Mental health predictors during the COVID-19 lockdown

This study evaluates some predictors of mental health during the COVID19 lockdown. An online survey with ad hoc instruments and the Goldberg General Health Questionnaire was administered to 2011 participants. Using descriptive analyses and stepwise regressions, moderate and low levels of social dysfunction, depression, and anxiety and medium and high levels of worry and boredom were identified. In relation to the prediction, we found that greater negative evaluation of COVID19, greater boredom, a negative attitude towards the situation, younger age and a higher level of worries about COVID19 predicted greater social dysfunction. Likewise, a higher level of worries, greater boredom, a negative attitude towards the situation, greater negative evaluation of COVID19 and being a woman, predicted greater depression and anxiety. The findings provide the basis for the development of prevention programs for a health crisis situation, such as the COVID19 pandemic. © 2023 Asoc. Espanola de Psicologia Clinica y Psicopatologia. All rights reserved.

The role of maladaptive personality traits on psychological stress the mediating effects of COVID-19-related worries and emotional dysregulation.

There is increasing evidence that dysfunctional personality traits, related to psychological maladjustment and psychopathology, can play an important role in a person's ability to cope with major stressful events. Relatively little is known about the specific effect of the emotional component on the relationship between maladaptive personality traits and psychological stress. Therefore, the aim of the present study was to investigate the relationship between the maladaptive personality traits of psychoticism, detachment, and negative affect, and psychological stress, considering the effects of COVID-19-related worries and emotional dysregulation. An online survey was administered to 1172 adult participants. A series of path analysis models showed that maladaptive personality traits (psychoticism, detachment, and negative affect) are related to psychological stress. COVID-19-related worries and emotional dysregulation partially explained this association. The results suggest that in the early months of 2022, during the reduction of government restrictions, although the world population was no longer in nationwide lockdown, the COVID-19-related emotional component could still explain, at least in part, the association between maladaptive personality traits and psychological stress.

COVID-19- Experiences and support needs of children and young people with Hydrocephalus and parents in the United Kingdom.

PURPOSE: Little is known about the impact of COVID-19 on children and young people (CYP) with hydrocephalus and their families. This study explored the experiences and support needs of CYP with hydrocephalus and parents who have a child with hydrocephalus during the COVID-19 pandemic. METHODS: CYP with hydrocephalus and parents of CYP with hydrocephalus in the United Kingdom completed an online survey with open and closed questions exploring experiences, information, support needs and decision making processes. Qualitative thematic content analysis and descriptive quantitative analyses were undertaken. RESULTS: CYP aged 12-32 years (n=25) and parents of CYP aged 0-20 years (n=69) responded. Parents (63.5%) and CYP (40.9%) worried about the virus, and both were vigilant for virus symptoms (86.5% and 57.1%). Parents (71.2%) and CYP (59.1%) worried about their child/feeling more isolated during the virus outbreak. Parents felt concerned about having to take their child to hospital with a suspected shunt problem during the virus outbreak (64.0%). Qualitative findings reported the following themes: (1) Healthcare and treatment provision: delays and challenges to access and availability of care (2) Impact of COVID-19/lockdown on daily lives and routines, and (3) Provision of information and support for parents and CYP with hydrocephalus. CONCLUSION: The impact of COVID-19 and national measures to control the spread of the virus- no contact with anyone outside the household significantly impacted the daily lives and routines of CYP with hydrocephalus and parents. Social engagements were missed, families faced challenges to their work life, education and access to health care and support, which subsequently contributed negatively to their mental wellbeing. CYP and parents highlighted a need for clear, timely and targeted information to address their concerns.

