COVID-19 Stress Research Articles

COVID-19 stressors for Hispanic/Latino patients living with type 2 diabetes: a qualitative study.

During the early stages of the COVID-19 pandemic, nationwide lockdowns caused disruption in the diets, physical activities, and lifestyles of patients with type 2 diabetes. Previous reports on the possible association between race/ethnicity, COVID-19, and mortality have shown that Hispanic/Latino patients with type 2 diabetes who are socioeconomically disadvantaged are disproportionately affected by this novel virus. The aim of this study was to explore stressors associated with changes in diabetes self-management behaviors. Our goal was to highlight the health disparities in these vulnerable racial/ethnic minority communities and underscore the need for effective interventions. Participants were enrolled in part of a larger randomized controlled trial to compare diabetes telehealth management (DTM) with comprehensive outpatient management (COM) in terms of critical patient-centered outcomes among Hispanic/Latino patients with type 2 diabetes. We conducted a thematic analysis using patient notes collected from two research nurses between March 2020 and March 2021. Two authors read through the transcripts independently to identify overarching themes. Once the themes had been identified, both authors convened to compare themes and ensure that similar themes were identified within the transcripts. Any discrepancies were discussed by the larger study team until a consensus was reached. Six themes emerged, each of which can be categorized as either a source or an outcome of stress. Sources of stress associated with the COVID-19 pandemic were (1) fear of contracting COVID-19, (2) disruptions from lockdowns, and (3) financial stressors (e.g., loss of income). Outcomes of COVID-19 stressors were (1) reduced diabetes management (e.g., reduced diabetes monitoring and physical activity), (2) suboptimal mental health outcomes (e.g., anxiety and depression), and (3) outcomes of financial stressors. The findings indicated that underserved Hispanic/Latino patients with type 2 diabetes encountered a number of stressors that led to the deterioration of diabetes self-management behaviors during the pandemic.

COVID-19 related risk factors and their association with non-syndromic orofacial clefts in five Arab countries: a case-control study

BackgroundThe environmental etiology of non-syndromic orofacial clefts (NSOFCs) is still under research. The aim of this case-control study is to assess COVID-19 associated factors that may be related to the risk of NSOFC in five Arab countries. These factors include COVID-19 infection, COVID-19 symptoms, family member or friends infected with COVID-19, stress, smoking, socioeconomic status and fear of COVID-19.MethodsThe study took place in governmental hospitals in five Arab countries from November 2020 to November 2021. Controls are matched in the month of delivery and site of recruitment. A clinical examination was carried out using LASHAL classification. Maternal exposure to medication, illnesses, supplementation, COVID-19 infection during their pregestation and 1st trimester periods were evaluated using a validated questionnaire. Maternal exposure to stress was assessed using the Life Events scale, fear of covid-19 scale, family member or friend affected with covid-19 infection, pregnancy planning and threatened abortion.ResultsThe study recruited 1135 infants (386 NSOFC and 749 controls). Living in urban areas, maternal exposure to medications 3-months pregestation, maternal exposure to any of the prenatal life events and maternal fear of COVID-19 significantly increased the risk of having a child with NSOFC. On the other hand, mothers exposed to supplementation 3-months pregestation, mothers suspected of having COVID-19 infection, family members or friends testing positive with COVID-19 significantly decreased the risk of having a child with NSOFC.ConclusionsThis study suggests that NSOFC may be associated with maternal exposure to lifetime stress and COVID-19 fear in particular, with no direct effect of the COVID-19 infection itself. This highlights the importance of providing psychological support for expecting mothers during stressful events that affect populations such as the COVID-19 pandemic, in addition to the usual antenatal care.

A U.S. National Study of Family Resilience During the COVID-19 Pandemic.

