Coronavirus Disease 2019 Anxiety Research Articles

Psychological status of residents at the onset of nationwide COVID-19 lockdown in low- and medium-risk areas of China.

The coronavirus disease 2019 (COVID-19), a dual threat to public physical and mental health, prompted an investigation into the psychological well-being of residents in low- to medium-risk areas of China during the initial stages of the pandemic. We administered WeChat-based questionnaire surveys and employed chi-square tests and multiple logistic regression to analyze correlations between residents' age, gender, education, symptoms, COVID-19 close contact history, information sources, and anxiety, depression, and attitudes toward lockdown measures. We received 10,433 valid questionnaires, revealing 26% anxiety and 19.5% depression. Support for lockdown measures reached 98.2%. Factors such as female gender, self-diagnosed pneumonia symptoms, close contact history, and higher education levels increased anxiety risk. Having a doctorate posed a severe anxiety risk, at 4.5 times (P = .019, 95% CI 1.29-15.73). Older age acted as a protective factor, reducing severe anxiety risk to 0.98 and 0.22 times (P < .001, 95% CI 0.14-0.34). Females with a master degree or below and those receiving COVID-19 information from multiple channels faced higher depression risk. Pneumonia symptoms were a risk for all anxiety and depression degrees. Attitudes toward lockdown measures had no significant impact on psychological status, nor did any of the analyzed factors affect residents' overall attitude toward lockdown. Our findings underscore the need for increased psychological counseling, particularly for young females with lower educational backgrounds or self-suspected infection symptoms, to mitigate mild to moderate anxiety and depression in future epidemics or pandemics. The public, especially those of working age with doctorates or higher education, bears the highest risk of severe anxiety. Lockdown measures enjoy strong support in low- to medium-risk areas of China.

Prevalence and associated factors of depression, anxiety and stress among clinical therapists in China in the context of early COVID-19 pandemic.

To study the socio-demographic characteristics and the prevalence of depression, anxiety, and stress among clinical therapists in China during the early Coronavirus disease 2019 (COVID-19) pandemic and to identify associated factors. This cross-sectional study was part of a multicenter, nationally representative survey conducted through WeChat from January 2021 to March 2021. Data, including socio-demographics, health-related behaviors, and information on whether they participated in the frontline work of treating COVID-19, were collected anonymously. Respondents also completed the Depression Anxiety Stress Scales-21 (DASS-21). In total, 396 clinical therapists in the selected hospitals completed the questionnaires, with a response rate of 89.0%. Respondents were predominantly female (77.3%). About 6.6% of the participants were current tobacco users, and 20.7% had participated in the frontline work of treating COVID-19. Overall, 22.0%, 17.9%, and 8.8% of participants were classified as having clinically meaningful depression, anxiety, and stress, respectively, based on DASS-21 scores. Multiple logistic regression in Model 1 and Model 2 showed that depression, anxiety, and stress were associated with regular physical activity and frequent insomnia (all, p < 0.05). In anxiety model 2, the associated factors for anxiety during the pandemic were identified as education (master's degree or more, OR=0.520; 95% CI=0.283-0.955), marital status (single, OR=2.064; 95% CI=1.022-4.168), tobacco use (OR=4.265; 95% CI=1.352-13.454), regular physical activity (OR=0.357; 95% CI=0.192-0.663), frequent insomnia (OR=6.298; 95% CI =2.522-15.729), and participation in the frontline work of treating COVID-19 (OR=3.179; 95% CI=1.697-5.954). The COVID-19 epidemic did not significantly increase the depression and stress levels among clinical therapists, but it did significantly increase anxiety levels. During the COVID-19 pandemic, depression, anxiety and stress were relatively common among clinical therapists in China. Regular physical activity and good sleep were important protective factors against emotional problems. Therefore, encouraging regular physical activity and actively addressing clinical therapists' sleep problems is beneficial to improving the ability to cope with negative emotions. The COVID-19 epidemic significantly increased anxiety, and awareness and interventions should be recommended to reduce anxiety among clinical therapists during the COVID-19 pandemic.

