Psychological distress among health professional students during the COVID-19 outbreak.

BACKGROUND: Due to the drastic surge of COVID-19 patients, many countries are considering or already graduating health professional students early to aid professional resources. We aimed to assess outbreak-related psychological distress and symptoms of acute stress reaction (ASR) in health professional students and to characterize individuals with potential need for interventions. METHODS: We conducted a prospective cohort study of 1442 health professional students at Sichuan University, China. At baseline (October 2019), participants were assessed for childhood adversity, stressful life events, internet addiction, and family functioning. Using multivariable logistic regression, we examined associations of the above exposures with subsequent psychological distress and ASR in response to the outbreak. RESULTS: Three hundred and eighty-four (26.63%) participants demonstrated clinically significant psychological distress, while 160 (11.10%) met the criterion for a probable ASR. Individuals who scored high on both childhood adversity and stressful life event experiences during the past year were at increased risks of both distress (ORs 2.00-2.66) and probable ASR (ORs 2.23-3.10), respectively. Moreover, internet addiction was associated with elevated risks of distress (OR 2.05, 95% CI 1.60-2.64) and probable ASR (OR 2.15, 95% CI 1.50-3.10). By contrast, good family functioning was associated with decreased risks of distress (OR 0.43, 95% CI 0.33-0.55) and probable ASR (OR 0.48, 95% CI 0.33-0.69). All associations were independent of baseline psychological distress. CONCLUSIONS: Our findings suggest that COVID-19 related psychological distress and high symptoms burden of ASR are common among health professional students. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.

Personal and family-related factors on willingness to volunteer among undergraduate medical students during COVID-19 pandemic in Saudi Arabia: a cross-sectional study.

OBJECTIVE: This study aimed to describe personal and family-related factors affecting undergraduate students' willingness to volunteer during the pandemic. This cross-sectional study was conducted on undergraduate medical students at Qassim University in Saudi Arabia through an online survey. PATIENTS AND METHODS: A pre-validated online questionnaire on willingness to volunteer during the pandemic was distributed through various messenger groups and social media. The questionnaire comprised two sections to collect demographics and how likely the volunteers work during the pandemic in different circumstances. The distribution of these parameters was reported by frequency and proportion for categorical variables. In addition to descriptive analytics, a chi-square test was used to compare key explanatory parameters between the low and high likelihood of volunteering. Data were analysed using IBM SPSS statistical software (version 25, Armonk, NY, USA). RESULTS: There was a high likelihood of willingness (60.7%) to volunteer among undergraduate medical students. However, there was no statistically significant difference in baseline parameters like gender, academic year, age (in years), marital status, children, and elderly dependents between the high and low likelihood of volunteer (p >0.05). However, a statistically significant difference indicated the best description of one's living arrangement between volunteers' high and low probability (p<0.05). CONCLUSIONS: Our findings suggested that undergraduate medical students can be motivated to volunteer effectively in this pandemic by ensuring personal and family protection. This is vital to optimally redistribute the work burden and effectively channelize the workforce during a pandemic situation.

Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. Objective: To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. Design, Setting, and Participants: This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020. Exposures: Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scale. Main Outcomes and Measures: The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Results: Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (ß = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (ß = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (ß = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (ß = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86). Conclusions and Relevance: This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women's careers and well-being.

Reframing aging during COVID-19: Familial role-based framing of older adults linked to decreased ageism.

BACKGROUND: Contributions of older adults amid the COVID-19 pandemic have been eclipsed by discourse positioning them as an at-risk population. We assess whether age-based framing (e.g., senior citizen) is associated with more negative stereotyping in the media compared to familial role-based framing (e.g., grandparent) across 8 months, from a baseline period (October 2019-December 2019) to the onset of the pandemic (January 2020-May 2020). METHODS: Leveraging a 12-billion-word news media database-with over 30 million news articles from over 7000 websites-we identified the most common synonyms for age-based framing (e.g., senior citizen) and familial role-based framing (e.g., grandparent). For each framing category, we compiled the most frequently used descriptors every month, amassing 488,907 descriptors in total. All descriptors were rated from 1 (very negative) to 5 (very positive) to determine a Cumulative Aging Narrative Score (CANS) for age-based and familial role-based framing. RESULTS: Age-based framing of older adults increased negative stereotyping in the media by seven times compared to familial role-based framing during COVID-19. The percentage of positive topics for age-based framing was significantly lower during COVID-19 (35%) than before (61%). Conversely, the percentage of positive topics for familial role-based framing was higher during the pandemic (91%) than before (70%). CONCLUSION: This is one of the first empirical studies on whether framing older adults based on age or role is linked to more negative stereotypes during COVID-19. We argue for a more role-centered approach in framing older adults so that their contributions are acknowledged and valued by society.

Psychological state, family functioning and coping strategies among undergraduate students in a Nigerian University during the COVID-19 lockdown.