The COVID-19 pandemic has significantly disrupted the lives of children and their caregivers. Recent research has examined the impact of the pandemic on child and caregiver functioning but there is a paucity of work examining the impact of the pandemic on the broader family system. The current study examined family resilience during the COVID-19 pandemic across three aims: Aim 1 tested whether meaning, control, and emotion systems form a unitary family adaption factor, Aim 2 evaluated a concurrent model of family resilience, and Aim 3 examined whether parent gender and vaccination status moderated paths in the final model. A nationally representative sample of U.S. parents (N = 796; 51.8% fathers, M age = 38.87 years, 60.3% Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021, including measures of COVID-19 family risk and protective factors, pre-existing family health vulnerabilities, race, COVID-19 stressors, and family adaptation. Confirmatory Factor Analysis demonstrated that the meaning (i.e., family making meaning of COVID-19), control (i.e., stability in routines), and emotional (i.e., family support) facets of family adaptation are unique but related. A path model revealed that there were concurrent effects from COVID-19 exposure, pre-existing vulnerabilities, and racial diversity status to the family protective, vulnerability, and adaptation variables. Additionally, parent COVID-19 vaccination status altered the association between pre-existing family health vulnerabilities and the family protective factor. Overall, results underscore the importance of examining pre-existing and concurrent risk and protective factors for family resilience during a stressful, global, and far-reaching event.

Examining pandemic stress and mental health among a community-based sample of sexual minority women in Los Angeles County

ABSTRACT In partnership with community stakeholders, the present study aimed to gather descriptive data on pandemic-related stress and its association with mental health outcomes among a community sample of self-identified sexual minority women (SMW) in Los Angeles County (N = 84; Mage = 35.61). The sample was comprised solely of women (i.e. self-identified gender identity as woman, including cisgender and transgender women). Data were collected in April 2021, the ‘third wave’ of the COVID-19 global pandemic. Los Angeles experienced some of the highest COVID-19 incidence rates in the United States. Yet, there was a significant lack of COVID-19 data on SMW, thus making it difficult to address the specific needs of this community. Background data were collected on pre-existing health conditions and COVID-19 infection history. Data were specific to COVID-19 stressors in the areas of mental health, financial strain, social isolation and health and discrimination concerns. Findings revealed that mental health concern was strongly associated with financial strain (r = .63, p < .01), social isolation (r = .62, p < .01) and health and discrimination concerns (r = .63, p < .01), thus demonstrating the wide-ranging negative impact of pandemic stressors on the mental health of SMW in Los Angeles during the third wave of COVID-19. Recommendations for future research, practice and policy implications are discussed.

Longitudinal Associations Between COVID-19 Stress and the Mental Health of Children With ADHD

Objective: To investigate the longitudinal associations between COVID-19 induced stress (related to COVID-19 restrictions/changes), attention-deficit/hyperactivity disorder (ADHD) symptoms, oppositional symptoms, and mental health outcomes (negative affect, anxiety, depression, and irritability) in children with ADHD during the COVID-19 pandemic. Method: Parents of 140 Australian children with ADHD (aged 5–17 years) completed an online survey in May 2020 during stay-at-home restrictions and 12-months later. Results: Baseline COVID-19 stress was associated with increased total ADHD symptom severity (β = .21, p = .007) and hyperactivity/impulsivity symptoms (β = .23, p = .002) at 12-months, after accounting for covariates (i.e., child age, gender, ADHD medication, socio-economic status, and baseline symptoms). Despite some indication of associations between baseline COVID-19 stress and 12-month oppositional symptoms and negative affect, these were attenuated when adjusting for baseline symptoms. Conclusions: The study provides initial evidence of the medium-term impacts of pandemic-related stress for children with ADHD.

Quality of Life During the First Three Waves of the COVID-19 Pandemic and Two Earthquakes in Croatia.

In a cross-sectional study, we measured the impact of the first three COVID-19 pandemic waves and two earthquakes, occurring during the same period in Croatia, on the quality of life (QoL) of the general adult population. An online survey consisting of sociodemographic questions, questions related to COVID-19 and earthquake stressors, the World Health Organization Quality of Life (WHOQoL)-BREF scale, Impact of Event Scale, and Patient Health Questionnaire 4 was completed by 220 men and 898 women (mean age, 35.1 ± 12.3 years). In a series of regressions, we examined the association among five blocks of predictors and six dependent QoL variables, four domain scores, and two global scores. Both WHOQoL-BREF global and domain scores after the prolonged stress were significantly predicted by anxiety, depression, stress symptoms, and sociodemographic characteristics. COVID-19-related stressors predicted significantly physical and psychological health, social relationships, and environmental QoL, whereas earthquake-related stressors predicted health satisfaction, physical and psychological health, and environmental QoL.

