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Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey.

ABSTRACT: (1) Background: The COVID-19 pandemic has not only changed people's health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Evidence from this survey will contribute to a targeted reference on how to deliver psychological counseling service in the face of outbreaks. (2) Methods: A cross-sectional, population-based online survey was conducted from 28 January to 5 February 2020 using an open online questionnaire for people aged 18 years or above, residing in China and abroad. The socio-demographic information of the respondents was collected, and anxiety scores were calculated. A direct standardization method was used to standardize anxiety scores and a general linear model was used to identify associations between some factors (e.g., sex, age, education, etc.) and anxiety scores. (3) Results: A total of 10,946 eligible participants were recruited in this study, with a completion rate of 98.16% (10,946/11,151). The average anxiety score was 6.46 ± 4.12 (total score = 15); women (6.86 ± 4.11) scored higher than men (5.67 ± 4.04). The age variable was inversely and significantly associated with the anxiety score (β = -2.12, 95% CI: -2.47--1.78). People possessing higher education (β = 1.15, 95% CI: 0.88-1.41) or a higher awareness of cognitive risk (β = 4.89, 95% CI: 4.33-5.46) reported higher levels of anxiety. There was a close association between poor subjective health and anxiety status (β = 2.83, 95% CI: 2.58-3.09). With the increase of confidence, the anxiety of the population exhibited a gradual decline (β = -2.45, 95% CI: -2.77--2.13). (4) Conclusion: Most people were vulnerable to anxiety during the earliest phase of the COVID-19 outbreak in China. Younger women, individuals with high education, people with high cognitive risk and subjective poor health were vulnerable to anxiety during the epidemic. In addition, increasing confidence in resisting this pandemic is a protective determinant for individuals to develop anxiety. The findings suggest that policymakers adopt psychosocial interventions to reduce anxiety during the pandemic.

SUBMITTER: Liu B

PROVIDER: S-EPMC8394659 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The COVID-19 pandemic has had far-ranging consequences for general physical and mental health. Country-specific research reveals a general reduction in mental and physical well-being, due to measures undertaken to stop the spread of COVID-19 disease. However, research is yet to examine the impact of the pandemic on global psychological distress and its effects upon vulnerable groups. Exploration of the factors that potentially mediate the relationship between stress and mental health during this period is needed, to assist in undertaking concrete measures to mitigate psychological distress and support vulnerable groups. Therefore, this study examined the impact of the COVID-19 pandemic on psychological distress globally, and identified factors that may exacerbate decline in mental health. N = 1653 participants (mean age 42.90 ± 13.63 years; 30.3% males) from 63 countries responded to the survey. Depression and anxiety were assessed using the Patient Health Questionnaire and State Trait Anxiety Inventory, respectively. Other measures included the Perceived Stress Scale, the Pittsburgh Sleep Quality Index, 3-item UCLA Loneliness Scale and the Brief Resilient Coping Scale. Globally, consistently high levels of stress, anxiety, depression and poor sleep were observed regardless of number of COVID-19 cases. Over 70% of the respondents had greater than moderate levels of stress, with 59% meeting the criteria for clinically significant anxiety and 39% reporting moderate depressive symptoms. People with a prior mental health diagnosis experienced greater psychological distress. Poor sleep, lower levels of resilience, younger age and loneliness significantly mediated the links between stress and depression, and stress and anxiety. Age-based differences revealed that younger age-groups were more vulnerable to stress, depression and anxiety symptoms. Results show that these vulnerable individuals need more support. Age-specific interventions for modifiable factors that mediate the psychological distress need to urgently deployed to address the global mental health pandemic.

