COVID-19 Vaccine Hesitancy Among Patients Recovered From COVID-19 Infection in Wuhan, China: Cross-Sectional Questionnaire Study.

BACKGROUND: Although patients recovered from COVID-19 already have immunity gained from natural infection, they are still at risk of reinfection due to the emergence of new variants of COVID-19 and the diminishing of naturally acquired immunity over time. Vaccination is associated with efficacious protection against COVID-19 infection and could boost infection-acquired immunity; however, various COVID-19 survivors have not been vaccinated due to vaccine hesitancy. OBJECTIVE: The aim of this study was to investigate COVID-19 vaccine hesitancy and related factors among COVID-19 survivors. METHODS: A cross-sectional questionnaire survey was conducted among patients who recovered from COVID-19 infection in Wuhan, China, between June 10 and July 25, 2021. The questionnaire included sociodemographic information, items on COVID-19 infection, the COVID-19 vaccine hesitancy scale based on the 3Cs (complacency, convenience, and confidence) model, trust in vaccine manufacturers and health facilities, and reasons for the decision to accept COVID-19 vaccination. Multivariate logistic regression analysis was used to assess the factors influencing COVID-19 vaccine hesitancy. RESULTS: Among the 1422 participants, 538 (37.8%) were not vaccinated against COVID-19. The COVID-19-recovered patients who self-reported having a current unhealthy status expressed more hesitancy about the COVID-19 vaccine than those who perceived themselves to be healthy (odds ratio [OR] 0.45, 95% CI 0.28-0.71). Compared to the asymptomatic patients, patients with mild symptoms were more likely to receive a COVID-19 vaccine (OR 1.67, 95% CI 1.02-2.82). Regarding the 3Cs model, high complacency (P=.005) and low convenience (P=.004) were significant negative factors for COVID-19 vaccination. Trust in vaccine manufacturers and health facilities was a significant positive factor for COVID-19 vaccination (OR 1.14, 95% CI 1.09-1.19). "Self-needs" was the main reason for patients to receive the COVID-19 vaccine, whereas "already have antibodies and do not need vaccination" was the main reason for patients to not receive the COVID-19 vaccine. CONCLUSIONS: Among the three major factors of vaccine hesitancy, complacency proved to be the most notable among COVID-19-recovered patients. Therefore, educational campaigns can focus on raising the awareness of risk of infection and the benefits of vaccination to reduce complacency toward vaccination among this population. In particular, for individuals who have recovered from COVID-19, improving factors related to convenience such as transportation, the environment of vaccination, and providing door-to-door service was also deemed necessary to facilitate their vaccination. In addition, addressing the concerns about vaccination of COVID-19-recovered patients could foster trust and promote their uptake of vaccination.

Suicidal ideation and associated risk factors among COVID-19 patients who recovered from the first wave of the pandemic in Wuhan, China.

BACKGROUND/OBJECTIVES: Symptoms of psychiatric, neurological, and physical illnesses with post-COVID syndrome could increase suicidal ideation (SI) and behavior in COVID-19 survivors. However, information on the level of SI among COVID-19 survivors in China is still limited. We aimed to assess the prevalence and risk factors of SI among COVID-19 survivors in Wuhan, China. METHODS: The cross-sectional study was carried out among former COVID-19 patients in Jianghan District (Wuhan, China) from June 10 to July 25, 2021. SI, fatigue, stigma, sleep disorder, resilience, peace of mind, and social support of the participants were measured by the SI-related item, Fatigue Scale (FS-14), short version of COVID-19 Stigma Scale, Pittsburgh Sleep Quality Index (PSQI), The Peace of Mind Scale (PoM), The Resilience Style Questionnaire (RSQ) and two single separate items for measuring social support. Logistic regression was utilized to identify associated factors of SI. Mediation analysis was performed to assess the potential mechanisms between psychological factors and SI. RESULTS: A total of 1,297 participants were included in this study. 6.7% of them reported SI. Marriage (AOR = 0.389, P = 0.003) and peace of mind (AOR = 0.854, P < 0.001) were negatively associated with SI. History of psychological or emotional counseling before COVID-19 infection (AOR = 1.889, P = 0.049), fatigue (AOR = 1.110, P = 0.007), higher self-reported COVID-19 related stigma (AOR = 1.054, P = 0.003) and sleep disorder (AOR = 1.112, P = 0.001) were positively associated with SI. CONCLUSIONS: Consideration should be taken into account to develop appropriate alleviating measures such as mindfulness-based cognitive therapy to reduce the rates of SI among COVID-19 survivors and improve their resilience to cope with the personal impact of the COVID-19 pandemic.

The relationship between home-based physical activity and general well-being among Chinese university students during the COVID-19 pandemic: the mediation effect of self-esteem.

