COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey.

Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people's lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.

Sources of COVID-19-Related Information in People with Various Levels of Risk Perception and Preventive Behaviors in Taiwan: A Latent Profile Analysis.

The present study aimed to identify the distinct levels of risk perception and preventive behaviors during the coronavirus disease 2019 (COVID-19) outbreak among people in Taiwan and to examine the roles of information sources in various levels of risk perception and preventive behavior. The online survey recruited 1984 participants through a Facebook advertisement. Their self-reported risk perception, adopted preventive behaviors and COVID-19-related information were collected. We analyzed individuals' risk perception and adopted preventive behaviors by using latent profile analysis and conducted multinomial logistic regression of latent class membership on COVID-19-related information sources. Four latent classes were identified, including the risk neutrals with high preventive behaviors, the risk exaggerators with high preventive behaviors, the risk deniers with moderate preventive behaviors, and the risk deniers with low preventive behaviors. Compared with the risk neutrals, the risk exaggerators with high preventive behaviors were more likely to obtain COVID-19 information from multiple sources, whereas the risk deniers with moderate preventive behaviors and risk deniers with low preventive behaviors were less likely to obtain COVID-19 information compared with the risk neutrals. Governments and health professions should take the variety of risk perception and adopted preventive behaviors into consideration when disseminating information on COVID-19 to the general public.

Voluntary Reduction of Social Interaction during the COVID-19 Pandemic in Taiwan: Related Factors and Association with Perceived Social Support.

This study aimed to determine the proportion of individuals who voluntarily reduced interaction with their family members, friends, and colleagues or classmates to avoid coronavirus disease 2019 (COVID-19) infection and the associations of reduced social interaction with perceived social support during the COVID-19 pandemic in Taiwan. Moreover, the related factors of voluntary reduction of social interaction were examined. We recruited participants via a Facebook advertisement. We determined the reduced social interaction, perceived social support, cognitive and affective constructs of health belief and demographic characteristics among 1954 respondents (1305 women and 649 men; mean age: 37.9 years with standard deviation 10.8 years). In total, 38.1% of respondents voluntarily reduced their social interaction with friends to avoid COVID-19 infection, 36.1% voluntarily reduced their interaction with colleagues or classmates, and 11.1% voluntarily reduced interaction with family members. Respondents who voluntarily reduced interaction with other people reported lower perceived social support than those who did not voluntarily reduce interaction. Respondents who were older and had a higher level of worry regarding contracting COVID-19 were more likely to voluntarily reduce interaction with family members, friends, and colleagues or classmates to avoid COVID-19 infection than respondents who were younger and had a lower level of worry regarding contracting COVID-19, respectively. The present study revealed that despite strict social distancing measures not being implemented in Taiwan, more than one-third of respondents voluntarily reduced their interaction with friends and colleagues or classmates. The general public should be encouraged to maintain social contacts through appropriately distanced in-person visits and telecommunication.

Risk Perception, Protective Behaviors, and General Anxiety during the Coronavirus Disease 2019 Pandemic among Affiliated Health Care Professionals in Taiwan: Comparisons with Frontline Health Care Professionals and the General Public.

This study aimed to compare risk perception, information sources, adoption of protective behaviors against coronavirus disease 2019 (COVID-19), and levels of general anxiety among affiliated health care professionals, frontline health care professionals, and the general public in Taiwan. We recruited participants via a Facebook advertisement. We determined the risk perception, information sources, adoption of protective behaviors against COVID-19, and levels of general anxiety among 1954 respondents. In total, 269 affiliated healthcare workers, 371 frontline healthcare workers, and 1314 members of the general public were recruited into this study. The results indicated that both affiliated and frontline health care professionals had a higher level of risk perception of COVID-19, and more adopted protective behaviors against COVID-19 than the general public. No significant differences in risk perception or the adoption of protective behaviors were identified between affiliated, and frontline, health care professionals. Affiliated health care professionals had a lower level of general anxiety than the general public, whereas frontline health care professionals exhibited no significant difference in level of general anxiety compared with the general public or affiliated health care professionals. As important members of COVID-19 treatment teams, the need for psychological and educational support in affiliated health care professionals should receive attention.

The Coronavirus Disease 2019 Pandemic in Taiwan: An Online Survey on Worry and Anxiety and Associated Factors.

