Features of the mental state of doctors of various specialties during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the burden on healthcare professionals at all levels has increased significantly, especially those who are at the forefront of the fight for patients' lives. Physicians directly caring for COVID-19 patients are exposed to excessive stress and significant biological and psychosocial risk. Objective. To identify the features of the mental state of doctors of various specialties during the COVID-19 pandemic. Material and methods. The study included 85 doctors of the Arkhangelsk region: 41 anesthesiologists/intensive care physicians (mean age 32.4+/-5.0 years) and 44 general practitioners (mean age 38.9+/-4.2 years). The study was conducted during the third wave of the COVID-19 pandemic (from May to June 2021). We used the following study methods: questionnaire, psychological testing (K. Maslach and S. Jackson Burnout Inventory (MBI), Beck's Depression Inventory, Perceived Stress Scale, World Health Organisation-Five Well-Being Index), mathematical and statistical processing of empirical data. Results and discussion. Analysis of the results showed that about half of the surveyed general practitioners and only 3 (7.3%) of the anesthesiologists/intensive care physicians had a history of COVID-19, having contracted it while performing professional duties. Manifestations of maladaptation, such as low professional competence, lack of soft skills, aggressiveness, introversion, risktaking, recklessness, and family problems, are more pronounced in anesthesiologists/intensive care physicians. They were more likely to have negative emotions and feelings, were less satisfied with themselves and life in general, and had a lower well-being index than general practitioners. General practitioners overestimated their professional burnout severity and more often complained about their state of health. Correlation analysis of the examination results for anesthesiologists/intensive care physicians allowed us to identify direct relationships between the level of perceived stress, overstrain and depression, low mood, difficulties in relationships with relatives and colleagues, dissatisfaction with various aspects of life, inverse relationships between the level of perceived stress and the well-being index. In general practitioners, direct relationships were established between perceived stress and overexertion, and inverse relationships were established between the level of perceived stress, the well-being index, and the reduction of personal achievements. Conclusion. The COVID-19 pandemic negatively impacts anesthesiologists/intensive care physicians more than general practitioners, causing negative emotions and maladaptation. In primary care physicians, the pandemic increases mobilization processes to address emerging professional challenges. Therefore, special attention should be paid to psychological support for anesthesiologists/intensive care physicians.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Features of the mental state of doctors of various specialties during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the burden on healthcare professionals at all levels has increased significantly, especially those who are at the forefront of the fight for patients' lives. Physicians directly caring for COVID-19 patients are exposed to excessive stress and significant biological and psychosocial risk. Objective. To identify the features of the mental state of doctors of various specialties during the COVID-19 pandemic. Material and methods. The study included 85 doctors of the Arkhangelsk region: 41 anesthesiologists/intensive care physicians (mean age 32.4+/-5.0 years) and 44 general practitioners (mean age 38.9+/-4.2 years). The study was conducted during the third wave of the COVID-19 pandemic (from May to June 2021). We used the following study methods: questionnaire, psychological testing (K. Maslach and S. Jackson Burnout Inventory (MBI), Beck's Depression Inventory, Perceived Stress Scale, World Health Organisation-Five Well-Being Index), mathematical and statistical processing of empirical data. Results and discussion. Analysis of the results showed that about half of the surveyed general practitioners and only 3 (7.3%) of the anesthesiologists/intensive care physicians had a history of COVID-19, having contracted it while performing professional duties. Manifestations of maladaptation, such as low professional competence, lack of soft skills, aggressiveness, introversion, risktaking, recklessness, and family problems, are more pronounced in anesthesiologists/intensive care physicians. They were more likely to have negative emotions and feelings, were less satisfied with themselves and life in general, and had a lower well-being index than general practitioners. General practitioners overestimated their professional burnout severity and more often complained about their state of health. Correlation analysis of the examination results for anesthesiologists/intensive care physicians allowed us to identify direct relationships between the level of perceived stress, overstrain and depression, low mood, difficulties in relationships with relatives and colleagues, dissatisfaction with various aspects of life, inverse relationships between the level of perceived stress and the well-being index. In general practitioners, direct relationships were established between perceived stress and overexertion, and inverse relationships were established between the level of perceived stress, the well-being index, and the reduction of personal achievements. Conclusion. The COVID-19 pandemic negatively impacts anesthesiologists/intensive care physicians more than general practitioners, causing negative emotions and maladaptation. In primary care physicians, the pandemic increases mobilization processes to address emerging professional challenges. Therefore, special attention should be paid to psychological support for anesthesiologists/intensive care physicians.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

The Role of Sports in the Subjective Psychological Well-Being of Hungarian Adult Population in Three Waves of the COVID-19 Pandemic.

