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The psychological impact of quarantine and how to reduce it: rapid review of the evidence
Abstract
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
... Para las personas que realizan el confinamiento es una vivencia desagradable en la mayoría de los casos. Los cambios que conlleva este distanciamiento social generan efectos diversos para los individuos debido a la separación de las familias y/o seres queridos: la pérdida de la libertad, el aburrimiento y la incertidumbre acerca del virus actual pueden presentarse durante esta situación de confinamiento voluntario (17). ...
... Duelo: consecuencias biopsicosociales de la pandemia por En recientes estudios se compararon los resultados del estado psicológico de sujetos que estaban pasando por un confinamiento voluntario y las personas que no lo estaban. En un estudio que se realizó a personal de un hospital con probabilidades de haber estado en contacto con el virus del Covid-19, se encontró nueve días después de haber terminado el período de la cuarentena que el haber estado en confinamiento era un factor más predictivo en cuanto a los síntomas del trastorno de estrés agudo (17). En el mismo estudio, también se observó que esta población era más propensa a experimentar desapego hacia las otras personas, ansiedad al interactuar con pacientes febriles, así como irritabilidad, insomnio, falta de concentración e indecisión, bajo desempeño en el área laboral y renuencia a trabajar. ...
... En la figura 7 se puede observar que el Covid-19 ha afectado de diversas maneras en los organismos de las personas, principalmente cansancio, agitación o problemas en la respiración, acompañado de cefalea, y diferentes pérdidas como en el sentido del olfato, el gusto, e incluso en el cabello. Además, otros participantes también indicaron [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Revista Salud Bosque Vol 13 Nº 01 | 2023 Nungaray -Rubio K., Villagómez -Zavala P G., Franco -Chávez SA., Peña -Ortiz M O. ...
Introducción. La pandemia por Covid-19 ha tenido impacto en los diversos contextos de la vida, presentándose pérdidas a nivel personal, social y afectando la salud de las personas. Estas pérdidas: muerte, salud, empleo, economía, socialización, libertad, entre otras, han traído diferentes duelos personales y sociales. Objetivo. El propósito de la investigación fue describir el impacto, las consecuencias y la perspectiva de la pérdida significativa en personas que experimentaron un duelo durante la epidemia de Covid-19, como el contagio, los significados asociados a las pérdidas y la fase de la ruptura psicosocial. Métodos. El instrumento se aplicó mediante formularios de Google y la información se sistematizó en una base de Excel. Se incluyó una población de 99 participantes; 76,76% de ellos perdió al menos un miembro de su familia nuclear debido al coronavirus y 62% reportó haberse contagiado por Covid-19 entre el periodo marzo 2020 a febrero 2021. Se realizó un análisis cuantitativo, con diseño no experimental, de corte transversal y descriptivo. Resultados. Las principales afectaciones en la salud de los participantes contagiados fueron en el área psicológica, principalmente el miedo, la tristeza y la ansiedad. Las pérdidas más sobresalientes en la pandemia fueron muerte, salud, confinamiento y economía en la pandemia, creando situaciones de tristeza, dolor y miedo Conclusiones: La enfermedad por virus SARS-Cov2 ha traído consigo secuelas a corto, mediano y largo plazo, con impactos en la calidad de vida de las personas y su bienestar biopsicosocial.
... Due to the high contagiousness of the virus and the associated high mortality rate, several virus containment measures were decreed worldwide, the most effective being the population lockdown [2]. This new situation resulted in the population around the world remaining in isolation for a considerable period of time, sometimes alone, leading to different health consequences, particularly adverse psychological effects such as anxiety [3,4]. It also led to unhealthy lifestyle habits such as eating diets of low nutritional quality [5], oversleeping or undersleeping [6,7]. ...
... In Spain, the lockdown began on 15 March 2020, along with other measures such as wearing masks and social distancing [9]. The isolation and loneliness resulting from these measures particularly affected the elderly and/or those at high risk of infection, such as people with chronic diseases, and in some cases, even led to a higher mortality rate in these groups [4,[10][11][12]. A recent study in a Spanish population with type 2 diabetes showed that during the lockdown, although unhealthy lifestyle habits, such as decreased physical activity (PA) and increased consumption of sugary food and snacks, were acquired, the consumption of vegetables increased [13]. ...
... 1 p-value (p) from chi-squared test (categorical variables) and ANOVA (continuous variables). 2 Mean (SD). 3 Adherence to an energy-restricted MedDiet was assessed using a 17-item questionnaire, a modified version of a validated 14-item questionnaire. 4 MET-min, metabolic-equivalent task minutes. 5 Self-reported answers. ...
Background: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. Methods: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. Results: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). Conclusions: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.
... The following cross-cultural research aims to examine the significant impact of the COVID-19 outbreak on individuals' mental illness and psychological distress. For example, research by Brooks et al. (2020) and Shigemura et al. (2020) found high levels of post-traumatic stress symptoms, confusion, anxiety, distress, and anger reported by individuals who were in quarantine or isolation during the COVID-19 pandemic as part of the public health authority's precautionary measures to constrain the spread of the disease. Li et al. (2020) conducted a study of 17,865 people in eastern China to examine the impact of COVID-19 on their emotional and cognitive indicators before and after the January 20 announcement of the pandemic. ...
... According to SCT , COVID-19 pandemic create a threatening environment that stimulate human behavioral processes to cope, control, or adapt with such changes that occur during the pandemic , and explain in turn the effect of the coping process on individuals' personal and behavioral condition. Brooks et al. (2020) showed that during the COVID-19 pandemic, the pandemic is observed as a threatening setting, in the process of controlling the threat or cope with it , individuals might alleviate stress reaction that affect subsequently their mental health. ...
... Overall, the total lockdown and social isolation during the CO-VID-19 pandemic may have many repercussions on the psychological wellbeing of individuals (Brooks et al., 2020;Shigemura et al., 2020). The Kuwaiti government was enforcing a total lockdown in Kuwait at the time of the study as a precautionary measure to constrain the spread of the disease. ...
Objectives: The aim of this cross-sectional study was to examine the differences between participants’ socio-demographic variables, and the Depression, Anxiety, and Stress Scale [DASS] and its three sub-scales (depression, anxiety, and stress) among individuals who lived in Kuwait during the total lockdown due to the COVID-19 pandemic. Method: An online survey was distributed to 975 participants via WhatsApp and Twitter, using the convenience non-random sampling method. The survey consisted of three sections: a written consent form, demographic items, and the DASS. Results: The findings showed that Kuwaitis, males, widowed, individuals who were 50 and above, businessmen, higher educational level had a greater likelihood of experiencing depression, anxiety, and stress than the other groups during this pandemic. Conclusion: It was determined that intervention programs aimed at improving the population’s mental health are needed in the lockdown period to support mental health and wellbeing and reduce mental illness symptoms during the COVID-19 pandemic.
... Moreover, quarantine was necessary to reduce the transmission rate, which has been imposed to protect physical health. However, it is equally impacting people's mental health (Brooks et al., 2020). In the case of COVID-19, families cannot stay with the infected person and are forcefully separated to reduce the transmission rate (Brooks et al., 2020). ...
... However, it is equally impacting people's mental health (Brooks et al., 2020). In the case of COVID-19, families cannot stay with the infected person and are forcefully separated to reduce the transmission rate (Brooks et al., 2020). Moreover, they must stay isolated until their status changes to COVID-19 negative (Brooks et al., 2020). ...
... In the case of COVID-19, families cannot stay with the infected person and are forcefully separated to reduce the transmission rate (Brooks et al., 2020). Moreover, they must stay isolated until their status changes to COVID-19 negative (Brooks et al., 2020). An earlier study revealed that quarantine causes stress among healthcare workers, affecting their mental health (Bai et al., 2004). ...
Covid 19 has severally affected various people across the world. Undoubtedly, a campaign on forming awareness of the pandemic among people is very important in order to curb the transmission from individual to individual. In this regard, social media influencers have played a significant role in many awareness campaigns organized by companies and the World Health Organization (WHO) because of their popularity and influence among the audience. Social media influencer campaigns on awareness of the pandemic conducted during this period have generated audience engagement. Moreover, it is vital to study the crucial factors that determine the creation of brand awareness among consumers related to influencer marketing campaigns on covid 19 awareness. This study has proposed a conceptual framework by integrating the variables from various theories. This research has incorporated variables such as awareness of covid 19, consumer engagement, physical health, mental health, and brand awareness. This study provides both theoretical and managerial implications.
... Meanwhile, the number of deaths due to COVID-19 is much higher, so that the death due to this disease was 1870 people only in China until February 18th, 2020 [3]. And as of May 19th, 2020, 320,448 deaths from this disease have been reported in the whole world, despite the fact that COVID- 19 has not yet been inhibited and the number of deaths caused by it is still increasing [4,5]. Mortality from this disease varies according to age and other health conditions such as the history of underlying diseases [6,7]. ...
... AGFI 8 =0.93. 1 Degree of Freedom. 2 Standardized root mean square residual.3 Root mean square error of approximation.4 Comparative fit index.5 Normed fit index.6 ...
Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs’ questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (β = 0.34, P-value < 0.001), and on the preventive behavior of students was insignificant (β = 0.12, P-value = 0.07) while the indirect effect of knowledge through increasing the constructs of the HBM on student behavior was positive and significant (β = 0.30, P < 0.001). The relationship between the constructs of the HBM constructs and student behavior was also positive and significant (β = 0.89, P-value < 0.001).Due to the fact that knowledge and HBM structures played a role in predicting the adoption of preventive behavior from COVID-19, it is possible to design appropriate interventions to increase knowledge, sensitivity, perceived severity, and self-efficacy, in order to recover from COVID-19 by adopting preventive behaviors.
... Over 6.89 million people have died globally, and more than 762.20 million COVID-19 confirmed cases have been reported as of April 3, 2023(World Health Organization, 2023. The COVID-19 pandemic has not only had an apparent impact on physical health but has also significantly influenced mental health and well-being (Gloster et al., 2020;Brooks et al., 2020). A broad range of negative psychological reactions, such as anxiety and depression, have been induced due to this pandemic's chronic and long-lasting nature (Daniali et al., 2023). ...
... Among the sociodemographic factors, young adults (Fried et al., 2022;Liang et al., 2020), students and females (AlRasheed et al., 2022;Jiang et al., 2020;Ochnik et al., 2021) have been found to be most susceptible to mental health worsening during the COVID-19 pandemic. Social isolation (AlRasheed et al., 2022), loneliness and quarantine (Brooks et al., 2020;González-Sanguino et al., 2020;Liu et al., 2020;Nkire et al., 2021), pre-existing mental health conditions (González-Sanguino et al., 2020), hospitalization Kantor & Kantor, 2020) and financial instability (Sinawi et al., 2021) were found to be several other sociodemographic risk factors for COVID-related distress. ...
Objective
This study assessed predictors of stress, anxiety and depression during the COVID‐19 pandemic using a large number of demographic, COVID‐19 context and psychological variables.
Methods
Data from 741 adults were drawn from the Boston College daily sleep and well‐being survey. Baseline demographics, the long version of the daily surveys and the round one assessment of the survey were utilized for the present study. A Gaussian graphical model (GGM) was estimated as a feature selection technique on a subset of ordinal/continuous variables. An ensemble Random Forest (RF) machine learning algorithm was used for prediction.
