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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.
... According to Montemurro (2020), infectious disease outbreaks such as COVID-19 can cause mental health disorders such as emotional distress and anxiety. Brooks et al. (2020) corroborate with Montemurro (2020) that mental health disorders caused by COVID-19, such as anxiety, Post-Traumatic Stress Disorder (PTSD), and anger, can last for years after the outbreak has been contained. ...
... Research done after the Severe Acute Respiratory Syndrome (SARS) outbreak was contained reveals comparable detrimental psychological effects linked to isolation (Hawryluck et al., 2004). On the other hand, reports of negative psychological impacts were frequently reported, according to an analysis of psychological abnormalities among groups of quarantined individuals (Brooks et al., 2020). The PTSD symptoms, anger and confusion were among the psychological effects reported. ...
... The PTSD symptoms, anger and confusion were among the psychological effects reported. The review emphasized possible stresses, such as prolonged quarantine periods, boredom, frustration, infection fears, stigma, insufficient supplies, insufficient information, and monetary loss (Brooks et al., 2020). (2020) that people may experience boredom, anger, and loneliness during quarantine periods. ...
The COVID-19 outbreak has resulted in a global public health and mental health disaster and a massive negative psychosocial experience for students. The counteractive measures are mainly on epidemiology, prevention, and management of the COVID-19 infection, with little attention on mental health. From this background, this study sought to assess the effect of COVID-19 on students’ mental health during quarantine and isolation. An exploratory qualitative research design was applied to determine how COVID-19 affected students' mental health during quarantine and isolation. Purposive sampling was used to obtain cases deemed rich in information to ensure that saturation was reached. Thus, 12 students participated in the study. Data was collected through semi-structured face-to-face interviews. The interviews were audio-recorded, transcribed, and analysed using Tesch’s method of data analysis. The trustworthiness of data was ensured through credibility, dependability, confirmability, and transferability. The study revealed that participants experienced behavioural changes during quarantine and isolation. Irregular sleeping patterns, difficulty in sleeping, and decreased appetite were the behavioural changes that the participants reported. The study also highlighted the coping techniques used by the participants during their quarantine and isolation periods. Religion and support from healthcare workers, family, and friends were some coping strategies that most participants believed to be beneficial. It is concluded that the COVID-19 pandemic poses an unprecedented threat to students’ mental health during quarantine and isolation.
... Mayer explored the connections between multimedia learning and cognitive processes and showed how multimedia learning increased the cognitive part of the learning process [1]. From our perspective, we are concerned by the social part of the education system, including how to create relations between students and thereby avoid the negative consequences of digital and remote teaching such as increased student isolation, loneliness, and dropout rates [2][3][4][5]. ...
... In the higher education sector, this resulted in the closing of universities for prolonged periods of time across the world and a shift to online teaching and students working from home. Studies investigating the effects of the COVID-19 pandemic and the subsequent restrictions found that many students felt isolated and depressed [3,4]. As a response to these challenges, a three-year Bachelor of Nursing program in Norway implemented a student peer mentoring program for firstyear nursing students in 2020 to increase student well-being and prevent students from dropping out. ...
... Combined with the motivation to be there for the first-year students was also a perception that it was difficult to draw a line in terms of what they could not help the mentees with, which was in line with previous studies. In particular, striking a balance between not providing enough support and providing too much support has been found to be especially difficult [3,6,25]. Knowing how difficult both the transition to higher education and being a student during the COVID-19 pandemic was for the first-year students made it particularly challenging for the student peer mentors to set boundaries. The moral squeeze, combined with the difficulties in managing expectations from the students as well as defining the role of a student peer mentor, seemed to be taking an emotional toll. ...
The use of digital and remote teaching has expanded in higher education and reached a peak during the COVID-19 pandemic. Reducing the social component of the learning process may increase students' isolation, loneliness, and dropout rates. This study aimed to investigate the experiences of student peer mentors who participated in a mentoring program that was implemented to increase student well-being and prevent dropping out among first-year Bachelor of Nursing students at a university in Norway during the COVID-19 pandemic. Eleven semi-structured interviews were carried out with student peer mentors. Using a thematic analysis, four themes were identified: being someone who can ease the transition, defining roles and boundaries, developing communication strategies, and developing their own professional competence. Knowing how difficult the transition to higher education was and being a student during the COVID-19 pandemic made it challenging for the mentors to set boundaries. It was also challenging to develop effective ways to communicate with the first-year students. Being a mentor was considered beneficial for developing professional skills such as empathy and communication and to gain self-confidence. There is a need for more knowledge about how to support mentors in clarifying the peer mentoring role, setting boundaries, and coping with the emotional labor involved in peer mentoring.
... Some countries, intending to reduce the impacts of the COVID-19 pandemic, its peak incidence, and the number of deaths, have adopted measures to isolate suspected cases, closing schools and universities and social distancing from risk groups (elderly and others), as well as quarantining the entire population [1,2]. It is estimated that these measures tend to delay the spread of the pandemic, promote a lower incidence peak during a given period, and reduce the likelihood that the capacity of hospital beds, respirators, and other supplies will be inadequate in the face of a sudden increase in demand, which would be associated with a higher mortality rate among the general population [2]. ...
... + βpxip) 1 + exp(β0 + β1xi1 + β21xi2 + . . . + βpxip) (1) The probability of failure is provided by 1−π i = 1 1 + exp(β0 + β1xi1 + β21xi2 + ... + βpxip) (2) The logit for the logistic regression model is characterized by ...
The social distancing imposed by the COVID-19 pandemic has been described as the “greatest psychological experiment in the world”. It has tested the human capacity to extract meaning from suffering and challenged individuals and society in Brazil and abroad to promote cohesion that cushions the impact of borderline experiences on mental life. In this context, a survey was conducted with teachers, administrative technicians, and outsourced employees at the Federal Institute of Piauí (IFPI). This educational institution offers professional and technological education in Piauí, Brazil. This study proposes a system for the early diagnosis of health quality during social distancing in the years 2020 and 2021, over the COVID-19 pandemic, combining multi-criteria decision support methodology, the Analytic Hierarchy Process (AHP) with machine learning algorithms (Random Forest, logistic regression, and Naïve Bayes). The hybrid approach of the machine learning algorithm with the AHP multi-criteria decision method with geometric mean accurately obtained a classification that stood out the most in the characteristics’ performance concerning emotions and feelings. In 2020, the situation was reported as the SAME AS BEFORE, in which the hybrid AHP with Geographical Average with the machine learning Random Forest algorithm stands out, highlighting the atypical situation in the quality of life of the interviewees and the timely manner in which they realized that their mental health remained unchanged. After that, in 2021, the situation was reported as WORSE THAN BEFORE, in which the hybrid AHP with geometric mean with the machine learning Random Forest algorithm provided an absolute result.
... Accordingly, population mobility was reduced by more than 50% in metropolitan areas [3], and all industry activity index declined by 10% between December 2019 and May 2020, mainly due to the mass closure of the service sector including gyms, retail shops, and restaurants [4]. People were overwhelmed by the tremendous psychological stress of loneliness, boredom, fear, and stigma of infection, financial hardship, and severe supply shortages [5], and the long-lasting stress led to negative lifestyle changes, including binge eating, insomnia, and excessive alcohol consumption [5][6][7]. For example, weight gain caused by behavioral changes during the pandemic is well illustrated by the new-coined word "depreobesity" [8]. ...
... Accordingly, population mobility was reduced by more than 50% in metropolitan areas [3], and all industry activity index declined by 10% between December 2019 and May 2020, mainly due to the mass closure of the service sector including gyms, retail shops, and restaurants [4]. People were overwhelmed by the tremendous psychological stress of loneliness, boredom, fear, and stigma of infection, financial hardship, and severe supply shortages [5], and the long-lasting stress led to negative lifestyle changes, including binge eating, insomnia, and excessive alcohol consumption [5][6][7]. For example, weight gain caused by behavioral changes during the pandemic is well illustrated by the new-coined word "depreobesity" [8]. ...
