Social Media Use and Its Association with Mental Health and Internet Addiction among Portuguese Higher Education Students during COVID-19 Confinement.

The use of social media was one of the most common way to keep in touch with friends and family during confinement. For higher education students, the fact that their universities were closed was a major change in their lives. The aim of this study is to relate the prevalence and type of social media with Internet addiction and mental health of university students in a district of Portugal during COVID-19 confinement. Mental health was studied by applying the reduced version of the Mental Health Inventory (MHI-5) and to measure the Internet use and dependence, the Internet Addiction Test (IAT) was used. The study (cross-sectional, descriptive, and correlational) used an online questionnaire, conducted on Google® Forms and the link was sent to 4450 students, in the months of April to June 2020, during the confinement. A total of 329 valid questionnaires were obtained. We can conclude that regarding mental health, students in the 18-24 age group, single or divorced and who are not in a relationship, and with worse academic results, show worse levels of mental health. It is noteworthy that the students with the same characteristics also have the highest levels of addiction to internet.

The Impact of COVID-19 Confinement on Substance Use and Mental Health in Portuguese Higher Education Students.

The mental health of higher education students is a constant concern, and the pandemic situation caused by COVID-19 has intensified this concern. The social measures imposed to control and minimize the disease have led, among other things, to the reconfiguration of higher education students' academic life habits, which has naturally altered their emotional balance, mental health, and substance abuse. This cross-sectional, descriptive, and correlational study assesses the influence of higher education students' personal characteristics on their (self-reported) use of addictive substances (alcohol, tobacco, drugs, and pharmaceutical drugs) before and during their first compulsory confinement in Portugal, as well as its relationship with mental health. An online questionnaire was applied between 15 April and 20 May 2020, to students from various study cycles of higher education institutions in one region of Portugal (northern area of Alentejo), which included the Mental Health Inventory in its reduced version (MHI-5) and questions (constructed by the authors) on personal characterization and on the use of addictive substances before and during confinement. The convenience sample included 329 mostly female health care students between the ages of 18 and 24. In our results, we found a statistically significant decrease in tobacco, alcohol, and drug use; however, there was an increase in tobacco use among older students and an increase in anxiolytic use among students with higher academic achievement and among students who exhibited more active social behavior in the period prior to confinement. Students who took anxiolytics during confinement had higher MHI-5 scores and students who used the most addictive substances during confinement had lower MHI-5 scores than the other students.

COVID-19 infection: Positive mental health, psychological vulnerability and sex: Cross-sectional study.

Since mid-March 2020, a state of emergency was decreed in Portugal due to the COVID-19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross-sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD-19 infection and analyze the association between PMH and psychological vulnerability among men and women. METHODS: The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross-sectional, descriptive, and correlational study was carried out. RESULTS: After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH. CONCLUSIONS: We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men. RELEVANCE TO CLINICAL PRACTICE: Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non-pandemic phase.

Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic.

The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.

COVID-19 in Brazil: Are there any differences in Mental Health Literacy between young and aged men? / COVID-19 no Brasil: existem diferenças no letramento em saúde mental entre homens jovens e idosos?

OBJECTIVE: to analyze the Mental Health Literacy of young and aged men living in Brazil in the COVID-19 pandemic context. METHOD: a qualitative study conducted with 87 men by means of an asynchronous online survey. The data were processed in the NVIVO12® software, structured with the Collective Subject Discourse method and analyzed through Anthony Jorm's theoretical concept of Mental Health Literacy. RESULTS: six central ideas emerged from the analysis of a synthesis discourse on the components of the Mental Health Literacy, namely: Ability to recognize specific disorders or different types of psychological distress; Knowledge and beliefs about risk factors and causes; Knowledge and beliefs about self-help interventions; Knowledge and beliefs about available professional help; Attitudes that facilitate recognition and the search for adequate help; and Knowledge on how to seek information on mental health. CONCLUSION: there are differences in the mental health literacy of young and aged men living in Brazil during the COVID-19 pandemic. Aged men were more competent for mental health care management and protection than young men, in relation to the Mental Health Literacy levels.

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men's Health: Health Literacy Is Important.

This study aimed at analyzing the psychosocial repercussions of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic on the health of men living in Brazil. For this, we carried out a socio-historical and qualitative study, with the participation of 200 men who answered an online questionnaire. The data collected were processed in the NVIVO12® software, structured by the Collective Subject Discourse method, and analyzed from the epidemic disease theoretical framework proposed by Charles Rosenberg. Our results showed that the SARS-CoV-2 pandemic brought about repercussions of different dimensions that compromised the health of men living in Brazil. The repercussions evidenced were behavioral changes and emergence of new habits due to the pandemic; uncomfortable family situations; impaired affective and sexual relationships; harms in marital relationships; and insecurity and psychological distress. It is important to implement strategies that maximize men's health literacy, promoting better communication in terms of health, and search for help and suitable information about health/mental health.

