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Aims: The DisCOVery study sought to better understand the experiences of young people with complex emerging mental health problems over the longer-term social restrictions related to the COVID-19 pandemic. Following the 'social cure' theory, this study aimed to investigate the association, and potential mechanisms, of group membership continuity and reducing mental ill-health amongst vulnerable young people. Method(s): Cross-sectional survey data from a sample of 105 young people aged 16-35, collected approximately 1 year after the global COVID-19 outbreak (January-July 2021). Correlational and path analyses were used to test the associations between group membership continuity and mental health problems (depression, anxiety, psychotic-like experiences), and the mediation of these associations by hope and social connectedness (in-person and online). Results and Conclusion(s): Prior multiple group memberships were associated with the preservation of group memberships during the COVID-19 pandemic. In-person social connectedness, online social connectedness and hope mediated the relationship between group membership continuity and mental health problem symptoms. The results suggest that clinical and public health practice should support vulnerable young people to foster and maintain their social group memberships, hopefulness and perceived sense of social connectedness as a means to potentially help prevent exacerbated symptoms and promote recovery of mental health problems, particularly during significant life events.
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Introduction: Multiple sclerosis (MS) is an often-disabling disease of the central nervous system (CNS). The possible triggers of its first presentation such as stressful events, viral infections, vaccinations, and labor are still a matter of debate among scientists. Considering the possible role of infections in MS onset and the reported cases of CNS demyelination following COVID-19 infection and variety of COVID-19 vaccines, this study was conducted to investigate and compare the possible social, environmental, and physical triggers of MS onset before and during the COVID-19 pandemic. Material(s) and Method(s): A cross-sectional study was conducted from 28 February 2022 to 9 June 2022. A researcher-made questionnaire was designed in MS research center of Iran and distributed as an online google form on social media among 1340 Iranian MS patients. Demographic information, MS disease-related data, possible MS triggers (stressful life events, COVID-19 and other infections, COVID-19 and other vaccines, pregnancy or labor, head trauma, surgery, weight loss) were recorded. Patients were divided into two groups regarding the time of MS diagnosis (before and during the COVID-19 pandemic). Binary logistic regression method was used to determine the possible association between patient-reported triggers and diagnosis time (before and during the pandemic) adjusting for possible confounders. Result(s): Of 920 participants, 670 (72.8 %) were female, and the mean age (SD) was 35.63 (+/-8.1). The majority of participants 637 (69.2%) had non-progressive forms of MS, and only 70 (7.6 %) needed assistance for ambulation. The time of MS diagnosis was before the start of the COVID-19 pandemic in 635 (69 %) participants. The differences between the most common first symptoms which led to MS diagnosis, visual type (n: 317 (49.9 %)) before the pandemic and sensory type (n: 170 (59.6 %)) after the pandemic were significant (p-values: 0.008 and <0.01 respectively). A stressful life event was the most common patient-reported MS trigger in both groups, (n: 356 (56.1%)) in patients who were diagnosed before the COVID-19 pandemic, and (n: 156 (54.7%)) in the latter group. Comparing two groups (MS diagnosed before and during the pandemic), economic problems (AOR: 1.81;95%ACI: 1.23-2.65) and job loss (AOR: 2.89;95%ACI: 1.37-6.08) were significantly more frequent stressful life event which trigger MS onset in the latter group while, the stress of occupational or educational exams (AOR: 0.52;95%ACI: 0.34-0.79) was more prevalent in the first group. Conclusion(s): Social triggers such as stressful life events are closely associated with MS onset that had been increased in some categories after the COVID-19 pandemic. If truly recognized, they could be used to prevent the development and exacerbation of the disease.Copyright © 2022
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Introduction: Since March 16, 2020, the date of the announcement of the first confinement in France in the context of the COVID-19 pandemic and health crisis, French residents have experienced a brutal and lasting disruption in their rhythms and habits. The health crisis has had a strong impact on the general population and especially on patients suffering from psychiatric disorders. The demand for mental health care has particularly heightened among young people, who seem to be the most affected by this crisis. In the first part of this article, we will describe the impact of the health crisis on the mental health of young people and on the attendance of psychiatric emergencies, with a review of French and international literature. In the second part, we will present a descriptive epidemiological study carried out in the largest French psychiatric emergency center. Methods and objective: Our sample included 