Stay-at-home strategies taken during the COVID-19 pandemic changed our lifestyle drastically. Although marital status and household size are important social determinants of health that affect lifestyle, their impacts on lifestyle during the pandemic are still unclear. We aimed to evaluate the association between marital status, household size, and lifestyle changes during the first pandemic in Japan. Questionnaire surveys on lifestyle changes from before to during the first COVID-19 pandemic were conducted on October 2020 in Japan. Classified into age groups, multivariable logistic regression analysis was performed to examine the combined association of marital status and household size on lifestyle, adjusted for potential confounders including socioeconomic factors. In our prospective cohort study, 1928 participants were included. Among older participants, the singles living alone were likely to perceive more unhealthy lifestyle changes (45.8%), compared with the married (33.2%), and significantly associated with at least one unhealthy change [adjusted odds ratio (OR): 1.81, 95% confidence interval (CI): 1,18-2.78], mainly due to decreased physical activity and increased alcohol consumption. Meanwhile, the younger participants showed no significant association between marital status, household size, and unhealthy changes, while those living alone had 2.87 times higher odds of weight gain (≥ 3 kg) than the married (adjusted OR: 2.87, 95% CI: 0.96-8.54) during the pandemic. Our findings suggest that older singles living alone are potentially vulnerable subgroups to drastic social changes which warrant special attention to prevent adverse health outcomes and additional burden on health systems in the following future.
... During the COVID-19 pandemic, concerns have been expressed about the possibility of increased domestic violence in many countries [8]. Some researchers reported increasing complaints from third parties about violent situations via social media [9]. However, in Iran, no study has been conducted on this issue during the Coronavirus pandemic. ...
... The prevalence of domestic violence in our study was less than in other countries [9]. The possible reasons for the decreasing prevalence of violence in this study may be because people's understandings of domestic violence vary in different regions and the fact that some women may suffer from violence, and they still do not take it as violence. ...
... The detrimental effects of the Covid-19 on psychological health are deeper and broader than previous pandemics, hence the expectation of more adverse psychological consequences. Studies have shown that the Covid-19-induced stress was 1.5 times greater than that of MERS and 1.4 times greater than local earthquakes [3], which indicate the great impact of this disease on physiological and psychological well-being, as well as urgent measures for the psychological health of people in a community [5,6]. ...
... The impact of the pandemic on mental health, including high rates of anxiety, depression, and post-traumatic stress disorder (PTSD) in the general population, has been reported in several countries across the Americas, Asia, the Middle East, and Europe [4], with few studies on specific age groups such as young adults and the elderly [7,8]. Therefore, there is a need for studies that simultaneously compare age groups in terms of psychological responses, especially in low-income countries with more serious crises during pandemics [5]. ...
Background
A widespread outbreak of epidemics like Covid-19 is a lethal threat to physical and mental health. Recent studies reported a higher prevalence of mental problems in younger individuals, contrary to the general assumption expected in older people. Therefore, it is necessary to compare anxiety, stress, depression and PTSD (post-traumatic stress disorder) symptoms in different age groups during the Covid-19 crisis.
Methods
A cross-sectional online survey was performed (from Dec. 2020 to Feb. 2021) on three age groups of elderly, middle-aged and young people. Data were collected by DASS-21 (Depression, Anxiety and Stress Scale) and IES-R (Impact of Event Revised Scale) and analyzed using ANOVA, χ2 test and logistic regression analysis.
Results
Overall, 601 participants completed the questionnaires, including 23.3% of the elderly (≥ 60 years), 29.5% of the young (18–29 years) and 47.3% of the middle-aged (30–59 years) with 71.4% of women. The logistic regression analysis revealed that the risk of PTSD in young people was higher than in the elderly (β = 2.242, CI: 1.03–4.87, P = 0.041), while the risk of depression, anxiety and stress did not differ significantly among the three age groups. Female gender, occupation, lower economic status, solitary life, and chronic disease were risk factors for psychological symptoms during the Covid-19 pandemic.
Conclusion
Findings on the higher odds ratio of PTSD symptoms in younger individuals have interestingly potential implications to meet the needs of mental health services during Covid-19.
... Several recent investigations have explored the psychological influences of the COVID-19 outbreak on health professionals caring for those who were ill and the public as well. Surveys of healthcare worker populations found negative effects of the COVID-19 outbreak [7][8][9]. Studies have reported a high level of physical and psychological pressure experienced by Chinese healthcare professionals as they responded to this huge public health emergency [10][11][12][13][14][15]. ...
... Zimet et al. [36] developed a self-administered 12-item measure of perceived adequacy of social support in three areas: family (Fam), friends (Fri), and significant others (SO). Each MSPSS item had a 7-point Likert scale response, ranging from 'very strongly disagree' (1) to 'very strongly agree' (7). When summed, the total MSPSS score ranged from 12 to 84. ...
... However, parents still need to conduct more basic education and supervision than usual, which may increase parental stress. In addition, unprecedented global school shutdowns and novel homeschooling styles substantially disrupt the routine lives of students and their families and may have negative consequences for their health [12,13] . Recent studies have suggested that home con nement contributes to longer screen time and social isolation, resulting in depression, sleep disturbances and other psychological consequences (e.g., stress, anxiety, family con ict) [11][12][13][14] . ...
... In addition, unprecedented global school shutdowns and novel homeschooling styles substantially disrupt the routine lives of students and their families and may have negative consequences for their health [12,13] . Recent studies have suggested that home con nement contributes to longer screen time and social isolation, resulting in depression, sleep disturbances and other psychological consequences (e.g., stress, anxiety, family con ict) [11][12][13][14] . Thus, a longer time of homeschooling may be correlated with worse parental mental health. ...
Background: Many countries worldwide implemented school closures to reduce COVID-19 transmission. By the new ‘homeschooling’ process, children could continue the regular school curriculum from the software-based system, which could alleviate parents' concerns about their children's educational attainment. However, parents still conduct more basic education and supervision, which may increase parental stress.
Objective: This study aims to examine the interaction effect of homeschooling experience and pandemic-related worries on Chinese parents’ mental health. In addition, whether and how the relationship between homeschooling experience, pandemic-related worries and mental health could vary between women and men was examined.
Method: This study recruited 746 Chinese parents with 10-18-year-old children during the COVID-19 pandemic. Data were analysed with multiple linear regression.
Results: We found a higher level of job-related worries was associated with worse parental mental health (β= 3.593，P<.001). Additionally, the learning process was significantly positively correlated with parental mental health (acceptance of parental homework support β=1.748, P=.003; children’s completion of the studying task β=1.337, P=.018). Job-related worries significantly moderated the relationship between homeschooling and parental mental health (β=2.215, P=.026), while virus-related and life-related worries did not. Regarding gender differences, the interaction effects of job-related worries on the relationship between homeschooling and parental psychological symptoms were only significant among mothers (β=2.579, P=.020).
Conclusion: Homeschooling is significantly associated with Chinese parents’ psychological symptoms. Parental worries are found to moderate the association between homeschooling and parental psychological symptoms. Moreover, job-related worries played a moderating role in the association between homeschooling and parental mental health. Thus, school intervention programs should also be implemented to help children adjust negative learning status in homeschooling.
... The perceived effect of the pandemic on daily life manifests itself not only as physiological problems and the risk of death, but also socially and psychologically. Additionally, the COVID-19 pandemic, which is perceived as an important threat to issues such as health and economy, has affected the flow of life by causing changes in the daily life behaviours of individuals with the social distancing rules, interruption of education, social isolation, quarantine rules, and working from home (Brooks et al., 2020;Cao et al., 2020;Di Giuseppe et al., 2020;Mukhtar, 2020). The lifestyle (ineffective weight control, insufficient physical activity, etc.) and psychosocial areas (anxiety, decrease in social support, depression, stigma, etc.) changes caused by the pandemic have been deeply felt worldwide (Brooks et al., 2020;Cao et al., 2020;Mukhtar, 2020). ...
... Additionally, the COVID-19 pandemic, which is perceived as an important threat to issues such as health and economy, has affected the flow of life by causing changes in the daily life behaviours of individuals with the social distancing rules, interruption of education, social isolation, quarantine rules, and working from home (Brooks et al., 2020;Cao et al., 2020;Di Giuseppe et al., 2020;Mukhtar, 2020). The lifestyle (ineffective weight control, insufficient physical activity, etc.) and psychosocial areas (anxiety, decrease in social support, depression, stigma, etc.) changes caused by the pandemic have been deeply felt worldwide (Brooks et al., 2020;Cao et al., 2020;Mukhtar, 2020). ...