HEALTH-RELATED ANXIETY, GENERALIZED ANXIETY, OBSESSIVE COMPULSIVE TENDENCIES, AND COVID-19 ANXIETY AMONG VACCINATED AND NON-VACCINATED ADULTS DURING PANDEMIC

The objectives of the present study were two-folded: first, to examine the predictive association of health-related anxiety with generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety;second, to examine the differences between vaccinated and non-vaccinated adults on health-related anxiety, generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety. A purposive sample of 350 adults falling between ages of 25-55 years (Mage = 21.58, SD= 2.45) were administered Health Anxiety Inventory, Yale-Brown Obsessive-Compulsive Scale, Generalized Anxiety Disorders Scale and Coronavirus Anxiety Scale. Results of linear regression analysis reveal health-related anxiety as significant predictor of generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety. Further, independent t-test reveals that vaccinated adults scored significantly lower than non-vaccinated adults on health-related anxiety, obsessive compulsive tendencies, generalized anxiety and COVID anxiety. The implications and future directions are proposed.

The politicized pandemic: Ideological polarization and the behavioral response to COVID-19.

In a representative sample of the U.S. population during the first summer of the COVID-19 pandemic, we investigate how prosociality and ideology interact in their relationship with health-protecting behavior and trust in the government to handle the crisis. We find that an experimental measure of prosociality based on standard economic games positively relates to protective behavior. Conservatives are less compliant with COVID-19-related behavioral restrictions than liberals and evaluate the government's handling of the crisis significantly more positively. We show that prosociality does not mediate the impact of political ideology. This finding means that conservatives are less compliant with protective health guidelines - independent of differences in prosociality between both ideological camps. Behavioral differences between liberals and conservatives are roughly only one-fourth of the size of their differences in judging the government's crisis management. This result suggests that Americans were more polarized in their political views than in their acceptance of public health advice.

Different facets of COVID-19-related stress in relation to emotional well-being, life satisfaction, and sleep quality.

Introduction: As the COVID-19 pandemic has shown, it is of great importance to investigate how people can maintain their mental health during chronically stressful times. This study therefore investigated which facets of COVID-19-related stress (Fear of COVID-19, financial worries, and social isolation) impacted people the most during a third COVID-19 infection wave from March until May 2021 and how these facets relate to well-being (emotional well-being and life satisfaction) and sleep quality. Methods: A study sample of 480 German participants (M age = 43, SD age = 13.7, 20-69 years, 50.8% female) completed a cross-sectional online questionnaire. Results: As predicted, social isolation was reported most often, followed by fear of COVID-19 and financial worries. In accordance with our expectations more social isolation and financial worries predicted lower emotional well-being and sleep quality. In contrast to our hypothesis, fear of COVID-19 only predicted emotional well-being and not sleep quality. Life satisfaction was solely predicted by financial worries and not by social isolation and fear of COVID-19, which only partly confirmed our hypotheses. These associations remained stable after controlling for age, gender, household income, and living alone. Discussion: Financial worries, although reported the least often, were the strongest and most stable predictor for emotional well-being, sleep quality, and life satisfaction. Implications for future research and practice are discussed.

Effects of Cognitive Appraisals on Perceived Self-Efficacy and Distress during the COVID-19 Lockdown: An Empirical Analysis Based on Structural Equation Modeling.

During the COVID-19 lockdown, individuals and households had to responsibly manage the difficulties and problems caused by the restrictions on their mobility, such as the interruptions to work schedules, insecure food supplies, and the procurement of services and health care. The perceptions of risk as well as the fear of disease were strongly linked to worry, defined as a sequence of thoughts that evoke negative emotions and elevated levels of anxiety and distress. This study evaluated how different cognitive appraisals of an individual's sources of worry could influence their perceived self-efficacy and directly or indirectly moderate their perceived general distress. A sample of 544 participants completed a survey that included questions based on the generalized self-efficacy scale, the sources of concern during the epidemic, the cognitive appraisal scale in emergency, and perceived discomfort. Subsequently, a structural-equation-modeling (SEM) analysis was performed to test the moderating role of cognitive appraisals and perceived self-efficacy on participants' overall distress during a lockdown. Overall, the model reported acceptable fit values and confirmed the hypotheses of the study. An individual's worries activated either a dysfunctional threat appraisal, which prompted a fear-and-closure response that then increased their overall state of distress; or two other functional appraisals (i.e., adaptive or supportive) that contributed to significantly improving the individual's self-efficacy. Higher self-efficacy was shown to be associated with lower levels of perceived distress. For the purposes of prevention and distress containment, it would be appropriate to promote psycho-educational interventions that promote the adoption of appraisal strategies that are functional and beneficial for perceived self-efficacy.