9,771 young patients from 15 to 25 years old. The main objective of our study is to highlight the changes in the flow of consultations of patients aged 15 to 25 years during the first year of the health crisis, compared to the three previous years. We calculated and compared the proportion of the target population consulting between the period of the first year of the health crisis (COVID period) and the period encompassing the previous three years (pre-COVID period). We also compared different variables, between the 2,179 young people consulting during the first year of COVID-19 health crisis and the 7,592 young people during the three last years: age, sex, marital status, symptoms, environmental context and CIM-10 diagnoses. Result(s): We observed a significant increase in the proportion of patients aged 15 to 25 during the COVID period (n = 29.4% vs. 27.6%;P < 0,001). The patients during the COVID period were predominantly female. We have seen a significant increase in patients coming for consultations for anxiety (+4.3%;P < 0.001), sleep disorders (+2.8%;P < 0.001) and suicidal thoughts (+2.7%;P = 0.006) during the COVID period. During the first year of the health crisis, the target population consulted less for claustration, withdrawal or odd behavior. Family conflicts, traumatic events and other life events were more frequent. Schizophrenia, schizotypal and delusional disorders were less frequently diagnosed. Conclusion(s): The health crisis has had a considerable impact on the mental health of the youth population. The mental health of young people is a current subject of concern and a major public health issue. Data from the literature warns of the impact of the health crisis on the mental health of this population and the need for early treatment, even as the supply of psychiatric care is decreasing.Copyright © 2022 Elsevier Masson SAS
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The COVID-19 pandemic has been vastly influencing the whole earth and billions of people all over the world face unexpected changes leading to major shifts in their daily routines (Lades et al., 2020), confronting public policy makers with serious challenges (Anderson et al., 2020);in the shortest possible time, they have to support their citizens to prevent possible deterioration of individual well-being (Pfefferbaum & North, 2020). Also, marketing management must flexibly react to ensure an optimal targeting of customers and, thus, marketing success (Koschate-Fischer et al., 2018). This paper investigates the impact of the COVID-19 life event on individuals' perceived stress, resultant active coping behavior, and consequently individual well-being. Additionally, to better understand coping behaviors in response to COVID-19 and their relationship to well-being, several concrete coping behaviors are examined in depth. A suitable theoretical approach to examine the impact of the COVID-19 life event are theories of stress, which involve coping mechanisms (Moschis, 2007). To date, however, as the COVID-19 pandemic represents a new and yet rather unexplored life event, we do not know the exact role of perceived stress or active coping behavior in the context of this particular life event. Results of an empirical study with a panel of 242 European consumers (Mage = 39.41 years, 59.50% male) show that perceived stress and active coping behavior serially mediate the effect of the COVID-19 life event on individual well-being, such that the COVID-19 life event increases perceived stress, which in turn increases active coping behavior. Moreover, active coping behavior enhances individual well-being. An independent, in-depth examination of additional concrete coping behaviors reveals that the COVID-19 life event has caused changes in almost all areas of life. While some coping behaviors have increased (e.g., going for a walk, purchasing food), others have not (e.g., gardening, purchasing fashion). Both positive and negative correlations of coping behaviors with individual well-being exist suggesting that an increase in certain coping behaviors (e.g., online activities) can even decrease individual well-being. Taken together, our study presents an initial step towards answering major questions concerning the COVID-19 life event. In a theoretical sense, this study contributes to the life event literature by pointing out the specific paths to re-install individual well-being. In addition, more sophisticated knowledge on the relevance of a broad range of coping behaviors is generated. Further, this study is relevant for public policy because it stresses the importance of supporting individuals and reveals the benefit of communication campaigns addressing COVID-19, but also for marketing management as it uncovers that retailers should especially promote their products or services online while focusing on utilitarian products. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background: Coronavirus disease 2019 (COVID-19) affected individuals' physical and mental health. Protective measures such as closures, social-distancing, masking, and isolation resulted in increased feelings of loneliness and isolation. This study aimed to investigate life changes associated with COVID-19 for family caregivers of persons with Lewy body disease (LBD). Method(s): Data were analyzed from an existing LBD caregiver needs and concerns study that took place between January 2021 and February 2021. A mixed methods approach was used to describe how 20 caregivers' lives changed as a result of the COVID-19 pandemic. Items from the Bakas Caregiving Outcomes Scale (BCOS) were adapted for COVID-19 and rated on a response scale ranging from 1 = changed for the worst to 7 = changed for the best, with 4 = did not change. Qualitative data were collected as participants expanded upon their responses to the scale items. Result(s): Caregivers experienced both positive and negative life changes as a result of COVID-19. On average, positive changes included increased use of the internet to order items (Mean = 4.35), videoconferencing to connect with others (Mean = 4.55), and improved financial well-being (Mean = 4.35). Negative changes included reduced social (Mean = 1.7) and family (Mean = 2.05) activities and decreased ability to cope with stress (Mean = 2.60). Most responses ranged from 1 to 4, with some items having wider ranges from 1 to 7 showing that individual caregivers were impacted differently by the COVID-19 pandemic. Qualitative comments were consistent with quantitative responses. Some caregivers expressed concerns that limited family and social contact contributed to a more rapid decline in the person with LBD. Caregiver health and well-being were negatively affected as well, with caregivers noting decreased level of energy and worsened physical health. Conclusion(s): Family caregivers of persons with LBD experienced both positive and negative life changes as a result of COVID-19. Responses indicated that caregivers were affected in a variety of ways and an individualized approach is recommended in dealing with caregiver life changes resulting from the COVID-19 pandemic. Copyright © 2022 the Alzheimer's Association.
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Introduction: Coronavirus Disease 2019 has prompted widespread school closures and physical distancing measures. Concerns regarding COVID-19 school closures often increase stress levels in parents. Objective(s): This study examined whether higher levels of parental concerns were associated with children's problematic behaviors and other factors during COVID-19-related primary school closures. Method(s): Participants were 217 parents who responded to a webbased questionnaire covering parental concerns, subjective stress, and depression;children's sleep patterns, behavioral problems, and changes in activity level after COVID-19;previously received mental health services;and media usage during the online-only class period from community center in Suwon city. Result(s): The number of parental concerns was associated with children's behavioral problem index (BPI) score (Pearson correlation 0.211, p < 0.01), sleep problems (0.183, p < 0.01), increased smartphone usage (0.166, p < 0.05), increased TV usage (0.187, p < 0.01), parents' subjective stress levels (0.168, p < 0.05), and parental depression (0.200, p < 0.01). In families with children who previously received mental health services, the children reportedly suffered from more sleep and behavioral problems but not increased media usage, and parents noted more stress and depression. Parental concerns are related to family factors such as change of caregiver, no available caregiver, decreased household income, and recent adverse life events. Economically vulnerable people also reported higher rates of reported caregiver burden during COVID-19-related primary school closures, thus will require the potential heightened mental health needs. Conclusion(s): Ongoing monitoring of mental health at risky group and multiple support systems should be considered for parents having difficulty in caring their children.
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Introduction: Many studies point to cognitive beliefs, attitudes and other psychologicalt traits involved in particularities of reactions to pandemic situation, but the differences in life events are often overlooked. Objective(s): Astudy of subjective evaluation of life events during the pandemics. Method(s): The modified Lifeline technique was used to elicit life events. In semistructured interview, using a timeline, subjects were asked to indicate and describe events that had an impact on their attitudes, behaviors and feelings since the start of pandemic. Then they evaluated with direct assessment scales each event as to what extent it was anxious, difficult to cope, changed the beliefs concerning COVID-19, fostered the changes of behavior and habits, and led to reappraisal of own values. The events were coded using dichotomous categories: COVID-related vs directly unrelated, universal vs individual, personally involved vs noninvolved, and also were further qualitatively evaluated. 25 young Azerbaijani residents took part in the study. Result(s): From 191 events named, 72%were COVID-related, 62% - universal, 62% - with personal involvement. 46% of events were unique (mentioned once). Universal events were more likely to be assessed as anxiogenic, while personal ones as leading to rethink own values and priorities (U, p<.01 and p<.05). Surprisingly, life events in total were assessed as less challenging the beliefs about pandemics while more frequently leading to rethink own values (T, p<.05). Individual events involvedmore conflictmeanings and implications. Conclusion(s): Lifeline technique may provide important insights on the impact of life events in complex social transitions and may be used in counseling.