(1) Background: In this study, sport and subjective psychological well-being is investigated in three waves of the COVID-19 pandemic. (2) Methods: We have conducted three different representative sample surveys (n = 3600 altogether) on the Hungarian adult population and investigated the sample's subjective psychological well-being with the WHO-5 Well-Being Index, as well as changes in their subjective well-being through the different waves of the pandemic. Sporting habits and socio-economic variables were also surveyed, and OLS regression models were created focused on the WHO-5 measures. (3) Results: The subjective psychological well-being of the Hungarian adult population decreased significantly, but in the second and third wave of pandemic restrictions, an increase in subjective psychological well-being has been measured. The relationships between the time spent on doing sports and subjective psychological well-being were significant in each pandemic waves. The highest subjective psychological well-being and its highest increase were reported by those who could increase their time spent on doing sports as well. (4) Conclusions: The relationships between the sports activities, physical health, size of settlement, changes in income and subjective psychological well-being of the Hungarian adult population were significant in all three waves of the COVID-19 pandemic.

Stress/depression across the COVID-19 pandemic in Denmark.

BACKGROUND: Global estimates suggest strained mental health during the first year of the COVID-19 pandemic, but the lack of nationally representative and longitudinal data with clinically validated measures limits knowledge longer into the pandemic. METHODS: Data from 10 rounds of nationally representative surveys from Denmark tracked trends in risk of stress/depression from just before the first lockdown and through to April 2022. We focused on age groups and men and women in different living arrangements and controlled for seasonality in mental health that could otherwise be spuriously related to pandemic intensity. RESULTS: Prior to first lockdown, we observed a "parent gap", which closed with the first lockdown. Instead, a gender gap materialized, with women experiencing higher risks than men-and higher than levels predating first lockdown. Older respondents (+ 70 years) experienced increasing risks of stress/depression early in the pandemic, while all other groups experienced decreases. But longer into the pandemic, risks increased for all age groups and reached (and sometimes exceeded) levels from before first lockdown. CONCLUSION: Denmark had low infection rates throughout most of the pandemic, low mortality rates across the entire pandemic, and offered financial aid packages to curb financial strains. Despite this circumstance, initial improvements to mental health during the first lockdown in Denmark were short-lived. Two years of pandemic societal restrictions correspond with deteriorating mental health, as well as a change from a parenthood gap in mental health before first lockdown to a gender gap two years into the pandemic.

The impact of COVID-19 on the quality of life of older adults: a cross-sectional study in Athens, Greece

Introduction: The COVID-19 has affected both physical and mental health of the elderly. Objective(s): The purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people. Method(s): A cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0 Results: 222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p <0.05) with female gender, low educational level and with comorbidities (coronary disease, diabetes mellitus and skeletomuscular diseases). Health precaution measures were negative correlated with mental health of the elderly. However, in participants with frequent contact with family and friends, lower anxiety levels were detected. Conclusion(s): Our results highlight that older adult has experienced negative impact on both quality of life and mental health during 2nd Covid-19 lockdown in Greece.

COVID-19 lockdown and its impact on mental health in various population groups in Greece: A crosssectional study

Introduction: COVID-19 pandemic and lockdown has brought a serious impact on physical and mental health. Objective(s): The purpose of the present study was to estimate the impact of the first lockdown in Greece, on both quality of life and anxiety levels in different occupational groups. Method(s): A cross-sectional on- line survey was conducted from 20th of April to 4th of May 2020. A 24-item anonymous questionnaire was administered to collect basic demographic and socioeconomic data. The 5-item WHO Well-Being Index (WHO-5, 0-100%, cut-off 52%) and the Generalized Anxiety Disorder Assessment (GAD-7) tools were used to assess well-being and anxiety, respectively. Statistical analysis was performed with SPSS for Windows v.24.0 Statistical Package. Result(s): A total of 575 participated in the study, 62.8% females, 48.5% aged between 40 to 59 years. 32.5% were employed in education sector, 32.5% in health sector and 20.3% as season workers in tourism sector. Males showed slightly higher levels of wellbeing (52.1 vs. 47.3, p=0.023) and lower levels of anxiety (7.1 vs. 8.2, p=0.023) compared to females. Factors associated with higher wellbeing and lower anxiety were higher education and income level, optimism, taking less protection measures, and being seasonal worker. Furthermore, participants with comorbidities and symptoms like headache, musculoskeletal pain, as well as feeling depressed or stressed revealed lower wellbeing and higher anxiety scores. Conclusion(s): Our study revealed an overall poor wellbeing and mild to moderate levels of anxiety during the lockdown. Actions should be taken to address and to prevent its serious impact on mental health.