Results
GGM was found to be an efficient feature selection method and supported the findings derived from the RF machine learning model. Psychological variables were significant predictors of stress, anxiety and depression, while demographic and COVID‐19‐related factors had minimal predictive value. The outcome variables were mutually predictive of each other, and negative affect and subjective sleep quality were the common predictors of these outcomes of stress, anxiety, and depression.
Conclusion
The study identifies risk factors for adverse mental health outcomes during the pandemic and informs interventions to mitigate the impact on mental health.
... The COVID-19 pandemic and the associated quarantine measures significantly affected the lives of all individuals in distinct circumstances (Brooks et al., 2020), as well as the mental health of people of different ages (Justo-Alonso et al., 2020). Governments implemented Extended author information available on the last page of the article different measures to contain the virus and reduce the number of positive cases, such as lockdowns and isolation. ...
... In Spain, the period of confinement started on March 15, 2020, and the state of alarm ended on June 21, 2020 (Gobierno de España, 2020. Like many other countries, the quarantine measures imposed on the population implied radical changes in lifestyle, with fundamental restrictions on mobility, which had an important impact on the daily activities and psychosocial situation of individuals (Brooks et al., 2020;Chu et al., 2020;Rodríguez-Rey et al., 2020). Indeed, the pandemic and the related restrictions had a significant impact on mental health, inducing uncertainty (Bakioğlu et al., 2020;Ruiz-Robledillo et al., 2022), and increasing the levels of stress, anxiety, and depression in individuals of different ages and conditions (González-Sanguino et al., 2020;Odriozola-González et al., 2022;Sandín et al., 2021). ...
The COVID-19 pandemic, and the associated confinement, imposed a novel personal and social context for university students; nevertheless, few studies have addressed the effects of this on distance university students. Indeed, defining the needs of these students under such unique circumstances will allow them to receive the support necessary to effectively reduce their perceived stress and improve their academic achievement. A predictive model was designed to examine the direct effects of the variables’ age and perceived study time on stress and academic achievement in students in an online learning context, as well as to assess the indirect effects through the mediating role of academic self-efficacy. Using path analysis, the model was tested on a sample of 1030 undergraduate students between 18 and 60 years old enrolled on a psychology degree course at the UNED (National Distance Learning University of Spain). The model provides a good fit to the data, confirming the mediating role of academic self-efficacy. Perceived study time is a factor negatively associated with stress and positively with academic achievement. However, it appeared that age was not related to academic achievement, indicating that academic self-efficacy had no mediating effect on these two variables. Academic self-efficacy is a mediator and protective factor in challenging times like the COVID-19 pandemic. These results may contribute to the design of educational and clinical interventions for students at an online learning university over an extended age range.
... In response to this unprecedented situation, tools have been developed to safeguard mental health, such as enforcing quarantine only for as long as necessary, providing clear rationales and detailed protocols for quarantine, and ensuring that adequate supplies are available. However, few strategies specifically address the unique needs of healthcare personnel [7]. ...
Over the COVID-19 pandemic, the impact of enduring mental health on healthcare workers has become increasingly evident. This review focuses on post-pandemic mental health challenges faced by healthcare personnel in Latin America. This highlights the persistent burden on healthcare workers, especially women, which is exacerbated by economic disparities, inadequacies in the healthcare system, and ongoing occupational stressors. Our literature review, utilizing databases such as PubMed, Scopus, and Google Scholar, scrutinized the mental health status of healthcare professionals in the region after the pandemic’s peak. The analysis indicated sustained levels of psychological distress, with frontline workers and women continuing to be affected disproportionately. These findings emphasize the urgent need for personalized interventions to effectively address the complex mental health challenges in this context. This review advocates strategic interventions, including tailored psychological support, innovative diagnostics, and technological solutions, integrated into patient-centered care models. Such approaches aim to enhance the mental resilience and overall well-being of healthcare professionals across Latin America in the post-COVID era.
... One study suggests a rise in adolescents' depressiveness particularly among extroverted youth between 2018/2019 and 2020 (Alt et al., 2021). Quarantine and isolation further contributed to negative psychological effects such as anger and post-traumatic stress (Brooks et al., 2020). Adolescents' stress and anger levels also increased longitudinally (Shanahan et al., 2022). ...
The COVID-19 pandemic was stressful for many adolescents and their families, but effects proved far from uniform. Using a person-centered approach, this study aimed to identify types of perceived changes in family climate during the pandemic’s first lockdown, and test risk and resilience factors for differential changes in family climate. Further, risk and protective factors regarding longitudinal changes in adolescents’ well-being were tested depending on family climate. The longitudinal analyses included 822 adolescent participants (age 16–20; 42.7% male) from the German Family Panel pairfam, who were assessed in 2018/2019 and in early summer 2020. Latent Class Analysis revealed three classes of perceived changes in family climate (58% stable, 14% improvement, 28% deterioration). Adolescents’ older age, parental separation, and financial difficulties were connected to a deterioration in family climate. Findings revealed predominantly negative changes in adolescents’ well-being, i.e., increased loneliness and reduced activity, but also reduced stress. Adolescents with a perceived deterioration in family climate experienced a substantial decline in well-being compared to the other classes. Factors like female gender and isolation from peers emerged as risk factors for adolescent well-being. Additional analyses within classes revealed strongest or exclusive effects of risk and protective factors on adolescents’ loneliness in the deterioration class. Findings point towards the important role of family dynamics for adolescent well-being in the context of crises. Interventions targeting adolescents should consider the negative consequences of the pandemic for the whole family system but also acknowledge that the lockdown did not only have negative effects.
... The lack of such activities had the potential to worsen both the physical and mental health of residents. Among the negative psychological and health consequences of such a situation, studies have shown increasing levels of depressive symptoms (Brooks et al., 2020;Qualter et al., 2013), functional and cognitive decline, and increased mortality (Flatharta & Mulkerrin, 2020;Morley & Vellas, 2020). The COVID-19 pandemic has starkly revealed the uneven territorial distribution of such facilities, with resources being disproportionately concentrated in wealthier regions, a distribution pattern that does not align with the geographical presence of vulnerable populations. ...
The COVID-19 pandemic was not only a biological challenge, but it also took a toll on the psychological and social well-being of older adults, especially those in nursing homes. This study aims to uncover the impact of the pandemic on the biopsychosocial well-being of nursing home residents, including the role of COVID-19 positivity and social contacts. Using a sample of 247 individuals in two Northern Italian nursing homes over 3 years (2018–2021), the study analyzed a broad range of biopsychosocial variables and traced the frequency of social contacts during the lockdown. The results showed a concerning trend of worsening well-being over time during the pandemic, irrespective of COVID-19 positivity. Surprisingly, the frequency of contacts with family caregivers did not seem to have a protective role, and worsening conditions were associated with an increase in subsequent social contacts. These findings shed light on the dynamics of the biopsychosocial well-being of institutionalized individuals, and they have significant public health implications. By disentangling the roles of the pandemic period, COVID-19 positivity, and social contacts, this study provides insights into the worsening of neuropsychiatric symptoms, as well as functional and clinical indicators, in nursing home residents.
... Asimismo, según Biddle et al. (2020), los cambios producidos por COVID-19 han tenido un efecto en las relaciones, puesto que las interacciones sociales y laborales se vieron afectadas, facilitando la construcción de nuevas interacciones y asociaciones afectivas. Una revisión publicada por Brooks et al. (2020), expone que entre más extensa Vol.3, N° 1 Enero-Junio, 2024 Doi: https://doi.org/10.32654/DialogosAbiertos.3-1.1 ~ 4 ~ sea la cuarentena, mayor será la probabilidad de peores resultados psicológicos, ya que los factores estresantes en los participantes podrían tener un creciente efecto dada la exposición prolongada. Estos autores plantean que una cuarentena superior a 10 días incrementa los síntomas de trastorno de estrés postraumático. ...
El confinamiento a raíz de la pandemia COVID-19 ha impactado en diversos ámbitos de la vida cotidiana de las personas en todo el mundo. En líneas generales, se manifestaron cambios a nivel económico, sanitario, social y consecuentemente a nivel emocional. Debido a esto, en las relaciones de pareja se encontraron nuevas fortalezas y otros tantos desafíos. Para poder comprender cómo el confinamiento impactó sobre las separaciones de las parejas, se propuso investigar en la población argentina algunas variables causales. Se realizó un estudio descriptivo con 2562 muestras de las cuales 467, es decir casi el 20%, se separó durante el aislamiento. El 53% mencionó problemas de comunicación, el 40% destacó la falta de amor y similares números con diferencias de valores y formas de convivencia. Las conclusiones obtenidas pretenden servir de utilidad en el diseño de futuras líneas de intervención y tratamiento en la práctica clínica, para parejas que presenten crisis estructurales en la pareja.
... With the pandemic, parents' ability to access social support outside the home has been disrupted. This social isolation and other challenges that the current outbreak has emerged have negatively affected the physical and psychological well-being of parents and their children (Babore et al., 2020;Brooks et al., 2020;Pitchik et al., 2021). Given the challenges posed by the COVID-19 pandemic to the psychological well-being of parents and children, the present study aimed to investigate the roles of coparenting and child routines in relation to children's social-emotional competence during the COVID-19 outbreak. ...
The purpose of the current study was to examine the contributions of coparenting quality and child routines to children’s social–emotional competence during COVID-19. Further, we investigated the indirect effects of coparenting quality on children’s social–emotional competence via child routines. The participants were 403 mothers of children between 23 and 102 months old (M = 59.23, SD = 10.92). Mothers reported their children’s social–emotional competence, coparenting quality, and children’s routines as main variables and the COVID-19 pandemic effects (financial, resources, psychological, and within-family interaction effects). Results from the structural equation model showed that higher levels of coparenting quality and consistency in child routines were positively related to children’s social–emotional competence. In addition, there was an indirect effect of coparenting on children’s social–emotional competence through child routines. In detail, higher parental coparenting quality was associated with more consistent child routines, and, in turn, more consistent child routines were associated with higher levels of social–emotional competence. These findings suggest that coparenting and child routines may play a crucial role in children’s social–emotional competence. Results are discussed, considering their functioning during the COVID-19 pandemic.
... During the pandemic, the coronavirus disease 2019 has had a detrimental effect on the mental health of the general population, causing anxiety, depressive symptoms and life dissatisfaction (Brooks et al., 2020;Coiro et al., 2021;Gan et al., 2022;Tan et al., 2022;White & Van Der Boor, 2020;Wu et al., 2021;Yue et al., 2022). Meanwhile, studies have revealed that, during the pandemic, the public has invested more in certain belief systems and worldviews, such as endorsing increased conspiracy theories (Mao et al., 2021;Šrol et al., 2021;Van Prooijen, 2022), embracing conservative or populist attitudes (Dennison & Turnbull-Dugarte, 2022;Karwowski et al., 2020) and justifying the current status quo (Jutzi et al., 2020;Sibley et al., 2020). ...