This study was aimed to determine the effects of the pandemic on life. This is a qualitative descriptive study and data were collected through semi-structured interviews (n = 200). The data were obtained by retrospectively examining the interviews made by the students between January and May 2021. The researchers prepared ‘Participant Information Form’ and ‘Semi-Structured Interview Form’, which were utilised as data collection tools during the interviews. The qualitative data acquired from the semi-structured interview using descriptive analysis. In the interviews, nursing students are in the role of interviewers. Participants were determined from among the relatives of the students. The research was structured and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist. The data acquired regarding the effects of the pandemic on life were conceptualised under three themes (nine sub-themes): the meaning of the pandemic(1), the effects of the pandemic on life(2), and coping with the pandemic(3). The study revealed that the pandemic included individual meanings at levels of emotions (fear, hopelessness, loneliness, despair, and uncertainty) and cognition - behaviour (danger, attention-caution, restriction and awareness).Pandemic resulted in changes in the life routines of the participants, changes in mental and social spheres, and various effects as the effect of the disease such as pain.Spiritual approaches (prayer and positive thinking), as well as social support and healthy lifestyle habits, were the methods used to cope with the pandemic. It is recommended that psychiatric nurses plan and implement individual/social interventions based on a psychosocial approach in order to cope with the short and long-term effects of the pandemic.
... An early study conducted via a survey during the SARS-CoV-2 pandemic lockdowns in China, found increased levels of depression and anxiety in a snowball sample of the general public via university students [21]. Other studies showed a greater increase in alcohol consumption as a coping strategy during the initial lockdown phase of the pandemic [22][23][24], consistent with previous findings on the psychological impact of pandemic-related quarantines [25]. In the US, alcohol sales in early March to mid-April 2020 rose significantly, with an increase in liquor store sales of 54% and online alcohol sales of 262%, compared with 2019 data [26]. ...
Alcohol consumption often increases in times of stress such as disease outbreaks. Wisconsin has historically ranked as one of the heaviest drinking states in the United States with a persistent drinking culture. Few studies have documented the impact of the COVID-19 pandemic on alcohol consumption after the first few months of the pandemic. The primary aim of this study is to identify factors related to changes in drinking at three timepoints during the first eighteen months of the pandemic. Survey data was collected from May to June 2020 (Wave 1), from January to February 2021 (Wave 2), and in June 2021 (Wave 3) among past participants of the Survey of the Health of Wisconsin. Study participants included 1290, 1868, and 1827 participants in each survey wave, respectively. Participants were asked how their alcohol consumption changed in each wave. Being younger, having anxiety, a bachelor’s degree or higher, having higher income, working remotely, and children in the home were significantly associated with increased drinking in all waves. Using logistic regression modeling, younger age was the most important predictor of increased alcohol consumption in each wave. Young adults in Wisconsin may be at higher risk for heavy drinking as these participants were more likely to increase alcohol use in all three surveys.
... Similar results were reported in both Australian and Bangladesh results [23,24]. Fear of contracting the infection, quarantine measures for infected individuals, and self-isolation/social distancing for the general population may have played a major role in influencing their mental health during the critical phases of the pandemic and could explain this association [39,40]. A study reported that patients affected with COVID-19 had a high level of post-traumatic stress symptoms and a significantly higher level of depressive symptoms [41]. ...
Background:
The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally.
Objectives:
We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE.
Methods:
We conducted a cross-sectional online survey across the UAE during November 2020. Adults aged ≥18 years, living in the UAE who were able to respond to an online questionnaire in English or Arabic were considered eligible to participate in the study. We used standard validated tools to measure psychological distress, fear and coping. Kessler Psychological Distress Scale [K10] was used to assess psychological distress, Fear of COVID-19 Scale [FCV-19S] was used to assess the level of fear, and Brief Resilient Coping Scale [BRCS] was used to assess the coping strategies.
Results:
A total of 417 individuals participated in this study with a mean age of 29 [± 10.7] years. More than half of the participants experienced high to very high levels of psychological distress [55%] and a quarter experienced high levels of fear of COVID-19 [23.3%] with almost a third of them [36.2%] having low resilient coping. About 37.4% of the participants had work-related mental health impacts and 32.4% were perceived to have moderate to a great deal of distress due to a change of employment status during the pandemic. One in ten participants [9.4%] reported increased smoking. Increased smoking [AOR 8.66, 95% CIs 1.08-69.1,], increased alcohol drinking [AOR 2.39, 95% CIs 1.05-5.47] and higher levels of fear of COVID-19 [AOR 2.93, 95% CIs 1.83-4.67] were associated with moderate to very high levels of psychological distress. Being female [AOR 1.82, p = 0.030], having a pre-existing mental health condition [AOR 9.88, 95% p = 0.027], engaging in high-risk behaviors such as increased smoking [AOR 21.14, p = 0.003], increased alcohol drinking [AOR 1.48, p = 0.359] in the previous four weeks, and higher levels of fear of COVID-19 [AOR 4.18, p <0.001] were associated with moderate to very high levels of psychological distress. Also, being a smoker [AOR, 0.840, p = 0.011], and having a high level of fear [AOR 0.372, p = 0.001] were found to be associated with low resilient coping.
Conclusion:
Community members in the UAE are at a higher risk of psychosocial distress and fear during the COVID-19 pandemic. Thus, healthcare providers and policymakers would need to be more alert to provide specific mental health support strategies for their wellbeing.
... The psychological impact of quarantine can range from immediate consequences such as irritability, fear of being infected and spreading of the infection to family members, anger, embarrassment, frustration, loneliness, denial, anxiety, depression, insomnia, despair, to extreme consequences including suicide (Brooks et al . 2020;Robertson et al. 2004;Barbisch et al. 2015). ...
the novel coronavirus disease of 2019 (COVID 2019) has gripped the world with fear, anxiety and confusion, and it is spreading as fast as a virus. In addition to the negative consequences of the infection of COVID-19 for health, the implementation of strict quarantine also affected the world economy. As a result, there is growing concern that the pandemic has harmed the mental health of the general population. Fear, anxiety, and stress are normal responses to perceived or real threats, and when we are faced with uncertainty or something unknown. Thus, it is normal and understandable for people to feel fear in the context of the COVID-19 pandemic. Together with a fear of being infected with a virus during a pandemic like COVID-19, there are significant changes to our daily lifestyle: our movements somewhere is restricted in support of efforts to contain and slow down the spread of the virus. As the COVID-19 pandemic and lockdown measures continue, there is growing interest in the long-term effects on mental health. In this article, we aim to review and summarize the results of various studies that have examined the psycho-sociological consequences of the pandemic and its impact on the mental well-being of population in a general.
... Online education during the pandemic was forced rather than intentionally accepted [11]. The circumstances surrounding the COVID-19 pandemic were remarkable, and there was cause for concern over the unfavourable effects of lockdowns and lengthy quarantine periods on the education and mental health of students [12]. ...
The purpose of this study is to explore the relationship between student motivation, student mindset, computer competency, and behavioural intention to continue using e-learning in the post-COVID-19 era among students at the community colleges in Kelantan, Malaysia. This quantitative study used a self-administered online survey questionnaire, and a convenience sampling method was employed to reach the respondents. Partial least square structural equation modelling (SmartPLS) 4.0 was then used for data analysis. The results of the current study reveal that community college students have a high behavioural intention to continue using e-learning in the post-COVID-19 era, and that behavioural intention positively correlates with student motivation and computer competency. However, there is limited evidence to support the relationship between student mindset and their behavioural intention to continue using e-learning in the post-COVID-19 era. Practically, the findings from this study can be an essential landmark to the management of Community Colleges in determining the direction of future learning in community colleges.
... In the case of the COVID-19 pandemic, the percentage of people who experience complications in the grieving process may be higher (Skalski et al., 2022). The COVID-19 pandemic has caused a devastating amount of physical and mental suffering to people around the world (Brooks et al., 2020;Gallegos et al., 2020;Shigemura et al., 2020). Many of those who lost loved ones to this deadly disease have experienced an especially difficult grieving process, referred to as pandemic grief. ...
Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dys-functional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dys-functional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p = .003), depression (p = .021), and COVID-19 obsession (p = .032) were significant (χ 2 = 84.31; Nagelkerke R 2 = .242) and predict a 24.2% chance of dys-functional bereavement.
... 8 In addition, the pandemic and efforts to contain it appear to have fostered a new mental health crisis. 9,10 A Centers for Disease Control and Prevention (CDC) survey in June 2020 found that more than 4 in 10 adults had at least 1 mental or behavioral health concern, with 31% reporting symptoms of anxiety or depression. 11 These concerns occurred more often among young adults, racial/ethnic minorities, and those with preexisting mental health concerns. ...
... Most countries imposed drastic measures to mitigate the spread of the coronavirus. 29,30 The closure of educational institutions and the shift to online learning have posed a myriad of challenges for both students and teachers. Moreover, COVID-19 has significantly impacted the practices of professional students regarding academics and social life. ...
... Anxiety and nervousness influence everyone in society. Recent research reveals that persons who are quarantined suffer from high levels of stress, worry and other negative emotions (Brooks et al., 2020) Travel anxiety is a sort of tourist self-anxiety. The desire to travel lessens, anxiety increases and travellers' perceptions of safety deteriorate (Gudykunst and Hammer, 1988). ...
Purpose
Applying three psychological theories, this study aims to attempt to investigate the role of consumer psychology, specifically the factors of trust in vaccination, threat severity, fear, anxiety, risk and hygiene, and safety, on intention to resume hotel consumption. The authors also tested the mediation effect of anxiety among psychological constructs: perceived threat, fear and risk with the intention to resume hotel consumption.
Design/methodology/approach
Using purposive sampling, data were collected from 470 respondents from four cities in Malaysia and analysed by applying analysis of moment structures (AMOS) structural equation model technique. The respondents for this study were frequent travellers meaning the leisure tourists who at least travel twice a year or travel when getting the occasion to explore new things. In this study, an online survey was employed to ensure easy accessibility and to enhance the number of replies.
Findings
The results of this study confirmed that perceived severity, risk and fear influence travellers' anxiety. This study further confirms that trust in vaccination and hygiene & safety provided by the hotelier reduces anxiety levels. Anxiety is found one of the most important predictors of intention to resume hotel consumption, which further mediates the relationship between other psychological variables: perceived severity, risk, fear and intention to resume hotel consumption. Anxiety mediates the relationship between perceived severity, fear and intention to resume hotel consumption and partially mediates the association between risk and intention to resume hotel consumption.
Originality/value
This study examined three psychological theories and extended them by including the trust in vaccination and the hygiene and safety constructs. Anxiety was investigated as a mediator.
... Common eye emergencies such as retinal detachment and acute angle-closure glaucoma, which require timely diagnosis and specialist intervention, were cumbersome and diffi cult to manage in this setting. Quarantine and stay-at-home prescriptions could lead to adverse psychological consequences, whereby patients may refuse to seek immediate medical care and may limit their access to appropriate eye care [4]. ...
The progress of information and communication technologies in the era of COVID-19 created an unprecedented opportunity for medicine to adapt to new models of care. Telemedicine and telehealth have enabled medical care at a distance in various fields, including ophthalmology. The aim of this article is to review the current state and the opportunities for telemedicine in ophthalmology.
Materials and methods
PubMed, ScienceDirect Database, Google Scholar databases, as well as official sites of various governmental and non-governmental institutions were explored. The search was conducted between May 1, 2022 and July 31, 2022 using as key words “teleophthalmology”; “telemedicine/telehealth and ophthalmology”; “ophthalmology and COVID-19”.
Results
87 primary sources were reviewed. An exploratory analysis of the current state and application of telemedicine in ophthalmology was made.
Conclusion
A great number of innovations have created an environment allowing for teleophthalmology to flourish, whereas the COVID-19 epidemic has accelerated the development and adoption of these digital technologies. Telemedicine has become an extremely valuable tool during a pandemic, and even if it would never fully replace in the person-to-person patient visits, it certainly has an important role in our dynamic and high-tech world.
... Amid the pandemic, donations can provide logistical support for the government, health centers, and individuals affected by COVID-19. 4 More specifically, pandemic prevention departments and medical units can use donations to implement better prevention and treatment measures. Thus, charitable donations and assistance can strengthen cooperation between government and citizens toward combating During the unprecedented quarantine of the epidemic, online donation platforms have become one of the most effective ways to make charitable donations. ...
Shuaiqi Li,1 Kehan Li,2 Jianbiao Li3 1School of Finance, Shandong University of Finance and Economics, Jinan, People’s Republic of China; 2School of Economics, Shandong University of Finance and Economics, Jinan, People’s Republic of China; 3Institute for Study of Brain-Like Economics/School of Economics, Shandong University, Jinan, People’s Republic of ChinaCorrespondence: Kehan Li; Jianbiao Li, Email kehanlee@126.com; biaojl@126.comPurpose: This study assesses how various social information influence individuals’ money donation behaviors towards charitable funds against the COVID-19 pandemic at different stages of the pandemic. It also explores the mediating role of social anxiety and the moderating role of self-control.Materials and Methods: This three-wave study was conducted with online survey experiments using convenience sampling at the pandemic’s outbreak stage (April–June 2020), trough stage (February–March 2021), and resurgence stage (May 2022) in China. The nudge power of social information was measured by whether participants changed their initial money donation decisions after informed positive or negative social information. Self-report scales were used to measure levels of social anxiety (Social Interaction Anxiety Scale) and self-control (Self-Control Scale). The final data set included 1371 participants from 26 provinces of mainland China. Stata medeff package and SPSS PROCESS were used to analyze the data.Results: Individuals’ initial donation behaviors did not fluctuate along with the pandemic status, but the nudge effect of social information did. From outbreak stage to trough stage, the nudge power of positive social information significantly declined, but did not significantly change again at the resurgence stage. By contrast, the nudge power of negative social information did not significantly differ between outbreak and trough stage but did significantly increase at the resurgence stage. Social anxiety played a significant mediating role in the relationship between COVID-19 status and power of social information. Moreover, self-control moderated the direct effect of COVID-19 status on power of social information and the indirect effect via social anxiety.Conclusion: Our findings enrich research on the nudge power variation of social information on individuals’ donation behaviors along with the pandemic status and its potential psychological influence factors. This study also helps guide organizations to better design and carry out social information nudge mechanism.Keywords: COVID-19, nudge, social information, donation, social anxiety, self-control
... For those who have been quarantined or hospitalized, the support should continue beyond the event as there is a persisting impact on the QoL of covid-19 survivors as well as their partners and family members [57]. Moreover, it has been reported that there is a longterm psychological impact of quarantine among hospital staff even after three years of the SARS outbreak [58] and organizational support reduced PTSD among HCWs in Wuhan, China during the COVID-19 pandemic [59]. This highlights the importance of continuing organizational support for this vulnerable group even after the events. ...
Background:
The coronavirus disease 2019 (COVID-19) affects almost all countries in the world and it impacts every aspect of people's life-physically, mentally, and socio-economically. There are several research studies examining the impact of this pandemic on health, however, very few studies examining the impact of this pandemic on quality of life. This study aimed to investigate the association between proximity to the COVID-19 and quality of life of healthcare workers and identify factors influencing quality of life.
Methods:
A cross-sectional study was conducted among hospital staff in a tertiary hospital in Singapore. Data on demographic, medical history, lifestyle factors, psychosocial factors, and quality of life were collected using online self-administered questionnaire. Quality of life (QoL) was measured by the WHOQOL-BREF questionnaire. Robust linear regression was used to determine factors associated with quality of life.
Results:
A total of 1911 participants were included in the analysis. The average age of participants was 38.25 (SD = 11.28) years old. 26.90% of participants had been quarantined, hospitalised, being suspected or diagnosed of having COVID-19 infection and they were found to have the lowest levels of QoL across all four domains (physical, psychological, social, and environmental domains). Participants who were singles or nurses, worked in shifts or worked longer hours, had chronic diseases were likely to have lower QoL scores compared to participants in other categories. Healthy lifestyle, social connectivity, resilience, social and workplace support were associated with higher QoL scores.
