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1.
PLoS One ; 17(4): e0264134, 2022.
Article in English | MEDLINE | ID: covidwho-2021605

ABSTRACT

BACKGROUND: Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. METHODS: To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. RESULTS: We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). CONCLUSIONS: Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Government , Humans , Pandemics/prevention & control , Public Opinion , SARS-CoV-2 , United Kingdom/epidemiology
2.
Int J Environ Res Public Health ; 19(15)2022 07 27.
Article in English | MEDLINE | ID: covidwho-1969210

ABSTRACT

Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the capability, opportunity, motivation model of behaviour (COM-B). One-to-one interviews were conducted with younger (aged 18-24) and older adults (aged 70+), those with long-term physical or mental health conditions, and parents of young children. Themes were identified using reflexive thematic analysis and were mapped onto COM-B domains. A total of 116 participants contributed (aged 18-93, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations/plans) COM-B domains. Future interventions should target these domains during pandemics (e.g., adapting PA guidance depending on location and giving education on the health benefits of PA).


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Child , Child, Preschool , Exercise/psychology , Female , Humans , Male , Motivation , Pandemics , Qualitative Research
4.
Int J Drug Policy ; 106: 103752, 2022 08.
Article in English | MEDLINE | ID: covidwho-1867048

ABSTRACT

BACKGROUND: People Who Inject Drugs (PWID) are subject to distinct socio-structural inequalities that can expose them to high risks of COVID-19 transmission and related health and social complications. In response to COVID-19 mitigation strategies, these vulnerabilities are being experienced in the context of adapted drug treatment service provision, including reduced in-person support and increased regulatory flexibility in opioid substitution therapy (OST) guidelines. This study aimed to explore the longer-term impact of the pandemic on the health and wellbeing of PWID in the UK, including provider and client experiences of treatment changes. METHODS: Interviews were conducted with 19 PWID and 17 drug treatment providers between May and September 2021, recruited from drug and homelessness charities providing treatment services and healthcare in the UK. Data were analysed using reflexive thematic analysis. RESULTS: Most participants expressed ongoing fears of COVID-19 transmission, although socio-structural inequalities limited the contexts in which physical distancing could be practised. In addition, virus mitigation strategies altered the risk environment for PWID, resulting in ongoing physical (e.g. changing drug use patterns, including transitions to crack cocaine, benzodiazepine and pregabalin use) and socio-economic harms (e.g. limited opportunities for sex work engagement and income generation). Finally, whilst clients reported some favourable experiences from service adaptations prompted by COVID-19, including increased regulatory flexibility in OST guidelines, there was continued scepticism and caution among providers toward sustaining any treatment changes beyond the pandemic period. CONCLUSIONS: Whilst our findings emphasize the importance of accessible harm reduction measures attending to changing indices of drug-related harm during this period, there is a need for additional structural supports to ensure pre-existing disparities and harms impacting PWID are not exacerbated further by the conditions of the pandemic. In addition, any sustained policy and service delivery adaptations prompted by COVID-19 will require further attention if they are to be acceptable to both service users and providers.


Subject(s)
COVID-19 , Drug Users , Substance Abuse, Intravenous , COVID-19/epidemiology , Harm Reduction , Humans , Pandemics , Pharmaceutical Preparations , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/epidemiology , Substance Abuse, Intravenous/therapy , United Kingdom/epidemiology
5.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-336987

ABSTRACT

Objectives Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited, so reasons for this have not been explored in-depth. This study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the Capability, Opportunity, Motivation Model of Behaviour (COM-B). Design Semi-structured qualitative interview study. Methods One-to-one telephone/videocall interviews were conducted with younger (aged 18-24) and older adults (aged 70+), those with long-term physical health conditions or mental health conditions, and parents of young children, probing about their experiences of PA. Barriers and facilitators were identified using reflexive thematic analysis, and themes were mapped onto COM-B dimensions. Results 116 participants were included (18-93 years old, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations and plans) COM-B domains. Conclusions Future interventions should increase physical opportunity and reflective motivation for PA during pandemics, to avoid further negative health outcomes following periods of lockdown. Strategies could include tailoring PA guidance depending on location and giving education on the health benefits of PA. Statement of Contribution What is already known on this subject? Physical activity (PA) levels reduced during the COVID-19 pandemic. The extent of this reduction varied across demographic groups. Very few qualitative studies have explored reasons for these changes. What does this study add? Novel interview data, giving context to existing quantitative data. Insight into which themes were important for different demographic groups. Suggestions for increasing PA in future pandemics, by mapping findings to a theoretical framework.