Contemplating the post-COVID psychological disorders in a selective sample using DASS-21 and the WHO-5 well-being index

Background: Earlier this year, the virus COVID-19 was detected for the first time and has since spread worldwide, causing widespread illness and death. A rise in emotional and psychological challenges worldwide has resulted from the disease's direct and indirect effects on individuals and families. It is usual for people to experience worry, tension, and other emotional responses during times of instability. Additional stress can increase symptoms in those already who have a mental illness. Methods: A survey is conducted on selective samples like students-teachers, COVID and non-COVID patients, small-medium scale entrepreneurs. A measurement scale of the WHO-5 Well-Being Index and The Depression, Anxiety, and Stress Scale-21 items (DASS-21) were taken in the questionnaire survey. When it comes to post-COVID mental diseases, data science is usually used to investigate the prevalence of these disorders, with a particular emphasis on their worry and melancholy. WHO-5 well-being index and the DASS-21 have their score calculations carried out in this study. Results: Among the 154 respondents of 77 males and 77 females, the WHO-well-being index has shown an average score of 55 among the sample selected. The male displayed a high score of 100 in 1.94%, and female respondents have reached 92 only. The Happiness index doesn't depend on the infection also. The DASS-21 shows a severity score, more in COVID affected persons than the non-affected ones. The students (COVID), Teachers (COVID), Medium Entrepreneurs (COVID) have shown the value of >60% in Depression and Stress. The anxiety value is comparatively less in both cases. © 2022 Nova Science Publishers, Inc. All rights reserved.

Are emojis ready to promote the WHO 5 moments for hand hygiene in healthcare?

BACKGROUND: Hand hygiene is universally recognized as a cornerstone measure for the prevention of healthcare-associated infections. Although the WHO "My five Moments for hand hygiene" poster has been used for more than a decade to delineate hand hygiene indications and promote action, adherence levels among healthcare workers are still notoriously low and disquieting. To compensate for the lack of effective hand hygiene communication, we aimed to evaluate emojis as possible surrogates for the non-verbal aspects of hand hygiene behaviour. METHODS: Following a thorough review of the Unicode version 12.0, the most applicable emojis to the terms used in the WHO 5 Moments poster were extracted. We developed a self-administered questionnaire to assess the view of infection prevention and control (IPC) practitioners regarding the use of emojis to show the WHO 5 Moments. Completed questionnaires were collected and analysed to determine the suitability of the existing emojis to illustrate a unified emoji poster. Data were analysed using R (version 3.6.3). RESULTS: A total of 95 IPC practitioners completed the questionnaire from May to October 2019 from different countries. Of these, 69 (74%) were female, and the mean age of the participants was 44.6 ± 10.87 years. We found appropriate emojis for six of the words used in the poster, including for touching (72%), for patient (63%), for clean (53%), for procedure (56%), for body fluid (58%), and for exposure risk (71%). The existing emojis proposed for the words "hygiene", "aseptic", and "surrounding" seemed to be less satisfactory. CONCLUSIONS: In summary, the findings of this study indicate that the existing emojis may not be able to substitute the words used in the WHO 5 Moments poster. Emojis might be helpful to address hand hygiene indications in healthcare that may eventually play a role in promoting this measure. However, emojis should be further studied to choose the most appropriate ones and avoid ambiguity and misinterpretation. More emojis to convey health related messages are needed. We recommend further research in this area to evaluate the effect of using emojis in healthcare-related behaviours.

The Lingering Effects: Examining Mental Health in India during a Period of Covid-19 Regression

PURPOSE: COVID-19 has been recognized as a contagious disease which can cause serious health problems, even proving to be fatal in some cases. The swift spread of COVID-19 epidemic shook the world which led to lockdowns, isolation, and social distancing for the general population so as to curb and contain the spread. This was found to lead to mental health disorders amongst people. This study examines the prevalence and severity of anxiety, stress perception, and well-being levels among the people at the time when the COVID-19 was in regression (decline) in India.METHODS: In this cross-sectional study, 374 respondents' mental health was evaluated using three standardized questionnaires: Generalized Anxiety Disorder [GAD-7], Perceived Stress Scale [PSS-4], and Five Wellbeing Index [WHO-5].RESULTS: The study revealed that almost 82% of respondents had moderate to severe levels of stress while 66% of respondents had mild to moderate levels of anxiety. Overall, 60% of respondents had poor (low) mental well-being. A strong negative correlation was found between mental well-being and perceived stress, and mental well-being and level of anxiety, in comparison to the correlation between anxiety and perceived stress was positive and statistically significant.CONCLUSIONS: This study identified several long-term psychological effects of COVID. The presence of stress and anxiety and poorer mental well-being even at the time of decline in COVID-19 cases, highlights the need for serious attention to be given to psychological and psychiatric help and support throughout the duration and regression of such diseases. Health policymakers must ensure coherent and consistent plans for screening the mental health of the general population are in place to provide the required support in managing the long-term psychological and psychiatric effects of COVID.

Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study.

This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.

Validating the Five-Item World Health Organization Well-Being Index.

Purpose: Research on the psychological well-being of caregivers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) suggests that the well-being of parents and caregivers has been negatively affected by the COVID-19 pandemic. Although the psychological well-being of caregivers is a major concern, few validated well-being measures exist for caregivers of children diagnosed with ADHD. Therefore, a valid self-report scale is needed to assess well-being during the pandemic. The brief Five-Item World Health Organization Well-Being Index (WHO-5) has previously been used in studies on caregivers. However, its validity in this population remains unknown. This study aimed to evaluate the reliability and construct validity of the WHO-5 with caregivers of children with ADHD. Methods: A cross-sectional anonymous online survey was conducted in Norway. The study recruited caregivers from a community sample during the COVID-19 pandemic. This was carried out to investigate the construct validity by exploring the relationship between well-being, quality of life, social support, self-reported psychological distress, and perceived stress. Results: The findings of unidimensionality and high internal consistency, together with the results from the hypothesis testing, demonstrate the reliability and construct validity of the Norwegian version of the WHO-5 in this population. Conclusions: This study provides the first empirical evidence of the validity and reliability of the WHO-5 from a sample of Norwegian caregivers of children diagnosed with ADHD, with excellent reliability and construct validity. The scale can be used to systematize the measurement of well-being in caregivers because of its brevity and good psychometric properties, making it a valuable resource in research settings and assisting healthcare professionals in their crucial work of caring for caregivers.

The impact of COVID-19 Epidemic on Teaching and Learning

Recently articles in Newspapers, University News Bulletins and Scientific Literature report about negative aspects of the wellbeing of students caused by COVID-19 epidemic. Half of the students have mental problems and don't participate in the teaching learning process anymore. In the Netherlands, Universities are surveyed by questionnaires, researching the mental health problems of students. In this paper we focus on students of Delft University of Technology. It proved from surveys, that many students complain about loneliness, fear, sleep deprivation and lack of study motivation. In this paper we report about experiments at the Faculty of Electrical Engineering, Mathematics and Computer Science, how students can be activated, motivated and socialized via study activities presented at the website of one of the Study Societies and via study-buddy groups. Students were personally invited to take part in discussions via a Forum, to enroll in group activities and to visit special lectures. A special COVID-19 didactics has been developed to stimulate students to make assignments in Calculus and Programing via Massive Open Online Courses developed in the framework EdX, an online learning destination and MOOC provider. © 2022 Owner/Author.

WORKING from HOME in PATIENTS with RMDS during the COVID-19 PANDEMIC in EUROPE. RESULTS from the REUMAVID STUDY (PHASE 1 and 2)

