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1.
Front Psychiatry ; 12: 735973, 2021.
Article in English | MEDLINE | ID: covidwho-1472406

ABSTRACT

Background: Depression has been a common mental health problem during the COVID-19 epidemic. From a network perspective, depression can be conceptualized as the result of mutual interactions among individual symptoms, an approach that may elucidate the structure and mechanisms underlying this disorder. This study aimed to examine the structure of depression among residents in Wuhan, the epicenter of the COVID-19 outbreak in China, in the later stage of the COVID-19 pandemic. Methods: A total of 2,515 participants were recruited from the community via snowball sampling. The Patient Health Questionnaire was used to assess self-reported depressive symptoms with the QuestionnaireStar program. The network structure and relevant centrality indices of depression were examined in this sample. Results: Network analysis revealed Fatigue, Sad mood, Guilt and Motor disturbances as the most central symptoms, while Suicide and Sleep problems had the lowest centrality. No significant differences were found between women and men regarding network structure (maximum difference = 0.11, p = 0.44) and global strength (global strength difference = 0.04; female vs. male: 3.78 vs. 3.83, p = 0.51), a finding that suggests there are no gender differences in the structure or centrality of depressive symptoms. Limitations: Due to the cross-sectional study design, causal relationships between these depressive symptoms or dynamic changes in networks over time could not be established. Conclusions: Fatigue, Sad mood, Guilt, and Motor disturbances should be prioritized as targets in interventions and prevention efforts to reduce depression among residents in Wuhan, in the later stage of the COVID-19 pandemic.

2.
Transl Psychiatry ; 11(1): 505, 2021 10 02.
Article in English | MEDLINE | ID: covidwho-1447295

ABSTRACT

Close contacts of those with COVID-19 (CC) may experience distress and long-lasting mental health effects. However, the mental health status and quality of life (QOL) in CC have not been adequately examined. This study examined the mental health status and QOL in CC during the post-COVID-19 period. This cross-sectional study comprised 1169 CC and 1290 who were non-close contacts (non-CC). Demographic data were collected; depression, fatigue, post-traumatic stress symptoms (PTSS) and QOL were assessed using the Patient Health Questionnaire - 9 items (PHQ-9), fatigue numeric rating scale, Post-Traumatic Stress Disorder Checklist - 17 items (PCL-17), and the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Analysis of covariance was used to compare depressive symptoms, QOL, fatigue, and PTSS between the CC and non-CC groups. Multiple logistic regression analyses were performed to determine the independent correlates for depression, fatigue, PTSS, and QOL in the CC group. Compared to the non-CC group, the CC group reported significantly more severe depression (F(1, 2458) = 5.58, p = 0.018) and fatigue (F(1, 2458) = 9.22, p = 0.002) in the post-COVID-19 period. No significant differences in PTSS and QOL between the CC and non-CC groups were found (F(1, 2458) = 2.93, p = 0.087 for PTSS; F(1, 2458) = 3.45, p = 0.064 for QOL). In the CC group, younger age, financial loss due to COVID-19, and perception of poor or fair health status were significantly associated with depression and fatigue, while frequent use of mass media was significantly associated with fatigue. In conclusion, close contacts of COVID-19 patients experienced high levels of depression and fatigue in the post-COVID-19 period. Due to the negative effects of depression and fatigue on daily functioning, early detection and timely interventions should be provided to this neglected population.


Subject(s)
COVID-19 , Quality of Life , Cross-Sectional Studies , Depression , Health Status , Humans , SARS-CoV-2 , Surveys and Questionnaires
3.
Am J Addict ; 30(6): 585-592, 2021 11.
Article in English | MEDLINE | ID: covidwho-1416264

ABSTRACT

BACKGROUND AND OBJECTIVES: The prevalence of problematic Internet use (PIU) in the post-COVID-19 pandemic era is not known. This cross-sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post-COVID-19 era. METHODS: A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF), respectively. t Tests, χ2 , tests, and Kruskal-Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates. RESULTS: The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%-25.8%). Multiple logistic regression analysis revealed that second- (p = .024) and third-year (p = .012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p = .014) and anxiety symptoms (p = .011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p = .002). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Problematic Internet use (PIU) was common among nursing students in the post-COVID-19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post-COVID-19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population.