Conclusions:
In planning of measures which aim to improve QoL of healthcare workers, priority should be given to individuals who have been quarantined, hospitalised, being suspected, or diagnosed of having COVID-19 infection. In addition to the proximity of the COVID, lifestyle and psychosocial factors contribute to QoL of healthcare workers. Hence, multifaceted interventions are needed to improve QoL of healthcare workers.
... La salud mental, desde una perspectiva integral y promocional, es comprendida como un estado de bienestar mental que permite a las personas hacer frente a los momentos de estrés de la vida, desarrollar todas sus habilidades, poder aprender y trabajar adecuadamente y contribuir a la mejora de su comunidad (Organización Mundial de Salud (OMS), 2011). Como ha sido ampliamente reportado, el contexto de confinamiento y distanciamiento físico y social asociado al COVID-19 ha predispuesto a las personas a un mayor desgaste psicológico y presentación de trastornos ansiosos y de estrés (Brooks et al., 2020), así como a un deterioro de la salud mental y del bienestar mental en general (Huarcaya-Victoria, 2020). Así, la crisis por COVID-19 ha sido considerada "un escenario que muestra la probabilidad de una crisis psicológica sin precedentes" (Abad & Abad, 2020, p.4). Por este motivo se han desarrollado a nivel internacional múltiples herramientas para atender la salud mental y para enfrentar situaciones estresantes (por ejemplo, Organización Mundial de la Salud [OMS], 2020), con miras a disminuir, además, el desgaste que se ha generado progresivamente ante la vivencia continua de importantes sucesos vitales estresantes asociados a la pandemia y su abordaje (Robles-Sánchez, 2021). ...
Se presenta una intervención pedagógica de Aprendizaje Servicio universitario realizada durante la primera ola de la crisis sanitaria por COVID-19, en el curso "Desgaste y cuidado en intervención social" de la formación profesional en psicología comunitaria de una universidad chilena. A partir de diversos insumos teóricos y empíricos, así como de los requerimientos de tres socios comunitarios, se reconoció la necesidad de abordar la salud mental y el desgaste en la docencia online, el teletrabajo y los encuentros interpersonales virtuales, realizándose cuatro infografías que tuvieron como objetivos promover una mirada integral y crítica del desgaste, y favorecer el cuidado en dichos espacios durante períodos de confinamiento. Se describe el proceso de elaboración y los contenidos de las infografías, las estrategias de divulgación, y la evaluación de la intervención. Como conclusiones, se reflexiona sobre la posibilidad de realizar Aprendizaje Servicio en contextos de crisis y sobre su contribución para abordarlas, así como sobre la importancia de favorecer el aprendizaje integral de los/as estudiantes, destacándose aportes de la psicología comunitaria.
... Diese gesundheitlichen Disparitäten sind häufig Folge von Minderheitenbelastungen aufgrund von sozialer Benachteiligung, Diskriminierung und Stigmatisierung in allen Lebensbereichen [27]. Krisen wie die COVID-19-Pandemie setzen LGBTIA-Personen nicht nur einem höheren Risiko für psychische Probleme aus [24,28,29,30], sondern schaffen weitere Barrieren zur Inanspruchnahme von medizinischer Versorgung, dazu gehören unter anderem der fehlende Zugang zu LGBTIAfreundlicher medizinischer Versorgung, Psychotherapie und sozialen Selbsthilfegruppen, insbesondere für diejenigen, die eine geschlechtsangleichende Gesundheitsversorgung und Dienstleistungen suchen [31]. In Deutschland wurde bereits mehrfach auf die Problematik der Diskriminierungserfahrungen von LGBTIA Personen im Gesundheitswesen hingewiesen [32,33,34]. ...
Introduction:
Measures against the COVID-19 pandemic led to restrictions in ambulatory health care in Germany. While the restrictions have been described from claims data, the patients' perspective has been missing. Lesbian, gay, bisexual, trans-, inter- and asexual persons (LGBTIA) might have been particularly affected by these restrictions because of their vulnerability. Thus, our research questions were: 1) How did the restrictions during the pandemic influence primary care and psychotherapy in Germany from the patients' perspective? 2) Are there differences between LGBTIA and cis-heterosexual persons regarding these restrictions?
Methods:
We conducted an online survey with two survey waves in March/April 2020 and January/February 2021. Sampling was conducted via multiplicators and via snowball sampling. Amongst others, the survey contained open-ended questions regarding primary care and psychotherapy. From the answers of the first survey wave we constructed quantitative items for the second survey wave. Descriptive and inferential statistical analysis was conducted, including linear regression with R.
Results:
6,784 participants took part in the survey (2,641 in the first survey wave), 5,442 of whom identified as LGBTIA. Categories of changes in primary care were: no health care utilization, no changes in primary care, insecurity regarding primary care, and changes in primary care which could be less frequent utilization, differing procedures or changes in ways of communication. In the second wave, LGBTIA participants rated the worsening of primary care during the pandemic as being more pronounced. Regarding psychotherapy, the change can be described as no change in care, changes in the form of therapy, treatment in emergencies only and a longer break from psychotherapy. There was no different rating by LGBTIA persons compared to cis-heterosexual persons in the second survey wave. Telephone and video consultations were more common in psychotherapy than in primary care.
Discussion:
LGBTIA persons were oversampled, so the sample included more people from urban areas than the German population. Due to the online survey form, older people were underrepresented relative to their numbers in the general German population.
Conclusion:
With respect to future pandemics GENERAL practitioners in primary care must be prepared that psychotherapy might be paused and delayed for some time. Video and telephone consultations should be offered to overcome pandemic-related restrictions in the future. General practitioners should know the gender identity and sexual orientation of their patients in order to proactively address health care barriers.
... social contacts and being at crowded places. By decreasing daily activities and social interactions, cognitive and physical well-being are compromised and the risk for many conditions such as falls, dementia, and psychiatric symptoms increase [31,32]. Historical data helps to explore whether the health profiles of geriatric patients in overall have changed during the pandemic. ...
Objective:
To analyse if the health progression of geriatric Covid-19 survivors three months after an acute Covid-19 infection was worse than in other geriatric patients. Specifically, we wanted to see if we could see distinct health profiles in the flow of re-admitted Covid-19 patients compared to re-admitted non-Covid-19 controls.
Design:
Matched cohort study.
Setting and participants:
Electronic medical records of geriatric patients hospitalised in geriatric clinics in Stockholm, Sweden, between March 2020 and January 2022. Patients readmitted three months after initial admission were selected for the analysis and Covid-19 survivors (n = 895) were compared to age-sex-Charlson comorbidity index (CCI)-matched non-Covid-19 controls (n = 2685).
Methods:
We assessed using binary logistic and Cox regression if a previous Covid-19 infection could be a risk factor for worse health progression indicated by the CCI, hospital frailty risk score (HFRS), mortality and specific comorbidities.
Results:
The patients were mostly older than 75 years and, already at baseline, had typically multiple comorbidities. The Covid-19 patients with readmission had mostly had their acute-phase infection in the 1st or 2nd pandemic waves before the vaccinations. The Covid-19 patients did not have worse health after three months compared to the matched controls according to the CCI (odds ratio, OR[95% confidence interval, CI] = 1.12[0.94-1.34]), HFRS (OR[95%CI] = 1.05[0.87-1.26]), 6-months (hazard ratio, HR[95%CI] = 1.04[0.70-1.52]) and 1-year-mortality risk (HR[95%CI] = 0.89[0.71-1.10]), adjusted for age, sex and health at baseline (the CCI and HFRS).
Conclusions and implications:
The overall health progression of re-hospitalized geriatric Covid-19 survivors did not differ dramatically from other re-hospitalized geriatric patients with similar age, sex and health at baseline. Our results emphasize that Covid-19 was especially detrimental for geriatric patients in the acute-phase, but not in the later phase. Further studies including post-vaccination samples are needed.
... In addition, parents may have faced economic insecurity, had to educate their children at home as a substitute for school attendance and had to deal with an uncertain outlook into the future. Working at home and living with preschool-aged children has particularly influenced the extent of mental distress during the pandemic [42,43]. Therefore, the impact of lockdowns implemented in response to COVID-19 on mental health has raised concerns [44,45]. ...