This study aimed to investigate the mediating effect of self-esteem on the relationship between home-based physical activity and the general well-being of university students. A web-based questionnaire survey was conducted on 311 Chinese university students using the Physical Activity Rating Scale, Rosenberg Self-Esteem Scale, and General Well-Being Scale. The influence of home-based physical activity on self-esteem and general well-being in Chinese university students was explored using a one-way ANOVA analysis of variance. The mediating model was tested with regression analysis to determine the mediating effects of self-esteem between home-based physical activity and general well-being among Chinese university students during COVID-19. The amount of home-based physical activity had a significant effect on the general well-being (F = 3.46, P < 0.05) and self-esteem (F = 6.99, P < 0.01) of university students. The study found that self-esteem had a full mediation (T = 4.445, P < 0.001) between medium and large amounts of home-based physical activity and general well-being among university students, accounting for 32.5% of the total effect. The study concluded that self-esteem mediated the relationship between home-based physical activity and general well-being in university students during the COVID-19 pandemic. The findings in this study highlight the importance of home-based physical activity in increasing the general well-being of university students during the pandemic.

Perceived stigma among discharged patients of COVID-19 in Wuhan, China: A latent profile analysis.

Background: Perceived stigma has greatly influenced the life quality of the COVID-19 patients who recovered and were discharged (RD hereafter). It is essential to understand COVID-19 stigma of RD and its related risk factors. The current study aims to identify the characteristics of perceived COVID-19 stigma in RD using latent profile analysis (LPA), to explore its psycho-social influencing factors, and to determine the cut-off point of the stigma scale using receiver operating characteristic (ROC) analysis. Methods: A cross-sectional study was conducted among COVID-19 RD in 13 communities in Jianghan District, Wuhan City, Hubei Province, China from June 10 to July 25, 2021, enrolling total 1,297 participants. Data were collected on demographic characteristics, COVID-19 perceived stigma, post-traumatic stress disorder (PTSD), anxiety, depression, sleep disorder, fatigue, resilience, social support, and peace of mind. LPA was performed to identify different profiles of perceived COVID-19 stigma level. Univariate analysis and multinominal logistic regression analysis were conducted to explore the influencing factors in different profiles. ROC analyses was carried out to identify the cut-off value of perceived stigma. Results: Among the participants, three profiles of perceived stigma were identified: "low perceived COVID-19 stigma" (12.8%), "moderate perceived COVID-19 stigma" (51.1%), and "severe perceived COVID-19 stigma" (36.1%). Multinominal logistic regression analysis revealed that older age, living with other people, anxiety, and sleep disorder were positively associated with moderate perceived COVID-19 stigma, while higher educational level was negatively associated with moderate perceived COVID-19 stigma. Female, older age, living with other people, anxiety, and sleep disorder were positively associated with severe perceived COVID-19 stigma, while higher educational level, social support, and peace of mind were negatively associated with severe perceived COVID-19 stigma. ROC curve of the Short Version of COVID-19 Stigma Scale (CSS-S) for screening perceived COVID-19 stigma showed that the optimal cut-off value was ≥ 20. Conclusion: The study focuses on the issue of perceived COVID-19 stigma and its psycho-socio influencing factors. It provides evidence for implementing relevant psychological interventions to COVID-19 RD.

Depressive symptoms, perceived social support, and anticipated HIV stigma among HIV-negative/unknown men who have sex with men in China during the COVID-19 pandemic: A multicenter online cross-sectional study.

OBJECTIVE: To investigate the prevalence of depressive symptoms among human immunodeficiency virus (HIV)-negative/unknown men who have sex with men (MSM) in China and explore the relationship between perceived social support, anticipated HIV stigma, and depressive symptoms. METHODS: Participants in this study were recruited from a gay social networking app (Blued) in China by convenience sampling from December 16, 2020 to March 1, 2021. Perceived Social Support Questionnaire, Anticipated HIV Stigma Questionnaire, and Center for Epidemiologic Studies Depression Scale were used to measure the social support, anticipated HIV stigma, and depressive symptoms of participants. Confirmatory factor analysis was performed to assess the reliability and validity of the measurement model. Structural equation modeling was employed to evaluate the association of perceived social support, anticipated HIV stigma, and depressive symptoms, as well as the mediation effects. RESULTS: Overall, 47.70% (665/1394) of the participants had depressive symptoms. Perceived social support could have both direct and indirect effects on depressive symptoms with the mediating role of anticipated HIV stigma among HIV-negative/unknown MSM. CONCLUSION: Tailored interventions regarding perceived social support and anticipated HIV stigma, such as group therapy, mutual support groups and mindfulness training, with the involvement of non-governmental or governmental organizations, should be taken into account to reduce depressive symptoms and stigma among HIV-negative/unknown MSM in China.

Global Experiences of Community Responses to COVID-19: A Systematic Literature Review.