The coronavirus disease 2019 (COVID‐19) pandemic has had a detrimental effect on people's mental health. Drawing on the palliative function of ideologies, we suggest that people rely on system‐justifying beliefs to mitigate psychological distress during the pandemic. We conducted three studies with correlational and experimental designs to examine whether and how system‐justifying beliefs can buffer against psychological distress during COVID‐19, and whether this effect may vary across social classes. The results indicated that (a) system‐justifying beliefs alleviated psychological distress during the pandemic, (b) personal control mediated this relationship and (c) this effect was consistent across all social classes. This study provides robust evidence for the palliative function of system‐justifying beliefs during a massive global health crisis (i.e. COVID‐19).
... There is a growing awareness that COVID-19 influenced the psychological wellbeing of individuals on a global scale, with researchers indicating that the general population experienced anger, frustration, boredom, financial loss, confusion, and posttraumatic stress symptoms during the pandemic (Brooks et al., 2020;Lestari & Setyawan, 2021). To develop understanding regarding this potential change in wellbeing, several studies focused on investigating the effects of COVID-19 on the mental health of the general population. ...
The COVID-19 pandemic influenced the way individuals conducted their lives, with consequencesrelating to mental health deterioration. Whilst researchers explored this outcome in the general popula-tion and athletic populations, less focus was on athletes with disabilities. The aim of this study was toinvestigate how the pandemic influenced the mental health of elite para-athletes in the United Kingdom.Nine elite-level athletes with disabilities participated in semi-structured interviews. Three broad themeswere interpreted from the data using reflexive thematic analysis, two themes reflected the negativeimpact of COVID-19 on mental health and one theme reflected positive outcomes of the pandemic.Athletes explained that losing face-to-face interactions and delays in major sporting events weresignificant factors in their mental health decline. This population group reported different challengesto able-bodied communities. Differences included increased susceptibility to contract the virus, difficul-ties in communication where face masks and online interactions became necessary and perceptions ofvulnerability relating to shielding protocols. Finally, positive outcomes related to the additional time torecover, to prepare for major events and time to reassess their values. Exploring experiences ofa pandemic on this population group warrants further exploration to enhance the effectiveness ofmental health support services in para-sporting organisations
... Similarly, emerging adults identified fears of infection, fears of death, economic and educational uncertainties, and loss of contact with others (Cao et al., 2020, Son et al., 2020, correlating with an increased prevalence of anxiety. Aside from educational uncertainty specific to the post-secondary population, these are similar to challenges experienced by the general adult population (Brooks et al., 2020, Giorgi et al., 2020. ...
This qualitative study was conducted to assess the responses of emerging adults with pre-existing mood and anxiety disorders to the third wave of the COVID-19 pandemic. Patients from the First Episode Mood and Anxiety Program in London, Ontario, Canada, which treats individuals aged 16–29 with mood and anxiety disorders, were invited between April 16th – 21st, 2021 to complete a survey on their current emotional states, activities and coping. Responses were analyzed using thematic analysis. A thematic analysis identified the theme of “Languishing,” among responses comprised of 3 organizing subthemes: “Dominance of Negative Emotion,” “Waiting and Stagnating,” and “Loss of Opportunity.” This study suggests that emerging adults with pre-existing mental illness languished as the pandemic and associated restrictions persisted. Emphasis on “Coping through Intentional Action,” a separate theme identified among those coping well, may be protective for this group.
... In consequence, people's life experiences became impoverished (e.g., Brooks et al., 2020;Kokkoris & Stavrova, 2021;Rajkumar, 2020;Rodriguez et al., 2020). The ensuing "covid fatigue" often motivated bucking the restrictions, throwing caution to the wind, and resuming unconstrained behavior. ...
It is commonly surmised that restrictions limit freedom. Yet, the sense of freedom is a psychological experience only partially determined by objective restrictions. Deriving from the psychology of goals, we propose that people’s sense of freedom depends on the goals they focus on, and their attainability. Across four preregistered studies, we investigated the impact of goal focus on participants’ sense of freedom. In Studies 1–3, participants indicated the goals they could pursue despite the pandemic restrictions (commitment condition), the goals they needed to relinquish due to the restrictions (sacrifice condition), or no goals whatsoever (control condition). In Study 4, we manipulated goal focus by priming participants with the goal of socializing (which was hindered during the pandemic) and the goal of spending time alone (which was facilitated during the pandemic). Consistently across four studies, we found that participants experienced a significantly higher sense of freedom when they focused on enabled versus disabled goals. Moreover, in Studies 2 and 3, we observed that a greater sense of freedom was associated with better coping during the pandemic, reduced resistance to imposed constraints (reduced reactance), and a more positive evaluation of the imposed restrictions. These findings indicate that focusing on attainable goals instills a sense of freedom and contributes to constructive coping under objective constraints.
... Therefore, while medical and public health professionals are trying to contain the spread of the pandemic, managers must manage the spread of negative emotions in the workplace and their consequences. Although several recent studies performed during the COVID-19 pandemic reported various consequences such as extreme fear, loneliness, and limited degrees of freedom (Brooks et al., 2020;Li et al., 2020), understanding the lived experience of employees during the COVID-19 pandemic can help to better understand the consequences of the spread of negative emotions in the workplace and provide a more complete picture. ...
Emotional contagion (EC) occurs when one person's moods and emotions influence others' feelings. This study aims to understand employees' lived experiences regarding EC and its consequences in Iran during the pandemic. This study used a phenomenological framework to elicit employees' experiences. Forty interviews with Iranian employees in 40 public organizations were conducted. Purposive sampling was used to identify the participants. The unearthed consequences were categorized into seven themes: mental disorders, negative emotions, negative physiological changes, job burnout, communication apprehension, venting at the workplace, and work-family spillover. Although several studies have considered the role of EC in the workplace, the consequences of EC during the COVID-19 pandemic in organizations have not yet been studied. Moreover, the findings illustrated that EC during the COVID-19 pandemic has dire consequences, which are not only confined to the individual sphere of employees but also permeate organizations, clients, and even families.
... During this period, various stressors were causing stress, such as quarantine, wage cuts, unemployment, insecurity, fear, harassment, assault, etc., among the population. Although quarantine is a vital prevention measure for curbing the spread of infectious diseases, several studies have shown that quarantine negatively affects people [96]. Containment at home is little benefit to many people, especially those in coercive relationships. ...
The novel coronavirus 2019 (COVID-19) pandemic poses a challenging and stress-ful situation among people from 2019 to date globally. This study analyzes various factors responsible for the stress intensity among India's urban cities to identify the most affected metropolitan city. The study identified six Indian urban cities and three major stress factors: routine, social, and job, with each factor having sub-criteria. A fuzzy analytic hierarchy process is used to model the situation, and a synthetic extent analysis method (EAM) is employed to solve the model. The modified EAM has been also applied and the two results compared. It has been found that the modified method is more robust than EAM. The concept of the minimum degree of possibility is applied to obtain the weight vector for the main criteria. After identifying the main stress criteria and its sub-criteria and six metropolitan cities, the hierarchy of identifying India's most affected metropolitan cities during COVID-19 is structured. The study found that using the EAM, Mumbai is the worst affected city, followed by Bengaluru, Chennai, Delhi-NCR, and Hyderabad. While using the modified method, the most affected area found to be Pune, followed by Mumbai, Chennai, Hyderabad, Delhi-NRC and Bengaluru. It further discovered that routine stress-related is the most critical factor in identifying the most affected metropolitan city, followed by social and job-related stresses.
... Such results do illustrate the classic situation of the Attribution Error -optimism bias. The same conclusion was reached by Maaravi, Heller in 2020, who studied anxiety in Great Britain using similar methods (STAI) [19,20,21]. ...
Introduction: The situation with COVID-19 is unexpected and unpredictable, and the consequences are tragic. The number of sick and dead has increased globally, including in Ukraine, and it is reasonable to assume that this will have a certain effect on the mental state of people, including their level of anxiety. Therefore, this study focuses on measuring the level of state anxiety and determining its relationship with the perception of various aspects of COVID-19 by the population of Ukraine. Material and methods: The survey was conducted by telephonic interview. Respondents were recruited randomly in the period from 17.04 to 22.05.2020. The sample consists of 412 people from all over Ukraine. State anxiety, which is dynamic and reflects the level of anxiety on the State Anxiety Scale from The State-Trait Anxiety Inventory (STAI) at a particular time, was studied. Results: Differences have been traced in responses of male and female respondents, where this indicator was higher among females. People tend to have a different subjective attitude towards the likelihood of finding themselves in the same situation, which for objective reasons is relatively equal for everyone who is in the same pandemic environment; they tend to believe they are more likely to protect themselves from the disease than those around them. Individuals tend to overestimate both their ability to achieve a certain success in the situation and the favorable circumstances ("hope for good luck"). There is a certain correlation between this assessment and the level of state anxiety (correlation = 0.2328 (p <0.01)), i.e. the higher the anxiety, the higher a person estimates the probability of contracting the disease themselves or of others falling ill. There are two extremes in the Ukrainian society: the part of the population that reasonably estimates their place in the world (if it is a global problem, and I am a part of the world then this is my problem) constitutes 42% of respondents who participated in the study; the part of the population that tends to separate themselves from the society as a whole (state anxiety in this group is lower) – this is a problem of the world but not mine (and am I a part of the world?) – constitutes 41%. Conclusions: State anxiety is almost independent of characteristics, such as age, gender, or place of residence, but this anxiety differs among people with different views of themselves and their place in society, which necessitates some in-depth research of other personal factors in parallel with state anxiety that could further clarify the situation. Keywords: COVID-19, anxiety, optimism bias, Ukraine
... When investigating the confinement of people in the current context, it is important to consider the influence and toxicity of social media on older individuals, who spend a large part of their day watching television or on their cell phones, constantly exposed to coronavirus issues throughout the day (Brooks et al., 2020). Social distancing changes the routines of older persons, bombarding them with bleak and worrisome information, with a negative effect on their QoL. ...
The aim of the study was to identify the level of physical activity and quality of life in elderly women during the pandemic. A total of 2,269 women took part (X= 66.46 ± 5.73 years). A sociodemographic questionnaire, the WHOQOL-Old for quality of life and the Baecke questionnaire for level of physical activity were used. The study population was 57.14% mulatto; 35.71% single; 40% literate; 50% retired; 60% with a monthly income ≤ 2 salaries (≤ US$200.00). 77.14% reported having some pre-established illness or continuous use of medication, and 86% had a sick parent. The results show that 90% of the participants had a low physical activity index (PAI) (X= 4.44 ± 3.79; PAI ≤ 9.11) and 61.4% had an average overall quality of life (OHQoL) (X= 13.56 ± 1.75; OHQoL between 10 - 14). It was concluded that the pandemic has a negative effect on the physical activity of elderly women, causing a decline in quality of life.
... Ornell et al. (2020) afirmam a necessidade de pesquisas e publicações científicas sobre a prática laboral diária do docente, vista a extensa quantidade de fatores desafiadores para a gestão do ensino do professor, potencializado pelo contexto do período pandêmico e pós pandêmico. Já Brooks et al. (2020) corroboram sobre possíveis impactos negativos dessas implicações, tanto no que diz respeito à saúde física, quanto mental, indicando que estes podem ocasionar danos à qualidade de vida dos docentes também. Ainda nesse contexto, Santos (2020) (Caveião et al., 2017;Frainer et al., 2020). ...