Anxiety and Worries of Individuals with Down Syndrome During the COVID-19 Pandemic: A Comparative Study in the UK.

The present study explored the effects of the pandemic on individuals with Down Syndrome (DS; n = 67) compared to other groups with Special Education Needs and Disabilities (SEND; n = 48) and their Typically Developing Siblings (TDS; n = 56). In total, 115 caregivers reported on their own anxiety and worries and of their children. Anxiety levels for individuals with DS appeared to be lower compared to other SEND populations and to TDS. In terms of worries, individuals with DS worried more about social-related worries but worried less about family-related aspects compared to the other groups. In sum, individuals with DS might show less anxiety but still worried more about specific aspects related to the impact of COVID-19 pandemic on their lives.

Biopsychosocial therapy of generalized anxiety disorder. Integrative treatment concept

The corona pandemic has led many people to experience an existential threat and has triggered different forms of coping with this persistent stress situation. The risk for the development of a generalized anxiety disorder (GAD) in particular has significantly increased. The established concepts of cognitive behavioral therapy (CBT) are only moderately effective in the treatment of GAD. Therefore, an integrative therapy concept is developed with reference to the biopsychosocial approach. This mediates a reference to early influences in the primary family (insecure ambivalent attachment, suppression of curiosity behavior) even during the psychoeducation as the cause of a permanent worrying and the underlying intolerance of uncertainty. The initial priority is on establishing a sustainable therapeutic relationship (alliance) in which the patient's autonomy and self-efficacy are promoted. Of central importance to therapeutic progress is the promotion of experiences that enhance self-efficacy and the reduction of avoidance behavior through exposure and behavioral experiments. The reduction of maladaptive anxiety coping through worry chains and reassurance behavior occurs through the development of an increasingly greater tolerance of uncertainty in actual daily life. Essential for the prognosis are the consideration of metacognitions and dysfunctional relationship patterns in the couple relationship as well as carrying out relaxation procedures and correctly dosed exercises. Finally, it is a matter of the processing of dysfunctional coping strategies, which promote chronification. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (German) Die Coronapandemie hat bei vielen Menschen zum Erleben einer existenziellen Bedrohung gefuhrt und unterschiedliche Formen der Bewaltigung dieser anhaltenden Stresssituation ausgelost. Besonders stark gestiegen ist das Risiko fur die Entwicklung einer generalisierten Angsterkrankung (generalized anxiety disorder", GAD). Die etablierten Konzepte der kognitiven Verhaltenstherapie (cognitive behavioral therapy", CBT) sind in der Behandlung einer GAD nur masig wirksam. Daher wird unter Bezugnahme auf den biopsychosozialen Ansatz ein integratives Therapiekonzept entwickelt. Dieses vermittelt bereits im Rahmen der Psychoedukation einen Bezug zu fruhen Pragungen in der Primarfamilie (unsicher-ambivalente Bindung, Unterdruckung von Neugierverhalten) als Ursache eines permanenten Sichsorgens und der dahinter stehenden Intoleranz fur Ungewissheit. Zunachst steht der Aufbau einer tragfahigen therapeutischen Beziehung (alliance") im Vordergrund, bei der die Autonomie und Selbstwirksamkeit des Patienten gefordert werden. Eine zentrale Bedeutung fur den therapeutischen Fortschritt haben die Forderung von Erfahrungen, die die Selbstwirksamkeit erhohen, sowie die Reduktion von Vermeidungsverhalten durch Exposition und Verhaltensexperimente. Der Abbau der maladaptiven Angstbewaltigung durch Sorgenketten und Ruckversicherungsverhalten geschieht durch die Entwicklung einer wachsenden Toleranz von Ungewissheit im jeweils aktuellen Lebensalltag. Prognostisch wesentlich sind die Berucksichtigung von Metakognitionen und dysfunktionalen Beziehungsmustern in der Paarbeziehung sowie die Durchfuhrung von Entspannungsverfahren und richtig dosierter Sporttherapie. Schlieslich geht es um die Bearbeitung dysfunktionaler Coping-Strategien, die die Chronifizierung fordern. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Analyzing the role of resilience and life satisfaction as mediators of the impact of COVID-19 worries on mental health.