COVID-19 anxiety and uncertainty of classes: Devastating effect on students’ academic behavior and performance

Background The second wave of coronavirus disease 2019 (COVID-19) upsurged the level of anxiety among students and in addition to this, frequent closure of class, switching of teaching and learning to virtual added more agony to academic life. This study aimed to assess the impact of COVID-19 anxiety and uncertainty in class on academic performance moderated through academic behavior. Methods A structured questionnaire was developed to collect primary data and was distributed to 480 students using a systematic sampling technique. A structured equation model was developed and tested with a few hypotheses to answer the research objectives. A conceptual model was developed with the help of literature in order to understand causal relationship between study variables and tested with the help of the structured equation model. Results The study results showed that COVID-19 anxiety and uncertainty in classes negatively impacted students’ academic behaviour, which lead to students’ poor performance. The study identified that COVID-19 anxiety and uncertainty of class do not have a direct impact on academic performance; it only has an indirect negative impact on academic performance. Conclusions It can be concluded that uncertainty of classes during lockdown increased anxiety among students and it negatively impacted the academic behaviour of the students which lead to poor academic performance. The study helps the policymakers of the education sector to uplift the spirit of students in this pandemic situation and motivate the students to keep hope in their future careers; therefore, this study helps to fill that gap by contributing a working model.

The chain mediating roles of anxiety and depression in the relationship between the effects of the COVID-19 pandemic and procrastination in adolescents: a longitudinal study

BackgroundThe relationship between the Coronavirus Disease 2019 (COVID-19) pandemic, which is a traumatic event for adolescents, and procrastination is not clear. Mental health may play an important role in this relationship; however, the underlying mechanisms remain unknown. This study aimed to construct chain mediation models to examine whether anxiety and depression symptoms mediate the effects of the COVID-19 pandemic on procrastination in adolescents.MethodsA convenience sample of 12 middle and high schools in Harbin, China, with four follow-up online surveys was conducted during the COVID-19 pandemic. A total of 4,156 Chinese adolescents were enrolled in this study, of whom ages 11–18 (Mean = 13.55; SD = 1.18), 50.75% were male, and 93.24% were middle school students. Descriptive demographic analysis and Pearson’s correlation analysis of the effects of the COVID-19 pandemic (T1), anxiety(T2), depression (T3), and procrastination (T4) were performed in SPSS 22.0. Chain mediation analysis performed with Mplus 8.3.ResultsThe effects of the COVID-19 pandemic, anxiety symptoms, depression symptoms, and procrastination were positively correlated (P < 0.01). The effects of the COVID-19 pandemic have a direct link on adolescent procrastination (effect = 0.156; SE = 0.031; 95%CI: 0.092, 0.214), and have three indirect paths on procrastination: the independent mediating role of anxiety symptoms was 29.01% (effect = 0.047; SE = 0.012; 95%CI: 0.024, 0.072), the independent mediating role of depression symptoms was 29.01% (effect = 0.047; SE = 0.010; 95%CI: 0.030, 0.068), as well as the completely chain mediating role of anxiety and depression symptoms was 15.43% (effect = 0.025; SE = 0.005; 95%CI: 0.017, 0.036).ConclusionsOur results suggest that anxiety and depressive symptoms are part of a causal chain between the effects of the COVID-19 pandemic and procrastination among Chinese adolescents. To effectively reduce their procrastination, attention should be paid to the emotional distress caused to adolescents by major events such as the COVID-19 epidemic. All data were taken from self-reported measures and one city in China, which may bias the results and limit their generalizability.

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

BackgroundAlthough several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale—21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.ResultsThe results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).ConclusionIn conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

COVID-19 anxiety and uncertainty of classes: Devastating effect on students’ academic behavior and performance

Background: The second wave of coronavirus disease 2019 (COVID-19) upsurged the level of anxiety among students and in addition to this, frequent closure of class, switching of teaching and learning to virtual added more agony to academic life. This study aimed to assess the impact of COVID-19 anxiety and uncertainty in class on academic performance moderated through academic behavior. Methods: A structured questionnaire was developed to collect primary data and was distributed to 480 students using a systematic sampling technique. A structured equation model was developed and tested with a few hypotheses to answer the research objectives. A conceptual model was developed with the help of literature in order to understand causal relationship between study variables and tested with the help of the structured equation model. Results: The study results showed that COVID-19 anxiety and uncertainty in classes negatively impacted students’ academic behaviour, which lead to students’ poor performance. The study identified that COVID-19 anxiety and uncertainty of class do not have a direct impact on academic performance; it only has an indirect negative impact on academic performance. Conclusions: It can be concluded that uncertainty of classes during lockdown increased anxiety among students and it negatively impacted the academic behaviour of the students which lead to poor academic performance. The study helps the policymakers of the education sector to uplift the spirit of students in this pandemic situation and motivate the students to keep hope in their future careers; therefore, this study helps to fill that gap by contributing a working model