4.
BMJ Open ; 11(9): e045454, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1398649

ABSTRACT

OBJECTIVES: This phenomenological study aimed to examine intensive care unit (ICU) nurses' experiences of caring for patients with COVID-19, and understand better their everyday experiences of patient' management in the ICU. DESIGN: A descriptive phenomenological research design was used. Individual interviews were conducted. The data were transcribed verbatim and analysed using Colaizzi's seven-step framework. SETTING: An ICU with 16 beds in a tertiary hospital in Wuhan, China. PARTICIPANTS: Nurses who had more than 1 year of experience and had provided care to patients with COVID-19 in ICU for more than 1 week were identified as participants. A total of 13 nurses were interviewed. RESULTS: An analysis of these significant statements yielded four distinct stages of feelings, thereby revealing the essence of this phenomenon. Worry about being infected and infecting family members was present across in all four stages. The themes associated with the four stages were as follows: initial contradictory feelings, quick adaption to the 'new working environment' in the first 1-2 weeks in the ICU, desperation after adaption, holding on and survive. CONCLUSIONS: The nurses reported distinct experiences of providing care to patients with COVID-19 in ICUs. Interventions, such as providing information about the disease, simulation training, emotional support and follow-up care, are needed to help nurses manage patients with COVID-19 and maintain nurses' health.


Subject(s)
COVID-19 , Nurses , Nursing Staff, Hospital , Humans , Intensive Care Units , Qualitative Research , SARS-CoV-2
5.
J Affect Disord ; 294: 753-760, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1322168

ABSTRACT

BACKGROUND: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and well-being of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. METHOD: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. RESULTS: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. LIMITATIONS: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. CONCLUSIONS: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.


Subject(s)
COVID-19 , Students, Nursing , Anxiety/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Humans , Pandemics , SARS-CoV-2
6.
PeerJ ; 9: e11154, 2021.
Article in English | MEDLINE | ID: covidwho-1184016

ABSTRACT

Background: Due to the COVID-19 outbreak, all teaching activities in nursing schools were suspended in China, and many nursing students were summoned to work in hospitals to compensate for the shortage of manpower. This study examined the prevalence of fatigue and its association with quality of life (QOL) among nursing students during the post-COVID-19 era in China. Methods: This was a multicenter, cross-sectional study. Nursing students in five Chinese universities were invited to participate. Fatigue, depressive and anxiety symptoms, pain and QOL were measured using standardized instruments. Results: A total of 1,070 nursing students participated. The prevalence of fatigue was 67.3% (95% CI [64.4-70.0]). Multiple logistic regression analysis revealed that male gender (P = 0.003, OR = 1.73, 95% CI [1.20-2.49]), and being a senior nursing student (second year: OR = 2.20, 95% CI [1.46-3.33], P < 0.001; third year: OR = 3.53, 95% CI [2.31-5.41], P < 0.001; and fourth year OR = 3.59, 95% CI [2.39-5.40], P < 0.001) were significantly associated with more severe fatigue. In addition, moderate economic loss during the COVID-19 pandemic (OR = 1.48, 95% CI [1.08-3.33], P < 0.015; compared to low loss), participants with more severe depressive (OR = 1.48, 95% CI [1.22-1.78], P < 0.001) and anxiety symptoms (OR = 1.12, 95% CI [1.05-1.20], P = 0.001), and more severe pain (OR = 1.67, 95%CI [1.46-1.91], P < 0.001) were significantly associated with reported more severe fatigue. After controlling for covariates, nursing students with fatigue had a lower overall QOL score compared to those without (F (1, 1070) = 31.4, P < 0.001). Conclusion: Fatigue was common among nursing students in the post-COVID-19 era. Considering the negative impact of fatigue on QOL and daily functioning, routine physical and mental health screening should be conducted for nursing students. Effective stress-reduction measures should be enforced to assist this subpopulation to combat fatigue and restore optimal health.