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Individuals with pre-existing psychiatric diagnoses appear to be vulnerable to worsening mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, psychiatric hospitalizations during the pandemic may be complicated by increased risk of SARS-Cov-2 infection and limited social engagement due to changes in hospital policies. The objective of our exploratory study was to determine whether social, economic, and health-related variables were associated with thoughts of suicide and/or self-harm since March 2020 in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic. Chi-square tests revealed four variables were significantly associated with thoughts of suicide and/or self-harm: 1) difficulty with cancellation of important events, 2) some form of loneliness, 3) decreased time spent in green spaces, and 4) increased time spent using devices with screens. The logistic regression model showed a significant association between suicidal and/or self-harm thoughts and cancellation of important events. Further investigation of the loneliness variable components revealed a significant association between suicidal and/or self-harm thoughts and feeling a lack of companionship, feeling isolated, and feeling alone. These results suggest that social challenges experienced during the pandemic were associated with negative mental health symptoms of individuals admitted to a psychiatric inpatient unit.
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COVID-19 , Self-Injurious Behavior , Humans , Suicidal Ideation , Pandemics , Inpatients , SARS-CoV-2 , Self-Injurious Behavior/psychology , HospitalizationABSTRACT
Aim: To assess the neurological and mental health responses to pandemic Covid-19. Study design: Cohort study Place and duration of study: Department of Medicine, Chandka Medical College Hospital Larkana and Department of Medicine, Khairpur Medical College Hospital Khairpur Mir's from 1st October 2021 to 31st March 2022. Methodology: Two hundred patients who suffered Covid-19 infection and 200 who had any other life event except Covid-19 were enrolled. All patients who were above 18 years of age and were positive for Covid-19 through reverse transcriptase PCR were included in the study.Global Psych trauma Screening was done by enlisting twenty-two items which assessed trauma related symptoms while five items only assessed the factors increasing risks. Result(s): There were 112 (56%) females and 88 (44%) males in Covid-19 patients and 150 (75%) females and 50 (25%) males in non-Covid patients. The mean age of the Covid-19 patients was 49.65+/-15.5 year while of non Covid patients was 39.02+/-12.01 years. A significant increase in post-traumatic stress disorder (PTSD) cases probability was noted in the Covid-19 cases than non Covid-19 related events. Neurological responses showed that patients who had suffered from Covid 19 infections had a generalized weakness with hyposmia formation. Conclusion(s): Covid-19 is related with high level of depression, anxiety, hyposmia and other mental and neurological responses. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Background/Purpose: As a result of the COVID-19 pandemic, changes in data collection methods have been introduced in research to ensure continuity despite physical distancing and lockdown restrictions. Our objective was to compare differences in physical and mental health of older adults participating in falls research using data collection methods pre-covid-19 pandemic (face-to-face) and during the pandemic (hybrid). Method(s): Individuals aged 60 years and over with at least one fall in the past 12 months, and controls with no history of falls in the past 12 months were recruited. Pre-pandemic, individuals were interviewed face-to-face exclusively, those interviews after the start of the pandemic were conducted virtually with physical assessments conducted face-to-face to minimize physical contact. Cognitive status, physical performance, psychological status, quality of life, physical activity, and social participation were measured. Result(s): Of the 145 participants of similar socio-demographic backgrounds, 69 were interviewed face-to-face, while 76 were assessed using a hybrid method. Differences were observed in presence of fall characteristics, with fewer fallers seeing a doctor and more fallers attending the emergency department after the start of the pandemic. After adjustment for baseline differences, participants interviewed using hybrid status had lower depression scores (OR (95%CI)=0.29(0.14-0.61)) and stress scores (OR(95%CI)=0.33(0.15-0.72)), but greater fear of falling (OR(95%CI)=2.16(1.04-4.48)) and reduced social participation (OR(95%CI)=2.64(1.20-5.79)). Conclusion(s): Alterations in data collection methods to overcome pandemic restrictions should take into consideration potential differences in individuals who agree to participate as well as the influence of major life events on the psychological status of participants. Copyright © 2022, Full Universe Integrated Marketing Limited. All rights reserved.