The aim of this study was to test whether resilience and life satisfaction (two traditional protective factors) mediate between COVID-19 related worries and the development of symptoms of depression, anxiety, and stress in adolescents and young adults. Participants involved 392 adolescents and young adults (70.20% female) aged between 12 and 25 years (M = 17.05 years, SD = 3.08). Participants completed the COVID-19 related worries scale, the CD-RISC to analyse resilience, the Satisfaction with Life Scale, and the Depression, Anxiety, and Stress Scales-21 to study emotional symptoms. Descriptive analyses and Pearson correlations were conducted, together with a structural equation modeling testing a mediational model and multigroup invariance. Results show that resilience and life satisfaction play a mediating role in the relation between the COVID-19 related worries and emotional symptoms (depression, anxiety, and stress). This study highlights the role of protective factors on adolescents' and young adults' emotional symptoms during the COVID-19 pandemic.

Development and Validation of the COVID-19 Worries and Fears Scale.

Objectives: How individuals perceive the risk of COVID-19 influences their mental health and protective behaviors. Therefore, the development of an instrument to capture COVID-19-related worries and fears is relevant. This study aims to develop and validate the CoV-WoFe to measure COVID-19-related worries and fears. Methods: An online questionnaire was completed by 593 participants during Christmas 2020 and by 328 participants during Summer 2021, from which 88 participants formed a longitudinal sample. Results: Analyses confirmed a robust adjustment for consistency over time and a gender-invariant bifactorial structure. Factor 1 represented worry about the health consequences of COVID-19 and Factor 2 represented the perceived physiological symptoms associated with fear of COVID-19. Construct validity was evidenced by: the expected relations between the CoV-WoFe and other theoretically related constructs; the serial mediating role of both dimensions in the relationship that security values establish with protective behaviors against COVID-19 and with anxiety; and the expected gender differences in the Cov-WoFe. Conclusion: The CoV-WoFe represents a short, valid, reliable, gender-invariant tool that is easy to apply in both the health professional and research context to assessCOVID-19-related worries and fears, which are variables of relevance for spread of the virus and for mental health.

COVI-Prim Longitudinal Survey: Experiences of Primary Care Physicians During the Early Phase of the COVID-19 Pandemic.

Background: General practitioners (GPs) are the mainstay of primary care and play a critical role in pandemics. During the first wave of the COVID-19 pandemic, this international study aimed to explore changes in the workload of general practitioners, as well as their interactions with patients and colleagues, and their self-confidence and concerns. Methods: An online survey was conducted among GPs in Austria and Germany. Participants were asked to answer a basic questionnaire and participate in a subsequent longitudinal survey containing closed and open-ended items. All data were pseudonymized. Results: Overall, 723 general practitioners from Austria and Germany took part in the longitudinal survey over a period of 12 weeks (April 3-July 2, 2020). The majority of GPs had less direct contact with patients at the beginning of the survey (96 vs. 49% at the end of the study period). At first, doctors were mainly concerned with pandemic-related issues and had to care for the patients of GP colleagues that were in quarantine, which meant they had less time for routine work such as screenings and treating chronic diseases. Over the survey period, GPs' self-confidence increased and their concerns about income loss decreased. Conclusions: Following a difficult initial phase when protective equipment and information were lacking, physicians in primary care adapted quickly to new situations. Experience with telemedicine should help them face future challenges and may help prevent a decline in the delivery of routine health care and care for chronically ill patients. Registration: Trial registration at the German Clinical Trials Register: DRKS00021231.

Emotional State, Life Satisfaction and Worries Regarding COVID-19 in Spanish and Chilean Adolescents during Spring 2020.