[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

Objective: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. Method: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. Results: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. Conclusions: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

OBJECTIVE: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. METHOD: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. RESULTS: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. CONCLUSIONS: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future

Objetivo Este estudio pretende explorar la percepción de los especialistas sobre el desempeño de las residencias de ancianos durante la COVID-19. Método Este es un estudio desarrollado en 2 fases: 1) un grupo focal, con el que se trabajó en mayo 2020, con 5 especialistas y 2) un Delphi modificado, implementado en septiembre 2020 con 22 especialistas, ambos en el área de asistencia en residencias de ancianos del norte y centro de Portugal. Resultados Los resultados permitieron identificar 3 áreas principales que influenciaron el desempeño de las residencias de ancianos desde el inicio del brote de la COVID-19: modelos de organización y recursos;salud física y mental de los residentes y;la familia como apoyo. Conclusiones Las personas mayores que residen en residencias para ancianos quedan particularmente vulnerables a la COVID-19, pues esta enfermedad puede tener para ellos consecuencias muy graves o incluso conducirle a la muerte. Es importante que las residencias prevengan la fragilidad física y mental de los ancianos, así como la soledad que muy probablemente les asola debido a las circunstancias pandémicas. Los responsables por las residencias de ancianos deben percibir que las personas mayores que viven en ellas tienen. por lo general. problemas de salud, lo que debería determinar la implementación de nuevas estrategias, entre ellas el aumento del número de profesionales debidamente capacitados.

The impact of the COVID-19 pandemic on the mental health of Portuguese university students.

Worldwide, the COVID-19 pandemic has had a disruptive effect on daily routines, especially for university students. This study aimed to compare pre-pandemic domains of students' mental health during the pandemic lockdown. One cross-sectional study was conducted in two waves with academic students from 20 Portuguese universities, in March 2020 before the COVID-19 pandemic (n = 3579) and 2 months after the first lockdown in May 2020 (n = 1228). The Positive Mental Health Questionnaire (PMHQ), the Mental Health Knowledge Questionnaire, the Mental Health-promoting knowledge, and the Psychological Vulnerability Scale were used. Statistical analyses were performed by bivariate associations and multiple linear regression models. Students were mostly women (79%), with an average age of 23.2 years (SD = 6.6), displaced from their family environment (43%), out-of-home (43%), and scholarship holders (37%). Higher scores found in the PVS were associated with decreased PMHQ in both moments (P < 0.01). These cross-sectional studies showed a slight variation in the mental health variables studied in the period before and during the COVID-19 outbreak. Being a woman, younger, out-of-home, and having a scholarship (P < 0.01) seem to increase susceptibility to mental health variation before and during the pandemic. Universities should develop strategies that promote students' mental health.

Positive Mental Health in University Students and Its Relations with Psychological Vulnerability, Mental Health Literacy, and Sociodemographic Characteristics: A Descriptive Correlational Study.

This study aimed to evaluate positive mental health (PMH) and its relation with sociodemographic characteristics, mental health literacy, and the psychological vulnerability scale (PVS) in Portuguese university students aged 17 to 62. A descriptive correlational study was carried out. An online survey was conducted to evaluate demographic variables, and several questionnaires were applied to evaluate positive mental health, psychological vulnerability, and mental health literacy. The data was collected from 1 November 2019 to 1 September 2020. Overall, 3405 students participated in the study. The results show that 67.8% of students revealed a high level of PMH, 31.6% presented a medium level of PMH, and 0.6% had a low level of PMH. Male students reported higher personal satisfaction (t (3170) = -2.39, p = 0.017) and autonomy (t (3170) = -3.33, p = 0.001) in PMH compared to female students. Students without a scholarship scored higher (t (3127) = -2.04, p = 0.42) in PMH than students who held a scholarship. Students who were not displaced from their home reported higher (t (3170) = -1.99, p = 0.047) self-control in PMH than those displaced from their home. University students with higher PMH results had lower PVS results and higher literacy results. The findings of this study will contribute to identifying students' PMH intervention needs.

Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support.

OBJECTIVE: To analyze the relationships between sociodemographic variables, intolerance to uncertainty (INT), social support, and psychological distress (i.e., indicators of Common Mental Disorders (CMDs) and perceived stress (PS)) in Brazilian men during the COVID-19 pandemic. METHODS: A cross-sectional study with national coverage, of the web survey type, and conducted with 1006 Brazilian men during the period of social circulation restriction imposed by the health authorities in Brazil for suppression of the coronavirus and control of the pandemic. Structural equation modeling analysis was performed. RESULTS: Statistically significant direct effects of race/skin color (λ = 0.268; p-value < 0.001), socioeconomic status (SES) (λ = 0.306; p-value < 0.001), household composition (λ = 0.281; p-value < 0.001), PS (λ = 0.513; p-value < 0.001), and INT (λ = 0.421; p-value < 0.001) were evidenced in the occurrence of CMDs. Black-skinned men with higher SES, living alone, and with higher PS and INT levels presented higher prevalence values of CMDs. CONCLUSIONS: High levels of PS and INT were the factors that presented the strongest associations with the occurrence of CMDs among the men. It is necessary to implement actions to reduce the stress-generating sources as well as to promote an increase in resilience and the development of intrinsic reinforcements to deal with uncertain threats.