Background: The COVID-19 pandemic has introduced signifcant changes in the workplace, implementing teleworking as an effective solution to reduce contagion Objectives: We sought to explore the impact of working from home on people with rheumatic and musculoskeletal diseases (RMDs) in Europe during the COVID-19 pandemic. Methods: REUMAVID is an international cross-sectional study collecting data through an online survey in seven European countries led by the Health & Territory Research group of the University of Seville, together with a multidisciplinary team including patient representatives, rheumatologists, and health researchers. Data were collected in two phases, the frst (P1) between April-July 2020 and the second (P2) between February-April 2021. Demographics, health behaviors, employment status, access to healthcare services, disease characteristics, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS) were collected. Workplace conditions including internet connection, computer, workstation, webcam, telephone, light, noise, calmness, and temperature were assessed (on a scale of 0 to 5, being 5 the best condition). Pearson's Chi-square test, Kruskal-Wallis and Mann-Whitney test were used to explore association with working from home. Results: There were a total of 3,802 participants across both phases (mean age 52.6 (P1) vs. 55.0 years (P2);80.2% female (P1) vs 83.7% (P2);69.6% married (P1) vs 68.3% (P2), 48.6% university educated (P1) vs 47.8% (P2), 34.7% employed (P1) vs 38.1 (P2)). Most prevalent RMD was axial spondyloarthritis in P1 (37.2%), and rheumatoid arthritis in P2 (53.1%). Rates of working from home were consistent (P1: 39.8% vs P2: 39.9%). In P2, 37.4% of those working from home had a home office, while 38.5% worked from their living room or kitchen. Work-related aspects at home were assessed, with the worst rated being the workplace (3.2) and the best being the computer (4.0). Compared to patients with good well-being and without anxiety and depression, patients with poorer well-being and at higher risk of anxiety or depression reported more frequently poorer rating of work from home issues, such as workplace (3.0 vs. 3.5;2.9 vs. 3.6;2.9 vs. 3.4;p<0.001), light (3.6 vs. 4.0;3.6 vs. 4.0;3.5 vs. 4.0;p<0.001), noise (3.3 vs. 3.8;3.2 vs. 3.9;3.2 vs. 3.8;p<0.001) and calmness (3.3 vs. 4.0;3.2 vs. 3.9;3.1 vs. 3.9;p<0.001;Table 1). Conclusion: Patients with poorer well-being, at higher risk of anxiety or depression reported poorer ratings of workspace-related aspects. Therefore, although work from home has helped to reduce the spread of the COVID-19 pandemic, the conditions under which RMD patients work from home must be considered, as these may affect the well-being and mental health of an already vulnerable group. It is necessary to assess the conditions of home-based workspaces-especially for workers with chronic diseases such as RMD patients-to ensure that it is feasible to work from home and that employers provide the necessary equipment for healthy work.

IMPACT of the COVID-19 PANDEMIC on HEALTHCARE UTILIZATIONS of RMD PATIENTS in EUROPE. RESULTS from the REUMAVID STUDY (PHASE 1 and 2)

Background: The beginning of the COVID-19 pandemic led to a collapse of healthcare systems that was difficult to manage. Objectives: The aim of this study was to assess the impact of the COVID-19 pandemic on RMD patients' healthcare utilization. Methods: REUMAVID is an international cross-sectional study collecting data through an online survey on RMD in seven European countries led by the Health & Territory Research group of the University of Seville, together with a multidisciplinary team including patient representatives, rheumatolo-gists, and health researchers. Data were collected in two phases, the frst (P1) between April-July 2020 and the second (P2) between February-April 2021. Demographics, health behaviours, employment status, access to healthcare services, disease characteristics, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS) were collected in the survey. Healthcare utilization includes scheduled appointments and attendance at the rheumatol-ogist, consultation of possible treatment effects if COVID-19 is contracted with the rheumatologist, primary health care and psychological care. Descriptive analysis and Mann-Whitney test was used to explore association with healthcare utilization in both phases of REUMAVID. Results: There were a total of 2,002 participants across both phases with comparable demographic characteristics [mean age 52.6 (P1) vs. 55.0 years (P2);80.2% female (P1) vs 83.7% (P2);69.6% married (P1) vs 68.3% (P2), 48.6% university educated (P1) vs 47.8% (P2)]. Most prevalent RMD was axial spondyloarthritis in P1 (37.2%), and rheumatoid arthritis in P2 (53.1%). Only 39.2% could have a scheduled appointment with their rheumatologist during P1, compared to 72.5% of patients in P2 (p<0.001). In this sense, only 41.6% of participants in the P1 attended such an appointment while in P2 this figure was 61.5% (p<0.001). The majority of patients (83%) had their scheduled face-to-face appointment changed to an online or telephone phone in the P2, although this proportion was lower in the P1 (54.4%). The most frequent reason for canceling the face-to-face appointment was the alternative of making it by phone or online (54.4% in P1 vs. 83.0% in P2, p<0.001). Although, in P1, 38.1% of participants could contact with their rheumatolo-gist by phone or online, this proportion was 64.3% in P2 (p<0.001). In P1, 64.0% of patients were able to consult with their rheumatologist about the possible effects of treatment in case of contracting COVID-19 (vs. 41.2% in P2;p<0.001). With respect to general practitioners, 57.6% of patients in P1 declared to had accessed primary care or general practitioner (vs. 77.5% in P2;p<0.001). Furthermore, in P2, a higher proportion of participants (63.2%) were able to continue their psychological or psychiatric therapy either online or by phone (vs. 48.3% in P1;p<0.001;Figure 1) Conclusion: During the frst year of COVID-19 pandemic, RMD patients had easier access to the healthcare system, specifcally to their rheumatologist. This access was improved through phone and online care. In addition, access to primary care as well as psychological care improved during the second year of pandemic.