Background: The lockdown due to COVID-19, has affected the mental health of the population. Recent literature suggests a greater psychological impact on adolescents regardless of their cultural background. Objective: The aim is to analyze the emotional state, life satisfaction and worries about COVID-19 in Chilean and Spanish adolescents. Method: A total of 1078 adolescents (M=15.18; SD=1.25) completed the Depression, Anxiety and Stress Scale, the COVID-19 Worry Scale and the Life Satisfaction Scale. The design was cross-sectional and descriptive. Descriptive analyses, t-tests, and linear regressions were performed. Results: More emotional symptoms, worries and lower life satisfaction were observed in Chile. Girls had more worries and emotional symptoms. An affected psychological state is also observed in Spanish adolescents, especially in Chilean adolescents. Worries about COVID-19 affect depression, anxiety, stress and life satisfaction in both samples. Conclusions: Further research is needed to prevent psychological distress in future pandemics. Developing tailored interventions are encouraged.

Perceptions and worries about monkeypox, and attitudes towards monkeypox vaccination among medical workers in China: A cross-sectional survey.

BACKGROUND: The World Health Organization (WHO) declared monkeypox a "public health emergency of international concern" on 23 June 2022. However, there is a lack of data on monkeypox perceptions among medical workers. The purposes of this study were to evaluate perceptions, worries about monkeypox, attitudes towards monkeypox vaccination and their correlates among medical workers in China. METHODS: Data were collected from medical practitioners using an online survey questionnaire between September 1 and September 30, 2022 in China. All the subjects completed an online questionnaire including general characteristics, perceptions/knowledge/worries about monkeypox, and attitudes towards monkeypox vaccination. Logistic regression was employed to examine the correlates of perceptions, worries about monkeypox, and attitudes toward monkeypox vaccination. RESULTS: In total, this study sample included 639 medical workers. The mean age was 37.9 ± 9.4 years old. Approximately 71.8% of individuals reported perceptions of monkeypox, 56.7% worried about monkeypox, and 64.9% supported the promotion of monkeypox vaccination. Medical workers who were older than 50 years (aOR 3.73, 95%CI 1.01-13.85), worked in the Infectious Diseases/Dermatology/Venereal Diseases departments (3.09, 1.61-5.91), and provided correct answer to monkeypox transmission route (10.19, 5.42-19.17) were more likely to know about monkeypox/monkeypox virus before investigation. 30.7% reported that they were more worried about monkeypox than the coronavirus (COVID-19). Participants reported that the key population most in need of monkeypox vaccination were health practitioners (78.2%) and people with immunodeficiency (74.3%), followed by children (65.4%) and older adults (63.2%). CONCLUSION: Awareness of monkeypox was high and attitude towards the promotion of monkeypox vaccination was positive among medical staff in China. Further targeted dissemination of monkeypox common knowledge among health care providers might improve their precaution measures and improve the promotion of monkeypox vaccination among key populations.

How and when institutional trust helps deal with group crisis like COVID-19 pandemic for Chinese employees? A social perspective of motivation.

Social factors cannot be neglected in predicting individual psychological health during a group crisis. Grounded in Vroom's expectancy theory of motivation, the present research explores how and when institutional trust influences crisis related worries and griefs. Both the survey study (N = 234) and the experimental study (N = 111) were conducted to examine our hypothesized moderated mediation model. Multiple waves of surveys were delivered in Study 1 and participants were requested to rate their experiences and responses during the COVID-19 pandemic. In Study 2, participants from both the collectivism manipulation group and the control group were requested to rate their psychological responses in an imagined group crisis. Regression analyses showed that institutional trust reduced worries and griefs by improving personal resilience, which is more significant for individuals with high levels of collectivism. These findings point to the importance of understanding individual psychological health in a social perspective of motivation.