O objetivo desta pesquisa foi analisar a qualidade de vida e a gestão do ensino docente, dentro do processo de ensino aprendizagem. Esta pesquisa foi baseada em um estudo descritivo, exploratório, com abordagem quantitativa. O cenário da pesquisa foi o Instituto Federal do Pará - Campus Tucuruí. Após a aprovação no Comitê de Ética do Centro de Ciências Biológicas e da Saúde da Universidade do Estado do Pará e assinatura do TCLE, iniciou-se a coleta de dados, via google forms, sendo sequencialmente feita a análise estatística e a discussão dos resultados da pesquisa. Notou-se que a maioria dos docentes referiram que no labor docente por si só há muitas sobrecargas e fatores que prejudicam a sua qualidade de vida, mas que os mesmos foram potencializados pelos malefícios abruptos, advindos do contexto pandêmico e pós pandêmico, explicitando que apesar das capacitações ofertadas, as dificuldades nessa temática em sua práxis, perduram até os dias atuais, apresentando desta forma repercussões negativas que interferem tanto na sua qualidade de vida quanto na sua gestão de ensino como docente. De posse destes resultados, a pesquisa apontou que a qualidade de vida dos docentes é considerada baixa pelo questionário SF-36 e corroborou para a necessidade de mais estudos acerca da temática, visando contribuir para a otimização da gestão do tempo, melhoria da qualidade de vida e da gestão do ensino do docente, proporcionando formação continuada ao docente e contribuindo para as práticas de ensino desenvolvidas pelos mesmos.
... E6 Nota-se que a falta de conhecimento acerca do que se tratava a Covid-19 foi um dos principais precursores da incerteza e da dificuldade de adaptação no momento do confinamento. Brooks et al (2020) assinalou que a falta de informações adequadas, clareza sobre os diferentes níveis de risco e esclarecimento sobre os objetivos da quarentena por parte das autoridades da saúde pública, levou os indivíduos a temerem o pior. O afastamento social decorrente da medida preventiva foi uma das mudanças expressadas pelos adolescentes que mais os impactaram neste período de quarentena. ...
Em dezembro de 2019, na província de Wang, na China, surgiram os primeiros casos detectados de uma síndrome respiratória aguda causada pelo vírus denominado Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2), que causa a Coronavirus disease (COVID-19) (Almeida et al, 2021).
... COVID-19 triggers inflammation in both the body and the brain, giving rise to psychiatric symptoms, particularly in individuals who have been discharged from the hospital after experiencing a significant level of emotional stress due to confinement within the hospital setting and the impact of the disease itself 2 . Social distancing and social isolation measures 3 According to previous evidence, individuals with COVID-19 manifest psychiatric symptoms that persist or become present months after the initial infection 5 . In a study carried out in Italy, about 56% of COVID-19 survivors had at least one of the domains evaluated for psychiatric sequelae (PTSD, depression, anxiety, insomnia and obsessivecompulsive symptomatology) after one month of hospitalization 6 . ...
Introduction: Currently, the physical and functional consequences on individuals who have recovered from the severe form of the Covid-19 and are experiencing traumatic stress remain unknown. Objective: To assess post-traumatic stress disorder (PTSD) in individuals post-hospital discharge following COVID-19 and investigate its relationship with sociodemographic variables, quality of life, muscle strength and functional capacity. Methods: A cross-sectional study was conducted, including individuals of both genders aged between 31 and 79 years, who had recovered from COVID-19 and required hospitalization. Participants underwent evaluations for PTSD, physical activity level, mobility and balance (Timed Up and Go test – TUG), the distance covered in the 6-minute walk test (6MWT) and quality of life (Short Form-36 Health Srvey -SF-36). Results: Out of 153 eligible individuals, 60 successfully completed the assessments. The age range was 31 to 77 years, and 63.3% were female. PTSD was identified in 48.3%, with 38.7% exhibiting partial symptoms. Furthermore, 65.5% of individuals with PTSD were obese, and 62.1% were hypertensive. This group demonstrated a higher degree of sedentary behavior (p=0.009), increased frequency of intensive care unit hospitalization, and a greater number of days hospitalized, respectively (p<0.001 and p=0.010). They exhibited longer times in the TUG (p=0.014), shorter distances than predicted in the 6MWT (p=0.001), and a reduction in all domains of the SF-36. Conclusion: Given the findings of this study, the follow-up of these individuals needs to be continued in order to verify the permanence of these symptoms and functional manifestations.
... In light of the existing literature, the emergence of the COVID-19 pandemic has created new incentives for understanding emotion recognition, particularly in children. The outbreak of COVID-19 led to profound changes in various facets of daily life, notably the mandatory use of face masks, as seen in numerous countries during the initial wave of the virus in May 2020 (Brooks et al., 2020). Part of this new reality included the temporary suspension of school and educational institution operations in Greece. ...
Introduction
Facial emotion recognition abilities of children have been the focus of attention across various fields, with implications for communication, social interaction, and human behavior. In response to the COVID-19 pandemic, wearing a face mask in public became mandatory in many countries, hindering social information perception and emotion recognition. Given the importance of visual communication for children’s social-emotional development, concerns have been raised on whether face masks could impair their ability to recognize emotions and thereby possibly impact their social-emotional development.
Methods
To this extent, a quasiexperimental study was designed with a two-fold objective: firstly, to identify children’s accuracy in recognizing basic emotions (anger, happiness, fear, disgust, sadness) and emotional neutrality when presented with faces under two conditions: one with no-masks and another with faces partially covered by various types of masks (medical, nonmedical, surgical, or cloth); secondly, to explore any correlation between children’s emotion recognition accuracy and their affective state. Sixty-nine (69) elementary school students aged 6-7 years old from Greece were recruited for this purpose. Following specific requirements of the second phase of the experiment students were assigned to one of three (3) distinct affective condition groups: Group A-Happiness, Group B-Sadness, and Group C-Emotional Neutrality. Image stimuli were drawn from the FACES Dataset, and students’ affective state was registered using the self-reporting emotions-registration tool, AffectLecture app.
Results
The study’s findings indicate that children can accurately recognize emotions even with masks, although recognizing disgust is more challenging. Additionally, following both positive and negative affective state priming promoted systematic inaccuracies in emotion recognition. Most significantly, results showed a negative bias for children in negative affective state and a positive bias for those in positive affective state.
Discussion
Children’s affective state significantly influenced their emotion recognition abilities; sad affective states led to lower recognition overall and a bias toward recognizing sad expressions, while happy affective states resulted in a positive bias, improving recognition of happiness, and affecting how emotional neutrality and sadness were actually perceived. In conclusion, this study sheds light on the intriguing dynamics of how face masks affect children’s emotion recognition, but also underlines the profound influence of their affective state.
... Research also showed that reduced social network during the pandemic was positively associated with psychological distress (Schwab et al., 2022). When the number of COVID-19 infections increase sharply, people would face quarantine or restriction of activities, which may lead to higher levels of distress (Brooks et al., 2020;Chen et al., 2022;Pfefferbaum & North, 2020). Therefore, the COVID-19 related stressors may be the important cause for the poor mental health condition among infertile patients. ...
The present study aimed to examine the psychological impact of the COVID‐19 pandemic on infertile patients. We adopted a comparison design and searched articles published from 1 September 2016 to 31 December 2019 as the control group, while articles published from 1 January 2020 to 31 April 2023 were treated as the pandemic group. Specifically, Web of Science, PubMed, Medline, PsycArticle, CNKI and PsycINFO were searched to identify potential eligible records. Risk of bias was assessed, and random‐effects meta‐analyses were conducted to estimate the prevalence of specific mental health problems. Forty studies with a total of 19,480 participants were included in the analysis. The pooled prevalence of anxiety in the pandemic group was significantly higher than that in the control group. The depression and stress prevalence in the pandemic group was higher than that in the control group, yet did not reach statistical significance. A subgroup analysis revealed region differences with developed countries exhibiting higher rates of anxiety and depression in the pandemic group, but the result was the opposite in the control group. Physiological factors, psychological factors and social factors correlated with infertile patients' mental health were identified. The COVID‐19 pandemic had a significant negative impact on infertile patients' mental health, emphasizing the importance of ways to mitigate the risks during the pandemic.
... Devido à facilidade de contágio, a doença se disseminou rapidamente, sobrecarregando os serviços hospitalares e acarretando o colapso dos sistemas de saúde locais (Oliveira, Magrin et al., 2020;Wang, Pan et al., 2020). Na tentativa de contenção da pandemia, medidas sanitárias não-farmacológicas foram implementadas em escala global com objetivo de reduzir a velocidade de transmissão, como uso de máscaras de proteção facial, higienização das mãos e desinfecção de superfícies, isolamento dos casos suspeitos e confirmados, período de quarentena e distanciamento social, assim como o fechamento de serviços não essenciais ou emergenciais (Brooks et al., 2020;Esper, Araújo, Santos, & Nascimento, 2022;Oliveira-Cardoso et al., 2020). O grau de intensidade das medidas preventivas variou conforme o número de casos novos, hospitalizações e mortes em cada região (Wang, Pan et al., 2020;Xiang et al., 2020). ...
Resumo: Pacientes com transtornos alimentares (TAs) são considerados mais vulneráveis ao sofrimento psíquico induzido pela pandemia de Covid-19. Este estudo teve como objetivo analisar as repercussões do isolamento social na saúde física e mental de pacientes com diagnóstico de TAs durante o primeiro ano da pandemia de Covid-19 e investigar suas reações à mudança do atendimento presencial para o online. Trata-se de uma pesquisa qualitativa, descritiva e exploratória, com delineamento longitudinal. Participaram 13 pacientes do sexo feminino, com idades entre 13 e 66 anos, em seguimento ambulatorial em um serviço vinculado ao Sistema Único de Saúde (SUS). Os dados foram colhidos de forma remota, por meio de um formulário aplicado e reaplicado em um intervalo de seis meses. Os resultados foram submetidos à análise temática reflexiva e agrupados em quatro categorias centrais: adaptação às condições de isolamento social; repercussões emocionais ao escutar o persistente rumor da morte; qualidade da alimentação, gestão das emoções e nível de insatisfação corporal; e facilidades e barreiras percebidas na transição para o atendimento online. Os achados evidenciam marcada vulnerabilidade psicossocial, que se reflete na piora de sintomas preexistentes e no aparecimento de novos sofrimentos psíquicos, indicando a necessidade de intensificar o acompanhamento terapêutico no período pandêmico, de acordo com as adaptações requeridas.
... Se espera que el estudio de las principales dificultades a las que se enfrenta la categoría contribuya a matizar el debate sobre la eficacia de las orientaciones puestas a disposición de los(as) psicólogos(as). (Braga, Oliveira, & Santos, 2020;Brooks et al., 2020;Freitas, Napimoga, & Donaliso, 2020;Oliveira, Oliveira-Cardoso et al., 2020;Silva, 2020). ...