Validation study of the Korean version of the COVID-19 Anxiety Scale (CAS-7) and psychometric comparison of different rating scales

We aimed to explore the validity and reliability of the Korean version of the COVID-19 Anxiety Scale (CAS-7) among the general population and compare the psychometric properties of the CAS-7 with major rating scales for viral anxiety according to the generalized anxiety disorder-7 (GAD-7) during the coronavirus disease 2019 (COVID-19) pandemic. This anonymous online survey was conducted among the general population in South Korea during November 9–15, 2021, and 400 people participated. The survey form included demographic characteristics and rating scales, including the CAS-7, Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Coronavirus Anxiety Scale (CAS), Fear of COVID-19 scale (FCV-19S), and GAD-7. The single-factor structure of CAS-7 showed good fits for the model and convergent validity with other viral anxiety scales. When comparing psychometric properties, the CAS-7 and SAVE-6 scales were more sensitive than CAS, which was the most discriminating as well as the most difficult. CAS, FCV-19S, and GAD-7 provided more information and were more efficient than CAS-7 and SAVE-6. The Korean version of the CAS-7 is a valid and reliable rating scale for measuring viral anxiety. The viral anxiety rating scale can be applied depending on the objective of assessment in this pandemic.

The Effect of Fear of COVID-19 Infection and Anxiety on Loneliness: Moderated Mediation Effects of Gratitude.

This study was conducted to identify factors related to loneliness during the coronavirus disease-2019 (COVID-19) pandemic and focused on how the fear of COVID-19 infection affects loneliness and the conditional effect of gratitude as a moderator in the relationship among the fear of COVID-19, anxiety, and loneliness. For the analysis of this study, a survey was conducted among 1,500 individuals aged 19 to 69 years living in three metropolitan areas in South Korea. Questionnaires included sociodemographic data, psychological experience and stress associated with COVID-19, Generalized Anxiety Disorder Scale-7, UCLA Loneliness Scale-3, and Gratitude Questionnaire-6. An analysis was conducted by applying SPSS PROCESS macro models 4 and 7. First, anxiety mediated the relationship between the fear of COVID-19 infection and loneliness. Second, the effect of the fear of COVID-19 infection on loneliness through anxiety was moderated by gratitude. The higher the gratitude, the more the fear of COVID-19 infection is buffered in the path to anxiety, and the lower the indirect effect on loneliness. This suggests that in the context of the COVID-19 pandemic, interventions for psychological problems such as anxiety and loneliness can be carried out through gratitude, a significant protective variable.

Determinants of the mental health status of university students in Japan: comparison between pandemic and recession periods during the 7th wave of COVID-19.

Although the number of identified coronavirus disease 2019 (COVID-19) cases and deaths has decreased, the repetitive crest-trough pattern of the spread of COVID-19 has yet to cease. The current situation may affect the mental health status of university students who are distracted in their academic and daily lives by the pandemic. This cross-sectional study aimed to identify the determinant factors of the mental health status of Japanese university students before and in the middle of the 7th wave of the pandemic, one of the largest waves to be experienced in Japan. A survey was administered to two groups of students during the recession period between the 6th and 7th waves (n = 156) and during the 7th wave of the pandemic (n = 97). T-tests showed no statistically significant differences between the two groups in Perceived Stress Scale (PSS) scores, while the COVID-19 anxiety scores (p < 0.001) and General Health Questionnaire (GHQ) scores were significantly higher in the Pandemic period group (p = 0.011). The multiple regression model indicated that PSS scores were the only determinant of GHQ scores in the Pandemic period group. The results indicate that stressful life events, such as the COVID-19 pandemic and daily hassles, which are measured by the PSS, affect students' mental health differently. Therefore, the author submits that school counselors should provide counseling to students to reduce anxiety caused by daily hassles, during recession and pandemic periods. Students also require assistance with the reduction of stress and anxiety caused by daily hassles, regardless of the pandemic situation.