INTRODUCTION: The curtailment of social gatherings and the lack of online academic engagement during the COVID-19 lockdown could have potentially damaging effects on the psychological state of university students in Nigerian public universities. This study examined the prevalence of anxiety and depression, including associated factors and coping methods, among undergraduate students. METHODS: This cross-sectional study, which involved 386 undergraduate students, was assigned approval number UI/EC/20/0242. An online questionnaire consisting mainly of the Hospital Anxiety and Depression Scale and the McMaster Family Assessment Device was circulated among the students. The results were analysed by means of descriptive statistics, chi-square, Analysis of Variance (ANOVA) and linear logistical regression, at α 0.05. RESULTS: Mean age was 21 ± 2.9 years, with females constituting 60.1% of the sample. The prevalence rates of anxiety and depression were 41.5 and 31.9%, respectively. Students in health-related faculties were significantly less anxious than others. Inability to afford three square meals, negative family functioning, chronic illness and living in a State/Region with a high incidence of COVID-19 were significantly associated with depression. These factors jointly accounted for 14% of depression. Coping methods included the use of social media, watching movies and participating in online skills-development programs. CONCLUSION: The overall level of anxiety and depression among undergraduate students during the COVID-19 lockdown was higher than the levels previously reported. Inadequate nutrition and poor family functioning contributed significantly to this. Proactive measures ought to be taken to support undergraduate students in order to prevent the negative consequences of poor mental health.

Olfactory Impairment and Close Social Relationships. A Narrative Review.

Olfactory impairment is one of the more unique symptoms of COVID-19 infection and has therefore enjoyed increased public attention in recent months. Olfactory impairment has various implications and consequences ranging from difficulty detecting dangerous pathogens to hindering social functioning and social behaviors. We provide an overview of how olfactory impairment can impact 3 types of close social relationships: family relationships, friendships, and romantic relationships. Evidence is divided into several categories representing potential mechanisms by which olfactory impairment can impact close social relationships: bonding disruptions, decreased social support, missed group-eating experiences, hygiene concerns, and altered sexual behaviors. We conclude with a discussion of emerging future research questions.

Higher Depression of Patients with Alzheimer's Disease During than Before the Lockdown.

We assessed depression in 72 patients with Alzheimer's disease (AD) who live in retirement homes during the COVID-19-related lockdown. We invited caregivers of 72 patients with AD who live in retirement homes to rate depression in the patients both before and during the lockdown. Analysis demonstrated increased depression in the patients during the lockdown. We attribute this increased depression to the restrictive measures on activities, visits, and physical contact between patients with AD and family members during the lockdown.

Evaluations of Healthcare Providers' Perceived Support From Personal, Hospital, and System Resources: Implications for Well-Being and Management in Healthcare in Montreal, Quebec, During COVID-19.

Increased stressful experiences are pervasive among healthcare providers (HCPs) during the COVID-19 pandemic. Identifying resources that help mitigate stress is critical to maintaining HCPs' well-being. However, to our knowledge, no instrument has systematically examined how different levels of resources help HCPs cope with stress during COVID-19. This cross-sectional study involved 119 HCPs (64 nurses and 55 physicians) and evaluated the perceived availability, utilization, and helpfulness of a list of personal, hospital, and healthcare system resources. Participants also reported on their level of burnout, psychological distress, and intentions to quit. Results revealed that HCPs perceived the most useful personal resource to be family support; the most useful hospital resources were a safe environment, personal protective equipment, and support from colleagues; the most useful system resources were job protection, and clear communication and information about COVID. Moreover, HCPs who perceived having more available hospital resources also reported lower levels of psychological distress symptoms, burnout, and intentions to quit. Finally, although training and counseling services were perceived as useful to reduce stress, training was not perceived as widely available, and counseling services, though reported as being available, were underutilized. This instrument helps identify resources that support HCPs, providing implications for healthcare management.

[Experience of care and daily life during national sanitary confinement in patients followed and treated in Cancer Control Centers: The BaroCov Inquiry]. / Expérience des soins et de la vie quotidienne pendant le confinement sanitaire national chez des patients suivis et traités en centre de lutte contre le cancer : l'enquête BaroCov.

Confinement within the framework of Covid 19 required organizations in cancer centers, in particular with postponing certain treatments. We interviewed 6080 patients who had a scheduled appointment during this period. 2478 patients gave their opinion regarding access and organization of care, teleconsultation, their concerns and their reasons for satisfaction. While 83 % of them say they are satisfied with the organization of care, 25 % of respondents say they have given up care that they consider essential in 1/3 of cases. The concern related to the follow-up of the cancerous disease takes precedence over that of being infected with the Sars-cov-2 virus, unlike the general population, and relationships with their loved ones are spontaneously cited as a reason for satisfaction. This method captures the experience of patients, despite certain limitations. Such an approach could be used to set up a specific system during normal periods.