Resumo: Com a emergência da pandemia de Covid-19, as(os) psicólogas(os) passaram a oferecer atendimento online para pacientes que até então eram atendidos de forma presencial. Na maior parte dos casos, essa mudança se deu de forma improvisada e sem capacitação prévia. Nesse contexto, este estudo, de caráter descritivo-exploratório, quanti-qualitativo e com delineamento transversal, buscou compreender a experiência das(os) psicólogas(os) na transição das intervenções da modalidade presencial para o atendimento remoto durante a pandemia de Covid-19 no Brasil, identificando dificuldades e lacunas percebidas nas orientações disponibilizadas pelo Conselho Federal de Psicologia. Participaram da pesquisa 385 psicólogas(os). Utilizou-se um questionário online para a coleta dos dados, distribuído por meio de uma plataforma digital entre maio e novembro de 2020. O estudo também foi divulgado em grupos da categoria profissional da psicologia em diversas redes sociais. Os dados quantitativos foram analisados por meio de análise estatística descritiva, e as respostas para as questões abertas por meio de análise temática reflexiva. Os achados foram organizados em três categorias temáticas: (a) lacunas percebidas nas orientações quanto à escolha da plataforma digital; (b) lacunas quanto ao preenchimento do cadastro no site E-Psi ; e (c) falta de treinamento adequado para realizar a transição para o formato online. Entre os principais resultados, destacaram-se a insegurança gerada pela falta de preparo prévio das(os) profissionais e a resistência de alguns clientes a aceitar a transposição dos atendimentos do modelo presencial para o online. Espera-se que o mapeamento das principais dificuldades enfrentadas pela categoria contribua para qualificar o debate sobre a efetividade das orientações disponibilizadas para as(os) psicólogas(os).
... Also, during COVID-19, the QOL of the healthcare providers has changed more than other people in society [21]. The quality of patient's services was affected due to the mental and psychological problems of healthcare providers [22][23]. ...
Background: The Covid-19 disease was the most significant pandemic of the century. Health care providers showed great sacrifices in managing this disease and saving humanity, and they suffered many injuries. So, this study aimed to investigate the effect of Covid-19 on the resident’s quality of life and comparison with medical students. Methods: This cross-sectional study was performed on 223 Residents and 225 medical students. Using a random sampling method, WHOQOL-BREF 26 questionnaire was distributed among the participants. The collected data were analyzed with SPSS 21 software using T-test and ANCOVA. Results: The results showed that covid-19 had caused a decrease in the quality of life of residents compared to medical students (P value<0.001). In addition, more advanced statistical analyzes showed that high work and study hours, irregular sleep, work history in COVID-19 wards, and the experience of CPR and intubation conditions of covid-19 patients have independent effects on the quality of life. Conclusion: Covid-19 hurt all aspects of the quality of life of residents. Considering the essential role of residents in educational and treatment hospitals, it is necessary to make plans to improve the quality of life and psychological support of these people to prevent the decline in the quality of healthcare services.
Background. The worldwide COVID-19 pandemic has impacted the physical and psychosocial health of the population, with consequences that stretch beyond the initial outbreak. In this context, our aim was to evaluate the psychological effects of the pandemic on individuals in Romania. Methods. We conducted a cross-sectional survey to compare the severity of psychological distress, encompassing anxiety, stress, and depression, in the general population, using DASS-21 questionnaire. Results. Among the 521 valid responses, the experience of illness has broadened the perception of all DASS indicators compared to individuals who have not encountered the disease. Moderate cases of the illness have notably increased anxiety and stress levels, while severe cases of COVID-19 have led to elevated levels of depression. Women exhibit all the assessed variables in a more pronounced manner compared to men. Among the surveyed population, individuals aged over 65 have shown a significant increase in DASS values in response to the COVID-19 pandemic. Conclusion. As we have navigated through the pandemic, it has become clear that varying degrees of psychosocial scars remain in its wake. Within Romania’s sociocultural context, it is apparent that women and the elderly demonstrate unique psychological susceptibilities. Urgent action is required to proactively address and reduce the adverse effects of the pandemic on these vulnerable groups.
Network analysis provides an innovative approach to examining symptom-to-symptom interactions in mental health, and adverse external conditions may change the network structures. This study compared the networks of common risk factors and mental health problems (loneliness, depressive symptoms, and anxiety symptoms) in community-dwelling older people before and during COVID-19. Older adults (aged ≥ 60) at risk for depression were recruited through non-governmental organizations. Loneliness, depressive symptoms and anxiety symptoms were measured using the three-item Loneliness Scale (UCLA-3), nine-item Patient Health Questionnaire (PHQ-9), and seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Data from 2549 (before) and 3506 (during COVID-19) respondents were included using propensity score matching. Being restless (GAD-7-item5) was most central, indicated by Expected Influence, in both pre and during COVID-19 networks despite low severity (mean score). The network during COVID-19 had higher global strength and edge variability than the pre-pandemic network, suggesting easier symptom spread and potentially more complex symptom presentation. In addition, feeling isolated from others (UCLA-3-item3) had stronger connections with feeling worthless/guilty (PHQ-9-item6) and anticipatory anxiety (GAD-7-item7) during COVID-19 than before. These findings may enhance our knowledge of the symptom structure of common mental health problems and the impacts of the pandemic. Targeting central symptoms may offer novel preventive strategies for older people.
Background
Large-scale crisis events such as COVID-19 often have secondary impacts on individuals’ mental well-being. University students are particularly vulnerable to such impacts. Traditional survey-based methods to identify those in need of support do not scale over large populations and they do not provide timely insights. We pursue an alternative approach through social media data and machine learning. Our models aim to complement surveys and provide early, precise, and objective predictions of students disrupted by COVID-19.
Objective
This study aims to demonstrate the feasibility of language on private social media as an indicator of crisis-induced disruption to mental well-being.
Methods
We modeled 4124 Facebook posts provided by 43 undergraduate students, spanning over 2 years. We extracted temporal trends in the psycholinguistic attributes of their posts and comments. These trends were used as features to predict how COVID-19 disrupted their mental well-being.
Results
The social media–enabled model had an F1-score of 0.79, which was a 39% improvement over a model trained on the self-reported mental state of the participant. The features we used showed promise in predicting other mental states such as anxiety, depression, social, isolation, and suicidal behavior (F1-scores varied between 0.85 and 0.93). We also found that selecting the windows of time 7 months after the COVID-19–induced lockdown presented better results, therefore, paving the way for data minimization.
Conclusions
We predicted COVID-19–induced disruptions to mental well-being by developing a machine learning model that leveraged language on private social media. The language in these posts described psycholinguistic trends in students’ online behavior. These longitudinal trends helped predict mental well-being disruption better than models trained on correlated mental health questionnaires. Our work inspires further research into the potential applications of early, precise, and automatic warnings for individuals concerned about their mental health in times of crisis.
Background and Objective
The WHO declared COVID-19 to be a public health emergency which has affected every sphere of life including mental health and is expected to affect the patients of obsessive-compulsive disorder (OCD) adversely. This study aimed to study phenomenology and treatment adherence in patients with the OCD during COVID-19 pandemic.
Materials and Methods
The sample consisted of 96 old and new patients of OCD between the age of 18 and 60 years, with the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) ≥16 and onset of illness prior to COVID-19 (March 2020). Diagnosis was made as per ICD-10-DCR, the likelihood of treatment adherence was assessed using the Medication Adherence Rating Scale, and the severity of OCD was assessed on Y-BOCS. The current and past phenomenologies as per D-YBOCS were compared. Among the patients adherent to treatment, subjective response on the current severity of symptoms as compared to before the onset of COVID-19 was recorded.
Results
The likelihood of treatment adherence was high (according to the Medication Adherence Scale) in 59.2% of cases. Pandemic reasons were reported by 69% of patients with low likelihood of treatment adherence. Few patients developed new symptoms, but no statistically significant change was found when compared to the pre-COVID-19 phenomenology.
Conclusions
Majority of the treatment adherent patients experienced a decrease or no change in their symptom severity as compared to the before COVID-19 severity, suggesting that no worsening of OCD symptoms during the pandemic was observed if the patients were adherent to medications. However, there is a need for long-term considerations and plan interventions accordingly to minimize this deleterious effect.
Purpose
Coronavirus disease 2019 (COVID-19) placed a significant strain on nursing homes, leading to numerous outbreaks and high mortality rates. This situation created considerable stress and challenges for residents, their physicians and nurses, as well as family caregivers. By understanding these challenges, we can gain new insights and learn valuable lessons. Thus, the purpose of this study is to examine the treatment and care provided to nursing home residents with COVID-19, as experienced by physicians, nurses, and family caregivers.
Participants and Methods
This study is a secondary analysis of 35 interviews with physicians, nurses, and family caregivers, each with personal experience caring for nursing home residents diagnosed with COVID-19. The interviews took place from December 2020 to April 2021. We analyzed the transcriptions based on Braun and Clarke’s reflexive thematic analysis model and followed a qualitative descriptive design as outlined by Sandelowski.
Findings
The analysis produced three themes: 1) Balancing medical treatment, 2) The need for increased systematic monitoring of vital functions, and 3) Determining the treatment level for nursing home residents. These themes were explored through the unique perspectives of the three participant groups: physicians, nurses, and family caregivers. The findings revealed several challenges related to treatment and care for nursing home residents diagnosed with COVID-19. This applied both to relief of symptoms, monitoring of vital functions, assessment of treatment level and use of advance care planning.
Conclusion
Drawing from the experiences of physicians, nurses, and family caregivers, there should be a unified plan at the municipal or national level for competency development in nursing homes to prepare for future crises like pandemics or epidemics. Additionally, the safe engagement of family caregivers and relatives should be given priority.
Background
Little is understood of Ebola virus disease (EVD) transmission dynamics and community compliance with control measures over time. Understanding these interactions is essential if interventions are to be effective in future outbreaks. We conducted a mixed-methods study to explore these factors in a rural village that experienced sustained EVD transmission in Kailahun District, Sierra Leone. Methods
We reconstructed transmission dynamics using a cross-sectional survey conducted in April 2015, and cross-referenced our results with surveillance, burial, and Ebola Management Centre (EMC) data. Factors associated with EVD transmission were assessed with Cox proportional hazards regression. Following the survey, qualitative semi-structured interviews explored views of community informants and households. ResultsAll households (n = 240; 1161 individuals) participated in the survey. 29 of 31 EVD probable/confirmed cases died (93·5% case fatality rate); six deaths (20·6%) had been missed by other surveillance systems. Transmission over five generations lasted 16 weeks. Although most households had ≤5 members there was a significant increase in risk of Ebola in households with > 5 members. Risk of EVD was also associated with older age. Cases were spatially clustered; all occurred in 15 households.EVD transmission was better understood when the community experience started to concord with public health messages being given. Perceptions of contact tracing changed from invading privacy and selling people to ensuring community safety. Burials in plastic bags, without female attendants or prayer, were perceived as dishonourable. Further reasons for low compliance were low EMC survival rates, family perceptions of a moral duty to provide care to relatives, poor communication with the EMC, and loss of livelihoods due to quarantine. Compliance with response measures increased only after the second generation, coinciding with the implementation of restrictive by-laws, return of the first survivor, reduced contact with dead bodies, and admission of patients to the EMC. Conclusions
Transmission occurred primarily in a few large households, with prolonged transmission and a high death toll. Return of a survivor to the village and more effective implementation of control strategies coincided with increased compliance to control measures, with few subsequent cases. We propose key recommendations for management of EVD outbreaks based on this experience.
Background:
Responding to health crises overseas can be both rewarding and distressing for staff involved.
Objective:
We interviewed UK staff involved in the 2014/15 Ebola response to identify experiences that positively or negatively affected them.