Illness anxiety: The missing point of the COVID-19 pandemic

Introduction: The coronavirus disease 2019 (COVID-19) epidemic was confirmed as global pandemic by the World Health Organization (WHO) by 11 March 2020. Materials and Methods: Data was collected from all the emergency medicine staff working in two referral main centers for COVID-19 affiliated to Tabriz University of Medical Sciences, Iran. The participants were enrolled in the study six months after the first COVID-19 hospitalization and the COVID-19 Anxiety Scale (CDAS) was used. Results: According to our results, while 46 (20.7%) participants had a moderate anxiety score, 26 (11.7%) had a severe anxiety score. Conclusion: The results of this study showed that emergency department staff are at risk of developing an Illness Anxiety Disorder (IAD). During the COVID-19 pandemic, more research should be done on these groups.

COVID-19 pandemic and burnout: factors associated with burnout levels among healthcare workers

Purpose: This study investigated the psychosocial and demographic factors influencing burnout levels among healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic.&#x0D; Materials and Methods: A cross-sectional and descriptive study was performed on a total of 418 healthcare workers from Cukurova University Faculty of Medicine, Balcalı Hospital in Turkey. While the participants were selected randomly, a personal information form consisting of 33 open- and close-ended questions, Coronavirus Anxiety Scale, the Maslach Burnout Scale and the Beck Burnout were applied.&#x0D; Results: They were 418 healthcare workers aged 19-63 (mean= 35.51±9.38), 284 of whom were 61.8% female, 132 (31.7%) of whom were male, and 2 (0.5%) of whom refused to specify their gender. The study found that emotional exhaustion and depersonalization scores were significantly positively correlated with COVID-19 anxiety scores and Beck anxiety scores in healthcare workers, while personal accomplishment scores were significantly negatively correlated with these variables. The study also revealed that COVID-19 anxiety, Beck anxiety, being female, being young, being unmarried, having children, being diagnosed with COVID-19, having a chronic illness, and working more hours per week were all contributing factors to burnout. &#x0D; Conclusion: Both during and after the COVID-19 pandemic, it is very important to provide various forms of psychological support and make arrangements to address factors that can impact the burnout of healthcare professionals.

Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic

ObjectivePatients with gynecological cancer commonly use complementary and alternative medicine (CAM) methods to cope with the disease. However, despite the existence of treatment strategies, the effect of fear and anxiety caused by coronavirus disease 2019 (COVID-19) pandemic on attitudes about CAM use is unclear. This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM. MethodsThis is a cross-sectional and descriptive study that included 177 women with gynecological cancer; participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021. Data were collected using an online survey that included the Personal Information Form, the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Attitude Towards Holistic Complementary and Alternative Medicine Scale. Descriptive statistics, t-test, Pearson’s correlation test, and simple linear and multiple regression analyses were performed to analyze the data. ResultsDuring the pandemic, 55.4% of the participants reported using CAM methods, but only 22.6% were using CAM before the pandemic. The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales (20.69 ± 5.37 and 13.09 ± 6.29, respectively) compared to the participants who did not use CAM (9.29 ± 2.72 and 6.35 ± 2.06, respectively). Fear of COVID-19 accounted for 52% of the CAM attitude score, while coronavirus anxiety accounted for 15% of the CAM attitude score. Fear of COVID-19 and coronavirus anxiety together accounted for 53% of CAM attitude. ConclusionGynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more. Given that the psychological effects of the pandemic will continue in the coming years, CAM use should be evaluated as a coping strategy, especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer. While the rational and effective CAM methods should be supported, strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments.Please cite this article as: Uslu-Sahan F, Yesilcınar I, Kurt G, Hancer E, Guvenc G. Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic. J Integr Med. 2023; 21(4): 377–384.

Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda.