Objective: This study aimed to conduct a systematic review of the global experiences of community responses to the COVID-19 epidemic. Method: Five electronic databases (PubMed, Embase, CINAHL, ScienceDirect, and Web of Science) were searched for peer-reviewed articles published in English, from inception to October 10, 2021. Two reviewers independently reviewed titles, abstracts, and full texts. A systematic review (with a scientific strategy for literature search and selection in the electronic databases applied to data collection) was used to investigate the experiences of community responses to the COVID-19 pandemic. Results: This review reported that community responses to COVID-19 consisted mainly of five ways. On the one hand, community-based screening and testing for Coronavirus was performed; on the other hand, the possible sources of transmission in communities were identified and cut off. In addition, communities provided medical aid for patients with mild cases of COVID-19. Moreover, social support for community residents, including material and psychosocial support, was provided to balance epidemic control and prevention and its impact on residents' lives. Last and most importantly, special care was provided to vulnerable residents during the epidemic. Conclusion: This study systematically reviewed how communities to respond to COVID-19. The findings presented some practical and useful tips for communities still overwhelmed by COVID-19 to deal with the epidemic. Also, some community-based practices reported in this review could provide valuable experiences for community responses to future epidemics.

Influencing factors of anxiety and depression of discharged COVID-19 patients in Wuhan, China.

OBJECTIVES: This study is intended to assess the prevalence of depression and anxiety in individuals who had recovered from COVID-19 and been discharged from hospital (RD hereafter) in Wuhan, China, and to explore the factors associated with these mental disorders. METHODS: Participants of this study were the RD who were infected at the beginning of the outbreak from 13 communities in Jianghan District of Wuhan City, Hubei Province, China by convenience sampling in mid-2021. The Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, the Resilience Style Questionnaire, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis, and logistic regression analysis were used to describe and analyze the data and to examine the factors associated with the mental health status of this population. RESULTS: In total, we recruited 1601 participants from 3059 COVID-19 patients, and 1541 participants completed the questionnaire survey, with a response rate of 96.25%. Finally, 1297 participants met the inclusion and exclusion criteria in this study, of whom 28.8% and 37.9% reported mild to severe levels of anxiety and depression symptoms. Perceived better mental health status during hospitalization, higher frequency of alcohol use per week, peace of mind, higher education level, and resilience were negatively associated with anxiety, while stigma and history of psychological or emotional counseling before infection was positively associated with anxiety. More severe clinical classification of COVID-19 and stigma (AOR = 1.057, P<0.001) were both positively associated with depression, while perceived better mental health status during hospitalization (AOR = 0.564, P<0.001), higher frequency of alcohol use per week (AOR = 0.462, P = 0.004), peace of mind (AOR = 0.857, P<0.001), and social support (AOR = 0.972, P = 0.034) were negatively associated with depression. CONCLUSIONS: Tailored interventions on reducing stigma, enhancing mindfulness and social support should be taken into account to alleviate anxiety and depression among RD.

Psychometric validation of a chinese version of COVID-19 vaccine hesitancy scale: a cross-sectional study.

BACKGROUND: COVID-19 vaccines have been administered in many countries; however, a sufficient vaccine coverage rate is not guaranteed due to vaccine hesitancy. To improve the uptake rate of COVID-19 vaccine, it is essential to evaluate the rate of vaccine hesitancy and explore relevant factors in different populations. An urgent need is to measure COVID-19 vaccine hesitancy among different population groups, hence a validated scale for measuring COVID-19 vaccine hesitancy is necessary. The present study aims to validate the COVID-19 vaccine hesitancy scale among different populations in China and to provide a scale measuring COVID-19 vaccine hesitancy with satisfactory reliability and validity. METHODS: Self-reported survey data were collected from different populations in China from January to March 2021. Based on the Parent Attitudes about Childhood Vaccines scale, 15 items were adapted to evaluate the COVID-19 vaccine hesitancy. Exploratory and confirmatory factor analysis were utilized to identify internal constructs of the COVID-19 vaccine hesitancy scale among two randomly split subsets of the overall sample. Reliability was analyzed with the internal consistency, composite reliability, and the test-retest reliability, and validity was analyzed with the criterion validity, convergent validity, and discriminant validity. RESULTS: A total of 4227 participants completed the survey, with 62.8% being medical workers, 17.8% being students, 10.3% being general population, and 9.1% being public health professionals. The exploratory factor analysis revealed a three-factor structure that explain 50.371% of the total variance. The confirmatory factor analysis showed that models consisting of three dimensions constructed in different populations had good or acceptable fit (CFI ranged from 0.902 to 0.929, RMSEA ranged from 0.061 to 0.069, and TLI ranged from 0.874 to 0.912). The Cronbach's α for the total scale and the three subscales was 0.756, 0.813, 0.774 and 0.705, respectively. Moreover, the COVID-19 vaccine hesitancy scale had adequate test-retest reliability, criterion validity, convergent validity, and discriminant validity. CONCLUSIONS: The COVID-19 vaccine hesitancy scale is a valid and reliable scale for identifying COVID-19 vaccine hesitancy among different population groups in China. Given the serious consequences of COVID-19 vaccine hesitancy, future studies should validate it across regions and time to better understand the application of the COVID-19 vaccine hesitancy scale.