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The COVID-19 pandemic has elicited increases in stress, anxiety and depression, as evidenced in large samples of adults (Ettman et al., 2020;Jia et al., 2020). In youth, mental health symptoms also appear elevated compared to pre-pandemic norms (Glynn et al., 2021, Hawke et al., 2020). While children's mental health symptoms appear to be increasing during the pandemic, many studies implement cross-sectional, rather than longitudinal designs. Therefore, less is known about the impact of the COVID-19 pandemic on youth's stress and within-person changes over time. In addition, studying stress biomarkers such as hair cortisol can inform about the impact that the current pandemic and resulting changes to daily life have on youth's stress physiology. To our knowledge, only one previous study examined hair cortisol concentrations (HCC) in children during the pandemic, and found that more negative changes to family life predicted greater HCC in 4-5-year-old children relative to pre-pandemic HCC (Hastings et al., 2021). The present study utilized hair cortisol data collected pre-pandemic (2017-2020) and re-contacted participants to participate in a follow-up study during the pandemic (October 2020 - March 2021). Participants (N = 86, 61.7% female) included youth ages 10-13 (M = 11.41, SD = .95) who had provided hair samples in the original study and agreed to provide a second hair sample during the pandemic. Parents collected hair samples from youth while guided by experimenters via Zoom and mailed the samples to our laboratory. Parents and youth also completed questionnaires regarding the impact of the pandemic on their lives, including the Covid-19 Adolescent Symptom & Psychological Experience Questionnaire. The Child Life Events and Perceived Stress Scales were administered both before and during the pandemic. Initial paired samples t-tests revealed a significant increase in hair cortisol from pre-pandemic to post-pandemic, t(79) = 3.305, p = .001, and increases in youth self-reported perceived stress, t(84) = 7.15, p < .0001. Conference analyses will include comparing post-pandemic HCC in this sample to another age-matched pre-pandemic comparison group to account for any age-related differences. The present study illustrates the impact of the COVID-19 pandemic on children's long-term cortisol output using a within-person design.
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Background: The COVID-19 pandemic has led to the death of over 700,000 Americans, with each death leaving 9 surviving Americans (i.e., over 6 million bereaved). One harsh reality of the pandemic has been that survivors have often not been able to care for their dying loved ones, and grieve for them in traditional ways (e.g., wakes, funerals), due to social distancing. The present study used semi-structured clinical interviews to investigate acute grief during the pandemic. Methods: Participants were interviewed by phone, including the Center for Epidemiological Studies-Depression scale, a 20-item measure of depression;the Prolonged Grief Disorder scale, a 13-item measure of prolonged grief disorder;the Work and Social Adjustment Scale (WSAS), a 5-item measure assessing for adjustment after major life events;the Post-Traumatic Growth (PTG) scale, a 10-item measure of growth following a traumatic event such as the death of a loved one;the Utrecht Grief Rumination Scale (UGRS), a 15-item scale measuring various aspects of grief-related rumination;the Interpersonal Support Evaluation List (ISEL), a 12-item measure assessing for social support following a major life event. Results: Participants (N = 51, 74.5% White, 80.4% non-Hispanic) had an average age of 51 (SD = 15.9) and were mostly female (76.5%). 53.0% said they were unable to provide support for their dying loved one, 45.1% said they were not able to say good-bye, 47.1% said they were not prepared, 45.1% said they should have been present for the death. The sample experienced sub-clinical depressive symptoms (M = 10.04, SD = 7.03), and moderate prolonged grief symptoms (M = 23.0, SD = 9.15). Participants had a mean of 7.61 (SD = 10.02) on the WSAS, 23.24 (SD = 13.50) on the PTG, 17.31 (SD = 14.50) on the UGRS, and 30.25 (SD = 4.63) on the ISEL. Conclusion: Despite feeling unprepared for the death of their loved ones during the pandemic, depression and grief scores suggest that many individuals are resilient, given their moderate prolonged grief and sub-clinical depression scores on average. The scores for the WSAS suggest that people are adjusting to work and social life following the death of their loved ones. Clinical intervention should focus on the small proportion who are not adjusting during pandemic bereavement.