6.
BJPsych Open ; 8(2): e72, 2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1753144

ABSTRACT

BACKGROUND: Around one in ten people who contract COVID-19 report persistent symptoms or 'long COVID'. Impaired mental health and well-being is commonly reported, including anxiety, depression and reduced quality of life. However, there is limited in-depth research exploring why mental health and well-being are affected in people experiencing long COVID. AIMS: To explore factors affecting mental health and well-being from the perspective of people with long COVID. METHOD: Semi-structured qualitative interviews were audio-recorded and transcribed. Data were analysed using reflexive thematic analysis. Twenty-one people with long COVID participated in the study. Participants were eligible if they self-reported a positive swab test/antibody test or one or more commonly reported COVID-19 symptoms at illness onset. and experiences of one or more long COVID symptoms ≥3 weeks following illness onset. RESULTS: Five themes were identified across participant accounts regarding factors affecting mental health and well-being, including symptoms causing severe disruption to daily life, lack of service and treatment options, uncertainty of illness trajectories, experiences of care and understanding from others and changes to identity. CONCLUSIONS: People with long COVID experience a range of factors that negatively affect their mental health and well-being. Providing patient-centred health services that integrate rapidly evolving research in this area is important, as are peer support groups and supported approaches to self-management.

7.
BMJ Open ; 12(2): e053676, 2022 02 09.
Article in English | MEDLINE | ID: covidwho-1741629

ABSTRACT

OBJECTIVES: Adolescents and young adults have been greatly affected by quarantine measures during the COVID-19 pandemic, but little is understood about how restrictions have affected their well-being, mental health, and social life. We therefore aimed to learn more about how UK quarantine measures affected the social lives, mental health and well-being of adolescents and young adults. DESIGN: Qualitative interview study. The data were analysed using reflexive thematic analysis, with particular attention paid to contextual factors (such as age, gender, ethnicity and health status) when analysing each individual transcript. SETTING: Data collection took place remotely across the UK via audio or video call, between June 2020 and January 2021. PARTICIPANTS: We conducted semi-structured interviews with 37 participants (aged 13-24 years) to elicit their views. RESULTS: Authors generated four themes during the qualitative analysis: (a) concerns about disruption to education, (b) missing social contact during lockdown, (c) changes to social relationships and (d) improved well-being during lockdown. Many participants said they struggled with a decline in mental health during the pandemic, lack of support and concern about socialising after the pandemic. However, some participants described experiences and changes brought on by the pandemic as helpful, including an increased awareness of mental health and feeling more at ease when talking about it, as well as stronger relationship ties with family members. CONCLUSIONS: Findings suggest that young people may have felt more comfortable when talking about their mental health compared with prepandemic, in part facilitated by initiatives through schools, universities and employers. However, many were worried about how the pandemic has affected their education and social connections, and support for young people should be tailored accordingly around some of these concerns.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Communicable Disease Control , Humans , SARS-CoV-2 , United Kingdom/epidemiology , Young Adult
8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307506

ABSTRACT

ObjectivesWhen followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. This study aimed to explore barriers and facilitators to compliance with United Kingdom social distancing guidelines during the COVID-19 pandemic.MethodSemi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to domains of the Capability, Opportunity and Motivation Model of Behaviour (COM-B).Main Outcome MeasuresWe identified 12 themes affecting compliance to UK social distancing guidelines.ResultsBarriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes acted both as a barrier or facilitator: lived environment and shared spaces, beliefs about consequences of non-compliance, influence of others, practical social support, and trust in government. Conclusions Participants experienced a range of barriers and facilitators to compliance, often dependent on individual circumstances. Reflective motivation, psychological capability and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies that help maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.