Project description:Introduction: Social disruption associated with coronavirus disease 2019 (COVID-19) threatens to impede access to regular healthcare, including for people living with HIV (PLHIV), potentially resulting in antiretroviral therapy (ART) interruption (ATI). We aimed to explore the characteristics and factors associated with ATI during the COVID-19 outbreak in China.Methods: We conducted an online survey among PLHIV by convenience sampling through social media between 5 and 17 February 2020. Respondents were asked to report whether they were at risk of ATI (i.e. experienced ATI, risk of imminent ATI, threatened but resolved risk of ATI [obtaining ART prior to interruption]) or were not at risk of ATI associated with the COVID-19 outbreak. PLHIV were also asked to report perceived risk factors for ATI and sources of additional ART. The factors associated with the risk of ATI were assessed using logistic regression. We also evaluated the factors associated with experienced ATI.Results: A total of 5084 PLHIV from 31 provinces, autonomous regions and municipalities in mainland China completed the survey, with valid response rate of 99.4%. The median age was 31 years (IQR 27 to 37), 96.5% of participants were men, and 71.3% were men who had sex with men. Over one-third (35.1%, 1782/5084) reported any risk of ATI during the COVID-19 outbreak, including 2.7% (135/5084) who experienced ATI, 18.0% (917/5084) at risk of imminent ATI and 14.4% (730/5084) at threatened but resolved risk. PLHIV with ATI were more likely to have previous interruptions in ART (aOR 8.3, 95% CI 5.6 to 12.3), travelled away from where they typically receive HIV care (aOR 3.0, 95% CI 2.1 to 4.5), stayed in an area that implemented citywide lockdowns or travel restrictions to control COVID-19 (aOR 2.5, 95% CI 1.4 to 4.6), and be in permanent residence in a rural area (aOR 3.7, 95% CI 2.3 to 5.8).Conclusions: A significant proportion of PLHIV in China are at risk of ATI during the COVID-19 outbreak and some have already experienced ATI. Correlates of ATI and self-reported barriers to ART suggest that social disruptions from COVID-19 have contributed to ATI. Our findings demonstrate an urgent need for policies and interventions to maintain access to HIV care during public health emergencies.

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Project description:BackgroundMaintaining compliance with personal preventive measures is important to achieve a balance of COVID-19 pandemic control and work resumption.ObjectiveThe aim of this study was to investigate self-reported compliance with four personal measures to prevent COVID-19 among a sample of factory workers in Shenzhen, China, at the beginning of work resumption in China following the COVID-19 outbreak. These preventive measures included consistent wearing of face masks in public spaces (the workplace and other public settings); sanitizing hands using soap, liquid soap, or alcohol-based hand sanitizer after returning from public spaces or touching public installations and equipment; avoiding social and meal gatherings; and avoiding crowded places.MethodsThe participants were adult factory workers who had resumed work in Shenzhen, China. A stratified two-stage cluster sampling design was used. We randomly selected 14 factories that had resumed work. All full-time employees aged ≥18 years who had resumed work in these factories were invited to complete a web-based survey. Out of 4158 workers who had resumed work in these factories, 3035 (73.0%) completed the web-based survey from March 1 to 14, 2020. Multilevel logistic regression models were fitted.ResultsAmong the 3035 participants, 2938 (96.8%) and 2996 (98.7%) reported always wearing a face mask in the workplace and in other public settings, respectively, in the past month. However, frequencies of self-reported sanitizing hands (2152/3035, 70.9%), avoiding social and meal gatherings (2225/3035, 73.3%), and avoiding crowded places (1997/3035, 65.8%) were relatively low. At the individual level, knowledge about COVID-19 (adjusted odds ratios [AORs] from 1.16, CI 1.10-1.24, to 1.29, CI 1.21-1.37), perceived risk (AORs from 0.58, CI 0.50-0.68, to 0.85, CI 0.72-0.99) and severity (AOR 1.05, CI 1.01-1.09, and AOR 1.07, CI 1.03-1.11) of COVID-19, perceived effectiveness of preventive measures by the individual (AORs from 1.05, CI 1.00-1.10, to 1.09, CI 1.04-1.13), organization (AOR 1.30, CI 1.20-1.41), and government (AORs from 1.14, CI 1.04-1.25, to 1.21, CI 1.02-1.42), perceived preparedness for a potential outbreak after work resumption (AORs from 1.10, CI 1.00-1.21, to 1.50, CI 1.36-1.64), and depressive symptoms (AORs from 0.93, CI 0.91-0.94, to 0.96, CI 0.92-0.99) were associated with self-reported compliance with at least one personal preventive measure. At the interpersonal level, exposure to COVID-19-specific information through official media channels (AOR 1.08, CI 1.04-1.11) and face-to-face communication (AOR 0.90, CI 0.83-0.98) were associated with self-reported sanitizing of hands. The number of preventive measures implemented in the workplace was positively associated with self-reported compliance with all four preventive measures (AORs from 1.30, CI 1.08-1.57, to 1.63, CI 1.45-1.84).ConclusionsMeasures are needed to strengthen hand hygiene and physical distancing among factory workers to reduce transmission following work resumption. Future programs in workplaces should address these factors at multiple levels.

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Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey.

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