Anxiety and social media use: a moderator of stress in the COVID-19.

As concern for students' psychological well-being is shared by all segments of the culture, many scholars have conducted research on this issue in early years. The problem with these studies was that people's mental health was affected by their use of social media during a very bad epidemic. However, nowadays, the association between the use of social media and well-being needs to be further explained in the context of persistent disease outbreaks over time. This paper examines COVID-19-related anxiety and social media use. SMU, COVID-19 stressors, anxiety, and variables were obtained from Chinese college students using an online questionnaire (e.g., health history, online media use, etc.). According to regression analyses, participants who spent more time using social media were more anxious in COVID-19-related content, while participants with more related stressors experienced less anxiety. The purpose of this study was to determine whether COVID-19 stressors moderated the association between social media use and mental health conditions such as anxiety in an epidemic setting in China. Study findings revealed that students with more COVID-19 stressors experiencing less anxiety when using social media, but COVID-19 stressors were no longer a risk factor.

Generalized stress and sleep hygiene explain the relationship between sexual/gender identity and sleep quality

Introduction Typically, LGBTQ + people sleep more poorly than their cisgender heterosexual (cishet) counterparts. However, there is a lack of literature investigating the impact of different lifestyle/psychosocial factors, outside of minority stress, on the negative relationship between being a sexual/gender identity minority and sleep quality. The current study aims to help fill critical gaps in the literature by looking at the effects generalized stress, COVID-19-related stress, social support, and sleep hygiene have on this relationship. Methods Two hundred and seventy-three participants (74 LGBTQ+; 199 cishet), recruited online, completed a series of questionnaires assessing sleep quality, sleep hygiene, generalized stress, minority stress, COVID-19-related stress, and social support. Results Analyses showed that LGBTQ + participants reported worse sleep quality, higher levels of generalized stress and COVID-19 stress, and smaller social networks than their cishet peers. Generalized stress fully mediated the relationship between sexual/gender identity and sleep while sleep hygiene partially mediated the relationship between generalized stress and sleep quality. Social support and COVID-19-related stress did not moderate the relationship between generalized stress and sleep. Conclusion Worse sleep quality in LGBTQ + than cishet adults is explained by differences in generalized stress and sleep hygiene. Stress management and sleep hygiene interventions may help prevent the negative associations between being LGBTQ + and poor sleep quality.

Influence of the Psychological Effect of COVID-19 on Saudi Student Nurses' Attitudes toward Nursing and Their Future Career Plans.

The effects of COVID-19 on the attitude of student nurses toward the nursing profession remain unclear because few studies have been conducted on this topic. Thus, this study examines the influence of the psychological effects of COVID-19 on student nurses' attitudes toward the nursing profession and their desire to become nurses. The study utilised a quantitative, cross-sectional, and observational design. It surveyed a convenience sample of 726 student nurses in Saudi Arabia during the first semester of the 2021-2022 academic year. The students reported low levels of COVID-19 fear, anxiety, stress, phobia, and obsession. The students reported positive attitudes toward the nursing profession and 86.0% highlighted their desire to continue with nursing as their future profession. Gender, knowing someone infected with COVID-19, confidence in the government's pandemic response, fear, anxiety, and phobia were significant predictors of the nurses' attitudes. Community, family members in the profession, "COVID-19-related anxiety", and "preference for the nursing profession" were significant predictors of the student's desire to continue nursing. Living in a rural community, having family members in the nursing profession, having low levels of COVID-19-related anxiety, and having positive attitudes toward nursing increased the likelihood of nursing students continuing their nursing careers during the COVID-19 pandemic.