9.
Front Psychol ; 12: 672694, 2021.
Article in English | MEDLINE | ID: covidwho-1686528

ABSTRACT

There are concerns that the socioeconomic consequences of COVID-19, including unemployment and financial insecurity, are having adverse effects on the mental wellbeing of the population. One group particularly vulnerable to socioeconomic adversity during this period are those employed freelance within the cultural industry. Many workers in the sector were already subject to income instability, erratic work schedules and a lack of economic security before the pandemic, and it is possible that COVID-19 may exacerbate pre-existing economic precarity. Through interviews with 20 freelancers working within the performing arts, visual arts, and film and television industries, this article explores the impact of the pandemic on their working lives. Findings suggest the pandemic is affecting the psychological wellbeing of freelancers through employment loss, financial instability and work dissonance, and illustrates the need for urgent economic and psychosocial support for those employed within the cultural sector.

10.
BMC Psychol ; 9(1): 194, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1581997

ABSTRACT

BACKGROUND: Parents have faced unique challenges during the coronavirus disease 2019 (COVID-19) pandemic, including mobility constraints, isolation measures, working from home, and the closure of schools and childcare facilities. There is presently a lack of in-depth qualitative research exploring how these changes have affected parents' mental health and wellbeing. METHODS: Semi-structured qualitative interviews with 29 parents of young children. Interviews were analysed using reflexive thematic analysis. RESULTS: We identified five superordinate themes affecting participant mental health and wellbeing: (1) navigation of multiple responsibilities and change inside the home; (2) disruption to home life; (3) changes to usual support networks; (4) changes in personal relationships; and (5) use of coping strategies. Participants described stress and exhaustion from navigating multiple pressures and conflicting responsibilities with home, schooling, and work, without their usual support networks and in the context of disrupted routines. Family roles and relationships were sometimes tested, however, many parents identified coping strategies that protected their wellbeing including access to outdoor space, spending time away from family, and avoiding conflict and pandemic-related media coverage. CONCLUSIONS: Employers must be cognisant of the challenges that the pandemic has placed on parents, particularly women and lone parents. Flexible working arrangements and support might therefore relieve stress and increase productivity. Coping strategies identified by parents in this study could be harnessed and encouraged by employers and policymakers to promote positive wellbeing during times of stress throughout the pandemic and beyond.


Subject(s)
COVID-19 , Child , Child, Preschool , Female , Humans , Mental Health , Pandemics/prevention & control , Parents , Qualitative Research , SARS-CoV-2
12.
Trials ; 22(1): 865, 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1551222

ABSTRACT

BACKGROUND: Most people living with dementia want to remain living in their own homes and are supported to do so by family carers. No interventions have consistently demonstrated improvements to people with dementia's life quality, functioning, or other indices of living as well as possible with dementia. We have co-produced, with health and social care professionals and family carers of people with dementia, a new intervention (NIDUS-family). To our knowledge, NIDUS-family is the first manualised intervention that can be tailored to personal goals of people living with dementia and their families and is delivered by facilitators without clinical training. The intervention utilizes components of behavioural management, carer support, psychoeducation, communication and coping skills training, enablement, and environmental adaptations, with modules selected to address dyads' selected goals. We will evaluate the effect of NIDUS-family and usual care on goal attainment, as measured by Goal Attainment Scaling (GAS) rated by family carers, compared to usual care alone at 12-month follow-up. We will also determine whether NIDUS-family and usual care is more cost-effective than usual care alone over 12 months. METHODS: A randomised, two-arm, single-masked, multi-site clinical trial involving 297 people living with dementia-family carer dyads. Dyads will be randomised 2:1 to receive the NIDUS-family intervention with usual care (n = 199) or usual care alone (n = 98). The intervention group will be offered, over 1 year, via 6-8 video call or telephone sessions (or face to face if COVID-19 restrictions allow in the recruitment period) in the initial 6 months, followed by telephone follow-ups every 1-2 months to support implementation, with a trained facilitator. DISCUSSION: Increasing the time lived at home by people living with dementia is likely to benefit lives now and in the future. Our intervention, which we adapted to include remote delivery prior to trial commencement due to the COVID-19 pandemic, aims to address barriers to living as well and as independently as possible that distress people living with dementia, exacerbate family carer(s) stress, negatively affect relationships, lead to safety risks, and frequently precipitate avoidable moves to a care home. TRIAL REGISTRATION: International Standard Randomised Controlled Trials Number ISRCTN11425138 . Registered on 7 October 2019.


