COVID-19-related knowledge influences mental health, self-care behaviors, and quality of life among elderly with non-communicable diseases in Northern Thailand.

Background: A growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand. Methods: In this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF. Results: Almost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = -0.85), mental health (r = -0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45-13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17-0.31) were associated with mental health problem (p < 0.05). Discussion: The findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.

Using the Health Belief Model to Predict Vaccination Intention Among COVID-19 Unvaccinated People in Thai Communities.

Background: The coronavirus disease 2019 (COVID-19) pandemic has become one of the biggest challenges to individual health and the public health system worldwide. COVID-19 morbidity and mortality are increasing, impacting almost every country including Thailand. This study used the Health Belief Model (HBM) as a framework to examine the intention of unvaccinated people living in northern Thailand to receive COVID-19 vaccines. Methods: This cross-sectional study was conducted during October and November 2021. A total of 1,024 participants who are currently living in four northern provinces of Thailand, Chiang Mai, Chiang Rai, Lamphun, and Phayao, were recruited to participate in the study. The questionnaire was developed using an HBM structure to obtain information about the perceived severity, perceived susceptibility, self-efficacy, perceived benefits and barriers, cues to action, and preventive behaviors relating to COVID-19 vaccination and the decision to become vaccinated. Multiple linear regression was used to analyze the data. Results: The unvaccinated participants were an average of 44.45 ± 16.63 years of age and more than half were women (54.5%). The COVID-19 preventive behavior score used perceived severity (B = 0.26), self-efficacy (B = 0.51), perceived benefits and barriers (B = 0.11), and cues to action (B = 0.18) after adjusting for age, underlying disease, and body mass index (R 2 = 42.5%). The COVID-19 vaccination decision score was positively correlated with perceived severity (B = 0.13), perceived susceptibility (B = 0.25), perceived benefits and barriers (B = 0.21), and cues to action (B = 0.27) after adjusting for underlying disease (R 2 = 38.7%). Discussion: The results demonstrated the usefulness of using the HBM structure to understand individual intention to receive a COVID-19 vaccine. Communities should consider a COVID-19 health campaign and programs that use the HBM model as a framework for altering perceptions and beliefs about the COVID-19 vaccine and improving vaccination rates among unvaccinated people in rural northern Thailand.