Despite the known link between poor living conditions and mental health, there has been little research on the mental health of slum dwellers worldwide. Although the Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health issues, little focus has been given to the impact on slum dwellers. The study aimed to investigate the association between recent COVID-19 diagnosis and the risk of depression and anxiety symptoms among people living in an urban slum in Uganda. A cross-sectional study was conducted among 284 adults (at least 18 years of age) in a slum settlement in Kampala, Uganda between April and May 2022. We assessed depression symptoms and anxiety using validated Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder assessment tool (GAD-7) questionnaires respectively. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms. Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively and 11.3% were reportedly diagnosed with COVID-19 in the previous 30 days. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%) (p<0.001). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%) (p = 0.014). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR = 1.60, 95% CI 1.09-2.34) and anxiety (PR = 2.83, 95% CI 1.50-5.31). This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.

The effect of Covid-19 anxiety on prenatal distress and prenatal attachment in pregnant women

Objective: In this study, we aimed to investigate the effect of Coronavirus Disease 2019 (COVID-19) anxiety on pregnant women, whether it causes prenatal distress and may be changes on mother-infant attachment. Method: The research population consists of pregnant women in all trimesters. Exclusion criteria from the study; anomaly risk in the fetus, abnormal examination findings, systemic chronic disease and drug use, presence of diagnosed psychiatric disease, consanguineous marriage between the pregnant woman and her spouse. 323 pregnant women who did not meet these exclusion criteria and agreed to participate in the study were included in this study. In the study data form: Income status, education level, age, gravidity, parity, presence and number of miscarriages, gestational week, smoking status, history of COVID-19 infection, if yes, in which week of pregnancy she had, history of COVID-19 infection in her close family, planned pregnancy, in vitro fertilization-intrauterine insemination (IVF-IUI) or a spontaneous pregnancy status were questionnaired. The patients included in the study were administered the Coronavirus Anxiety Scale (CAS), Revised Prenatal Distress Questionnaire (NuPDQ), Prenatal Attachment Scale (PAS). Results: COVID-19 anxiety increases more if close relatives have coronavirus rather than participants themselves. We detected that high coronavirus anxiety also caused an increase in the sub-dimensions of prenatal distress. We also found that high COVID-19 anxiety negatively affects prenatal attachment. Conclusion: Pregnant women should be given information and education about the possible effects of coronavirus on their pregnancy during their routine follow-up during the pandemic period. Otherwise, both psychologically and physically unhealthy generations await the whole world.

Evaluation of the relationship between the geriatric anxiety and COVID-19 anxiety and fear levels in geriatric dental patients during the COVID-19 pandemic.

Illness, social isolation and loneliness may cause different psychological problems in the geriatric population, including depression and anxiety. Factors such as anxiety and fear can negatively affect dental treatment processes and prognoses. Thus, in terms of dental approach to geriatric individuals, it is important to be aware of the emotional processes the elderly may have experienced during the pandemic. This study aimed to determine the relationship between the geriatric anxiety levels and the coronavirus disease 2019 (COVID-19) anxiety and fear levels in the geriatric population. In this correlational study, 129 geriatric individuals were selected through the convenience sampling method. To gather the data, the Geriatric Anxiety Scale (GAS), the COVID-19 Anxiety Scale (CAS), the COVID-19 Fear Scale (CFS), and a questionnaire assessing demographic variables were used. Simple linear regression and Pearson's correlation coefficients were used to evaluate the relationships between the variables. The sample consisted of 70.5% males and 29.5% females aged ≥65 years. The GAS total score (15.64 ±9.34) and its 3 subscale scores were strongly correlated with the CAS and CFS scores. The GAS total score and its subscale scores had a significant linear regression with both the CAS and CFS scores (p < 0.001). An increase in the anxiety and fear levels associated with the pandemic was observed in geriatric individuals. Thus, it should be considered that geriatric individuals may encounter some difficulties during dental treatment and prosthetic rehabilitation after the pandemic. Therefore, it is important to normalize the anxiety levels with the help of professionals, and to implement interventions such as socialization, physical activity and meditation to help balance the anxiety levels.