Global Experiences of Community Responses to COVID-19: A Systematic Literature Review

Objective This study aimed to conduct a systematic review of the global experiences of community responses to the COVID-19 epidemic. Method Five electronic databases (PubMed, Embase, CINAHL, ScienceDirect, and Web of Science) were searched for peer-reviewed articles published in English, from inception to October 10, 2021. Two reviewers independently reviewed titles, s, and full texts. A systematic review (with a scientific strategy for literature search and selection in the electronic databases applied to data collection) was used to investigate the experiences of community responses to the COVID-19 pandemic. Results This review reported that community responses to COVID-19 consisted mainly of five ways. On the one hand, community-based screening and testing for Coronavirus was performed;on the other hand, the possible sources of transmission in communities were identified and cut off. In addition, communities provided medical aid for patients with mild cases of COVID-19. Moreover, social support for community residents, including material and psychosocial support, was provided to balance epidemic control and prevention and its impact on residents' lives. Last and most importantly, special care was provided to vulnerable residents during the epidemic. Conclusion This study systematically reviewed how communities to respond to COVID-19. The findings presented some practical and useful tips for communities still overwhelmed by COVID-19 to deal with the epidemic. Also, some community-based practices reported in this review could provide valuable experiences for community responses to future epidemics.

Experience and Perceptions of Chinese University Students Regarding the COVID-19 Pandemic: A Qualitative Analysis.

The COVID-19 pandemic has exerted a significant influence on university student's learning, life and mental health. Using the method of inductive content analysis, this study examined the experience and perceptions of Chinese university students regarding the COVID-19 pandemic. Eighteen university students including seven males and eleven females were involved in this study. In this study, we identified five themes concerning experience and perceptions of Chinese university students regarding the COVID-19 pandemic, that is, emotional reactions toward the COVID-19 pandemic, the influence of the COVID-19 pandemic on the participant's learning, the influence of the COVID-19 pandemic on the participant's daily life, participants' positive responses to the COVID-19 pandemic, and China's moves toward the COVID-19 pandemic. This study elaborated on experience and perceptions of Chinese university students regarding the COVID-19 pandemic, which would provide us a better understanding of how university students perceive the COVID-19 pandemic and to what extent the COVID-19 pandemic has influenced their learning and daily lives.

Control and Prevention of the COVID-19 Epidemic in China: A Qualitative Community Case Study.

BACKGROUND: Cross-infection among residents in communities is one of the most critical reasons for the rapid spread of the COVID-19 epidemic. The COVID-19 epidemic has been well controlled within Chinese communities, which has made important contributions to the country's fight against it. METHODS: In this study, a qualitative case study design, with mixed methods applied to data collection and analysis, was employed to explore epidemic prevention measures taken by a Chinese community, namely Mulin, during the pandemic. RESULTS: The Mulin community established an integrated plan for epidemic prevention, including the prevention of the invasion of COVID-19, the prevention of cross-infection within the community, gaining the residents' trust and support, and providing the residents with convenient services. CONCLUSION: In the present work, the Mulin community was taken as a typical case study, and qualitative methods were employed to comprehensively summarize the practice and experience of the community's epidemic prevention. Mulin's practices could shed light on how communities in other countries, especially developing countries with large populations, can prevent the spread of COVID-19.

Epidemic Prevention During Work Resumption: A Case Study of One Chinese Company's Experience.

Background: The COVID-19 epidemic not only brings challenges to the health of people all over the world, but also impacts the global economy, and employment. Therefore, promoting industry and business to resume work safely has become an important step to be taken by all countries in overcoming the economic recession and restarting growth. Objective: This study aims to elaborate on epidemic prevention measures a Chinese company (Company C) took during work resumption. Methods: In this study, we used a case study design, with field research method applied to data collection and analysis. Results: It has been identified that Company C took a range of measures to prevent the outbreak of COVID-19 inside the company, which involve work resumption preparation (information survey, health training, work resumption plan, epidemic prevention plan), facilities management, materials management, employee activity management, and so on. Conclusion: When the COVID-19 epidemic was initially controlled in February, the Chinese government allowed enterprises to resume work voluntarily, which did not bring about a rebound in the epidemic. One important reason is that Chinese enterprises have taken multiple measures to prevent the spread of the COVID-19 virus. Company C's practices could shed some light on how companies in Western countries resume their work during the COVID-19 pandemic.