Background
There is consistent evidence that the COVID-19 pandemic is associated with an increased psychosocial burden on children and adolescents and their parents. Relatively little is known about its particular impact on high-risk groups with chronic physical health conditions (CCs). Therefore, the primary aim of the study is to analyze the multiple impacts on health care and psychosocial well-being on these children and adolescents and their parents.
Methods
We will implement a two-stage approach. In the first step, parents and their underage children from three German patient registries for diabetes, obesity, and rheumatic diseases, are invited to fill out short questionnaires including questions about corona-specific stressors, the health care situation, and psychosocial well-being. In the next step, a more comprehensive, in-depth online survey is carried out in a smaller subsample.
Discussion
The study will provide insights into the multiple longer-term stressors during the COVID-19 pandemic in families with a child with a CC. The simultaneous consideration of medical and psycho-social endpoints will help to gain a deeper understanding of the complex interactions affecting family functioning, psychological well-being, and health care delivery.
Trial registration
German Clinical Trials Register (DRKS), no. DRKS00027974. Registered on 27th of January 2022.
In a society that strives for appearance, fitness is increasingly viewed as a means to reach a certain aesthetic ideal, rather than a way to improve health and physical performance. Every day millions of posts appear on social media promoting a visual representation of apparently fit, healthy and 'perfect' bodies. Combining personal accounts, clinical cases, and scientific research, this book explores how such new trends in society can lead to the development of exercise addiction and body image disorders. It explains how such a concern with physical appearance can act as a precursor or be symptomatic of other conditions, such as eating disorders, mood disorders, and the use of performance and image enhancing drugs. It highlights throughout the importance of raising awareness amongst health professionals, including psychiatrists, psychologists, mental health nurses, social workers and primary care physicians, of this growing challenge to prevent harm and improve treatment.
Although an estimated 1.4 million women living with HIV (WHIV) are pregnant each year globally, data describing the effects of the COVID-19 pandemic on postpartum women in low- and middle-income countries (LMICs) are limited. To address this gap, we conducted phone surveys among 170 WHIV ≥18 years and 18-24 months postpartum enrolled in HIV care at the Academic Model Providing Access to Healthcare in western Kenya, and assessed the effects of the pandemic across health, social and economic domains. We found that 47% of WHIV experienced income loss and 71% experienced food insecurity during the pandemic. The majority (96%) of women reported having adequate access to antiretroviral treatment and only 3% reported difficulties refilling medications, suggesting that the program's strategies to maintain HIV service delivery during the early phase of the pandemic were effective. However, 21% of WHIV screened positive for depression and 8% for anxiety disorder, indicating the need for interventions to address the mental health needs of this population. Given the scale and duration of the pandemic, HIV programs in LMICs should work with governments and non-governmental organizations to provide targeted support to WHIV at highest risk of food and income insecurity and their associated adverse health outcomes.
Objective: This study was conducted to evaluate the relationship between household conflict and parental attitude during the quarantine period. Material and Method: This study cross-sectional, and web-based was conducted. A maternity and child hospital located in southeast in Turkey between 24 May and 30 June 2021, particularly after the 3-week full-lockdown. Power analysis was used to determine the sample size, and accordingly, the study was completed with a total of 246 parents with children aged 2-6. In the study, a questionnaire regarding socio-demographic data and Household Conflict, which is a subscale of the COVID-19 Household Environment Scale, and Parent Attitude Scale was used. Results: It was shown that the parents participating in the study were highly democratic and overprotective, moderately authoritarian and permissive. It was determined that conflicts for the family increased during the pandemic process, and that conflict decreased when the parents displayed a democratic attitude. It was established that intra-familial conflict increased when parents exhibited authoritarian, overprotective and permissive attitudes, and in addition, it was found that intra-familial conflict increased when the number of children increased. Conclusion and Recommendations: Consequently, it was found that intra-family conflict affected parental attitude. Support strategies can be created for families at risk. Nurses identify families in this environment and provide necessary care, training, and consultation service.
Amaç: Bu çalışmanın amacı pandeminin ilk yılında uygulanan uzaktan eğitimin, hemşirelik öğrencilerinin fiziksel aktivite ve beslenme düzeylerine olan etkisini belirlemektir. Gereç ve Yöntem: Tanımlayıcı tipte olan bu araştırma 01 Mayıs-31 Ekim 2021 tarihleri arasında İstanbul’da bir devlet üniversitesinde öğrenim gören 569 hemşirelik öğrencisi ile yürütüldü (N=1050). Araştırmanın verileri Kişisel Bilgi Formu, Uluslararası Fiziksel Aktivite Anketi, Beslenme-Egzersiz Davranış Ölçeği kullanılarak toplandı, yüzdelik dağılım, ortalama, Wilcoxon test, Mann Whitney U, Kruskal Wallies testleri ile değerlendirildi. Bulgular: Öğrencilerin, beslenme-egzersiz davranış ölçeği toplam ve alt boyut puan ortalamaları, pandemi dönemi ve öncesi ile karşılaştırıldığında “sağlıksız beslenme-egzersiz davranışı’’ alt boyut puan ortalamasının, pandemi döneminde düştüğü tespit edildi (p
Introduction: The differential effect of the Covid-19 pandemic on the mental
health of the population around the globe is well documented. Social isolation,
loss of job, financial crisis, and fear of infection due to the pandemic have
widely affected people across countries, and the sexual and gender minority
(SGM) group is no exception. However, the additional stressors like stigma,
discrimination, rejection, non-acceptance, and violence associated with diverse
sexual orientation complicated the situation for the SGM group in the context of
the Covid-19 pandemic.
Method: The present study conducted a systematic review of research (n = 16)
investigating the impact of Covid-19 stress on the psychological health of SGM
individuals. The review had two objectives: (a) to explore the effect of the stress
associated with the pandemic on the psychological health of the SGM
individuals; and (b) to identify potential stressors associated with the Covid-19
pandemic affecting the mental health of SGM individuals. Studies were selected
following a PRISMA protocol and several inclusion criteria.
Results: The review provided new insights into the mental health issues of the
SGM individual in the Covid-19 context. The outcome of the review focused on
five aspects: (a) depression and anxiety symptoms related to Covid-19
symptoms; (b) perceived social support and Covid-19 stress; (c) family support
and psychological distress related to Covid-19; (d) Covid-19 stress and
disordered eating, and (e) problem drinking and substance abuse associated
with Covid-19 stress.
Discussion: The present review indicated a negative association between Covid-19
stress and psychological distress among sexual and gender minority individuals.
The findings have important implications for psychologists and social workers
working with this population and policymakers around the globe.
KEYWORDS
Sexual and gender minority (LGBTQ) populations issues, LGBTQ+, depression, anxiety,
COVID-19 pandemic, stress
Objective: This study examine the health status of women in the flexible production process during the pandemic period. Material and Method: In this study, the qualitative research method was preferred. Maximum variation, sampling method, was used to determine the study group. The data were collected using a semi-structured interview form with the in-depth interview technique and the interviews lasted for 15-20 minutes. Content analysis was used in the research. The study was carried out with 15 people until data repetition occurred. Results: In the research, the category was determined and the categories are as follows: Changes in women's working life before and after the pandemic, economic problems during remote working, housework during the pandemic, being affected by the care of the elderly and children, the barriers of being a woman in business life during the pandemic and gender equality in business life before and after the pandemic. Conclusion and Recommendations: It has been determined that women pay attention to protection measures during the pandemic period. It was found that women were tired and stressed due to housework and childcare, lost income due to full closure during the pandemic period, exposed to double standards in their workplaces. It is recommended that future research, including men, compare perceptions during the pandemic.
The aim of the study was to estimate the effect of the COVID- 19 pandemic and response policies on the psychiatric ward admissions in the hospitals referring to the ASST Lariana (province of Como, Italy) and the Hospital of Mendrisio (Canton of Ticino, Switzerland), two similar territories that belong to countries that dealt differently with the pandemic. We compared the two territories for type of admission (voluntary vs. compulsory), the Stringency Index (SI) and the country’s number of admission in Intensive Care Units (ICU). We found a significant reduction in the psychiatric ward admission in the lockdown period in both territories, even in periods with milder lockdown measures. The admission rate’s reduction in the ASST Lariana was significantly associated with the ICU admissions (p<0.001). In the Hospital of Mendrisio, admissions included a weekly seasonality, were significantly correlated with SI (p=0.001) and period (pre-pandemic and pandemic; p<0.001) and we observed also a significant reduction of compulsory admission that is influenced both by the stringency index (p<0.001) and period (p<0.001). The differences between the two territories seem influenced by the different mental health systems.