Depression and anxiety in peruvian military personnel during the pandemic context: a cross-sectional study

BackgroundDuring the COVID-19 pandemic, increased workload and stress could have increased mental health problems (anxiety and depression) in military personnel. However, the number of studies in military members is scarce, especially in regard to mental health. The objective of this study was determine the prevalence and factors associated with depression and anxiety in Peruvian military personnel.MethodsWe undertook an analytical cross-sectional study. The survey was distributed face to face between November 02 and 09, 2021, during the second wave of the COVID-19 pandemic among the military personnel. We used some instruments to measure depression (Patient Health Questionnaire, PHQ-9), anxiety (Generalized Anxiety Disorder, GAD-7), insomnia (Insomnia Severity Index, ISI), food insecurity (Household Food Insecurity Access Scale, HFIAS), physical activity (International Physical Activity Questionnaires, IPAQ-S), resilience (abbreviated CD-RISC), and fear of COVID-19 scale. The exclusion criteria included those who did not completely fill out the evaluation instruments.ResultsWe analyzed the data of 615 military personnel that participated in the survey. Of them, 93.7% were male and the median age was 22 years old. There was a prevalence of 29.9% and 22.0% in regard to depression and anxiety symptoms, respectively. In addition, it was found that being married (PR: 0.63; 95% IC: 0.42–0.94), having a relative with mental health problems (PR: 2.16), having experienced food insecurity (PR: 1.48), insomnia (PR: 2.71), fear of COVID-19 (PR: 1.48), and a high level of resilience (PR: 0.65) were factors associated with depression. In regard to anxiety, the factors associated were working for more than 18 months since the beginning of the COVID-19 pandemic (PR: 0.52), a high level of resilience (PR: 0.50; 95% IC: 0.33–0.77), insomnia (PR: 3.32), fear of COVID-19 (PR: 2.43).ConclusionWe found a prevalence of symptoms of depression and anxiety of 29.9% and 22.0%, respectively. In regard to the factors that attenuate depression, we can mention being married and having resilience; and among the aggravating factors, having a relative with mental health problems, food insecurity, insomnia, and fear of COVID-19. Finally, anxiety increased through working time, insomnia, and fear of COVID-19.

Awe Correlates With Resilience to COVID-19 Stressors Independent of Religiosity

Awe is an emotion defined by an experience of vastness and cognitive accommodation that is unique among other positive emotions in that its cognitive effects are more similar to those of negative emotions. The current study posits that because of its unique cognitive effects, awe may related to resilience to stressors introduced by the COVID-19 pandemic. It was hypothesized that awe would significantly correlate with resilience to COVID-19 even when controlling for religiosity. Religiosity was included in the analyses because of strong support in previous research connecting it to both awe and resilience. Regression analyses revealed that awe and religiosity were both significant correlates of resilience but when placed in the same model, the relationship between religiosity and resilience disappeared. An exploratory mediation analysis was conducted to further explore this result. Implications for understanding resilience in the face of COVID-19 and directions for future research are discussed.

Mental health during the COVID-19 pandemic: Stress and strain profiles in the German population.

Clinical observations indicate that people frequently display stress-related behavior during the COVID-19 pandemic. Although numerous studies have been published concerning pandemic-related psychological distress, systematic data on the interrelationships between stress sensitivity, personality, and behavioral characteristics of people are still lacking. In the present cross-sectional online survey study, we applied a German version of the COVID Stress Scales (CSS) and standard psychological questionnaires to systematically identify the complex interplay between stress sensitivity, gender, and personality in the modulation of quality of life and mental health in the German population (N = 1774; age ≥ 16 years). A CSS-based cluster analysis revealed two clusters characterized by higher and lower stress levels. Study participants in each cluster differed significantly with respect to neuroticism, extraversion, agreeableness, quality of life, depression, and anxiety. Females were significantly overrepresented in the higher stress cluster, while there was an overrepresentation of males in the lower stress cluster. Neuroticism was identified as a risk factor and extraversion as a protective factor for enhanced pandemic-related stress responses. For the first time our data show a taxonomy of factors, which modulate pandemic-related stress sensitivity and warrant consideration as key indicators of quality of life and psychological distress during the COVID-19 pandemic. We suggest that our data may advise governmental regulation of pandemic-related public health measures, to optimize quality of life and psychological health in different groups of the population.