7.
Front Psychiatry ; 12: 553021, 2021.
Article in English | MEDLINE | ID: covidwho-1170126

ABSTRACT

Background: The outbreak of COVID-19 occurred in 2020 which resulted in high levels of psychological stress in both the general public and healthcare providers. Purpose: The study aimed to address the mental health status of people in China in the early stage of the COVID-19 outbreak, and to identify differences among the general public, frontline, and non-frontline healthcare providers. Method: A cross-sectional study was used to identify the mental health status of the general public and healthcare providers between Jan 29 and Feb 11, 2020. Data were collected using an online survey from a convenience sample. The instruments used included: Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, and Impact of Event Scale-Revised. Descriptive statistics were used to describe the data. Kruskal-Wallis H tests were performed to assess differences in measurements among the three groups; P < 0.05 (two-sided) was considered to be statistically significant. Results: Results showed that a majority of participants experienced post-traumatic stress (68.8%), depression (46.1%), anxiety (39.8%), and insomnia (31.4%). Significant changes in the mental health status of frontline providers was found as compared to those of the other groups (P < 0.001). Interestingly, the scores of the general public were significantly higher than those of the non-frontline healthcare providers (P < 0.001). Conclusion: These findings provide information to evaluate outbreak associated psychological stress for the general public and healthcare providers, and assist in providing professional support and actionable guidance to ease psychological stress and improve mental health.

8.
J Nurs Manag ; 29(4): 805-812, 2021 May.
Article in English | MEDLINE | ID: covidwho-991599

ABSTRACT

AIMS: To investigate the eHealth literacy and the psychological status of Chinese residents during the COVID-19 pandemic and explore their interrelationship. BACKGROUND: The COVID-19 outbreak has placed intense psychological pressure on community residents. Their psychological status may be affected by eHealth literacy due to home isolation during this rampant pandemic. METHODS: This is a Web-based cross-sectional survey conducted on the JD Health platform, which resulted in 15,000 respondents having participated in this survey. The eHealth Literacy Questionnaire (EHLQ), Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI) and Impact of Event Scale-Revised (IES-R) were used. The Pearson correlation was used to analyse the relationship between eHealth literacy and depression, insomnia and post-traumatic stress disorder. RESULTS: The score of eHealth literacy was 48.88 ± 8.46, and 11.4%, 6.8% and 20.1% of respondents experienced moderate to severe depression, insomnia and post-traumatic stress disorder. eHealth literacy negatively correlated with depression (r = -0.331), insomnia (r = -0.366) and post-traumatic stress disorder (r = -0.320). CONCLUSION: eHealth literacy is closely related to psychological status. Improving eHealth literacy may contribute to maintaining good psychological well-being. IMPLICATIONS FOR NURSING MANAGEMENT: It is necessary to strengthen the education of primary health care providers to enhance their ability to help community residents effectively use eHealth information.


Subject(s)
COVID-19 , Health Literacy , Mental Disorders , Pandemics , Telemedicine , Adolescent , Adult , COVID-19/epidemiology , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Female , Health Literacy/statistics & numerical data , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Social Isolation/psychology , Surveys and Questionnaires , Young Adult
12.
Lancet Glob Health ; 8(6): e790-e798, 2020 06.
Article in English | MEDLINE | ID: covidwho-141633

ABSTRACT

BACKGROUND: In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. METHODS: We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. FINDINGS: We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was "being fully responsible for patients' wellbeing-'this is my duty'". Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was "challenges of working on COVID-19 wards". Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was "resilience amid challenges". Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. INTERPRETATION: The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. FUNDING: National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Outbreaks , Medical Staff, Hospital/psychology , Nursing Staff, Hospital/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Adult , COVID-19 , China/epidemiology , Female , Humans , Male , Medical Staff, Hospital/statistics & numerical data , Nursing Staff, Hospital/statistics & numerical data , Pandemics , Qualitative Research , Young Adult
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