Introduction
Brazil faced a catastrophic situation in the coronavirus pandemic. Due to the high risk of contamination and spread of COVID-19, dentist have been attending only urgency and emergency services in Brazil at the beginning of the pandemic.
Objective
This research aimed to evaluate the psychological and financial impacts caused by the coronavirus pandemic in Brazilian orthodontists.
Methods
This population-based cross-sectional study collected demographic data and mental health measurements from 404 orthodontists. Depression, anxiety, insomnia, and distress were evaluated through Brazilian versions of the 9-item Patient Health Questionnaire (9-PHQ), the 7-item Generalized Anxiety Disorder scale and Mini-Tracking (GAD), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R), respectively. The demographic data of the sample was described using descriptive statistics. The data was analyzed according to sex, professional status, and economic income. Comparisons were performed using Chi-square tests, Mann-Whitney U tests, and Kruskal-Wallis followed by post-hoc tests.
Results
Females, graduate students, and lower incomes subgroups showed higher levels of depression, anxiety, insomnia, and distress. Most orthodontists showed moderate to extreme financial and professional concerns during the pandemic.
Conclusion
The coronavirus pandemic negatively affected the psychological health and increased the financial concerns of the Brazilian orthodontists, mainly female, graduate students, and with income below 10k participants.
Keywords:
COVID-19; Psychology; Orthodontics
People have been experiencing more negative affect (NA) during the coronavirus disease 2019 pandemic than prior to its onset. This may increase instances of people venting their emotions and blaming others to relieve the flood of unregulated NA. This study examined individuals’ venting and blaming processes within the context of the pandemic and explored the mediating role of emotional clarity across cultures. We conducted an online survey with 210 and 197 participants from the US and South Korea, respectively. The results of the moderated mediation analysis showed that individuals’ NA during the pandemic significantly affected their venting and blaming via emotional clarity among US participants. This finding implies that when people in individualistic cultures do not fully understand their emotions, they are more likely to vent to or blame others. This can serve as a potential risk factor for hate crimes during the pandemic. Conversely, the mediation effect of emotional clarity was not significant among South Korean participants, suggesting dissimilar roles played by emotional clarity in individualistic versus collectivistic cultures in managing NA.
COVID-19 has affected many communities across the world prompting different strategies of containing it. The strategies to contain COVID-19 included restrictive environments such as self-isolation and quarantine. This research study was set to explore the experiences of quarantined individuals arriving in the United Kingdom (UK) from red listed countries in Southern Africa. This research study utilises an exploratory qualitative approach. Semi-structured interviews were used to collect data from twenty-five research participants. A thematic approach underpinning the four phases of data analysis in The Silence Framework (TSF) was used to analyse the data. The study found that the research participants reported confinement, dehumanisation, feeling swindled, depressed, anxious and stigmatised. Less restrictive and non-oppressive quarantine regimes should be considered to foster positive mental health outcomes on individuals undergoing quarantine during pandemics.
Objective This study aimed to evaluate the development of adjustment disorder in patients who were followed up for Covid-19 infection. Methods A cross-sectional survey was conducted from September to November 2020. After sample size calculation, we aimed to reach minimum 170 people out of 1290 people who applied to the hospital for Covid-19 disease treatment. Participants were selected from the patients admitted to the hospital using a simple stratified random sampling method. We reached 182 people after treating the patients who were followed up with Covid-19 infection in a University Hospital in Istanbul, Turkey. A questionnaire and the Adjustment Disorder New Module-20 scale were applied via phone / mail at the end of the 6th month after Covid-19 related hospital admission by researchers. Results Adjustment disorder was found in 32.3% (n=54) of the patients. While the rate of development of adjustment disorder due to Covid-19-related stress was 26.9 % (n=45); the rate of development of adjustment disorder due to non-Covid-19 stress was found to be 5.4 % (n=9). With the increase in stress load, the development of adjustment disorder increased significantly. The frequency of developing Covid-19-related stress-related adjustment disorder was statistically significantly increased with the duration of exposure to stress. Conclusion We have found out that one out of every four people who apply to the hospital for health care services due to Covid-19 infection may develop an adjustment disorder. Assessment of the adjustment disorder more frequently and making early interventions may contribute to the prevention of progressive mental disorders.
Background and Objective: The outbreak of the coronavirus disease 2019 (COVID-19) and the psychological consequences of social distancing are among the most important social events of the 21st century that have made nurses' families face their related psychological consequences. This study aimed to evaluate the effectiveness of family-centered problem-solving training on the negative effects of social distancing caused by COVID-19 in the families of nurses at Kermanshah University of Medical Sciences, Kermanshah, Iran. Materials and Methods: The present quasi-experimental study was conducted based on a pretest-posttest control group design. The statistical population (n=380) included the families of married nurses working in the COVID-19 ward of public hospitals in Kermanshah, 2020-2021. The sample consisted of the families of nurses who obtained a high score in the social distance measurement tool; accordingly, 100 people were included in the study and assigned to two groups of intervention and control (n=50 each). For the intervention group, 10 two-hour virtual sessions of training family-centered problem-solving protocols were held. Post-test was performed on both groups. Data were analyzed in SPSS software (version 20) using frequency, mean and standard deviation, and analysis of covariance. Results: The findings showed that family-centered problem-solving training was effective on marital conflict, anxiety, and fear in nurses, and a significant difference was observed between the control and intervention groups (P<0.001). Conclusion: Family-centered problem-solving training was effective on the negative effects of social distancing caused by COVID-19 in nurses' families.
COVID-19-related regulations have impacted the economy and people's well-being, highlighting the long-standing problem of inequality. This research explored how COVID-19-related restrictive policies, such as a lockdown or social distancing, affected people's well-being. In Study 1, a cross-sectional online survey (N = 685), we examined the associations between socio-economic characteristics, the number of resources, their relative change, people's stress levels, and their support of restrictive policies. We found that financial loss due to COVID-19, the number of children at home, and the intensity of restrictive measures were associated with higher stress by restrictive measures. The lower support for restrictive measures was observed among those who experienced financial loss due to COVID-19, had more children at home, less frequently accessed COVID-19-related information in the media, and did not perform self-isolation. Men were generally less supportive of restrictions than women, and the number of new COVID-19 cases was negatively related to the support. Lower stress and higher support for restrictive measures were positively associated with life satisfaction. In Study 2, an experience-sampling survey (Nparticipants = 46, Nresponses = 1112), the participants rated their well-being and level of available resources daily for one month. We observed that daily increases in well-being, characterized by higher life satisfaction and lower levels of stress and boredom, were positively associated with more social communication and being outdoors. In summary, the findings support the resource and demand framework, which states that people with access to resources can better cope with the demands of restrictive policies. Implications for policies and interventions to improve well-being are discussed.
Psychosocial factors, including life satisfaction, resilience, and social support, have been proposed to influence depressive symptom severity in adults because the age of onset of depressive disorders, i.e. adolescence to early adulthood, is associated with various impairments in psychosocial functioning. In this study, a psychosocial model was constructed to verify these relationships to prevent depression. For this study, 370 participants were recruited from the community via poster or online advertisements. They completed several questionnaires to assess depressive symptom severity: the Connor-Davidson Resilience Scale (CD-RISC), Satisfaction with Life Scale (SwLS), Peace of Mind (PoM) scale, Social Support Questionnaire (SSQ), and Beck Depression Inventory (BDI-II). A negative association was found between depressive symptom severity and all other variables, including PoM and CD-RISC scores, life satisfaction, and social support. Such factors can be considered protective against increased depressive symptom severity. In addition, indirect effects of PoM and resilience on the negative association between SwLS scores and depressive symptom severity were observed. Moreover, social support was found to mediate the correlation between PoM and resilience, implying that social support mediates the relationship between state of mind and resilience. The psychosocial model suggested that depressive symptom severity is influenced by internal factors (an individual’s state of mind, subjective view of events and their life) and external factors (including social support).