This study explored the associations of individual factors (demographic characteristics, self-confidence in responding to the coronavirus disease 2019 (COVID-19), and self-rated physical and mental health) and environmental factors (perceived confidence in COVID-19 management by the regional government and adequacy of resources and support available to address the COVID-19 pandemic) with worry toward COVID-19 and general anxiety among people in Taiwan. The Chi-square was used to compare difference for worry and anxiety among categorical variables. The logistic regression was used to examine the associations between worry as well as anxiety and individual as well as environmental factors. In total, 1970 respondents were recruited and completed an online survey on worry regarding COVID-19, general anxiety during the pandemic, and individual and environmental factors. In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Exhibited worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was associated with a higher level of worry toward COVID-19. Lower perceived social support was associated with a higher level of general anxiety during the COVID-19 pandemic. The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the outbreak. This suggests health care providers need additional surveillance of worry and anxiety during the pandemic. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. Factors found in the present study can be used for the development of intervention programs, supportive services, and government policy to reduce worry and anxiety during the COVID-19 pandemic.

The Coronavirus Disease 2019 Pandemic in Taiwan: An Online Survey on Worry and Anxiety and Associated Factors

This study explored the associations of individual factors (demographic characteristics, self-confidence in responding to the coronavirus disease 2019 (COVID-19), and self-rated physical and mental health) and environmental factors (perceived confidence in COVID-19 management by the regional government and adequacy of resources and support available to address the COVID-19 pandemic) with worry toward COVID-19 and general anxiety among people in Taiwan. The Chi-square was used to compare difference for worry and anxiety among categorical variables. The logistic regression was used to examine the associations between worry as well as anxiety and individual as well as environmental factors. In total, 1970 respondents were recruited and completed an online survey on worry regarding COVID-19, general anxiety during the pandemic, and individual and environmental factors. In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Exhibited worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was associated with a higher level of worry toward COVID-19. Lower perceived social support was associated with a higher level of general anxiety during the COVID-19 pandemic. The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the outbreak. This suggests health care providers need additional surveillance of worry and anxiety during the pandemic. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. Factors found in the present study can be used for the development of intervention programs, supportive services, and government policy to reduce worry and anxiety during the COVID-19 pandemic

Voluntary Reduction of Social Interaction during the COVID-19 Pandemic in Taiwan: Related Factors and Association with Perceived Social Support

This study aimed to determine the proportion of individuals who voluntarily reduced interaction with their family members, friends, and colleagues or classmates to avoid coronavirus disease 2019 (COVID-19) infection and the associations of reduced social interaction with perceived social support during the COVID-19 pandemic in Taiwan. Moreover, the related factors of voluntary reduction of social interaction were examined. We recruited participants via a Facebook advertisement. We determined the reduced social interaction, perceived social support, cognitive and affective constructs of health belief and demographic characteristics among 1954 respondents (1305 women and 649 men;mean age: 37.9 years with standard deviation 10.8 years). In total, 38.1% of respondents voluntarily reduced their social interaction with friends to avoid COVID-19 infection, 36.1% voluntarily reduced their interaction with colleagues or classmates, and 11.1% voluntarily reduced interaction with family members. Respondents who voluntarily reduced interaction with other people reported lower perceived social support than those who did not voluntarily reduce interaction. Respondents who were older and had a higher level of worry regarding contracting COVID-19 were more likely to voluntarily reduce interaction with family members, friends, and colleagues or classmates to avoid COVID-19 infection than respondents who were younger and had a lower level of worry regarding contracting COVID-19, respectively. The present study revealed that despite strict social distancing measures not being implemented in Taiwan, more than one-third of respondents voluntarily reduced their interaction with friends and colleagues or classmates. The general public should be encouraged to maintain social contacts through appropriately distanced in-person visits and telecommunication.

Subjective Deterioration of Physical and Psychological Health during the COVID-19 Pandemic in Taiwan: Their Association with the Adoption of Protective Behaviors and Mental Health Problems.

