.1 in the United Kingdom to 78.4 in Portugal. Moreover, the EQ-5D-5L index ranged from .82 in Denmark to .94 in France. The occurrence of COVID-19 infection, changes in the perceived risk to one's own health from COVID-19, the occurrence of income difficulties and an increase in the COVID-19 stringency index were associated with increased likelihood of problems in EQ-5D dimensions, reduced EQ-VAS score and reduced EQ-5D-5L index. CONCLUSIONS: Across seven European countries, we found large proportions of respondents reporting problems in HRQoL dimensions throughout the pandemic, especially for anxiety/depression. Various sociodemographic and COVID-19-related variables were associated with HRQoL in longitudinal analysis.

Gender Differences in Mental Health, Quality of Life, and Caregiver Burden among Informal Caregivers during the Second Wave of the COVID-19 Pandemic in Germany: A Representative, Population-Based Study.

INTRODUCTION: This study aimed to compare the mental health, quality of life, and caregiving burden between male and female informal caregivers of older adults (≥60 years) during the second wave of the COVID-19 pandemic in Germany. METHODS: The sample consisted of 301 female and 188 male informal caregivers of older adults in need of care (≥60 years). Data were used from a cross-sectional study in March 2021 that questioned a representative sample of adults aged 40 years and older from Germany. Information on informal care provision, mental health (depressive and anxiety symptoms), caregiving burden, and quality of life was assessed for the period between December 2020 and March 2021. Regression analyses, adjusted for (1) the sociodemographic background and health of the caregivers, (2) the caregiving time and caregiving tasks, and (3) the perception of impairment and danger posed by the pandemic, were conducted. RESULTS: Findings of the fully adjusted model indicated a higher level of anxiety and lower quality of life among female caregivers, compared to male caregivers. Gender differences in depression and caregiver burden were not significant in analyses that controlled for care tasks and time. Moderator analyses indicated that gender differences in caregiver's anxiety levels were influenced by the danger perceived to be posed by the pandemic: among men the danger to the care recipient, and among women the danger to themselves, increased anxiety. CONCLUSION: Female informal caregivers were more negatively affected than male informal caregivers during the pandemic, as indicated by higher levels of anxiety and lower quality of life. Gender differences in anxiety depended on the perceived danger posed by the pandemic. Thus, policy and pandemic measures should focus on gender-specific support of female caregivers who seem to be particularly vulnerable during the pandemic. More caregiver-specific support and information around protecting themselves and their care recipients are recommended. Also, further research on gender differences in care performance and their relation to psychosocial health outcomes is recommended.

Prevalence and correlates of coronavirus anxiety in Germany: Results of a nationally representative survey.

The aim was to identify the prevalence and correlates of coronavirus anxiety in the nationally representative adult population in Germany (N = 3,075) via an online survey conducted in August/September 2021. The Coronavirus Anxiety Scale was used to quantify coronavirus anxiety. In sum, 71.2% of the respondents did not report coronavirus anxiety at all (i.e., a score of zero). The average score for coronavirus anxiety was 1.3 (SD: 2.9, ranging from 0 to 20). Several correlates were identified via two-part models. Knowledge about the correlates of coronavirus anxiety may assist in providing targeted support to individuals at risk of high anxiety levels.

Personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic: findings of a representative survey.

BACKGROUND: The aim of our study was to assess the personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic. METHODS: We used data from a representative online-survey covering the general German adult population (data collection: mid-March 2022). We restricted our sample to full-time employed individuals aged 18 to 64 years (n = 1,342 individuals). Sick leave days in the preceding 12 months served as outcome measure. Validated and established tools were used to quantify personality characteristics and psychosocial factors (such as the Coronavirus Anxiety Scale or the De Jong Gierveld loneliness tool). Negative binomial regression models were used. RESULTS: After adjusting for various sociodemographic and health-related factors, regressions showed that a higher number of sick leave days was associated with lower levels of conscientiousness (IRR: 0.84, 95% CI: 0.73-0.97), higher levels of openness to experience (IRR: 1.19, 1.04-1.35), less coronavirus anxiety (IRR: 0.90, 95% CI: 0.86-0.93), and more depressive symptoms (IRR: 1.06, 1.02-1.11). CONCLUSION: After adjusting for various sociodemographic and health-related factors, our study showed an association between personality-related and psychosocial factors with sick leave days. More research is required to clarify the underlying pathways.

Depression and anxiety in later COVID-19 waves across Europe: New evidence from the European COvid Survey (ECOS)

We aimed to investigate the prevalence of probable depression and anxiety and their correlates during later stages of the COVID-19 pandemic in eight European countries. Longitudinal data (wave 7 in June/July 2021: n=8,032;wave 8 in September 2021: n=8,250;wave 9 in December 2021/January 2022: n=8,319) were used from the European COvid Survey – a representative sample of community-dwelling adults from several European countries (Germany, United Kingdom, Denmark, Netherlands, France, Portugal, Italy and Spain). In wave 7 (wave 8;wave 9), 23.8% (22.0%;24.3%) of all respondents had probable depression and 22.6% (22.1%;23.7%) had probable anxiety. These prevalence rates substantially differed between the European countries. Regressions showed that emerging difficulties with the income were associated with both increases in depressive symptoms and anxiety symptoms. An increase in one's own perceived risk of getting infected with the SARS-CoV-2, the birth of a child and an increase in the Covid-19 stringency index were associated with increases in depressive symptoms. The significance of probable depression and anxiety during later stages of the COVID-19 pandemic in eight European countries was highlighted. Avoiding income difficulties may also contribute to mental health.

Fear of COVID-19 among homeless individuals in Germany in mid-2021.