Social isolation, psychological distress and resilience of Chinese college students during COVID-19 pandemic

ABSTRACT It has been 3 years since the first appearance of COVID-19 in China. During this time, social isolation was widely used as an important method to fight it. However, this measure had many negative effects on the mental health of college students. To better understand this issue, this study aims to explore the impact of social isolation and COVID-19-related stress on psychological distress among Chinese college students. Additionally, resilience has been evaluated as a key component of stress resistance in this situation. Coronavirus Stress Measure (CSM), the Connor-Davidson Resilience Scale (CD-RISC) and the Brief Symptom Inventory (BSI) were used in this study. A total of 388 Chinese college students participated in the survey via the Internet. Two groups (isolated group vs. non-isolated group) were divided according to whether they have been isolated from their classmates and families. Data analysis adopts t-test, F test and mediate effect analysis by SPSS21.0. (1) All factors, except resilience, were found to have lower scores in the isolated group; (2) significant correlations were found between all factors; (3) resilience partially mitigated the impact of COVID-19 stress on psychological symptoms. Social isolation has been found to be a significant factor contributing to negative psychological distress in Chinese college students. The COVID-19-related stress may increase the likelihood of psychological suffering among isolated group. Resilience can help reduce the negative effects of COVID-19 stress on college students. Therefore, providing appropriate psychological support tailored to different isolation situations is crucial.

Santé mentale des médecins libéraux français pendant la deuxième vague de COVID 19

IntroductionThe 2019 coronavirus (COVID-19) pandemic has caused a public health crisis worldwide. Concerns have been expressed about the rapid deterioration of mental health among primary care physicians among whom burnout already had a high prevalence prior to the pandemic. However, there is little data on private doctors during the pandemic. France experienced a second wave with a second lockdown. We aimed to assess and compare physicians’ burnout, anxiety and depression symptoms and insomnia between general practitioners (GP) and all other private specialists during the second Covid-19 wave. MethodsWe conducted an online survey of private practitioners registered on Doctolib® (n=32,655), the interface software most used by private practitioners for booking medical appointments in France. Doctors were invited by email to complete an online survey in November 2020. Inclusions were closed on 1st December. The 2nd lockdown lasted from 30th October to 15th December 2020. We used the Copenhagen Burnout Inventory (CBI) to assess burnout syndrome. A mean score of>50 in at least one subscale defined burnout. The Hospital Anxiety and Depression Scale assessed anxiety and depression symptoms. We used two cut-offs, 8 (>7) and 11 (>10), as both are validated in the ability to find cases. The Insomnia Severity Index (ISI) measures sleep-related complaints among physicians (cut-off >7). To link variations in the psychological scales to the COVID-19 pandemic, one of the items asked explicitly whether participants considered that “the COVID-19 epidemic we are currently experiencing is a source of excess stress, psychological suffering or burnout”. Approval for this study was obtained from the local institutional review board of the University of Paris-Saclay, France. The questionnaires were collected anonymously. Statistical significance was tested using the chi-square test and student's t-test to compare the prevalence between GPs and other specialities. Subsequently, logistic regression models were run for statistically significant associations. Results1992 physicians replied, a response rate of 12.8% of those who received the invitation email. Among them, 79.4% suffered from psychological distress (symptoms of anxiety or depression or burnout), of which 71.3% suffered from burnout, 26.7% from depressive symptoms, 58.9% from anxiety symptoms and 45.8% from insomnia. There was no difference in gender between GPs and specialists, but there was an age difference (P<0.001). GPs had a higher prevalence of burnout (OR=1.33 CI95 [1.09;1.63]) and took more psychotropic drugs (1.38 CI95 [1.05;1.81]). They were also more likely to perceive their stress as work-related (OR=1.50 CI95 [1.23;1.81]) or COVID-19-related (OR=1.43 CI95 [1.16;1.77]). ConclusionOur study is the first to assess the mental health of private practitioners in the second wave in association with COVID-19 stress. Firstly, GPs who provide primary care have a significantly higher burnout rate than other doctors. Secondly, COVID-19 stress is associated with more significant psychological distress. Thirdly, almost 80% of the private doctors surveyed suffer from psychological pain, and 71% suffer from burnout. This study has strengths and limitations. Firstly, this study assesses mental health and stress related to its COVID-19 association. Second, this is the largest population of private physicians during the COVID-19 pandemic. The low response rate is the main limit of this study. The alarming rates of psychological distress among private doctors and, in particular, GPs should lead to intervention to help doctors reduce stress, burnout and other mental disorders. This study gives a picture of the situation during the second wave and the lock-in, and we need to be cautious with the next waves.