HOW FEARS and HOPES HAVE EVOLVED in PATIENTS with RMDS THROUGHOUT the COVID-19 PANDEMIC? RESULTS from the REUMAVID STUDY (PHASE 1 and 2)

Background: The COVID-19 pandemic has generated uncertainties and concerns along with expectations and hopes that may be of relevance to patients with rheumatic diseases. Objectives: The aim of this study is to assess changes in the fears and hopes of patients with rheumatic diseases throughout the two phases of REUMAVID. Methods: REUMAVID is an international cross-sectional study collecting data through an online survey in seven European countries led by the Health & Territory Research group of the University of Seville, together with a multidisciplinary team including patient representatives, rheumatologists, and health researchers. Data were collected in two phases: Phase 1 (P1) between April-July 2020 and Phase 2 (P2) between February-April 2021. Demographics, health behaviours, employment status, access to healthcare services, disease characteristics, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS). Participants rated a series of fears (infection, medication consequences, lack of medication, impact on healthcare, lost job, civil disorder) on a scale from zero ('no concern at all') to five ('extremely concerned') and hopes (treatment/vaccine availability, going outside, travel, economic situation, treatment continuation, health status) on a scale from zero ('no hopeful at all') to five ('extremely hopeful'). Descriptive analysis and Mann-Whitney test were used to explore fears and hopes in both phases of REUMAVID. Results: A total of 3,802 participants were recruited across both phases in REU-MAVID with comparable demographic characteristics: mean age 52.6 (P1) vs. 55.0 years (P2), 80.2% female (P1) vs. 83.7% (P2), 69.6% married (P1) vs. 68.3% (P2), and 48.6% university educated (P1) vs. 47.8% (P2). Most prevalent RMD was axial spondyloarthritis in P1 (37.2%), and rheumatoid arthritis in P2 (53.1%). In P1 and P2 the major concern was the impact on healthcare in the future (3.1 and 3.2 out of 5, p=0.051). Compared to P1, patients in P2 had less fears about RMD medications not reaching the country (2.4 vs. 1.9, p<0.001), civil disorders (2.0 vs. 1.8, p=0.001), or losing their jobs (1.4 vs. 1.5, p=0.003). Comparing hopes with P1, patients in P2 had greater hopes about availability of treatments or vaccines suitable for COVID-19 (3.2 vs. 3.9, p<0.001), to be able to go out as before the pandemic (3.1 vs. 3.5, p<0.001), to be able to travel as before the pandemic (2.8 vs. 3.3, p<0.001), maintain and even improve the current economic situation after the pandemic (2.6 vs. 3.0, p<0.001), and to be able to continue their treatment as usual (3.8 vs. 3.8, p=0.049;Table 1) Conclusion: During the frst phase of REUMAVID at the beginning of the pandemic, patients with RMDs were more fearful and less hopeful compared to the second phase. These fears were notable in terms of lack of medication for their RMD, while during the second phase, patients were hopeful of a treatment or vaccine against COVID-19, and of being able to go out and travel as before.

THERAPEUTIC ALLIANCE AND WELL-BEING FROM USE OF A GLOBAL DIGITAL MENTAL HEALTH BENEFIT DURING THE COVID-19 PANDEMIC

Background: Digital mental health services leverage technology to increase access to care, yet less is known about how quality therapeutic relationships form in a virtual setting. This study examined therapeutic alliance (a mechanism underlying successful treatment) and its association with well-being among registrants of a digital mental health platform. Method: Adults (n=3,087, M age=36±9 years, 54% female) engaged in videoconference sessions with a licensed therapist (18%), certified coach (65%), or both (17%) between 9/29/20-10/12/21. Members completed 2 adapted items of the Working Alliance Inventory (goal and bond) after each session and we averaged ratings across visits (?=.72). We used the WHO-5 to measure changes in well-being. We performed Mann-Whitney U tests, Kruskal-Wallis tests, paired samples t-tests, and linear regressions to examine: (1) average alliance ratings;(2) differences in alliance by member demographics and provider type;and (3) if alliance was related to changes in well-being over time. Results: Members completed a median of 3 digital sessions over a median of 28 days. Median therapeutic alliance was 4.8 (range=1-5) and did not differ by age, country, or baseline well-being (ps>.07). Females reported higher alliance than males (4.88 vs. 4.67, p=.01). Members in coaching reported higher alliance than those in therapy or both modalities (4.83 v. 4.75, p=.004), though effect sizes were negligible. Members reported an average WHO-5 increase of 4.14 points (95% CI [3.44, 4.83], p<.001), a 10% improvement in well-being (d=0.22). Therapeutic alliance predicted greater well-being at follow-up (b=2.17, 95% CI [1.07, 3.28]) after controlling for age, sex, and baseline WHO-5 (R2=.22, p<.001). This association did not differ by provider type (p=.78). Conclusion: Members of a global digital mental health benefit formed a high therapeutic alliance with their providers, both coaches and therapists. Higher alliance was associated with greater well-being improvements, providing evidence that it is a key mechanism in virtual care outcomes as it is in face-to-face care. Continued focus on the quality of therapeutic relationships will ensure digital mental health services are patient-tailored as these platforms expand equitable access to evidence-based care.