This study aimed to determine the proportion of individuals who reported the deterioration of physical and psychological health during the coronavirus disease 2019 (COVID-19) pandemic in Taiwan. Moreover, the related factors of deterioration of physical and psychological health and the association between deterioration of health and adoption of protective behavior against COVID-19 and mental health problems were also examined. We recruited participants via a Facebook advertisement. We determined the subjective physical and psychological health states, cognitive and affective construct of health belief, perceived social support, mental health problems, adoption of protective behavior and demographic characteristics among 1954 respondents (1305 women and 649 men; mean age: 37.9 years with standard deviation 10.8 years). In total, 13.2% and 19.3% of respondents reported deteriorated physical and psychological health during the COVID-19 pandemic, respectively. Participants with higher perceived harm from COVID-19 compared with severe acute respiratory syndrome (SARS) were more likely to report the subjective deterioration of physical and psychological health, whereas respondents who were older and perceived a higher level of social support were less likely to report a deterioration of physical and psychological health. The subjective deterioration of psychological health was significantly associated with avoiding crowded places and wearing a mask. Both subjective deteriorations of physical and psychological health positively related to general anxiety.

Changes in Sex Life among People in Taiwan during the COVID-19 Pandemic: The Roles of Risk Perception, General Anxiety, and Demographic Characteristics.

This study used data collected from an online survey study on coronavirus disease 2019 (COVID-19) in Taiwan to examine changes in sex life during the pandemic and the factors affecting such changes. In total, 1954 respondents were recruited from a Facebook advertisement. The survey inquired changes in sex life during the pandemic, including satisfaction with the individual's sex life, frequency of sexual activity, frequency of sex-seeking activity, and frequency of using protection for sex. The associations of change in sex life with risk perception of COVID-19, general anxiety, gender, age, and sexual orientation were also examined. For each aspect of their sex life, 1.4%-13.5% of respondents reported a decrease in frequency or satisfaction, and 1.6%-2.9% reported an increase in frequency or satisfaction. Risk perception of COVID-19 was significantly and negatively associated with frequencies of sexual and sex-seeking activities. Higher general anxiety was significantly and negatively associated with satisfaction of sex life and frequencies of sexual and sex-seeking activities. Sexual minority respondents were more likely to report decreased satisfaction with sex life and frequencies of sexual activity and sex-seeking activities during COVID-19. Health care providers should consider these factors when developing strategies for sexual wellness amid respiratory infection epidemics.

Cognitive, Affective, and Behavioral Constructs of COVID-19 Health Beliefs: A Comparison Between Sexual Minority and Heterosexual Individuals in Taiwan.

This online survey study aimed to compare the cognitive, affective, and behavioral constructs of health beliefs related to coronavirus disease 2019 (COVID-19) between sexual minority and heterosexual individuals in Taiwan. In total, 533 sexual minority and 1421 heterosexual participants were recruited through a Facebook advertisement. The constructs pertaining to cognition (perceived relative susceptibility to COVID-19, perceived COVID-19 severity, having sufficient knowledge and information on COVID-19, and confidence in coping with COVID-19), affect (worry toward COVID-19), and behavior (adoption of health-protective behaviors) in relation to health beliefs about COVID-19 were compared between sexual minority and heterosexual participants. The results indicated that sexual minority participants had lower perceived susceptibility to COVID-19, greater self-confidence in coping with COVID-19, and lower worry about COVID-19 and were less likely to maintain good indoor ventilation and disinfect their household than heterosexual individuals. Sexual orientation is the modifying factor for the Health Belief Model in the COVID-19 pandemic and should be taken into consideration when medical professionals establish prevention programs for COVID-19.

COVID-19-Related Information Sources and the Relationship With Confidence in People Coping with COVID-19: Facebook Survey Study in Taiwan.

BACKGROUND: People obtain information on the coronavirus disease (COVID-19) from the internet and other sources. Understanding the factors related to such information sources aids health professionals in educating individuals. OBJECTIVE: This study used data collected from the online survey study on COVID-19 in Taiwan to examine what major COVID-19 information sources are available and which sources are significantly related to the self-confidence of people in coping with COVID-19 in Taiwan. METHODS: A total of 1904 participants (1270 non-health-care workers and 634 health care workers) were recruited from the Facebook advertisement. Their major sources of information about COVID-19, the relationships between the sources and demographic factors, and the relationships between the sources and the self-confidence in coping with COVID-19 were surveyed. RESULTS: Most Taiwanese people relied on the internet for COVID-19 information. Many respondents also used a variety of sources of information on COVID-19; such variety was associated with sex, age, and the level of worry toward COVID-19, as well as if one was a health care worker. For health care workers, the use of formal lessons as an information source was significantly associated with better self-confidence in coping with COVID-19. The significant association between receiving information from more sources and greater self-confidence was found only in health care workers but not in non-health-care workers. CONCLUSIONS: Medical professionals should consider subgroups of the population when establishing various means to deliver information on COVID-19.