Covid-19 Stress, Smoking and Heavy Drinking Behaviors in University Students in Singapore

Aims: This study investigates multi-dimensional Covid-19 related stressors and the extent to which these stressors are related to young adult’s smoking and heavy alcohol use among university students in Singapore during the Covid-19 pandemic. Design/Setting/Participants: A total of 2,339 undergraduate students (862 male, 1309 female) in Singapore participated in an online survey. Measures: The Covid-19 Stressors Questionnaire (C19SQ) is a developmentally influenced, Covid-19 related stress scale, used alongside mental health measures (GAD &amp; PHQ) and substance use. Structural equation modeling was used to model the association between four types of Covid-19 related stressors and past month smoking and heavy drinking while accounting for student mental health, family socio-economic status, gender and race/ethnicity. Findings: Stress related to Covid-19 social restrictions was associated with increased likelihood of heavy drinking and smoking behavior, whereas stress related to health concerns was associated with decreased likelihood of smoking and heavy drinking. Covid-19 related stressors related to resource constraints and future uncertainties were not associated with young adult substance use. Conclusions: Our finding that Covid-19 stressors related to Social Restrictions and Health Concerns were particularly salient for university student’s substance use, but in opposite directions, extend prior work by demonstrating that young adult substance use behavior is differentially impacted by specific types of Covid-19 stress and point to areas where public health and clinical intervention efforts can focus in the wake of the Covid-19 pandemic for this vulnerable population.

Administration and Scoring Errors on the Woodcock-Johnson IV Tests of Achievement: Before and During COVID-19.

Eighty Woodcock-Johnson IV Tests of Achievement protocols from 40 test administrators were examined to determine the types and frequencies of administration and scoring errors made. Non-critical errors (e.g., failure to record verbatim) were found on every protocol (M = 37.2). Critical (e.g., standard score, start point) errors were found on 98.8% of protocols (M = 15.3). Additionally, a series of paired samples t-test were conducted to determine differences in total, critical, and non-critical errors pre- and during-COVID-19. No statistic differences were found. Our findings add to a growing body of research that suggests that errors on norm-referenced tests of achievement are pervasive. However, the frequency of errors did not appear to be affected by COVID-19 stressors or social distancing requirements. Implications of these findings for training and practice are discussed. Suggestions for future research are also provided.

Symptom characteristics of health care workers seeking outpatient psychiatric care during the COVID-19 pandemic.

Though there is a growing body of research establishing a broad negative psychological impact of COVID-19 among healthcare workers (HCWs), there are comparably fewer studies evaluating symptom presentation and clinical diagnoses among treatment-seeking HCWs. The present report seeks to fill this gap in the literature by establishing the prevalence of anxiety, depression, post-traumatic stress, alcohol misuse, and well-being among treatment-seeking HCWs. Data were collected from 421 treatment-seeking HCWs in an outpatient hospital-based mental health setting. Both self-report measures and semi-structured interviews were utilized to assess symptom severity and render psychiatric diagnosis at intake. Adjustment disorders were the most prevalent diagnosis at 44.2%. Of the 347 who completed self-report measures, over 47% endorsed moderate-to-severe depressive symptoms, with 13% endorsing suicidal ideation (SI). Fifty-eight percent scored in the moderate-to-severe range for anxiety, and 19% screened positive for COVID-related post-traumatic stress disorder. Further analyses revealed that those in medical support roles endorsed significantly greater depression symptoms relative to other groups and also reported SI at greater frequency. Medical trainees also endorsed SI at higher frequencies. These findings are consistent with previous research on the adverse impact of COVID-19 stressors on HCWs' mental health. We further identified vulnerable groups that are underrepresented in the literature. These findings highlight the need for targeted outreach and intervention among overlooked HCWs populations.