Psychometric Properties of the WHO-5 Well-Being Index among Nurses during the COVID-19 Pandemic: A Cross-Sectional Study in Three Countries.

Nurses' well-being has been increasingly recognised due to the ongoing pandemic. However, no validation scales measuring nurses' well-being currently exist. Thus, we aimed to validate the WHO-5 Well-Being Index (WHO-5) in a sample of nurses. A cross-sectional multinational study was conducted, and a total of 678 nurses who worked during the COVID-19 pandemic in Spain (36.9%), Chile (40.0%) and Norway (23.1%) participated in this study. The nurses completed the WHO-5, the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2) and three questions about the quality of life (QoL). The WHO-5 demonstrated good reliability and validity in the three countries. Cronbach's alphas ranged from 0.81 to 0.90. High correlations were found between the WHO-5 and the psychological well-being dimension of QoL, and negative correlations between the WHO-5 and PHQ-2. The unidimensional scale structure was confirmed in all the countries, explaining more than 68% of the variance. The item response theory likelihood ratio model did not show discernible differences in the WHO-5 across the countries. To conclude, the WHO-5 is a psychometrically sound scale for measuring nurses' well-being during a pandemic. The scale showed strong construct validity for cross-cultural comparisons; however, more research is required with larger sample sizes.

The importance for wellbeing of having views of nature from and in the home during the COVID-19 pandemic. Results from the GreenCOVID study.

Introduction: The COVID-19 pandemic has influenced the daily lives of people and may affect their well-being. The aim of the present study is to assess well-being and associated factors during the first wave of the COVID-19 pandemic in the general population in three European countries. Methods: GreenCOVID was an observational cross-sectional study using an online survey (7 April 2020 to 24 July 2020) promoted by the Health & Territory Research (HTR) of the University of Seville in Spain, Maynooth University in Ireland, and the University of Winchester in England, which included a sample of 3109 unselected adults. Well-being was measured using the World Health Organization-Five Well-Being Index (WHO-5) scale. Seven aspects, related to the natural environment of the home, were evaluated (role of outdoor views in coping with lockdown, importance of blue spaces during lockdown, importance of green spaces during lockdown, quality of view from home, use of outdoor spaces or window views, elements of nature in the home, and views of green or blue spaces from home). Binary logistic regression was conducted to identify the parameters associated with poor well-being. Results: Mean age was 39.7 years and 79.3% lived in Spain, the majority in urban areas (92.8%). 73.0% were female and 72.0% had undertaken university studies. Poor well-being was reported by 59.0%, while 26.6% indicated the possible presence of clinical depression. The factors most associated with poor well-being were students (OR = 1.541), those who had no engagement in physical activity (OR = 1.389), those who reported 'living in Spain' compared to Ireland (OR = 0.724), being female (OR = 1.256), poor quality views from home (OR = 0.887), less benefit from views of the natural environment to cope with lockdown (OR = 0.964), and those younger in age (OR = 0.990). Conclusions: More than half of participants reported poor well-being and one in four indicated the possible presence of clinical depression during the first wave of the COVID-19 pandemic. We identified that belonging to a younger age cohort, being a student, being female, not being able to continue with daily pursuits such as physical activity, and having poorer quality of views from home led to poor well-being among participants. Our study highlights the importance of continued physical activity and views of nature to improve the well-being of individuals during times of crisis such as the COVID-19 pandemic.

Improving Well-being With a Mobile Artificial Intelligence-Powered Acceptance Commitment Therapy Tool: Pragmatic Retrospective Study.