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Background: The COVID-19 pandemic and subsequent social distancing measures have undermined several healthy habits that families had or were establishing prior to the start of the pandemic. This study looks at those changes through online survey to Missouri families to evaluate how COVID-19 has impacted healthy lifestyle habits in Missouri families, along with degree of social distancing and any associations in changes in employment, food scarcity issues, and health concerns. Methods: An online survey (through RedCap) was conducted during spring to summer 2020 evaluate changes during the time of initial lock down and social distancing, for families living in Missouri with children ages 2-18 years. The survey was advertised on social media and in local clinics to gather participants' responses. Results: A total of 298 responses were received from the survey. 58% of respondents noted a change in employment (35% stated now working from home, 18% noted decrease in work hours, and 5% noted they had been laid off or lost job completely). While there were no overall statistically significant changes in healthy habits during the initial lock down period in spring-summer 2020 noted, a subset analysis noted that when comparing those with a change in employment to those without a change in employment, Missouri families did note several statistically significant changes in their healthy habits. Those with a change in employment were more likely to note a decrease in their child(ren)'s physical activity, report an increase in screen time (p = 0.044), are more likely to report noticing family members eating between meals or snacking more (p = 0.004), and are also more likely to report worrying about their child(ren)'s nutrition (p = 0.049), and are more likely to note changes in their child(ren)'s sleep patterns (p = 0.021) during the pandemic. These groups were not significantly different in their self-reported income, the degree to which they socially distanced, their grocery store frequency, food scarcity, or how much they were eating out. Conclusion: Our study of Missouri families and healthy-habit maintenance during the initial months of the COVID-19 pandemic revealed that overall healthy habits were maintained during the initial months of COVID-19. However, a subset analysis comparing those who reported a change in employment vs. those who did not report a change in employment revealed that those who experienced a change in employment were more likely to report changes in healthy habits such as amount of screen time and physical activity, snacking between meals, changes in sleep, and overall concern for their child(ren)'s nutrition. This study highlights that major life events may affect healthy habit changes and families' abilities to change healthy habits during these events and can help pediatricians understand the impact of major life changes for families on healthy habit development and maintenance.
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Background: The prevalence of anxiety and depression is high in rheumatoid arthritis (RA) patients. As RA patients tend to be immunodeficient, they are at greater risk of coronavirus disease 2019 (COVID-19) infection due to their scheduled hospital appoint-ments. Therefore, they have become more anxious and worried during COVID-19 pandemic, and some patients recently have can-celed or postponed their treatment. Objectives: This study aimed to assess the effect of stress, anxiety, and depression due to COVID-19 outbreak on non-compliance to treatment among RA patients. Methods: In this cross-sectional study, we included 149 RA patients (male/female = 12: 137). Four questionnaires, including the 21-item Depression, Anxiety, and Stress Scale (DASS-21), 14-item Perceived Stress Scale (PSS-14), 18-item Health Anxiety Inventory (HAI-18), and 8-item Morisky Medication Adherence Scale (MMAS-8) were employed. The questionnaires were filled by the researchers on behalf of the participants using telephone interviews due to social distancing protocol. Results: There was a significant negative correlation between stress (P = 0.001), anxiety (P < 0.001), health anxiety (P = 0.014), and depression (P = 0.001) and compliance to treatment among RA patients. However, anxiety was the only predictor for non-compliance to treatment. Conclusions: Therapists should be aware of the symptoms of stress, anxiety, and depression among their RA patients, especially during stressful life events, and carefully monitor their compliance to treatment to prevent exacerbation of RA.
