Coping, Symptoms, and Insomnia among People with Heart Failure during the Covid-19 Pandemic.

AIM: Increases in stress, symptoms of anxiety and depression and sleep problems have been reported during the Covid-19 pandemic, and people with chronic medical conditions such as heart failure (HF) are especially vulnerable. The purpose of this study was to examine the extent to which sleep characteristics, sleep-related cognitions, anxiety, depression, perceived stress, and changes in these phenomena over time predict ways of coping with pandemic-related stress among participants in the HeartSleep study, a randomized controlled trial of the effects of cognitive behavioral therapy for insomnia (CBT-I) in people with HF. METHODS: Participants completed questionnaires to elicit sleep characteristics, daytime symptoms, mood and stress at baseline, six-months after the intervention and during the Covid-19 pandemic. We added measures of coping during the pandemic (June-August 2020). RESULTS: The sample included 112 participants (M age = 63 ± 12.9 years; 47% women; 13% Black; 68% NY Heart Class II or III). Participants (43%) reported pandemic-related stressors and most often used secondary control coping. Insomnia severity, anxiety, depression, perceived stress, and sleep-related cognitions predicted secondary control coping (positive thinking, cognitive restructuring, acceptance, distraction), involuntary engagement (physiological arousal, rumination) and involuntary disengagement (emotional numbing). CONCLUSIONS: Insomnia and mood disturbance are important determinants of coping and responses to stress. Improving sleep and symptoms among people with HF may improve coping during stressful events, and CBT-I may have protective effects.

Sleep, Stress, and Symptoms Among People With Heart Failure During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic raised concerns about the effects of stress on sleep and mental health, particularly among people with chronic conditions, including people with heart failure (HF). OBJECTIVE: The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with HF who participated in a randomized controlled trial of cognitive behavioral therapy for insomnia before the COVID-19 pandemic. METHODS: Participants self-reported sleep characteristics, symptoms, mood, and stress at baseline, 6 months after cognitive behavioral therapy for insomnia or HF self-management education (attention control), and during the pandemic. RESULTS: The sample included 112 participants (mean age, 63 ± 12.9 years; 47% women; 13% Black; 68% New York Heart Association class II or III). Statistically significant improvements in sleep, stress, mood, and symptoms that occurred 6 months post treatment were sustained during the pandemic. CONCLUSIONS: Improving sleep and symptoms among people with HF may improve coping during stressful events, and cognitive behavioral therapy for insomnia may be protective.

Facilitating the Urgent Public Health Need to Improve Data Sharing With Tribal Epidemiology Centers.

Tribal epidemiology centers (TECs) are an essential and unique part of the public health system and an important part of federal efforts to improve the health status of American Indian and Alaska Native people. Pursuant to federal statute, TECs serve the 574 federally recognized tribes (hereinafter, "tribes") and their members across the United States, as well as American Indian and Alaska Native people in general. The COVID-19 pandemic has highlighted the need for timely, complete, and accurate public health data, particularly for American Indian and Alaska Native communities and others who may have been disproportionately impacted by COVID-19. This article reviews the history and importance of TECs and federal statutes governing TECs' ability to access and use protected health information for public health purposes. TECs and tribes often encounter difficulty receiving public health data from state and federal agencies despite their designation as "public health authorities" under the Health Insurance Portability and Accountability Act and associated regulations. Limited access to this information hinders the statutory mission of TECs as well as tribal monitoring of and response to public health threats such as SARS-CoV-2. Agency acknowledgment and compliance with current federal law regarding data sharing with TECs are essential to improve data access and the fragile public health of tribal communities.

Stressors, concerns, and mental health in the early pandemic in South Dakota

This study presents data on psychological functioning, stress, concerns, and attitudes related to Coronovirus disease (COVID-19) during the early phases of the pandemic in a rural Midwestern state. From March 24 to April 14, 2020, South Dakota residents (n = 4,761) reported on their psychological symptoms, pandemic-related stressful experiences, top concerns regarding the pandemic, attitudes toward COVID-19, and social distancing behaviors. Most participants were engaging in at least some social distancing and indicated at least moderate concern about COVID-19. Across age groups, getting sick from the coronavirus was the most frequently endorsed concern. Younger adults endorsed concerns about not being able to work, whereas older adults endorsed concerns about accessing medical care. Greater mental health problems were found for younger adults, racial minorities, and women. Anxiety was prominent among participants concerned about getting sick, whereas both anxiety and depression were relevant for participants with employment concerns. Concerns about health and employment (as well as other concerns) each predicted mental health functioning, even when controlling for other relevant variables. These data provide insight into the specific challenges experienced in a rural state during the early phase of the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement This study provides information about stress, attitudes, top concerns, and mental health functioning of adults during the early phase of the pandemic in South Dakota. Mental health symptoms are related to pandemic-related concerns. (PsycInfo Database Record (c) 2021 APA, all rights reserved)