BACKGROUND: Research and dissemination of smartphone apps to deliver coaching and psychological driven intervention had seen a great surge in recent years. Notably, Acceptance Commitment Therapy (ACT) protocols were shown to be uniquely effective in treating symptoms for both depression and anxiety when delivered through smartphone apps. The aim of this study is to expand on that work and test the suitability of artificial intelligence-driven interventions delivered directly through popular texting apps. OBJECTIVE: This study evaluated our hypothesis that using Kai.ai will result in improved well-being. METHODS: We performed a pragmatic retrospective analysis of 2909 users who used Kai.ai on one of the top messaging apps (iMessage, WhatsApp, Discord, Telegram, etc). Users' well-being levels were tracked using the World Health Organization-Five Well-Being Index throughout the engagement with service. A 1-tailed paired samples t test was used to assess well-being levels before and after usage, and hierarchical linear modeling was used to examine the change in symptoms over time. RESULTS: The median well-being score at the last measurement was higher (median 52) than that at the start of the intervention (median 40), indicating a significant improvement (W=2682927; P<.001). Furthermore, HLM results showed that the improvement in well-being was linearly related to the number of daily messages a user sent (ß=.029; t81.36=4; P<.001), as well as the interaction between the number of messages and unique number of days (ß=-.0003; t81.36=-2.2; P=.03). CONCLUSIONS: Mobile-based ACT interventions are effective means to improve individuals' well-being. Our findings further demonstrate Kai.ai's great promise in helping individuals improve and maintain high levels of well-being and thus improve their daily lives.

The Reliability and Validity of the 5-Item Who Well-Being Index (WHO-5) amongst Doctors and Nurses in Nigeria.

BACKGROUND: The WHO-5 is a brief measure of psychological well-being. Validity studies for the WHO-5 are quite limited in sub-Saharan Africa and most importantly, no study has confirmed the unidimensional factor structure of the instrument in Nigeria. The aim of this research is to evaluate the reliability and determine the unidimensional factor structure of the WHO-5 well-being index in a population of medical doctors and nurses in Nigeria during the COVID-19 pandemic. METHODS: Overall, 464 medical doctors and nurses from various parts of Nigeria, completed the assessment between April and July 2020. The participants completed the WHO-5 well-being index and the 9-item Patient Health Questionnaire (PHQ-9). Principal Component Analysis (PCA) was carried out. The internal consistency of the WHO-5 was measured and external validity was determined as well. RESULTS: The inter-item correlations among the WHO-5 items ranged from 0.447 to 0.685. Internal consistency was adequate (Cronbach's alpha = 0.868). The corrected item-total correlations ranged from 0.596 to 0.750 with a mean of 0.693. PCA identified a single factor structure of the WHO-5. The WHO-5 significantly correlated with the PHQ-9 (r = -0.590), ascertaining convergent validity. CONCLUSION: The WHO-5 demonstrated satisfactory reliability and validity in our study population. It is therefore a suitable measure for the assessment of the mental well-being of healthcare professionals in our environment.

CONTEXTE: L'OMS-5 est une brève mesure du bien-être psychologique. Les études de validité de l'OMS-5 sont assez limitées en Afrique subsaharienne et surtout, aucune étude n'a confirmé la structure factorielle unidimensionnelle de l'instrument au Nigeria. L'objectif de cette recherche est d'évaluer la fiabilité et la structure factorielle unidimensionnelle de l'indice de bien-être WHO-5 dans une population de médecins et d'infirmiers au Nigeria pendant la pandémie de COVID-19. MÉTHODES: Au total, 464 médecins et infirmières de diverses régions du Nigeria, ont complété l'évaluation entre avril et juillet 2020. Les participants ont rempli l'indice de bien-être de l'OMS-5 et le questionnaire sur la santé des patients en 9 points (PHQ-9). Une analyse en composantes principales (ACP) a été réalisée. La cohérence interne de l'OMS-5 a été mesurée et la validité externe a également été déterminée. RÉSULTATS: Les corrélations inter-items entre les items de l'OMS-5 varient de 0,447 à 0,685. La cohérence interne était adéquate (alpha de Cronbach = 0,868). Les corrélations itemtotal corrigées variaient de 0,596 à 0,750 avec une moyenne de 0,693. L'ACP a identifié une structure factorielle unique de l'OMS-5. L'OMS-5 a été significativement corrélé avec le PHQ- 9 (r = -0,590), ce qui atteste la validité convergente. CONCLUSION: L'OMS-5 a démontré une fiabilité et une validité satisfaisantes et la validité dans notre population d'étude. Il s'agit donc d'une mesure appropriée pour l'évaluation du bien-être mental des professionnels de santé dans notre environnement. Mots-clés: OMS-5, Bien-être, Fiabilité, Validité, Nigeria.