Aims: To investigate the prevalence and the correlates of fear of COVID-19 among homeless individuals. Methods: We used data from the "national survey on psychiatric and somatic health of homeless individuals during the COVID-19 pandemic" (NAPSHI-study) which took place in several large cities in Germany in Mid-2021 (n = 666 in the analytical sample). Mean age equaled 43.3 years (SD: 12.1 years), ranging from 18 to 80 years. Multiple linear regressions were performed. Results: In our study, 70.9% of the homeless individuals reported no fear of COVID-19. Furthermore, 14.0% reported a little fear of COVID-19, 8.4% reported some fear of COVID-19 and 6.7% reported severe fear of COVID-19. Multiple linear regressions revealed that fear of COVID-19 was higher among individuals aged 50-64 years (compared to individuals aged 18-29 years: ß = 0.28, p < 0.05), among individuals with a higher perceived own risk of contracting the coronavirus 1 day (ß = 0.28, p < 0.001) as well as among individuals with a higher agreement that a diagnosis of the coronavirus would ruin his/her life (ß = 0.15, p < 0.001). Conclusions: Only a small proportion of homeless individuals reported fear of COVID-19 in mid-2021 in Germany. Such knowledge about the correlates of higher levels of fear of COVID-19 may be helpful for addressing certain risk groups (e.g., homeless individuals aged 50-64 years). In a further step, avoiding extraordinarily high levels of fear of COVID-19 may be beneficial to avoid irrational thinking and acting regarding COVID-19 in this group.

Conspiracy mentality among informal caregivers as a risk factor for caregiver burden, mental health, perceived loneliness and social isolation during the COVID-19 pandemic: findings of a representative online study from Germany.

PURPOSE: This study aims to analyze if and how conspiracy mentality is associated with mental health, burden and perceived social isolation and loneliness of informal caregivers of older individuals with care needs. METHODS: A quantitative, cross-sectional study was conducted. Participants had to be at least 40 years of age and were drawn randomly from the German online panel forsa.omninet and questioned between the 4th and 19th of March 2021. A sample of 489 informal caregivers (relatives and non-relatives supporting individuals aged ≥ 60 years) was questioned. Conspiracy mentality, depressive symptoms, loneliness and social exclusion were measured with validated instruments (e.g., The Conspiracy Mentality Questionnaire). Questions referred to the last three months prior to assessment. Multiple linear regression analyses, adjusted for sociodemographic, economic and health factors and indicators of the pandemic, were conducted. RESULTS: Findings indicate a significant positive association between conspiracy mentality and caregiver burden, loneliness, social exclusion, and depressive symptoms. No gender differences were found for any outcome. CONCLUSIONS: The results indicate that conspiracy mentality could be a risk factor for mental health, perceived social isolation and loneliness, and contribute to increased caregiver burden among informal caregivers of older care recipients during the COVID-19 pandemic. Accordingly, informal caregivers could benefit from actions focused on reducing conspiracy mentality during a health crisis, which could improve psychosocial health and wellbeing in this vulnerable group.

Determinants of Outpatient Physician Visits in the General Adult German Population during Later Stages of the COVID-19 Pandemic.

The goal of this study was to investigate the determinants of outpatient physician visits in Germany during the later stages of the COVID-19 pandemic. Cross-sectional data were used from the general adult population in Germany with n = 3091 individuals (data collection in mid-March 2022). Determinants were selected based on the extended Andersen model. The number of GP visits as well as the number of specialist visits in the past 12 months were used as outcome measures. Negative binomial regressions showed that the number of GP visits was positively associated with a lower educational level, being retired, lower levels of loneliness, the presence of at least one chronic condition, lower self-rated health, being vaccinated against COVID-19, and the presence of depression. Moreover, negative binomial regressions showed that the number of specialist visits was positively associated with being female, a lower age, having children, being married, not being full-time employed, the presence of at least one chronic condition, lower self-rated health, the presence of depression, being vaccinated against COVID-19 and having a lower coronavirus anxiety. In conclusion, while our study showed that need factors are still a main driver of outpatient physician visits, our findings additionally showed that predisposing characteristics, enabling resources and psychosocial factors are also important for the number of outpatient physician visits in Germany during the COVID-19 pandemic. Knowledge about these determinants (e.g., vaccination status, loneliness or coronavirus anxiety) is also important to avoid under- or overuse of the healthcare system.

Prevalence and correlates of loneliness, perceived and objective social isolation during the COVID-19 pandemic. Evidence from a representative survey in Germany.

PURPOSE: Our aim was to identify the prevalence and correlates of loneliness, perceived and objective social isolation in the German population during the COVID-19 pandemic. METHODS: Data were taken from a representative survey with n = 3075 individuals (18-70 years; August/September 2021). Valid measures were used to quantify the outcomes (loneliness: De Jong Gierveld scale; perceived social isolation: Bude/Lantermann tool; objective social isolation: Lubben Social Network Scale). Multiple logistic regressions were used to identify the correlates of these three outcomes. RESULTS: The prevalence of loneliness was 83.4%, the prevalence of perceived social isolation was 59.1% and the prevalence of objective social isolation was 28.9%. The prevalence rate significantly differed between the subgroups (e.g., the prevalence of perceived social isolation was 73.9% among individuals aged 18-29 years, whereas it was 48.8% among individuals aged 60-70 years). In regression analysis, several correlates of these outcomes were identified (e.g., marital status, age group (with changing signs), migration background, sports activities, or self-rated health). CONCLUSION: Our study particularly identified very to extraordinarily high prevalence rates for social isolation and loneliness, respectively. Knowledge about the correlates (e.g., age group) may help to address these individuals during the ongoing pandemic.