COVID-19 anxiety and uncertainty of classes: Devastating effect on students’ academic behavior and performance

Background: The second wave of coronavirus disease 2019 (COVID-19) upsurged the level of anxiety among students and in addition to this, frequent closure of class, switching of teaching and learning to virtual added more agony to academic life. This study aimed to assess the impact of COVID-19 anxiety and uncertainty in class on academic performance moderated through academic behavior. Methods: A structured questionnaire was developed to collect primary data and was distributed to 480 students using a systematic sampling technique. A structured equation model was developed and tested with a few hypotheses to answer the research objectives. A conceptual model was developed with the help of literature in order to understand causal relationship between study variables and tested with the help of the structured equation model. Results: The study results showed that COVID-19 anxiety and uncertainty in classes negatively impacted students' academic behaviour, which lead to students' poor performance. The study identified that COVID-19 anxiety and uncertainty of class do not have a direct impact on academic performance; it only has an indirect negative impact on academic performance. Conclusions: It can be concluded that uncertainty of classes during lockdown increased anxiety among students and it negatively impacted the academic behaviour of the students which lead to poor academic performance. The study helps the policymakers of the education sector to uplift the spirit of students in this pandemic situation and motivate the students to keep hope in their future careers; therefore, this study helps to fill that gap by contributing a working model

The relationship between depression, anxiety, e-health literacy, and health-promoting behavior in nursing students during COVID-19.

The purpose of this study was to identify the correlation between depression, anxiety, e-health literacy (eHL), and health-promoting behaviors among nursing students during the coronavirus disease 2019 (COVID-19) pandemic, and to identify the factors affecting health-promoting behaviors. A cross-sectional study was conducted online, recruiting 301 nursing students recruited from 4 universities in the Chungcheng Province and Daejeon Metropolitan City in South Korea between May 28 and June 30, 2021. Data were analyzed using SPSS WIN 27.0. The general characteristics of the study participants were analyzed by frequency and percentage, and the degree of depression, anxiety, eHL, and health-promoting behaviors were calculated as averages and standard deviations. Differences in health-promoting behaviors according to general characteristics were analyzed using independent t tests and analysis of variance, and a post hoc Scheffe test was conducted. Correlations between depression, anxiety, eHL, and health-promoting behaviors were measured using Pearson correlation matrices. Stepwise multiple regression was performed to identify factors affecting health-promoting behaviors. During the COVID-19 pandemic, the average level of depression and anxiety was reported to be 3.93 (4.71) and 3.40 (4.30), respectively; 33.2% of nursing students experienced more than mild depression and 29.2% experienced anxiety. The average eHL level was 3.91 (0.56), and the average of health-promoting behaviors was 2.43 (0.45). Depression was positively correlated with anxiety (R = 0.734, P < .001) and negatively correlated with health-promoting behaviors (r = -0.198, P = .001), whereas eHL had a positive correlation with health-promoting behaviors (R = 0.347, P < .001). The factors affecting health-promoting behaviors were religion (β = -0.160, standard error [SE] = 0.048), current health status (β = -0.097, SE = 0.032), frequency of searching the Internet for health-related information in a week (β = -0.070, SE = 0.026), interest in health (β = -0.191, SE = 0.039), and critical eHL (β = 0.243, SE = 0.040); the explanatory power was 27.4%. Results demonstrate that during the COVID-19 pandemic, higher depression and anxiety among nursing students decreased health-promoting behaviors, while higher eHL increased health-promoting behaviors, and eHL was a major factor affecting health-promoting behaviors. These results contribute to the provision of basic data for the development of nursing intervention programs and educational strategies that can establish correct health-promoting behaviors by managing depression and anxiety among nursing students and improving eHL.

Psychological Impacts of Returning Home During the COVID-19 Pandemic: A Cross-Sectional Survey Among Iranian Students

Background: In addition to its potentially harmful physical consequences, coronavirus disease 2019 (COVID-19) can cause various negative psychological consequences for individuals. One cohort likely to have been affected is university students who have had to return and study from their home cities due to the physical closures of universities. Objectives: The present study was conducted on students to assess psychological impacts (i.e., anxiety, depression, and stress) in predicting COVID-19 anxiety resulting from returning home and quarantining due to university closure. Materials and Methods: The study sample comprised 715 Iranian students who were asked to complete the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Corona Disease Anxiety Scale. Results: The mean scale scores for COVID-19 anxiety, stress, depression, and anxiety were 13.75 (out of 54), 6.68 (out of 21), 5.54 (out of 21), and 4.74 (out of 21), respectively. Significantly higher levels of COVID-19 anxiety were observed among students who had been infected with the virus or had family/friends infected with the virus (compared to individuals who had not). Moreover, students who lived with their friends reported significantly higher COVID-19 anxiety than those who lived with their families. Conclusions: The study showed a positive association between psychological distress and COVID-19 anxiety among students who returned to their homes during the pandemic. The findings suggest that mental health interventions are needed for students and should be implemented in the early stages of future pandemics.

