Social Connectedness and Perceived Stress Among Caregivers During the COVID-19 Pandemic: a Mixed-Methods Study.

BACKGROUND: The COVID-19 pandemic has created unprecedented stressors for caregivers due to social distancing requirements that simultaneously increased their responsibilities and reduced opportunities for social connection and support. This concurrent embedded mixed-methods study examined differences between caregivers and non-caregivers regarding the effects of social connectedness on perceived stress and explored challenges caregivers experienced related to social connectedness and perceived stress. METHOD: A national online survey containing forced-choice and free-response questions was administered between April and June 2020. The survey was distributed via social media advertisements and a crowdsourcing platform to eligible adult residents in the United States (US) fluent in either English or Spanish. Multivariable regression and thematic analysis were used to analyze the quantitative and qualitative data. Mixed-methods integration occurred during the data analysis, interpretation, and reporting phases. RESULTS: The study sample comprised 1540 US adults (1275 non-caregivers, 265 caregivers; 65% women; 36% racial/ethnic minorities). Relative to non-caregivers, caregivers had lower levels of social connectedness and higher levels of perceived stress. Social connectedness was also inversely related to perceived stress for non-caregivers (p < 0.001) and slightly but not significantly positively related to perceived stress for caregivers. Qualitative findings showed caregivers experienced a variety of stressors including fear of COVID-19 exposure to their care recipients, disruption to usual care routines, and difficulty accessing healthcare services that may have contributed to decrements in social connectedness and higher levels of perceived stress. CONCLUSION: Findings suggest social connectedness may be beneficial for reducing perceived stress, but its impact can vary depending on individual circumstances. Overall, findings support the idea that caregivers are a particularly vulnerable sub-group of the population and may benefit from more targeted support and interventions.

Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic.

This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The study sample comprised 1673 respondents (66% women). Overall, 46% reported high levels of anxiety, and women experienced significantly (p < 0.001) higher levels of anxiety than men. Women were significantly (p < 0.05) more likely to use acceptance, self-distraction, positive reframing, and emotional support than men. Significant interactions between gender and coping strategies were also identified. Women engaging in high (+1SD) vs. low (−1SD) levels of active coping were not found to have significantly different anxiety levels. In contrast, men reported higher levels of anxiety when they engaged in high levels of active coping and lower levels of anxiety when they engaged in low levels of active coping (b2 = 0.88, t = 3.33, p = 0.001). Additionally, women engaging in high levels of acceptance and positive reframing reported significantly lower anxiety levels than when engag-ing in low levels of acceptance (b1 = −1.03, t = −4.58, p < 0.001) and positive reframing (b1 = −0.72, t = −3.95, p < 0.001). No significant associations between acceptance and positive reframing levels and anxiety levels were found with men. Overall, these findings extend our understanding of the nature of gender differences in stress responsivity during periods of high psychological distress and can inform the development of mental health interventions to respond to the COVID-19 pandemic and future infectious disease outbreaks.

Balancing Work and Cancer Care: Challenges Faced by Employed Informal Caregivers.

Individuals with cancer commonly rely on their informal caregivers (e.g., spouse/partner, family member, close friend) to help them manage the demands of the disease and its treatment. Caregiving, including helping with patient care, performing household chores, and providing emotional and practical support, can be particularly demanding for employed caregivers, who must juggle their work responsibilities while providing care. Although a burgeoning literature describes the toll that balancing these oft-competing demands can exact, few resources exist to support employed cancer caregivers. To address this gap, we conducted a narrative review of the impacts of cancer on employed caregivers. We found that employed caregivers experience significant financial impacts in terms of lost time and income. They also experience a variety of work-related (e.g., reduced productivity, absenteeism) and mental health (e.g., stress, burden) impacts. Going forward, prospective studies are needed to characterize changes in caregiver support needs and preferences at different time points along the cancer care continuum (e.g., at diagnosis, during treatment, end-of-life) so that appropriate workplace accommodations can be provided. More population-based studies are also needed to develop models for identifying caregivers who are at increased risk for poor employment or mental health outcomes so that more targeted support programs can be developed. Ultimately, a multipronged effort on behalf of employers, healthcare, and community-based organizations may be needed to support and empower this vulnerable subgroup.

Risk and resilience in couple's adjustment to the COVID-19 pandemic.

The COVID-19 pandemic's global scope and resulting social distancing measures have caused unprecedented economic, lifestyle, and social impacts to personal and relationship well-being. While lockdowns have prompted individuals to increase reliance on intimate partners for support, stressful external contexts can also interfere with partners' capacity to request and provide support, resulting in relationship dissatisfaction and even dissolution. Guided by a risk and resilience framework, this study examined the impact of perceived stress, social contextual factors, and dyadic coping on self-reported relationship satisfaction changes during the initial United States COVID-19 lockdown period. Participants were adults in romantic relationships who completed an online survey between April 13 and June 8, 2020. Overall, survey respondents (N = 1106) reported higher perceived stress levels than established population norms, and small but significant decrements in relationship satisfaction. Multivariable models revealed that higher perceived stress levels were associated with lower relationship satisfaction levels. Additionally, dyadic coping was found to moderate the impact of perceived stress on relationship satisfaction (B = .05, 95% CI = .02- .07), suggesting that engaging in dyadic coping buffered individuals from adverse effects of perceived stress on their relationships. Findings emphasize heightened stress experienced by individuals during the pandemic, potential detrimental effects of stress on couple relationships, and suggest dyadic coping may help buffer couples from adverse effects of the pandemic on their relationships. As such, dyadic coping may be an important target for future interventions designed to assist couples during the ongoing pandemic and future pandemics/natural disasters.