Method:
We conducted qualitative telephone interviews with 30 Public Health England (PHE) staff and 21 non-governmental organisation (NGO) staff who had deployed to West Africa.
Results:
The main motivations for deploying were for moral reasons and personal development. Families were largely supportive of deployment, although family tension was apparent. Pre-deployment training was largely viewed positively. Common stressors included dealing with death and suffering as well as concerns about contagion, while uplifting aspects included seeing patients improve and receiving thanks from community members. Communications with home were largely satisfactory, although participants commonly self-censored their communication. Inter-organisational tensions caused stress, particularly for PHE staff hosted by NGOs. After deployment, loss of motivation and being avoided by friends and family were common.
Conclusion:
Highlighting the personal benefits arising from deployments, as well as their moral value, may help to increase volunteering. Efforts to improve the support given to responders should focus on identifying how to better support families, preparing all staff members for dealing with death and the risk of contagion, providing opportunities for staff to more frequently experience the uplifting aspects of deployment, resolving inter-organisational difficulties, and educating others about the low risk posed by responders on their return.
OBJECTIVES
Isolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months.
METHODS
Of 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS.
RESULTS
Of 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss.
CONCLUSIONS
Mental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.
Background
Korea has experienced diverse kind of disasters these days. Among them the 2015 middle eastern respiratory syndrome (MERS) outbreak imposed great psychological stress on almost all Korean citizens. Following the MERS outbreak, government is reviewing overall infectious disease management system and prioritizing the establishment of mental health service systems for infectious disease. This study makes suggestions for implementing disaster-related mental health service systems by analyzing the example of Gyeonggi Province, which proactively intervened with residents’ psychological problems caused by the large-scale outbreak of an infectious disease. Case descriptionMental health service system for MERS victims had the following two parts: a mental health service for people who had been placed in quarantine and a service provided to families of patients who had died or recovered patients. The government of Gyeonggi province, public health centers, regional and local Community Mental Health Centers and the National Center for Crisis Mental Health Management participated in this service system. Among 1221 Gyeonggi people placed in quarantine and who experienced psychological and emotional difficulties, 350 required continuing services; 124 of this group received continuing services. That is, 35 % of people who required psychological intervention received contact from service providers and received the required services. Conclusions
This study reflects a proactive monitoring system for thousands of people placed under quarantine for the first time in Korea. It is significant that the service utilization rate by a proactive manner, that is the professionals administering it actively approached and contacted people with problems rather than passively providing information was much higher than other general mental health situation in Korea. The core value of public mental health services is adequate public accessibility; it is therefore essential for governments to strengthen their professional competence and establish effective systems. These criteria should also be applied to psychological problems caused by disastrous infectious disease outbreaks.
Introduction:
In the Ebola Virus Disease (EVD) outbreak in Liberia, two major emergency disease-control measures were cremation of bodies and enforcement of quarantine for asymptomatic individuals suspected of being in contact with a positive case. Enforced by State-related actors, these were promoted as the only method to curtail transmissions as soon as possible. However, as with other harsh measures witnessed by Liberian citizens, in many cases those measures elicited uncontrolled negative reactions within the communities (stigma; fear) that produced, in some cases, the opposite effect of that intended.
Methodology:
The research has been conducted in two phases, for a total of 8 weeks. Ethnography of local practices was carried out in 7 neighbourhoods in Monrovia and 5 villages in Grand Cape Mount County in Liberia. 45 Focus Group Discussions (432 participants) and 30 semi-structured interviews sustained the observing participation. Randomly selected people from different social layers were targeted. The principal investigator worked with the help of two local assistants. Perceptions and practices were both analysed.
Results:
Participants stressed how cremation perpetuated the social breakdown that started with the isolation for the sickness. Socio-economical divides were created by inequitable management of the dead: those who could bribe the burial teams obtained a burial in a private cemetery or the use of Funeral Homes. Conversely, those in economic disadvantage were forced to send their dead for cremation. State-enforced quarantine, with a mandatory prohibition of movement, raised condemnation, strengthened stigmatization and created serious socio-economic distress. Food was distributed intermittently and some houses shared latrines with non-quarantined neighbours. Escapes were also recorded. Study participants narrated how they adopted local measures of containment, through local task forces and socially-rooted control of outsiders. They also stressed how information that was not spread built up rumours and suspicion.
Conclusions:
Populations experiencing an epidemic feel a high degree of social insecurity, in addition to the health hazards. Vertical and coercive measures increase mistrust and fear, producing a counter-productive effect in the containment of the epidemic. On the other hand, local communities show a will to be engaged and a high degree of flexibility in participating to the epidemic response. Efforts in the direction of awareness and community involvement could prove to be better strategy to control the epidemic and root the response on social participation.
Quarantine has been used for centuries in an effort to prevent the introduction, transmission, and spread of communicable diseases. While backed by legal authority, the public and even the health care worker community's understanding of the term is murky at best and scientific evidence to support the use of quarantine is frequently lacking. The multiple interpretations and references to quarantine, the inconsistent application of public health quarantine laws across jurisdictional boundaries, and reports of ineffectiveness are further complicated by associated infringement of civil liberties and human rights abuses. Given the need to balance public safety with human rights, we must be more precise about the meaning of quarantine and consider the efficacy and negative secondary effects resulting from its implementation. This article explains quarantine terminology and then uses a case study from Taiwan during the 2002-2003 severe acute respiratory syndrome (SARS) outbreak to illustrate the key principles associated with quarantine measures taken during the 2014 Ebola outbreak and the potential hazards that can arise from quarantines. Finally, we provide a quarantine and isolation decision tree to assist policy makers and public health officials in applying medically defensible, outcomes-based data and legal authorities to optimize management of emerging infectious diseases. (Disaster Med Public Health Preparedness. 2015;0:1-7).
Objectives:
This study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences.
Methods:
A mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C).
Results:
Disease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports).
Conclusions:
These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures.
Background
During the 2009 H1N1 influenza pandemic, Australian public health officials closed schools as a strategy to mitigate the spread of the infection. This article examines school communities’ understanding of, and participation in, school closures and the beliefs and values which underpinned school responses to the closures.
Methods
We interviewed four school principals, 25 staff, 14 parents and 13 students in five schools in one Australian city which were either fully or partially closed during the 2009 H1N1 pandemic.
Results
Drawing on Thompson et al’s ethical framework for pandemic planning, we show that considerable variation existed between and within schools in their attention to ethical processes and values. In all schools, health officials and school leaders were strongly committed to providing high quality care for members of the school community. There was variation in the extent to which information was shared openly and transparently, the degree to which school community members considered themselves participants in decision-making, and the responsiveness of decision-makers to the changing situation. Reservations were expressed about the need for closures and quarantine and there was a lack of understanding of the rationale for the closures. All schools displayed a strong duty of care toward those in need, although school communities had a broader view of care than that of the public health officials. Similarly, there was a clear understanding of and commitment to protect the public from harm and to demonstrate responsible stewardship.
Conclusions
We conclude that school closures during an influenza pandemic represent both a challenge for public health officials and a litmus test for the level of trust in public officials, government and the school as institution. In our study, trust was the foundation upon which effective responses to the school closure were built. Trust relations within the school were the basis on which different values and beliefs were used to develop and justify the practices and strategies in response to the pandemic.
The aim of the study was to examine, among hospital employees exposed to an outbreak of severe acute respiratory syndrome (SARS), post-outbreak levels of depressive symptoms and the relationship between those depressive symptom levels and the types of outbreak event exposures experienced.
In 2006, randomly selected employees (N = 549) of a hospital in Beijing were surveyed concerning their exposures to the city's 2003 SARS outbreak and the ways in which the outbreak had affected their mental health. Subjects were assessed on sociodemographic factors, on types of exposure to the outbreak, and on symptoms of posttraumatic stress disorder and depression.
The results of multinomial regression analyses showed that, with other relevant factors controlled for, being single, having been quarantined during the outbreak, having been exposed to other traumatic events before SARS, and perceived SARS-related risk level during the outbreak were found to increase the odds of having a high level of depressive symptoms 3 years later. Altruistic acceptance of risk during the outbreak was found to decrease the odds of high post-outbreak depressive symptom levels.
Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware that the experience of being quarantined can, in some cases, lead to long-term adverse mental health consequences.
To investigate strategies for broad mass isolation during outbreaks of infectious diseases.
A survey using a self-administered questionnaire was conducted on 300 printing company workers in Beijing, China, which was under mass isolation following the 2003 SARS outbreak, in the 7-8 months after the isolation was lifted.
Individuals with psychological disorders were classified on the basis of scores on the 30-item General Health Questionnaire during the recovery period. Psychological disorders were observed in 49 of 187 respondents (26.2%; 95% CI = 20.2, 32.7).
The predicting factor with the highest correlation was income reduction, with an odds ratio of 25.0. Other items obtained were gender, range of activities, eating restrictions, restrictions in going out, disinfection of clothing, and infection control, with odds ratios of 3.2, 5.5, 3.9, 3.2, 0.2, and 0.1, respectively, and the contribution ratio was 87.7%.
Securing income is suggested to be important in future strategies.
In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak.
Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure.
In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57-2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36-2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82-2.73; p < 0.001).
Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.
The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the psychological and occupational impact of this event within a large hospital in the first 4 weeks of the outbreak and the subsequent administrative and mental health response.
Two principal authors met with core team members and mental health care providers at Mount Sinai Hospital, Toronto, to compile retrospectively descriptions of the experiences of staff and patients based on informal observation. All authors reviewed and analyzed the descriptions in an iterative process between Apr. 3 and Apr. 13, 2003.
In a 4-week period, 19 individuals developed SARS, including 11 health care workers. The hospital's response included establishing a leadership command team and a SARS isolation unit, implementing mental health support interventions for patients and staff, overcoming problems with logistics and communication, and overcoming resistance to directives. Patients with SARS reported fear, loneliness, boredom and anger, and they worried about the effects of quarantine and contagion on family members and friends. They experienced anxiety about fever and the effects of insomnia. Staff were adversely affected by fear of contagion and of infecting family, friends and colleagues. Caring for health care workers as patients and colleagues was emotionally difficult. Uncertainty and stigmatization were prominent themes for both staff and patients.
The hospital's response required clear communication, sensitivity to individual responses to stress, collaboration between disciplines, authoritative leadership and provision of relevant support. The emotional and behavioural reactions of patients and staff are understood to be a normal, adaptive response to stress in the face of an overwhelming event.
Because of their evolving nature and inherent scientific uncertainties, outbreaks of emerging infectious diseases can be associated with considerable fear in the general public or in specific communities, especially when illness and deaths are substantial. Mitigating fear and discrimination directed toward persons infected with, and affected by, infectious disease can be important in controlling transmission. Persons who are feared and stigmatized may delay seeking care and remain in the community undetected. This article outlines efforts to rapidly assess, monitor, and address fears associated with the 2003 severe acute respiratory syndrome (SARS) epidemic in the United States. Although fear, stigmatization, and discrimination were not widespread in the general public, Asian-American communities were particularly affected.