Subject(s)
COVID-19 , Dementia , Caregivers , Cost-Benefit Analysis , Dementia/diagnosis , Dementia/therapy , Humans , Pandemics , Psychosocial Intervention , Quality of Life , SARS-CoV-2
13.
BMJ Open ; 11(11): e050945, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1515301

ABSTRACT

OBJECTIVES: Non-healthcare keyworkers face distinct occupational vulnerabilities that have received little consideration within broader debates about 'essential' work and psychological distress during the COVID-19 pandemic. The aim of this study was therefore to explore the impact of the pandemic on the working lives and mental health and well-being of non-healthcare keyworkers in the UK. DESIGN: In-depth, qualitative interviews, analysed using a reflexive thematic analysis. SETTING: Telephone or video call interviews, conducted in the UK between September 2020 and January 2021. PARTICIPANTS: 23 participants aged 26-61 (mean age=47.2) years employed in a range of non-healthcare keyworker occupations, including transport, retail, education, postal services, the police and fire services, waste collection, finance and religious services. RESULTS: Keyworkers experienced adverse psychological effects during the COVID-19 pandemic, including fears of COVID-19 exposure, contagion and subsequent transmission to others, especially their families. These concerns were often experienced in the context of multiple exposure risks, including insufficient personal protective equipment and a lack of workplace mitigation practices. Keyworkers also described multiple work-related challenges, including increased workload, a lack of public and organisational recognition and feelings of disempowerment. CONCLUSIONS: In efforts to reduce psychosocial concerns among non-healthcare keyworkers, there is a need for appropriate support during the COVID-19 pandemic and in preparation for other infections (eg, seasonal influenza) in the future. This includes the provision of psychological and workplace measures attending to the intersections of personal vulnerability and work conditions that cause unique risks and challenges among those in frontline keyworker occupations.


Subject(s)
COVID-19 , Pandemics , Health Personnel , Humans , Middle Aged , SARS-CoV-2 , Social Change , United Kingdom/epidemiology
14.
J Ment Health ; : 1-8, 2021 Jul 29.
Article in English | MEDLINE | ID: covidwho-1331503

ABSTRACT

BACKGROUND: People with mental health conditions have been identified as particularly vulnerable to poor mental health during the coronavirus disease 2019 (COVID-19) pandemic. However, why this population have faced these adverse effects, how they have experienced them and how they have coped remains under-explored. AIMS: To explore how the COVID-19 pandemic affected the mental health of people with existing mental health conditions, and to identify coping strategies for positive mental health. METHODS: Semi-structured qualitative interviews with 22 people with mental health conditions. Participants were purposively recruited via social media, study newsletters and third sector mental health organisations. Data were analysed using reflexive thematic analysis. RESULTS: Participants were aged 23-70 (mean age 43), predominantly female (59.1%) and of white ethnicity (68.2%). Fifty percent were unable to work due to illness and the most frequently reported mental health condition was depression. Five pandemic-related factors contributed to deteriorating mental health: (i) feeling safe but isolated at home; (ii) disruption to mental health services; (iii) cancelled plans and changed routines; (iv) uncertainty and lack of control; (v) rolling media coverage. Five coping strategies were identified for maintaining mental health: (i) previous experience of adversity; (ii) social comparison and accountability; (iii) engaging in hobbies and activities; (iv) staying connected with others; (v) perceived social support. CONCLUSIONS: Challenges were identified as a direct result of the pandemic and people with severe mental illnesses were particularly negatively affected. However, some found this period a time of respite, drew upon reserves of resilience and adapted their coping strategies to maintain positive well-being.

15.
BMJ Open ; 11(2): e047353, 2021 02 08.
Article in English | MEDLINE | ID: covidwho-1072769

ABSTRACT

OBJECTIVES: To explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic. DESIGN: This was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding. PARTICIPANTS: This study involved 25 participants from a range of frontline professions in health and social care. SETTING: Interviews were conducted over the phone or video call, depending on participant preference. RESULTS: From the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life. CONCLUSIONS: This study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Pandemics , Social Workers/psychology , Adult , Aged , Female , Humans , Interviews as Topic , Male , Middle Aged , Qualitative Research , United Kingdom/epidemiology
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