대학생의 코로나 19(COVID-19) 스트레스가 우울에 미치는 영향

Objectives The purpose of this study is to examine relations betweeen COVID-19 stress and depression, and examine the mediating effects of difficulties of emotion regulation among the undergraduate students. Methods Subjects were 426 undergraduate students who agreed to participate. For descriptive statistical analysis, Pearson analysis, and regression analysis by Baron &amp; Kenny(1986) methods were performed using the IBM SPSS 21.0 program. Results First, it was found that COVID-19 stress and difficulties of emotion regulation showed a negative correlation with depression. In particular, among the sub-variables of COVID-19 stress, it was confirmed that fear of infection and difficulties due to distancing had a statistically significant effect on depression. Second, among the sub-variables of emotional control difficulty, lack of emotional attention/awareness, lack of emotional clarity, and limited access to emotion regulation strategies were found to have a statistically significant effect on depression. Third, it was confirmed that difficulties in emotion regulation partially mediating role in the relations between COVID-19 stress and depression. Conclusions Results of this study will be useful as basic data to understand the COVID-19 stress, difficulties of emotion regulation, depression among undergraduate students and to develop education program and help and support measures for clients.

Preventive practices and parents' psychological health of children with disabilities after COVID‐19 lockdown in Pakistan

To find out differences in mental health outcomes between parents of children with different disabilities due to COVID-19 by determining the relationship between preventive practices, fear and stress in parents of disabled children. A sample of 213 parents, whose children with disabilities (age range 1-16 years) were previously on regular follow-up before pandemic but did not take therapy for 1 year or more during COVID-19 lockdown and resumed sessions after a gap period, was surveyed. Perceived stress scale, fear and adherence to preventive measures questionnaire (developed by researchers) were used to measure stress, fear response of parents due to COVID-19 and preventive measures practiced by disabled children respectively. Parents who had financial difficulties and believed their disabled children had more chance of getting COVID-19 were more stressed. Parents who received any help from community/government were less stressed. One-way analysis of variance showed parents of cerebral palsy (CP) children reported more stress of COVID-19 as compared to parents of autism spectrum disorder (ASD), global developmental delay (GDD) and intellectual disability (ID). Parents of ID children reported more stress than ASD. Parents of CP children had more fear of loss of family members or getting infected with COVID-19 than GDD parents. ASD, GDD and CP children adhered more to preventive measures than ID children; however, CP children adhered more to preventive measures than GDD children. COVID-19 lockdown has persisting impact on mental health of parents of disabled children. Those parents experienced increased levels of stress and fear but reported adherence to preventive measures depending on the child's disability.

코로나19 스트레스 인식에 의한 웰니스관광의 세분화 연구

본 연구의 목적은 코로나19에 따른 스트레스 변인을 바탕으로 세분집단을 도출하고 집단별 웰니스관광 행동의 특징을 제시하고자 하였다. 이를 위해 코로나19 스트레스에 대한 요인을 도출하고, 스트레스 요인을 기준으로 세분화를 실시한 후 세분집단간 인구통계 및 웰니스관광 특성을 비교, 분석하였다. 본 연구의 설문은 국내 성인 남녀를 대상으로 실시하였으며 부적정한 데이터를 제외하고 376부를 최종 분석데이터로 사용하였다. 첫째, 코로나19 스트레스에 대한 요인분석 결과 4개 요인(관광여가활동 결핍, 코로나 포비아, 팬데믹 피로감, 코로나 트라우마)이 도출되었다. 둘째, 군집분석 결과 4개의 군집(군집 Ⅰ: 저스트레스 집단, 군집 Ⅱ: 고스트레스 집단, 군집 Ⅲ: 관광여가활동 결핍 집단, 군집 Ⅳ: 코로나포비아 집단)이 도출되었다. 셋째, 세분집단별 특성 차이를 분석한 결과 인구통계 특성(성별, 연령대, 직업)과 웰니스관광 행동 특성(관여도, 선호유형, 선택속성, 웰니스관광 행동의도)에서 유의미한 차이가 있는 것으로 나타났다. 본 연구의 결과는 코로나19 스트레스 인식 특성에 따른 차별화되고 효율적인 웰니스관광 마케팅을 전개하는데 참조원이 될 수 있을 것으로 기대된다.