Frequency of fibromyalgia syndrome and anxiety post-corona virus disease-2019 (COVID-19) in patients attending the rheumatology clinic

Aim of the workTo screen for the new development of fibromyalgia syndrome (FMS) and anxiety in rheumatic diseases (RDs) patients and control who recovered from coronavirus disease 2019 (COVID-19). Patients and methodsThe study included 200 RDs patients and 100 matched controls with no previous history of FMS and who recovered from COVID-19. The patients’ RDs included rheumatoid arthritis (RA) (n = 50), systemic lupus erythematosus (SLE) (n = 50), juvenile idiopathic arthritis (JIA) (n = 40) and spondyloarthritis (SpA) (n = 60). The fibromyalgia symptom scale (FS), fibromyalgia impact questionnaire (FIQ) and Hamilton Anxiety rating scale were assessed. ResultsThe mean age of patients was 35.9 ± 8.5 years with female: male 2.6:1. Fibromyalgia and anxiety were significantly higher in cases than control (22.5 % vs 12 % and 27 % vs16 %, p = 0.002, p = 0.03 respectively). Hypertension, obesity, anxiety, severe COVID-19, frequency of SLE and SpA were significantly higher in patients with FMS compared to those without (31.1 % vs 11.6 %, 68.9 % vs 21.9 %, 84.4 % vs 10.3 %, 48.9 % vs 16.8 %, 31.1 % vs 23.2 % and 40 % vs 27.1; p = 0.002, p < 0.001, p < 0.001, p < 0.001, p = 0.014, p = 0.004 respectively).Severity of COVID-19, diabetes and anxiety were significant predictors of FMS(β = 1.1, p = 0.007; β = 3.03, p = 0.001 and β = 4.44, p < 0.001 respectively). Fibromyalgia increases with increase anxiety grade; the percentage of fibromyalgia was 4.7 %, 50 %, 90 % and 100 % among patients with no anxiety, mild, moderate, and severe anxiety respectively (p < 0.001). ConclusionFibromyalgia is common in RDs patients post-COVID-19. Diabetes, COVID-19 infection severity and anxiety predict the risk of developing post-COVID-19 fibromyalgia. Post-COVID-19 fibromyalgia occurred more in hypertensive, obese, anxious and patients with severe COVID infection.

Motivation for solitude, COVID-19-related anxiety and resilience among Indian medical students.

Recent reports indicate that self-isolation because of coronavirus disease 2019 (COVID-19)-related lockdowns had significant influence on mental health of medical students. To understand the relationship between two different motivations for solitude - self-determined versus non-self-determined with medical students' COVID-19-related anxiety and psychological resilience during their self-isolation because of COVID-19-related lockdowns. After the approval of the Institutional Ethics Committee, this online survey was done on undergraduate Indian medical students during the COVID-19 pandemic. Expressing consent at the beginning of the online form, enabled the students to proceed to the next section comprising their sociodemographic details and clinical details. The last section of the form comprised the Motivation for Solitude Scale-Short Form, the COVID-19 Anxiety Scale, and the Connor-Davidson Resilience Scale-Abbreviated. 282 out of 286 students of either sex gave their consent and completed the given form. Both self-determined and non-self-determined motivations for solitude were higher in female medical students. The self-determined motivation for solitude was directly related to all students' resilience. A past history of psychiatric illness was directly associated with the non-self-determined motivation for solitude of the students. The non-self-directed motivation for solitude of female students was indirectly related to their resilience. The COVID-19-related anxiety was not related to either type of motivation for solitude as well as the resilience of the medical students. Indian female medical students are more motivated for solitude, be it self-determined or non-self-determined, than their male counterparts. The student's resilience has a direct relationship with students' self-determined motivation. The COVID-19-related anxiety among the medical students is not related to their motivations for solitude or resilience.