Background:
During the 2020/2021 winter, the labour market was under the impact of the COVID-19 pandemic. Changes in socioeconomic resources during this period could have influenced individual mental health. This association may have been mitigated or exacerbated by subjective risk perceptions, such as perceived risk of getting infected with SARS-CoV-2 or perception of the national economic situation. Therefore, we aimed to determine if changes in financial resources and employment situation during and after the second COVID-19 wave were prospectively associated with depression, anxiety and stress, and whether perceptions of the national economic situation and of the risk of getting infected modified this association.
Methods:
One thousand seven hundred fifty nine participants from a nation-wide population-based eCohort in Switzerland were followed between November 2020 and September 2021. Financial resources and employment status were assessed twice (Nov2020-Mar2021, May-Jul 2021). Mental health was assessed after the second measurement of financial resources and employment status, using the Depression, Anxiety and Stress Scale (DASS-21). We modelled DASS-21 scores with linear regression, adjusting for demographics, health status, social relationships and changes in workload, and tested interactions with subjective risk perceptions.
Results:
We observed scores above thresholds for normal levels for 16% (95%CI = 15-18) of participants for depression, 8% (95%CI = 7-10) for anxiety, and 10% (95%CI = 9-12) for stress. Compared to continuously comfortable or sufficient financial resources, continuously precarious or insufficient resources were associated with worse scores for all outcomes. Increased financial resources were associated with higher anxiety. In the working-age group, shifting from full to part-time employment was associated with higher stress and anxiety. Perceiving the Swiss economic situation as worrisome was associated with higher anxiety in participants who lost financial resources or had continuously precarious or insufficient resources.
Conclusion:
This study confirms the association of economic stressors and mental health during the COVID-19 pandemic and highlights the exacerbating role of subjective risk perception on this association.
The COVID-19 pandemic may have been psychologically stressful for everyone who was affected by it, but people who are predisposed to mental health problems may have felt it more intensely than others. Students at universities are one of these vulnerable populations. The uncertainty brought on by COVID-19 had a negative psychological impact on them, but this effect became more complex in the process of restarting education after a long break. The purpose of this study is to investigate the psychological situation of Turkish university students during the period when face-to-face education began to reappear as a result of the COVID-19 precautions being reduced. For this aim, the psychological situation of 224 Turkish students aged 17–25 was assessed using the Beck Depression Inventory (BDI), State and Trait Anxiety Scale (STAT), Connor Davidson-Resilience Scale (CD-RISC), Positive and Negative Affect Schedule (PANAS), and Brief Symptom Inventory (BSI). In addition, the students were asked about their life satisfaction, chronic illness, duration of physical activity, screen time, and needs of psychological support. The results revealed that during this period, students reported low levels of exercise and physical activity time, increased time spent in front of a screen, low life satisfaction, higher rates of receiving and needing psychological support, and higher levels of negative affect, depression, anxiety, and brief symptoms. Furthermore, the results showed that positive affect and resilience are protective factors for psychological health. The findings of the study highlighted the critical role of psychological support services at universities in promoting and preserving students' mental health.
Given the scope and duration of the COVID-19 pandemic, it is not surprising that research has documented negative effects to youth’s mental health. Yet, there is negligible research on the impact of the pandemic among clinical samples of youth receiving treatment for pre-existing trauma exposure and symptoms. The current study investigates COVID-19 as an index trauma, and if prior traumatic stress scores mediate the relationship between pandemic-related exposure and subsequent traumatic stress. Methods: This is a study of 130 youth ages 7–18 receiving trauma treatment at an academic medical center. The University of California Los Angeles Post-traumatic Stress Disorder-Reaction Index (UCLA-PTSD-RI) was completed by all youth during intake as part of routine data collection. From April, 2020 to March, 2022 the UCLA Brief COVID-19 Screen for Child/Adolescent PTSD was also administered to assess trauma exposures and symptoms specifically-related to the pandemic experience. Univariate and bivariate analyses were conducted on all variables of interest to describe response patterns cross-sectionally and longitudinally; a mediational analysis was used to determine if prior trauma symptoms mediate the relationship between COVID-19 exposure and response. Additionally, interviews were conducted with youth using a series of open-ended questions about their perceptions of safety, threat and coping related to the pandemic. Results: A quarter of the sample reported COVID-19 related exposures that would meet Criterion A for PTSD. Participants whose UCLA-COVID scores that exceeded the clinical cutoff had lower scores on two items measuring social support. There was no evidence of full or partial mediation. Responses to interview questions revealed low levels of threat reactivity, perceptions of no to little impact, positive changes, varying opinions on social isolation, some evidence of inaccurate messaging and adaptive coping using strategies learned in treatment. Implications: The findings broaden our understanding of the impact of COVID-19 on vulnerable children and provide insight into how prior trauma history and the provision of evidence-based trauma treatment impact a youth’s response to pandemic conditions.
Background:
Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multi-dimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome" which is associated with health anxiety, problematic internet use and obsessive-compulsive symptoms. Cyberchondria is not included in the ICD-11 or the DSM-5, and its defining features, etiological mechanisms and assessment continue to be debated.
Objective:
This study aimed to investigate changes in the severity of cyberchondria during the pandemic and identify predictors of cyberchondria at this time.
Methods:
Data collection started on May 4, 2020 and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the present study took place, French-speaking countries in Europe (France, Switzerland, Belgium and Luxembourg) all implemented lockdown or semi-lockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level and country of residence) and information on socioeconomic circumstances during the first lockdown (e.g., economic situation, housing and employment status), and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18 to 77 years (mean 33.29, SD 12.88 years), with females constituting the majority (416/725, 57.4%).
Results:
The results show that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and interference with functioning increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). Also, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic.
Conclusions:
These findings provide evidence about the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. Also, they are consistent with the theoretical model of cyberchondria during the COVID-19 pandemic proposed by Starcevic and his colleagues in 2020. In addition, the findings have implications for the conceptualization and future assessment of cyberchondria.
Adaptation to distance learning, which is one of the most effective ways of fighting against the COVID-19 pandemic, presented numerous challenges to society and the economy. The study aims to assess the consequences of distance learning as a result of the pandemic from the perspective of students and teachers. Quantitative research was conducted. The students (n = 417) and teachers (n = 47) of all disciplines from Tbilisi universities (Republic of Georgia) participated in the research. Non-probability convenience sampling technique was used for the study. Respondents evaluated the process of distance learning positively since they had the opportunity to attend lectures from any location, thus, saving costs, learning new skills, gaining valuable experience, and having more free time left than before. Using a Likert scale, the distance learning process was positively assessed by students (3.2 points out of 5) and teachers (3 points out of 5). The majority of students (n = 288, 69%) preferred the synthesis of distance and auditory learning methods as they consider the student’s own choices in a superior way. Respondents pointed out some deficiencies, such as limited communication, technical access difficulties, low quality and malfunction of internet access, an inconvenient environment, students’ involvement process and complicated social relationships. The crisis caused by the COVID-19 epidemic has identified the need to advance the methods of high-quality acquisition of knowledge. It is preferable to equip university auditoriums with the necessary technical capabilities and to develop curricula that allow students to decide whether to attend lectures in the classroom or to participate online.
This chapter discusses the role of the media in the management of pandemic situations in Africa. Examples from various African countries such as Egypt, Ghana, Kenya, Nigeria, South Africa and Tanzania are examined to highlight the actual situation. Communication and health communication theories discussed are: Theory of Reasoned Action, Health Belief Model (HBM) and the Protection Motivation Theory. The role the media (Newspapers, magazines, radio, television and social media networks) have played in persuading people to accept to be vaccinated and to wear masks is discussed. Studies conducted in Africa reveal that different countries have had to deal with different reactions towards COVID-19 communication. Studies reviewed from other continents show that what is applicable there can also work in Africa. African, Chinese and Iranian examples are discussed to prove that the above-named theories can also be applied in Africa to persuade people to maintain COVID-19 protocols and to accept to be vaccinated. Social media users communicated COVID-19 messages but most of them have participated more in spreading misinformation and propaganda about COVID-19 just as it happened during the Ebola pandemic in West Africa.KeywordsCOVID-19MediaPandemic protocols and vaccination
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.
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.
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.
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.