[Impact of the lockdown on children and families: a survey of family pediatricians within a community.] / Impatto del lockdown sui bambini e sulle famiglie: un'indagine dei pediatri di famiglia all'interno di una comunità.

OBJECTIVES: The recent lockdown, resulting from the SARS-CoV-2 pandemic, has had a strong social and psychological impact on the most fragile individuals and family structures. In the present work we investigated the experience of families without specific elements of social or health vulnerability during the quarantine period that occurred in the spring of 2020. MATERIALS AND METHODS: Between May and July 2020, 22 primary care pediatricians belonging to AUSL Romagna administered to a number of families a questionnaire to detect changes that occurred, during the lockdown, in family environment, school attendance and personal attitudes. RESULTS: A total of 721 questionnaires were collected, analyzing the associations between variables relating to home environment, daily rhythms, school and warning signs in relation to the age of children. As a result of the lockdown, family habits changed in 31% of cases, with a greater presence of the reference figure in 68% of these. Three out of four families reported they had sufficient domestic spaces, and nine out of ten had access to an outdoor, private or condominium space. Daily rhythms were preserved in 56.7% of cases; mood disorders appeared in 30% of adolescent children, followed by sleep, appetite and psychosomatic disorders. One in three children has made progress in terms of evolution and behavior, and one in 5 children has seen their relationships improve. The overall resilience of families during the lockdown period was considered good in 66.3%, sufficient in 31.3% and not satisfactory in only 2.4% of cases. CONCLUSIONS: Our data show that, in the interviewed families, the simultaneous presence of adults and children at home has generally intensified. Families refer, on the whole, a positive and resilient behavior in the lockdown period, even if initial emotional problems are reported in one out of three children-adolescents. The ability to maintain a family organized structure seems to be partially compromised. Forced cohabitation leads to competition for the same resources of time and space and affects the entire family unit. The school institution emerges as a protective factor for children, young people and also for the well-being of families themselves.

A parent-sibling dyadic interview to explore how an individual with Autism Spectrum Disorder can impact family dynamics.

BACKGROUND: Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics. AIMS: To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown. METHODS: Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support. CONCLUSIONS: The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics.

Impact of the COVID-19 pandemic on children with and without risk for neurodevelopmental impairments.

AIM: To examine how the ongoing COVID-19 pandemic impacts child well-being and family functioning, particularly among children at risk for neurodevelopmental impairments. METHODS: Families of 73 typically developing children, 54 children born very preterm (VPT) and 73 children with congenital heart disease (CHD) from two prospective cohort studies were assessed prior to (mean age: 10.4 [SD: 1.2] years) and during (mean age: 12.8 [SD: 2.0] years) the pandemic, more specifically, in April/May 2020. Child well-being and family functioning were assessed with validated, parent-reported questionnaires and tested with linear mixed models. Group comparison of child distress and parental concerns related to medical implications of COVID-19 and homeschooling, assessed with 5-point Likert scales, was done with Mann-Whitney U tests. RESULTS: Children's psychological well-being and family functioning (both, p < 0.001) decreased significantly during the pandemic, irrespective of group. Children with CHD were reported to be more concerned about becoming infected with SARS-CoV-2 than were others. Child distress due to homeschooling and parents' concerns about children's academic achievements were significantly higher in VPT and CHD children than in typically developing peers (all p < 0.001). CONCLUSION: The COVID-19 pandemic substantially impacts the whole family and leads to additional distress in families with children at risk for neurodevelopmental impairments. These families should receive individualised counselling and assistance from healthcare providers and schools during the pandemic.

Gender Diversity and Work-Life Conflict in Changing Times.

The aim of the study is to contribute to the "well-being, diversity, equity, and inclusion" dialogue of the post-pandemic era. Specifically, we explored the joint effects of biological sex and gender diversity in self-identity on the role demands-work and family conflict relationships. To advance the inclusion of scientific knowledge, the present study was conducted in the cultural context of a Chinese society. We surveyed a sample of 317 Taiwanese employees. We used structured questionnaires to collect data on biological sex, gender identity (self-endorsement on masculinity and femininity traits), work and family demands, work-to-family conflict (WFC), and family-to-work conflict (FWC). We found two sets of significant three-way interactions (sex × femininity × role demands) in predicting work and family conflict. First, for men, identifying with high femininity traits strengthened the positive relationship between work demands and FWC; for women, identifying with low femininity traits strengthened the same relationship. Second, for men, identifying with high femininity traits strengthened the relationship between family demands and WFC; for women, identifying with low femininity traits strengthened the same relationship. Our findings highlight the importance of jointly examining the biological, psychological, and social aspects of gender on the work and family interface. Contextualizing in an Eastern cultural tradition, we put the spotlight on societal pressure on people of nontraditional gender identities.