Using data from 13 surveys of the public, this article compares the public's response to severe acute respiratory syndrome
(SARS) in Ontario (specifically, Toronto), the other Canadian provinces, and the United States, which had substantial differences
in the number of SARS cases. Findings suggest that, even at a relatively low level of spread among the population, the SARS
outbreak had a significant psychological and economic impact. They also suggest that the success of efforts to educate the
public about the risk of SARS and appropriate precautions was mixed. Some of the community-wide problems with SARS might have
been avoided with better communication by public health officials and clinicians.
To examine the psychosocial effects on health care workers of being quarantined because of exposure to severe acute respiratory syndrome (SARS).
We used semistructured qualitative interviews.
We identified 3 major themes concerning psychosocial effects: loss, duty, and conflict.
Quarantined workers experienced stigma, fear, and frustration. We highlight the need for clear and easily accessible information on dealing with infectious diseases. Practical advice on coping and stress management techniques for health care workers are needed in preparation for potential future outbreaks of infectious diseases.
As a transmissible infectious disease, severe acute respiratory syndrome (SARS) was successfully contained globally by instituting widespread quarantine measures. Although these measures were successful in terminating the outbreak in all areas of the world, the adverse effects of quarantine have not previously been determined in a systematic manner. In this hypothesis-generating study supported by a convenience sample drawn in close temporal proximity to the period of quarantine, we examined the psychological effects of quarantine on persons in Toronto, Canada. The 129 quarantined persons who responded to a Web-based survey exhibited a high prevalence of psychological distress. Symptoms of posttraumatic stress disorder (PTSD) and depression were observed in 28.9% and 31.2% of respondents, respectively. Longer durations of quarantine were associated with an increased prevalence of PTSD symptoms. Acquaintance with or direct exposure to someone with a diagnosis of SARS was also associated with PTSD and depressive symptoms.
The outbreak of severe acute respiratory syndrome (SARS) was unique because it was highly concentrated in health care settings and a large number of health care workers were infected. This study investigated stress reactions among 338 staff members in a hospital in East Taiwan that discontinued emergency and outpatient services to prevent possible nosocomial outbreak. Seventeen staff members (5 percent) suffered from an acute stress disorder; stepwise multiple logistic regression analysis determined that quarantine was the most related factor. Sixty-six staff members (20 percent) felt stigmatized and rejected in their neighborhood because of their hospital work, and 20 of 218 health care workers (9 percent) reported reluctance to work or had considered resignation.
To assess the impact of the bombings in London on 7 July on stress levels and travel intentions in London's population.
A cross sectional telephone survey using random digit dialling was conducted to contact a representative sample of adults. Respondents were asked to participate in an interview enquiring about current levels of stress and travel intentions.
Interviews took place between 18 and 20 July.
1010 participants (10% of the eligible people we contacted) completed the interviews.
Main outcomes were presence of substantial stress, measured by using an identical tool to that used to assess the emotional impact of 11 September 2001 in the US population, and intention to travel less on tubes, trains, and buses, or into central London, once the transport network had returned to normal.
31% of Londoners reported substantial stress and 32% reported an intention to travel less. Among other things, having difficulty contacting friends or family by mobile phone (odds ratio 1.7, 95% confidence interval 1.1 to 2.7), having thought you could have been injured or killed (3.8, 2.4 to 6.2), and being Muslim (4.0, 2.5 to 6.6) were associated with a greater presence of substantial stress, whereas being white (0.3, 0.2 to 0.4) and having previous experience of terrorism (0.6, 0.5 to 0.9) were associated with reduced stress. Only 12 participants (1%) felt that they needed professional help to deal with their emotional response to the attacks.
Although the psychological needs of those intimately caught up in the attacks will require further assessment, we found no evidence of a widespread desire for professional counselling. The attacks have inflicted disproportionately high levels of distress among non-white and Muslim Londoners.
Research has suggested that rescue workers are at increased risk for psychological distress. To determine whether 9/11 deployment was a significant risk factor for canine search and rescue handlers, 82 deployed handlers were compared to 32 nondeployed handlers on measures of posttraumatic stress disorder (PTSD), depression, anxiety, acute stress, and clinical diagnoses. Deployed handlers reported more PTSD and general psychological distress 6 months after 9/11. Among deployed handlers, prior diagnoses and peritraumatic reactions were associated with psychological distress whereas social support and training were protective. Results suggest that more extensive screening and prophylactic interventions for individuals with a history of mental illness could be beneficial. Future research should examine identified risk/resilience factors prospectively, and training and intervention should be designed accordingly.
This study examines a cohort of persons quarantined during the 2003 SARS outbreak in Canada and describes their understanding of, difficulties and compliance with, and the psychological impact of the quarantine experience. A mailed questionnaire was administered to 1912 eligible adults and included the Impact of Events Scale - Revised (IES-R) to assess symptoms of post-traumatic stress disorder (PTSD). Self-reported compliance with all required quarantine measures was low (15.8+/-2.3%), although significantly higher when the rationale for quarantine was understood (P=0.018). Health-care workers (HCW) experienced greater psychological distress, including symptoms of PTSD (P<0.001). Increasing perceived difficulty with compliance, HCW, longer quarantine and compliance with quarantine requirements were significant contributors to higher IES-R scores. The low compliance with quarantine requirements introduces concerns about the effectiveness of quarantine as a public health measure. Improvements in compliance and reduced psychological distress may be possible by minimizing duration, revising requirements, and providing enhanced education and support.
To assess the relation between frequency and duration of deployment of UK armed forces personnel on mental health.
First phase of a cohort study.
UK armed forces personnel.
Operational history in past three years of a randomly chosen stratified sample of 5547 regulars with experience of deployment.
Psychological distress (general health questionnaire-12), caseness for post-traumatic stress disorder, physical symptoms, and alcohol use (alcohol use disorders identification test).
Personnel who were deployed for 13 months or more in the past three years were more likely to fulfil the criteria for post-traumatic stress disorder (odds ratio 1.55, 95% confidence interval 1.07 to 2.32), show caseness on the general health questionnaire (1.35, 1.10 to 1.63), and have multiple physical symptoms (1.49, 1.19 to 1.87). A significant association was found between duration of deployment and severe alcohol problems. Exposure to combat partly accounted for these associations. The associations between number of deployments in the past three years and mental disorders were less consistent than those related to duration of deployment. Post-traumatic stress disorder was also associated with a mismatch between expectations about the duration of deployment and the reality.
A clear and explicit policy on the duration of each deployment of armed forces personnel may reduce the risk of post-traumatic stress disorder. An association was found between deployment for more than a year in the past three years and mental health that might be explained by exposure to combat.
Aims:
Exposure to infection is a risk for all healthcare workers. This risk acquires another dimension in an outbreak of highly contagious, lethal disease, such as the Ebola epidemic in West Africa in 2014. Healthcare workers are usually well and correctly informed about the risks from such diseases, but family, neighbours, friends, or colleagues may react strongly to the risk that staff might bring infection home from an epidemic overseas. Research around such stigmatization is scarce. We wanted to investigate how common it is, which expressions it assumes and how it is influenced by dissemination of information.
Methods:
We interviewed a sample of Swedish healthcare workers who had worked in West Africa during the 2014 outbreak of Ebola, as well as one close contact for each of them, about reactions before leaving and after returning, and also about information received.
Results and conclusions:
The majority of contact persons reported no or little concern, neither when the healthcare worker revealed the plan to leave, nor on the healthcare worker's return. The prevailing reason was trust in the judgement of 'their' healthcare worker, mainly using information received from the healthcare worker to assess risks, and relying little on other information channels. This means that the person assessing the risk was at the same time the hazard. There were indications that instructions regarding quarantine and self-isolation were less stringently followed by healthcare workers than by other aid workers in the outbreak, which could give confusing signals to the public. Simple, clear and non-negotiable rules should be preferred - also from an information perspective.
Objective:
To conduct a systematic literature review to identify social and occupational factors affecting the psychological wellbeing of healthcare workers involved in the SARS crisis.
Methods:
Four literature databases were searched and data extracted from relevant papers.
Results:
18,005 papers were found and 22 included in the review. The psychological impact of SARS on employees appeared to be associated with occupational role; training/preparedness; high-risk work environments; quarantine; role-related stressors; perceived risk; social support; social rejection/isolation; and impact of SARS on personal or professional life.
Conclusions:
To minimise the psychological impact of future outbreaks of infectious diseases, healthcare workers should be prepared for the potential psychological impact; employers should encourage a supportive environment in the workplace and ensure that support is in place for those most at risk, for example those with the most patient contact.
Background
In early 2015, a patient from a cluster of cases of Ebola Virus Disease (EVD) in Monrovia, Liberia traveled to a rural village in Margibi County, potentially exposing numerous persons. The patient died in the village and post-mortem testing confirmed Ebola Virus infection.
Problem
The Margibi County Health Team (CHT; Kakata, Margibi, Liberia) needed to prevent further transmission of EVD within and outside of the affected villages, and they needed to better understand the factors that support or impede compliance with measures to stop the spread of EVD.
Methods
In February-March 2015, the Margibi CHT instituted a 21-day quarantine and active monitoring for two villages where the patient had contact with numerous residents, and a 21-day active monitoring for five other villages where the patient had possible contact with an unknown number of persons. One contact developed EVD and quarantine was extended an additional 12 days in one village. In April 2015, the Margibi CHT conducted a household-based EVD knowledge, attitudes, and practices (KAP) survey of the seven villages. From April 24-29, 2015, interview teams approached every household in the seven villages and collected information on demographics, knowledge of EVD, attitudes about quarantine to prevent the spread of EVD, and their quarantine experiences and practices. Descriptive statistics were calculated.
Results
One hundred fifteen interviews were conducted, representing the majority of the households in the seven villages. Most (99%) correctly identified touching an infected person’s body fluids and contact with the body of someone who has died from EVD as transmission routes. However, interviewees sometimes incorrectly identified mosquito bites (58%) and airborne spread (32%) as routes of EVD transmission, and 72% incorrectly identified the longest EVD incubation period as ≤seven days. Eight of 16 households in the two quarantined villages (50%) reported times when there was not enough water or food during quarantine. Nine of 16 (56%) reported that a household member had illnesses or injuries during quarantine; of these, all (100%) obtained care from a clinic, hospital, or Ebola treatment unit (ETU).
Conclusion
Residents’ knowledge of EVD transmission routes and incubation period were suboptimal. Public health authorities should consider assessing residents’ understanding of Ebola transmission routes and effectively educate them to ensure correct understanding. Quarantined residents should be provided with sufficient food, water, and access to medical care.
WilkenJA , PordellP , GoodeB , JartehR , MillerZ , SaygarBGSr. , MaximoreL , BorborWM , CarmueM , WalkerGW , YeiahA . Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola Virus Disease — Margibi County, Liberia: February-March 2015 . Prehosp Disaster Med . 2017 ; 32 ( 6 ): 1 – 6 .