Impact of COVID-19 outbreak on nurses' mental health: A prospective cohort study.

OBJECTIVES: To evaluate variations in nurses' sleep quality and symptoms of depression, anxiety and stress during the COVID-19 outbreak, and to evaluate whether the presence of potential risk factors influenced these symptoms over time. METHODS: This prospective cohort study surveyed nurses three times - surveying personal factors, working conditions, family dynamics, and attitude towards COVID-19 - between March 31 and May 4, 2020. Nurses' mental health was assessed through Depression Anxiety Stress Scales - short version (DASS-21); their sleep quality was assessed through a 5-point Likert scale question. RESULTS: Nurses' sleep quality and symptoms of depression, anxiety and stress presented a positive variation over the COVID-19 outbreak. The only factors which are directly related to the COVID-19 outbreak and that were associated with the positive variation in nurses' symptoms of depression, anxiety and stress were the fear to infect others and the fear to be infected (higher fear of being infected or to infect someone corresponded to increased symptoms of depression, anxiety and stress). CONCLUSIONS: Although the COVID-19 outbreak seems to have had an immediate impact on nurses' mental health, a psychological adaptation phenomenon was also observed. Future research should focus on assessing nurses' symptoms of depression, anxiety and stress, after the COVID-19 pandemic, in order to compare and contrast the findings with the results of our study.

Portuguese Nurses' Stress, Anxiety, and Depression Reduction Strategies during the COVID-19 Outbreak.

The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aims of this study were (a) to explore the association between the mental health promotion strategies used by nurses during the COVID-19 outbreak and their symptoms of depression, anxiety, and stress; (b) to compare the symptoms of depression, anxiety, and stress of mental health nurses to those of non-mental health nurses; and (c) to compare the frequency of use of mental health strategies of mental health nurses to those of non-mental health nurses. A cross-sectional study was conducted with a sample of 821 nurses. Univariate and multivariate regression models were developed to identify potential protective factors of depression, anxiety, and stress. The chi-square test was also used to compare the use of strategies among mental health and non-mental health nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 were associated with better mental health. Mental health nurses had less depression, anxiety, and stress, and used more strategies to promote mental health than other nurses. We consider it important to promote nurses' mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.

Nurses' Mental Health During the Covid-19 Outbreak: A Cross-Sectional Study.

OBJECTIVE: To describe nurses' mental health status during the Covid-19 outbreak and to explore the factors that might accentuate the negative consequences on their mental health. METHODS: We conducted an online survey to evaluate demographic variables, working conditions, family dynamics, and mental health variables in nurses working in healthcare settings, in Portugal, during the Covid-19 outbreak. RESULTS: Portuguese nurses presented higher depression, anxiety and stress levels, when compared to the Portuguese general population, during the outbreak. Overall, nurses who did not consider the quantity and quality of personal protective equipment as adequate presented significantly higher levels of depression, anxiety, and stress. CONCLUSIONS: Our results suggest that nurses' mental health status seems to be particularly affected by the Covid-19 outbreak and that some modifiable elements might accentuate the impacts on their mental health.

The use of mental health promotion strategies by nurses to reduce anxiety, stress, and depression during the COVID-19 outbreak: A prospective cohort study.

OBJECTIVES: To evaluate and compare nurses' depression, anxiety and stress symptoms at the beginning of the COVID-19 pandemic and after six months; to evaluate and compare the frequency of use of mental health promotion strategies during the same period; and to identify the relationship between the frequency of use of mental health promotion strategies, during the same period, with nurses' depression, anxiety and stress symptoms. METHODS: Data collection was carried out in two moments: at baseline and after six months. An online questionnaire was applied to nurses to assess the frequency of use of some mental health promotion strategies and their depression, anxiety, and stress symptoms (through the Depression Anxiety Stress Scales - short version (DASS-21)). RESULTS: The anxiety and stress symptoms significantly decreased over time. The physical activity increased, and a decrease was observed in the remote social contacts after six months. The stress, anxiety and depression scores were significantly lower in nurses who frequently or always used all strategies compared to participants who never or rarely used them, except for one strategy (rejecting information about COVID-19 from unreliable sources). CONCLUSIONS: Mental health promotion strategies, such as physical activity, relaxation activity, recreational activity, healthy diet, adequate water intake, breaks between work shifts, maintenance of remote social contacts, and verbalization of feelings/emotions, are crucial to reduce nurses' stress, anxiety and depression symptoms during the COVID-19 outbreak.