Assessment of worries and attitudes towards the COVID-19 pandemic and the vaccine among Tunisian elderly

Introduction: The COVID-19 pandemic poses a threat particularly to the elderly. Although the current vaccination strategy is recognized as an adequate measure to reduce mortality, it still raises concerns about its efficacy and safety. Objective(s): Assessment of worries and attitudes among Tunisian elderly towards the pandemic. Method(s): Adescriptive cross-sectional study on a sample of 50 consultants in a geriatric service, aged between 65 years and over. A questionnaire was formulated based on the recommendations of WHO and INEAS. Result(s): The average age of our population is 74.6 years. The participants were mainly female, retired (76%) and with low educational attainment. Most of the elderly reported that they respected the wearing of the mask in public (90%) and washing their hands regularly (92%). Social distancing was respected by only 44% of the participants. Concerning the vaccine registration, we noted that 48% of the subjects expressed their willingness to register on the Evax.tn platform. On the other hand, 15 people expressed their refusal to receive the anti-Covid vaccine.We noted that only 22% had a dose of the Covid-19 vaccine. Only 4% of the respondents did not have concerns about new variants of the virus. About half (52%) of the subjects expressed significant concern about an increased risk of virulence and mortality due to the new variant. Vaccination was considered ineffective by most of the participants (70%). Conclusion(s): Addressingworries about vaccinewould be an important step to accept it among Tunisian elderly. Adequate information strategy is essential to change attitudes during the pandemic.

Preschooler stressor-related thoughts and worries during the COVID-19 pandemic: Development and validation of a caregiver-report instrument

There is little evidence on cognitions that are associated with emotional and behavioral problems in preschoolers during stressful events such as the COVID-19 pandemic. This article presents the initial development and validation of a caregiver-report instrument, the Preschooler Stressor-related Thoughts and Worries (PSTW) scale, developed during the COVID-19 pandemic. In 2020, caregivers from two countries reported on their child's cognitions at baseline (T0) and three months later (T1;age 3-5 years;Australia: N = 559;United States: N = 346). Exploratory factor analysis (EFA) was conducted with the Australian sample at T0 and confirmed with the U.S. sample at T0. Exploratory factor analysis suggested a one-factor model including 10 items. Results of the confirmatory factor analysis failed to clearly support this structure (comparative fit index = .91, root mean square error of approximation = .11). Construct validity was supported by positive associations between PSTW scores and emotional and behavioral problems. Although the PSTW is a promising instrument to assess preschooler cognitions related to COVID-19, further investigation of its performance in other contexts (e.g., other countries, other stressful or traumatic events) is needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Resilience as a Source of Easement to Health-Related Worries in Women at Increased Risk for Breast or Ovarian Cancer During the COVID-19 Pandemic.

Purpose: The COVID-19 pandemic has affected individuals' and society's physical and psychological well-being. The study was conducted in order to assess the predictors for health-related worries during the COVID-19 pandemic in vulnerable populations. Patients and Methods: A cross-sectional web-based survey of women who had a higher risk of developing breast cancer (BC) or ovarian cancer (OC) was conducted, regardless of whether they had experienced an active malignant disease during the pandemic. A self-reported questionnaire was designed for this study to assess health-related worries. The PHQ-4 questionnaire was used to evaluate mental health, and the Brief Resilience Scale (BRS) questionnaire was employed to investigate resilience. Results: History of BC or OC was recognized as an independent significant risk factor for worries regarding being more susceptible to a more severe course of COVID-19 disease (OR 3.593; 95% CI 1.030-12.536; p = 0.045). High scores in the BRS questionnaire were negatively correlated with health-related worries, such as an increased risk for occurrence of BC or OC (OR 0.332; 95% CI 0.118-0.933; p = 0.37) or worsening of oncological outcome as a result of an infection with the SARS-CoV-2 virus (OR 0.330; 95% I 0.114-0.956; p = 0.041). Conclusion: The obtained findings determined resilience as an independent and potent protective parameter in terms of health-related concerns in women at high risk for BC and OC. The results may assist in identifying women at risk for health-related concerns during adverse life events, allowing healthcare providers to respond fast and according to the patients´ needs.

Parental perceptions and the 5C psychological antecedents of COVID-19 vaccination during the first month of omicron variant surge: A large-scale cross-sectional survey in Saudi Arabia.

