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2.
Soc Sci Med ; 274: 113779, 2021 04.
Article in English | MEDLINE | ID: covidwho-1176937

ABSTRACT

RATIONALE: Severe acute respiratory syndrome Coronavirus 2 (SARS CoV-2), the virus that causes COVID-19, and consequent social distancing directives have been observed to negatively impact social relationships but the impact of these changes on the quality of social relationships at a population level has not been explored. OBJECTIVE: To evaluate changes in social relationships in a U.S. population sample during a time of social distancing. METHODS: We deployed a matched, longitudinal survey design of the National Institutes of Health Adult Social Relationship Scales to assess the social aspects of emotional support, instrumental support, friendship, loneliness, perceived hostility, and perceived rejection from a time without social distancing (February 2018) to a time where social distancing directives were active (May 2020). Changes in social relationships were compared using paired t-tests, and generalized linear regression models were constructed to identify subpopulations experiencing differential changes in each subdomain of social relationships during social distancing. RESULTS: Within our sample population, individuals experienced an increased sense of emotional support, instrumental support, and loneliness, and decreased feelings of friendship and perceived hostility during a period of social distancing. Individuals with low self-rated health experienced a decreased sense of emotional support, and females experienced increased feelings of loneliness compared with males. CONCLUSIONS: Social distancing measurably impacts social relationships and may have a disproportionate impact on females and individuals with lower self-rated health. If novel emergent infectious diseases become more commonplace, social interventions may be needed to mitigate the potential adverse impact of social distancing on social relationships.


Subject(s)
/psychology , Interpersonal Relations , Pandemics/prevention & control , Quarantine/psychology , Adult , Female , Humans , Longitudinal Studies , Male , Surveys and Questionnaires , United States
4.
BMC Public Health ; 21(1): 684, 2021 04 08.
Article in English | MEDLINE | ID: covidwho-1175312

ABSTRACT

BACKGROUND: We investigated if people's response to the official recommendations during the COVID-19 pandemic is associated with conspiracy beliefs related to COVID-19, a distrust in the sources providing information on COVID-19, and an endorsement of complementary and alternative medicine (CAM). METHODS: The sample consisted of 1325 Finnish adults who filled out an online survey marketed on Facebook. Structural regression analysis was used to investigate whether: 1) conspiracy beliefs, a distrust in information sources, and endorsement of CAM predict people's response to the non-pharmaceutical interventions (NPIs) implemented by the government during the COVID-19 pandemic, and 2) conspiracy beliefs, a distrust in information sources, and endorsement of CAM are related to people's willingness to take a COVID-19 vaccine. RESULTS: Individuals with more conspiracy beliefs and a lower trust in information sources were less likely to have a positive response to the NPIs. Individuals with less trust in information sources and more endorsement of CAM were more unwilling to take a COVID-19 vaccine. Distrust in information sources was the strongest and most consistent predictor in all models. Our analyses also revealed that some of the people who respond negatively to the NPIs also have a lower likelihood to take the vaccine. This association was partly related to a lower trust in information sources. CONCLUSIONS: Distrusting the establishment to provide accurate information, believing in conspiracy theories, and endorsing treatments and substances that are not part of conventional medicine, are all associated with a more negative response to the official guidelines during COVID-19. How people respond to the guidelines, however, is more strongly and consistently related to the degree of trust they feel in the information sources, than to their tendency to hold conspiracy beliefs or endorse CAM. These findings highlight the need for governments and health authorities to create communication strategies that build public trust.


Subject(s)
Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care , Adolescent , Adult , Aged , /prevention & control , Complementary Therapies , Female , Finland/epidemiology , Humans , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Trust , Vaccination/psychology , Young Adult
5.
BMC Public Health ; 21(1): 578, 2021 04 09.
Article in English | MEDLINE | ID: covidwho-1175311

ABSTRACT

BACKGROUND: Communities with low vaccination rates are at greater risk during outbreaks of vaccine preventable diseases. Most Australian parents support vaccines, but some refuse and are often judged harshly by their community, especially during an outbreak. We sought the perspectives of Australian public health experts on the key issues faced when managing a measles outbreak in an area with high anti-vaccination sentiment. METHODS: A measles outbreak scenario formed the basis of a 3-round modified Delphi process to identify key practitioner concerns in relation to parents/carers who don't follow the recommended vaccination schedule. We surveyed a range of professionals in the field: policymakers, infectious disease experts, immunisation program staff, and others involved in delivering childhood vaccinations, to identify key priorities when responding to an outbreak in a community with low vaccination coverage. RESULTS: Findings indicate that responses to measles outbreaks in communities with high anti-vaccination sentiment are motivated by concerns about the potential for a much larger outbreak event. The highest operational priority is to isolate infected children. The two most highly ranked practical issues are mistrust from non-vaccinating members of the local region and combatting misinformation about vaccines. Trying to change minds of such individuals is not a priority during an outbreak, nor is vaccinating their children. Using media and social media to provide information about the outbreak and measures the public can take to limit the spread of the disease was a focus. CONCLUSIONS: Our findings provide a deeper understanding of the challenges faced during an outbreak and priorities for communicating with communities where there is a high level of anti-vaccination sentiment. In the context of a global pandemic, the results of this study also have implications for managing public health responses to community transmission of SARS-CoV-2, as COVID-19 vaccines becomes widely available.