During the 2014–2016 West Africa Ebola epidemic, transmission chains were controlled through contact tracing, i.e., identification and follow-up of people exposed to Ebola cases. WHO recommendations for daily check-ups of physical symptoms with social distancing for 21 days were unevenly applied and sometimes interpreted as quarantine. Criticisms arose regarding the use of coercion and questioned contact tracing on ethical grounds. This article aims to analyze contact cases' perceptions and acceptance of contact monitoring at the field level. In Senegal, an imported case of Ebola virus disease in September 2014 resulted in placing 74 contact cases in home containment with daily visits by volunteers. An ethnographic study based on in-depth interviews with all stakeholders performed in September–October 2014 showed four main perceptions of monitoring: a biosecurity preventive measure, suspension of professional activity, stigma attached to Ebola, and a social obligation. Contacts demonstrated diverse attitudes. Initially, most contacts agreed to comply because they feared being infected. They adhered to the national Ebola response measures and appreciated the empathy shown by volunteers. Later, acceptance was improved by the provision of moral, economic, and social support, and by the final lack of any new contamination. But it was limited by the socio-economic impact on fulfilling basic needs, the fear of being infected, how contacts' family members interpreted monitoring, conflation of contacts as Ebola cases, and challenging the rationale for containment. Acceptance was also related to individual aspects, such as the professional status of women and health workers who had been exposed, and contextual aspects, such as the media's role in the social production of stigma. Ethnographic results show that, even when contacts adhere rather than comply to containment through coercion, contact monitoring raises several ethical issues. These insights should contribute to the ethics debate about individual rights versus crisis public health measures.
Kaci Hickox was a nurse who worked with persons who were infected with Ebola in West Africa. When she returned to the United States, the governors of New Jersey and Maine intervened to confine her to inpatient quarantine despite the fact that she was asymptomatic and had no serological evidence of infection. She defied the quarantine which resulted in enormous public attention and discussion of quarantine and public fear. This article summarizes the case discussing the history of the case, the government actions, and the final legal rulings.
This article is an initial description of a meaningful and valuable clinical experience in interacting with SARS home-quarantined college students in a support group in Taiwan. Information about SARS and home quarantine, the tasks of the Counseling Centers and group work after the SARS outbreak, the support group for home-quarantined members, the observation of support group processes, the therapeutic factors for the SARS home-quarantined support group, and limitations and further recommendations are discussed.
The outbreak of bubonic plague that struck London and Westminster in 1636 provoked the usual frenzied response to epidemics, including popular flight and government-mandated quarantine. The government asserted that plague control measures were acts of public health for the benefit of all. However, contrary to this government narrative of disease prevention there was a popular account that portrayed quarantine and isolation as personal punishment rather than prudent policy. In examining the 1636 outbreak on the parish as well as the individual level, reasons for this inconsistency between official and unofficial perspectives emerge. Quarantine and its effects were not classless, and its implementation was not always strictly in the name of public health. Government application of quarantine was remarkably effective, but it could never be uncontroversial both because of circumstances and because of misuse. The flight of the wealthiest from London and Westminster left only the more socially vulnerable to be quarantined. Though plague policy was financially sensitive to the poorest, it was costly to the middling sort. Another cause of controversy was the government's use of quarantine as a punishment to control individuals found breaking other laws. Though not widely publicized, popular narratives continually included grievances about the cruelty and inequity of quarantine and the militaristic nature of its implementation. Despite these objections, quarantine remained a staple of the government response to plague outbreaks throughout the seventeenth century.
Recent attention has begun to be focused on the effects of disaster recovery work on nonrescue workers. The goal of this study was to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and related symptoms in a population of utility workers deployed to the World Trade Center (WTC) site in the aftermath of 9/11.
Utility workers deployed to the WTC site were screened at their place of employment between 10 and 34 months following the WTC attacks, utilizing both structured interviews and self-report measures. PTSD symptoms were assessed by the CAPS and the PCL; co-morbid disorders were also assessed. 2,960 individuals with complete CAPS and PCL data were included in the analyses.
Eight percent of participants had symptoms consistent with full PTSD, 9.3% with subthreshold PTSD, 6% with MDD, 3.5% with GAD, and 2.5% with panic disorder. Although risk factors included psychiatric and trauma history, 51% of individuals with probable PTSD had neither; subjective perception of threat to one's life was the best predictor of probable PTSD. Extent of exposure predicted 89% of PTSD cases in those without a psychiatric or trauma history, but only 67% of cases among those with both.
Nonrescue workers deployed to a disaster site are at risk for PTSD and depression. Extent of exposure affected the most vulnerable workers differently than the least vulnerable ones. These results suggest that the relationship among predictors of PTSD may be different for different vulnerability groups, and underscore the importance of screening, education, and prevention programs for disaster workers.
To investigate whether being quarantined to contain H1N1 flu transmission is related to immediate negative psychological consequences or not.
Immediate psychological consequences were evaluated with the 20-item Self-Report Questionnaire (SRQ-20) and the Impact of Event Scale-Revised (IES-R) among 419 undergraduate students (176 being quarantined and 243 being nonquarantined).
No significant difference was found between the quarantined group and the nonquarantined group for IES-R screening-positive rate or SRQ-20 screening-positive rate. Multinomial logistic regression analyses indicated that dissatisfaction with control measures was the significant predictor of both SRQ-20 positive screening (OR=2.22) and IES-R positive screening (OR=2.22).
These results are consistent with the conclusion that quarantine does not have negative psychological effects under these circumstances.
Effectively controlling the spread of contagious illnesses has become a critical focus of disaster planning. It is likely that quarantine will be a key part of the overall public health strategy utilised during a pandemic, an act of bioterrorism or other emergencies involving contagious agents. While the United States lacks recent experience of large-scale quarantines, it has considerable accumulated experience of large-scale evacuations. Risk perception, life circumstance, work-related issues, and the opinions of influential family, friends and credible public spokespersons all play a role in determining compliance with an evacuation order. Although the comparison is not reported elsewhere to our knowledge, this review of the principal factors affecting compliance with evacuations demonstrates many similarities with those likely to occur during a quarantine. Accurate identification and understanding of barriers to compliance allows for improved planning to protect the public more effectively.
We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China.
In 2006, randomly selected employees (n = 549) of a hospital in Beijing were surveyed concerning their exposure to the 2003 SARS outbreak, and the ways in which the outbreak had affected their mental health.
About 10% of the respondents had experienced high levels of posttraumatic stress (PTS) symptoms since the SARS outbreak. Respondents who had been quarantined, or worked in high-risk locations such as SARS wards, or had friends or close relatives who contracted SARS, were 2 to 3 times more likely to have high PTS symptom levels, than those without these exposures. Respondents' perceptions of SARS-related risks were significantly positively associated with PTS symptom levels and partially mediated the effects of exposure. Altruistic acceptance of work-related risks was negatively related to PTS levels.
The psychological impact of stressful events related to an infectious disease outbreak may be mediated by peoples' perceptions of those events; altruism may help to protect some health care workers against these negative impacts.
The purpose of this study was to cull lessons from Toronto's experiences with large-scale quarantine during the outbreak of Severe Acute Respiratory Syndrome in early 2003. We focused on issues that affected the population's willingness to comply with quarantine. Information was acquired from interviews, telephone polling, and focus groups. Issues of quarantine legitimacy, criteria for quarantine, and the need to allow some quarantined healthcare workers to leave their homes to go to work were identified. Also important was the need to answer questions from people entering quarantine about the continuation of their wages, salaries, and other forms of income while they were not working, and about the means by which they would be supplied with groceries and other services necessary for daily living. The threat of enforcement had less effect on compliance than did the credibility of compliance-monitoring. Fighting boredom and other psychological stresses of quarantine, muting the forces of stigma against those in quarantine, and crafting and delivering effective and believable communications to a population of mixed cultures and languages also were critical. The need for officials to develop consistent quarantine policies, procedures, and public messages across jurisdictional boundaries was paramount.
Severe Acute Respiratory Syndrome (SARS) possesses characteristics that render it particularly prone to stigmatization. SARS-related stigma, despite its salience for public health and stigma research, has had little examination. This study combines survey and case study methods to examine subjective stigma among residents of Amoy Gardens (AG), the first officially recognized site of community outbreak of SARS in Hong Kong. A total of 903 residents of AG completed a self-report questionnaire derived from two focus groups conducted toward the end of the 3-month outbreak. Case studies of two residents who lived in Block E, the heart of the SARS epidemic at AG, complement the survey data. Findings show that stigma affected most residents and took various forms of being shunned, insulted, marginalized, and rejected in the domains of work, interpersonal relationships, use of services and schooling. Stigma was also associated with psychosomatic distress. Residents' strategies for diminishing stigma varied with gender, age, education, occupation, and proximity to perceived risk factors for SARS such as residential location, previous SARS infection and the presence of ex-SARS household members. Residents attributed stigma to government mismanagement, contagiousness of the mysterious SARS virus, and alarmist media reporting. Stigma clearly decreased, but never completely disappeared, after the outbreak. The findings confirm and add to existing knowledge on the varied origins, correlates, and impacts of stigma. They also highlight the synergistic roles of inconsistent health policy responses and risk miscommunication by the media in rapidly amplifying stigma toward an unfamiliar illness. While recognizing the intrinsically stigmatizing nature of public health measures to control SARS, we recommend that a consistent inter-sectoral approach is needed to minimize stigma and to make an effective health response to future outbreaks.
The purpose of this study was to explore the experience of home quarantine during the severe acute respiratory syndrome (SARS) outbreak in Toronto in 2003.
Qualitative descriptive design.
Stratified random sampling techniques were used to generate a list of potential participants, who varied in terms of gender and closeness of exposure to someone with suspected SARS (contact level). Twenty-one individuals participated in the study.
All interviews were audiotaped and followed a semistructured interview guide. Participants were invited to describe their experience of quarantine in detail including their advice for Public Health.
The experience followed a trajectory of stages beginning before quarantine and ending after quarantine. Despite individual differences, common themes of uncertainty, isolation, and coping intersected the data.
Public Health has a dual role of monitoring compliance and providing support to people in quarantine. This study has implications for public health policy and practice in planning for future public health emergencies in terms of the information and the resources required to mount an effective response.
The purpose of this investigation was to examine the relationship between psychosocial variables and working conditions, and nurses' coping methods and distress in response to the severe acute respiratory syndrome (SARS) crisis in Canada. PARTICIPANTS AND PROCEDURE: The sample consisted of 333 nurses (315 women, 18 men) who completed an Internet-mediated questionnaire that was posted on the Registered Nurses' Association of Ontario (RNAO) website between March and May 2004. The questionnaire was restricted to respondents who had to authenticate their RNAO membership with a valid username and password before accessing the questionnaire. This served a dual purpose: to ensure that only RNAO nurses completed the questionnaire and thereby safeguarding the generalizability of the findings; and second, to prevent any one nurse from contributing more than once to the overall sample.
Correlational analysis yielded several significant relationships between psychosocial variables and working conditions, and the traditional correlates of burnout and stress. Three multiple regression analysis revealed that the model we evolved--including higher levels of vigor, organizational support, and trust in equipment/infection control initiative; and lower levels of contact with SARS patients, and time spent in quarantine--predicted to lower levels of avoidance behavior, emotional exhaustion, and state anger.
By employing models of stress and burnout that combine psychosocial variables and working conditions, researchers can account for significant amounts of variance in outcomes related to burnout. These findings highlight the importance of vigor and perceived organizational support in predicting nurses' symptoms of burnout. For healthcare administrators, this means that a likely strategy for assuaging the negative outcomes of stress should address nurses' psychosocial concerns and the working conditions that they face during novel times of crisis.
Assessing psychological trauma and PTSD
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