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Introduction The impact of the COVID-19 pandemic on the psychological wellbeing of oncology healthcare professionals (HCPs) is an emerging field of inquiry, with new research focusing on the experiences and needs of staff. Occupational health and workforce literature places emphasis on preventive initiatives in the workplace, and the promotion of positive psychological health amongst HCPs (Boorman 2009). There is an overwhelming literature on stress, anxiety and burnout amongst HCPs using self-report questionnaires, in contrast to how individuals develop and sustain positive wellbeing under difficult circumstances through the self-management of stress and mobilisation of coping strategies (Cai et al. 2020). The effects of high stress working environments, particularly in health crises may lead to poorer psychological wellbeing outcomes amongst HCPs because of reduced peer support, low autonomy and social belonging, increased staff turnover rates and high workloads (Morgantini et al. 2020). This study explores the evolving experiences of oncology HCPs in the workplace during the COVID pandemic, and its impact on their psychological health. We captured the experiences of a wide range of staff to provide a broad understanding of their needs and where support might be required. Qualitative methods were used to explore how HCPs coped and managed their wellbeing during the pandemic. Methods The study aims were to: i) explore how oncology HCPs managed their psychological wellbeing during the pandemic, together with the support systems, coping strategies and knowledge and skills they used to maintain positive mental health, ii) identify the barriers and opportunities for psychological wellbeing, iii) inform the development of interventions and resources to promote and sustain the self-management of psychological wellbeing amongst oncology HCPs. Data was collected using diaries and semi-structured interviews over a period of 4 months from December 2020 to April 2021. A total of 102 HCPs were recruited comprising medical staff, nursing staff, radiographers, allied health professionals (non-Radiographers) and support staff (Cancer Support Workers, Healthcare Assistants). Fifty participants submitted diaries and 35 interviews were undertaken. The response rate was 64%. Thirty-five participants consented but did not submit data and two nurses requested to withdraw (37% non-response rate). Demographic data revealed the majority of participants were female (83%) and worked full-time (73%). The age range was evenly distributed between the 21-50 year groups (16% in the 51-60 age group). Most participants (62%) had been employed at the cancer centre for < 5 years, reflecting the recruitment of new staff associated with the expansion of the organisation. Transcribed diaries and interviews were analysed using Interpretative phenomenological analysis (Smith & Osborn 2015). IPA recognises individuals make sense of situations through an interpretation of events, and offers insights into how a person, within a specific context, understands and experiences a phenomenon. Results Participants experienced a myriad of emotions associated with coping during the COVID pandemic. Emotions fluctuated between positive and negative feelings, marked by the passage of time, life events and organisational changes. Regardless of professional group, individuals were dealing with similar challenges, as all were experiencing the pandemic in the context of the same organisational environment. Four main themes emerged: 1) Self-management, 2) Delivery of patient care, 3) Managing professional roles, 4) Managing the employer/ employee relationships. Self-management Participants used different strategies to manage wellbeing such as concealing emotions and speaking out. The concealment of emotions was used to maintain the appearance of coping, which was important in managing professional relationships, such as not letting colleagues down. Various strategies were used to regulate emotions, including slowing down, appreciating life more and being positive. Thought rocessing enabled the long-term consequences of the pandemic to be managed, helping to minimise the impact of fatigue and loss of concentration, however, this was not without its consequences. Sustaining the ups and downs of positive outlooks over long periods was described as an emotional 'roller-coaster'. The 'emotional roller-coaster' metaphor was used in conjunction with 'Ground Hog' day, denoting the monotony and drawn out nature of the pandemic. Seeing the bigger picture and comparing self with others aided adjustment and self-regulation, supported by the belief that others were experiencing worse situations such a job losses. Participants expressed guilt and gratitude that they had not been redeployed to the COVID front line. Delivery of patient care The provision of high quality patient care was a dominant theme in the narratives of staff. Job satisfaction was contingent on being able to meet the needs of patients and feeling that a good job had been done. The transition to remote working, loss of face-to-face contact with patients and absence of patients' families required adjustment to new ways of working. Participants described how the loss of physical contact with patients impacted negatively on patient-professional communication, in particular, not being able to interpret the person's body language as a result of mask-wearing and social distancing. The pandemic dramatically altered the cancer care landscape from reductions and cancellations in elective care and cancer treatment to protect immunosuppressed patients, to delays in diagnoses and treatment, cessation of clinical trials, and more advanced stage disease in patients with poorer health outcomes. Service pressures linked to the reinstatement and escalation of cancer services required resilience and adjustment on the part of participants. Managing professional roles The management of professional roles during the pandemic disrupted usual ways of working linked to changes in patient care, multidisciplinary teamwork and workforce organisation. Although a proportion of staff continued to work in their clinical areas during the pandemic, other teams adopted a hybrid approach, working between clinical and home environments. Working from home, dealing with technology-related issues, finding a suitable location to work in, managing home schooling and care of elderly relatives alongside the job required additional psychological resources. Participants faced redeployment from their usual places of work to help other clinical areas in greater need. As staff transitioned to working from home, corridor conversations and informal networking opportunities were lost. That said, the normality of working life and support of colleagues was a constant in the lives of participants and provided a platform on which to build positive wellbeing. Participants described the 'Dunkirk spirit' and being 'in the same boat' as others, with team solidarity and camaraderie being a core component of the wellbeing experience. Managing the employer/employee relationships A number of staff expressed frustration that management did not appear to listen to concerns and were unaware of what staff were going through, however, others felt positively supported. Although several spoke of hiding their emotions and anxieties, openly displaying feelings resulted in support being offered. Staff believed more attention should be paid to the day-to-day pressures of providing patient care. It was acknowledged that managers may have their own mental health needs, but it was less clear how these were being met. Support was believed to differ between management grades, with those closer to the workforce and more visible being valued. Communication between staff and the organisation was seen as key to understanding wellbeing needs. Email appeared to be the preferred method for conveying information during the pandemic, however, access to email was variable across staff groups, potentially leading to inequalities in staff experiences. The majority of staff in this study had not accessed wellbeing resources, mainly due to lack of time and being unfamiliar with how to use them. Conclusions This study has identified the dynamic and evolving nature of mental health and wellbeing amongst HCPs. Participants displayed enormous resilience throughout the pandemic, rising to the challenges posed by COVID, however, the study has highlighted the importance of identifying mental health issues and how these may change over time.