Subject(s)
Attitude of Health Personnel , Disease Outbreaks , Measles Vaccine , Measles , Public Health , Vaccination , Australia/epidemiology , /prevention & control , Child , Disease Outbreaks/prevention & control , Humans , Measles/epidemiology , Measles/prevention & control , Measles Vaccine/administration & dosage , Vaccination/psychology
7.
JMIR Public Health Surveill ; 6(3): e19831, 2020 07 30.
Article in English | MEDLINE | ID: covidwho-1172930

ABSTRACT

Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.


Subject(s)
Coronavirus Infections/epidemiology , Domestic Violence/prevention & control , Intimate Partner Violence/prevention & control , Pandemics , Pneumonia, Viral/epidemiology , Telemedicine/methods , Coronavirus Infections/prevention & control , Domestic Violence/statistics & numerical data , Female , Global Health/statistics & numerical data , Humans , Intimate Partner Violence/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Prevalence , Social Support , Survivors/psychology
8.
J Psychiatr Pract ; 26(4): 309-312, 2020 07.
Article in English | MEDLINE | ID: covidwho-1172669

ABSTRACT

This column anticipates challenges likely to be faced by psychotherapists and their patients after the coronavirus disease 2019 (COVID-19) pandemic subsides. It looks beyond the current impact of loneliness, isolation, thwarted belongingness, and loss toward the longer term impact of moral injury and blocked opportunities for mourning.


Subject(s)
Coronavirus Infections , Grief , Pandemics , Pneumonia, Viral , Psychotherapy , Survivors , Betacoronavirus , Coronavirus/isolation & purification , Coronavirus Infections/mortality , Coronavirus Infections/psychology , Humans , Pneumonia, Viral/mortality , Pneumonia, Viral/psychology
10.
BMC Public Health ; 21(1): 670, 2021 04 07.
Article in English | MEDLINE | ID: covidwho-1172830

ABSTRACT

BACKGROUND: The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. METHODS: We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. RESULTS: The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. CONCLUSIONS: The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.


Subject(s)
Disease Outbreaks , Mental Disorders , Severe Acute Respiratory Syndrome , /epidemiology , Disease Outbreaks/history , History, 21st Century , Humans , Mental Disorders/epidemiology , Protective Factors , Risk Factors , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/history , Severe Acute Respiratory Syndrome/psychology
11.
PLoS One ; 16(4): e0249716, 2021.
Article in English | MEDLINE | ID: covidwho-1170008

ABSTRACT

RATIONAL: During pandemics, including the most recent COVID-19 pandemic, the mental health of university healthcare students' is expected to be affected negatively, impacting the students' learning process. OBJECTIVES: The aim of this study was to assess the level of anxiety and depression of healthcare students living in Jordan, and the effect on their learning process during the COVID-19 pandemic. METHODS: This descriptive cross-sectional study was conducted via an online survey completed by students studying a healthcare-oriented degree in a university in Jordan. Participants were recruited through social media (Facebook and WhatsApp). The validated previously published Hospital Anxiety and Depression Scale (HADS) questionnaire was used as a part of the online survey to assess students' anxiety/depression scores. Students' responses regarding their learning process during the COVID-19 was also assessed. RESULTS: The mean age of participants was 21.62 (SD = 4.90), with the majority being females (67.1%). The HADs' assessment revealed that 43.8% and 40.0% of participants had normal anxiety and depression scores, while 22.4% showed borderline abnormal anxiety/depression scores (33.8%). Many students (33.8%) were classified to have abnormal anxiety scores, while a smaller proportion (26.2%) was classified to have abnormal depression scores. Smoking (p = 0.022), lower family income (p = 0.039), and use of medications (p = 0.032) were positively associated with higher (worse) anxiety scores. Ranking the learning process during COVID-19 showed that 45.8% of the participants believed it was a 'good/very good/excellent' process. CONCLUSIONS: Anxiety and depression levels amongst university healthcare students in Jordan were found to be high when assessed during the COVID-19 pandemic. In addition, the learning process during the pandemic was not accepted by more than half of the students. Implementing psychological interventions for healthcare students during pandemics is strongly recommended in order to optimize students' mental health and their learning process alike.