Background: With the rapid surge of SARS-CoV-2 Omicron variant, we aimed to assess parents' perceptions of the COVID-19 vaccines and the psychological antecedents of vaccinations during the first month of the Omicron spread. Methods: A cross-sectional online survey in Saudi Arabia was conducted (December 20, 2021-January 7, 2022). Convenience sampling was used to invite participants through several social media platforms, including WhatsApp, Twitter, and email lists. We utilized the validated 5C Scale, which evaluates five psychological factors influencing vaccination intention and behavior: confidence, complacency, constraints, calculation, and collective responsibility. Results: Of the 1,340 respondents, 61.3% received two doses of the COVID-19 vaccine, while 35% received an additional booster dose. Fify four percentage were unwilling to vaccinate their children aged 5-11, and 57.2% were unwilling to give the additional booster vaccine to children aged 12-18. Respondents had higher scores on the construct of collective responsibility, followed by calculation, confidence, complacency, and finally constraints. Confidence in vaccines was associated with willingness to vaccinate children and positively correlated with collective responsibility (p < 0.010). Complacency about COVID-19 was associated with unwillingness to vaccinate older children (12-18 years) and with increased constraints and calculation scores (p < 0.010). While increasing constraints scores did not correlate with decreased willingness to vaccinate children (p = 0.140), they did correlate negatively with confidence and collective responsibility (p < 0.010). Conclusions: The findings demonstrate the relationship between the five antecedents of vaccination, the importance of confidence in vaccines, and a sense of collective responsibility in parents' intention to vaccinate their children. Campaigns addressing constraints and collective responsibility could help influence the public's vaccination behavior.

Healthcare Workers' Worries and Monkeypox Vaccine Advocacy during the First Month of the WHO Monkeypox Alert: Cross-Sectional Survey in Saudi Arabia.

Background: Monkeypox virus re-surged in May 2022 as a new potential global health threat, with outbreaks bursting in multiple countries across different continents. This study was conducted in Saudi Arabia during the first month following the WHO announcement of the Monkeypox outbreak, to assess healthcare workers (HCWs) perceptions of, worries concerning, and vaccine acceptance for, Monkeypox, in light of the resolving COVID-19 pandemic. Methods: A national cross-sectional survey was conducted between 27 May and 10 June 2022, in Saudi Arabia. Data were collected on: HCWs' sociodemographic and job-related characteristics; COVID-19 infection status; and worries concerning Monkeypox, compared to COVID-19 and its sources; as well as their perceptions and awareness of, and advocacy for, supporting Monkeypox vaccination. Results: A total of 1130 HCWs completed the survey, of which 41.6% have already developed COVID-19. However, 56.5% were more concerned about COVID-19 compared to Monkeypox, while the rest were more worried about Monkeypox disease. The main cause for concern among 68.8% of the participants was the development of another worldwide pandemic, post-COVID-19, followed by their concern of either themselves or their families contracting the infection (49.6%). Most HCWs (60%) rated their level of self-awareness of Monkeypox disease as moderate to high. Males, and those who had previously developed COVID-19, were significantly less likely to worry about Monkeypox. The worry about Monkeypox developing into a pandemic, and the perception of Monkeypox being a severe disease, correlated significantly positively with the odds of high worry concerning the disease. The major predictors of participants' advocacy for vaccination against Monkeypox disease were: those who had developed COVID-19 previously; and those who supported tighter infection control measures (than those currently used) to combat the disease. A total of 74.2% of the surveyed HCWs perceived that they needed to read more about Monkeypox disease. Conclusions: Approximately half of the HCWs in this study were more concerned about Monkeypox disease than COVID-19, particularly regarding its possible progression into a new pandemic, during the first month following the WHO's Monkeypox international alert. In addition, the majority of participants were in favor of applying tighter infection prevention measures to combat the disease. The current study highlights areas requiring attention for healthcare administrators regarding HCWs' perceptions and preparedness for Monkeypox, especially in the event of a local or international pandemic.