ABSTRACT
Introduction: The COVID-19 pandemic has resulted in substantial changes in social interactions, work schedules, and socioeconomic factors that may negatively impact sleep onset, maintenance, and quality. The ongoing stress of the pandemic also may exacerbate existing racial/ ethnic disparities in sleep health. In this study, we examined the effects of COVID-19 related distress on sleep-related impairment and sleep disturbances among trauma-exposed South Asian adults. Since a health advantage among foreign-born individuals has been previously noted in the literature (the immigrant paradox), we also assessed whether generational status (i.e., being born in the U.S. or not) moderated associations between COVID-19 related distress and sleep outcomes. Methods: Participants were recruited through Amazon's Mechanical Turk and completed online surveys on demographic information, the COVID-19 Stress Scale, The Life Events Checklist for DSM-5 (LEC-5), and PROMIS™ Sleep-Related Impairment and Sleep Disturbances Scale. The final sample included 316 South Asian adults residing in the U.S, who had been exposed to a traumatic event at some point in their lifetime. Most participants were male (55%) and U.S.-born citizens (64%), with an average age of 35.32 (SD = 9.52) years. Results: Examination of t-scores for PROMIS™ sleep-related and sleep disturbances revealed that our sample endorsed slightly higher values than the general U.S. population. Greater COVID-19 distress was associated with more sleep disturbances (b = 0.09, p < .001, sr2 = .04) and sleep-related impairment (b = 0.20, p < .001, sr2 = .12). Generational status was not associated with sleep, nor did it modify associations between COVID-19 distress and sleep. Conclusion: In our sample, we found that psychological distress triggered by the pandemic (e.g., fear of contamination, fear of the dangerousness of the virus, socioeconomic worries) was associated with greater sleep difficulties. Our findings highlight the importance of developing targeted interventions to cope with stress and sleep disturbances during the pandemic, particularly among vulnerable populations, such as those exposed to trauma. Our results did not support the immigration paradox: stress and sleep associations were similar regardless of generational status. Future studies are needed to better understand the role of generational status on sleep across different immigrant subgroups.
ABSTRACT
Female entrepreneurship drives tourism development in resource-scarce destinations but little is known about why local women engage in business and what determines their success in a time of a life event crisis. This knowledge is important as it can support policies on regional regeneration and poverty alleviation. This study draws upon the Bourdieu's model of practice with its notions of capital, agents, field, and habitus to examine the experiences of women running tourism enterprises in a destination with the legacy of an anthropogenic environmental disaster, the Aral Sea region. Semi-structured interviews with women entrepreneurs in Uzbekistan (n = 18) and Kazakhstan (n = 15) showcase prevalence of the necessity-based and extrinsic motivations in a time of crisis. Interviews also demonstrate the importance of social capital women entrepreneurs built with such agents of entrepreneurial practice as family, friends, policymakers, employees, and competitors. The original contribution of the study is in revealing how local cultural traditions reinforce various types of capital, strengthen the field of knowledge, and shape habitus of women entrepreneurs in critical times. Another original contribution is in highlighting how the experience of past life event crises has aided in psychological coping of women tourism entrepreneurs during COVID-19. [ FROM AUTHOR] Copyright of Journal of Sustainable Tourism is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)