ABSTRACT
Goal adjustment capacities (i.e., goal disengagement and goal reengagement) are core self-regulatory resources theorized to buffer psychological well-being during intractable life circumstances. However, research has yet to examine whether these capacities protect well-being for individuals who encounter uncontrollable losses in their ability to pursue important life goals due to the COVID-19 pandemic. Using a nationally-representative sample of American adults aged 18-80 (n = 292), the present longitudinal study examined the influence of goal disengagement and reengagement on levels and change in psychological well-being for individuals who differed in perceived control over their goals early in the pandemic. Results from multilevel growth models showed that goal reengagement, but not goal disengagement, capacities predicted higher levels of well-being (lower perceived stress, depressive symptoms; higher life satisfaction, meaning in life) for individuals who reported pandemic-induced declines in control over their goals. Findings inform theories of motivation and self-regulation and point to the adaptive value of goal reengagement capacities during uncontrollable life circumstances.
Subject(s)
COVID-19ABSTRACT
Goal adjustment capacities (i.e., goal disengagement and goal reengagement) are core self-regulatory resources theorized to buffer psychological well-being during intractable life circumstances. However, research has yet to examine whether these capacities protect well-being for individuals who encounter uncontrollable losses in their ability to pursue important life goals due to the COVID-19 pandemic. Using a nationally-representative sample of American adults aged 18-80 (n = 292), the present longitudinal study examined the influence of goal disengagement and reengagement on levels and change in psychological well-being for individuals who differed in perceived control over their goals early in the pandemic. Results from multilevel growth models showed that goal reengagement, but not goal disengagement, capacities predicted higher levels of well-being (lower perceived stress, depressive symptoms; higher life satisfaction, meaning in life) for individuals who reported pandemic-induced declines in control over their goals. Findings inform theories of motivation and self-regulation and point to the adaptive value of goal reengagement capacities during uncontrollable life circumstances.
Subject(s)
COVID-19ABSTRACT
Objectives: To determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic. Design: Systematic review Eligibility: Eligible studies compared utilisation of services during COVID-19 pandemic to at least one comparable period in prior years. Services included visits, admissions, diagnostics, and therapeutics. Studies were excluded if from single-centres or studied only COVID-19 patients. Data sources: PubMed, Embase, Cochrane COVID-19 Study Register, and pre-prints were searched, without language restrictions, until August 10, using detailed searches with key concepts including COVID-19, health services and impact. Data analysis: Risk of bias was assessed by adapting ROBINS-I and Cochrane Effective Practice and Organization of Care tool. Results were analysed using descriptive statistics, graphical figures, and narrative synthesis. Outcome measures: Primary outcome was change in service utilisation between pre-pandemic and pandemic periods. Secondary outcome was the change in proportions of users of healthcare services with milder or more severe illness (e.g. triage scores). Results: 3097 unique references were identified, and 81 studies across 20 countries included, reporting on >11 million services pre-pandemic and 6.9 million during pandemic. For the primary outcome, there were 143 estimates of changes, with a median 37% reduction in services overall (interquartile range -51% to -20%), comprising median reductions for visits of 42%(-53% to -32%), admissions, 28%(-40% to -17%), diagnostics, 31%(-53% to -24%), and for therapeutics, 30%(-57% to -19%). Among 35 studies reporting secondary outcomes, there were 60 estimates, with 27(45%) reporting larger reductions in utilisation among people with a milder spectrum of illness, and 33 (55%) reporting no change. Conclusions: Healthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health-systems prioritise higher-value care in the post-pandemic recovery. Funding, Study registration: No funding was required. PROSPERO: CRD42020203729