Subject(s)
Anxiety/epidemiology , Depression/epidemiology , Learning Health System , Students, Health Occupations/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Jordan , Male , Pandemics , Qualitative Research , Surveys and Questionnaires , Universities , Young Adult
12.
BMC Public Health ; 21(1): 654, 2021 04 06.
Article in English | MEDLINE | ID: covidwho-1169959

ABSTRACT

BACKGROUND: The COVID-19 pandemic has prompted a lockdown in many countries to control the exponential spread of the SARS-CoV-2 virus, hereby reducing the time-varying basic reproduction number (Rt) to below one. Governments are looking for evidence to balance the demand of their citizens to ease some of the restriction, against the fear of a new peak in infections. In this study, we wanted to quantify the relative contribution of mobility restrictions, and that of behavioral changes that occurred already before the lockdowns, on the reduction of transmission during lockdowns in Western countries in early 2020. METHODS: Incidence data of cases and deaths from the first wave of infections for 35 Western countries (32 European, plus Israel, USA and Canada) were analyzed using epidemiological compartment models in a Bayesian framework. Mobility data was used to estimate the timing of changes associated with a lockdown, and was correlated with estimated reductions of Rt. RESULTS: Across all countries, the initial median estimate for Rt was 3.6 (95% IQR 2.4-5.2), and it was reduced to 0.78 (95% IQR 0.58-1.01) during lockdown. 48% (18-65%) of the reduction occurred already in the week before lockdown, with lockdown itself causing the remaining drop in transmission. A lower Rt during lockdown was independently associated with an increased time spent at home (0.21 per 10% more time, p < 0.007), and decreased mobility related to retail and recreation (0.07 per 10% less mobility, p < 0.008). CONCLUSIONS: In a Western population unaware of the risk, SARS-CoV-2 can be highly contagious with a reproduction number R0 > 5. Our results are consistent with evidence that recreational activities (including restaurant and bar visits) enable super-spreading events. Exiting from lockdown therefore requires continued physical distancing and tight control on this kind of activities.


Subject(s)
Commerce , Quarantine , Recreation , Bayes Theorem , /prevention & control , Canada/epidemiology , Commerce/statistics & numerical data , Europe/epidemiology , Humans , Israel/epidemiology , Quarantine/psychology , Recreation/psychology , United States/epidemiology
13.
Evid Based Nurs ; 24(2): 29-30, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1169880
14.
BMJ Open Qual ; 10(2)2021 04.
Article in English | MEDLINE | ID: covidwho-1169878

ABSTRACT

BACKGROUND: Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients' distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work. METHODS: The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed. RESULTS: The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff. CONCLUSIONS: This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.


Subject(s)
Feeding and Eating Disorders/psychology , Food Service, Hospital/standards , Meals/psychology , Quality Improvement , Adult , Anxiety/psychology , Behavior Observation Techniques , Feeding and Eating Disorders/therapy , Female , Humans , Inpatients/psychology , Male , Personnel, Hospital/psychology , Qualitative Research , Stress, Psychological/psychology
20.
MMWR Morb Mortal Wkly Rep ; 70(13): 473-477, 2021 Apr 02.
Article in English | MEDLINE | ID: covidwho-1168276

ABSTRACT

Incarcerated and detained persons are at increased risk for acquiring COVID-19. However, little is known about their willingness to receive a COVID-19 vaccination. During September-December 2020, residents in three prisons and 13 jails in four states were surveyed regarding their willingness to receive a COVID-19 vaccination and their reasons for COVID-19 vaccination hesitancy or refusal. Among 5,110 participants, 2,294 (44.9%) said they would receive a COVID-19 vaccination, 498 (9.8%) said they would hesitate to receive it, and 2,318 (45.4%) said they would refuse to receive it. Willingness to receive a COVID-19 vaccination was lowest among Black/African American (Black) (36.7%; 510 of 1,390) persons, participants aged 18-29 years (38.5%; 583 of 1,516), and those who lived in jails versus prisons (43.7%; 1,850 of 4,232). Common reasons reported for COVID-19 vaccine hesitancy were waiting for more information (54.8%) and efficacy or safety concerns (31.0%). The most common reason for COVID-19 vaccination refusal was distrust of health care, correctional, or government personnel or institutions (20.1%). Public health interventions to improve vaccine confidence and trust are needed to increase vaccination acceptance by incarcerated or detained persons.


Subject(s)
/administration & dosage , Patient Acceptance of Health Care/psychology , Prisoners/psychology , Vaccination/psychology , Adolescent , Adult , Aged , Aged, 80 and over , /prevention & control , Disease Outbreaks/prevention & control , Female , Humans , Male , Middle Aged , Prisoners/statistics & numerical data , Prisons , Socioeconomic Factors , Surveys and Questionnaires , United States/epidemiology , Young Adult
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