Prevalence and determinants of healthcare avoidance during the COVID-19 pandemic: A population-based cross-sectional study
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ABSTRACT:
SUBMITTER: Splinter M
PROVIDER: S-EPMC8610236 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe COVID-19 pandemic and its prevention and control measures, such as social distancing, self-isolation, and quarantine, have a negative impact on the population's mental health. This study aimed to determine the prevalence of anxiety and stress among the general population during the outbreak of COVID-19 and assess their associated factors.MethodsWe carried out a cross-sectional study in Erbil governorate, Iraqi Kurdistan Region, from July 18 to September 12, 2020. We used an online survey questionnaire to collect data from a sample of Erbil population. The 10-items Perceived Stress Scale and the 7-item Generalized Anxiety Disorder scale were used to measure the levels of stress and anxiety.ResultsA total of 851 persons responded to the survey. The prevalence of moderate and high perceived stress was 59.6% and 16.6%, respectively. The prevalence of moderate and severe anxiety was 24.7% and 22.7%, respectively. Age, gender, economic level, having contact with COVID-19 patients, and following COVID-19 news were independent variables significantly associated with stress levels. Age, gender, economic level, employment status, having symptoms of COVID-19, having contact with COVID-19 patients, and following COVID-19 news were independent variables significantly associated with anxiety levels.ConclusionA high proportion of people experienced stress and anxiety during the COVID-19 outbreak in Erbil, Iraqi Kurdistan Region. Females, younger age, poor, and unemployed reported significantly higher stress and anxiety levels. There is a need to establish mechanisms at the population level to decrease the stress and anxiety risks and provide mental health coping measures in times of crisis, such as education about positive thinking, stress management programs, and the role of social support.
| S-EPMC10096275 | biostudies-literature
Project description:ObjectiveThis study aims to examine the factors influencing COVID-19 vaccine uptake among healthcare professionals (HCPs) and the general population in Cyprus.MethodsA web-based cross-sectional study was conducted (November 2021-January 2022), using a self-administered, anonymous questionnaire to collect information covering a wide range of potential determinants including sociodemographic and health-related characteristics, trust in the healthcare system, satisfaction with it, utilization of preventive healthcare services, COVID-19 vaccination information and general vaccination knowledge.ResultsA total of 2582 participants completed the survey. Overall, 53.5% of participants representing the general population, and 70.0% of the HCPs received the COVID-19 vaccination. We found that as the age increases by 1 year among the general population, the odds of being vaccinated against COVID-19 increase by 1.02 units (95% 1.00, 1.03, p= 0.035). In addition, participants among the general population with increased trust in national healthcare authorities' guidelines (OR = 3.96, 95% CI: 3.41, 4.61), and increased vaccination knowledge scores (OR = 1.11, 95% CI: 1.05, 1.18) were significantly more likely to be vaccinated, while those who had underage children living in the household were significantly less likely to be vaccinated against COVID-19 (OR = 0.68, 95% CI: 0.50, 0.91). Furthermore, male HCPs (OR = 1.91, 95% CI: 1.01, 3.59), and those who reported increased trust in national healthcare authorities' guidelines (OR = 5.38, 95% CI: 3.65, 7.95) were significantly more likely to be vaccinated.ConclusionPublic health policymakers can use national campaigns and long-term planning to build public trust in national healthcare authorities and raise awareness about the benefits of vaccination. Such strategies could pave the way for adequate vaccine uptake and prepare the public for unfavourable scenarios, such as future pandemics.
| S-EPMC9538130 | biostudies-literature
Project description:The aim of this population-based cross-sectional study was to assess the prevalence of healthcare avoidance during the COVID-19 pandemic and its associated factors among the Sámi population in Sweden. Data from the "Sámi Health on Equal Terms" (SámiHET) survey conducted in 2021 were used. Overall, 3,658 individuals constituted the analytical sample. Analysis was framed using the social determinants of health framework. The association between healthcare avoidance and several sociodemographic, material, and cultural factors was explored through log-binomial regression analyses. Sampling weights were applied in all analyses. Thirty percent of the Sámi in Sweden avoided healthcare during the COVID-19 pandemic. Sámi women (PR: 1.52, 95% CI: 1.36-1.70), young adults (PR: 1.22, 95% CI:1.05-1.47), Sámi living outside Sápmi (PR: 1.17, 95% CI: 1.03-1.34), and those having low income (PR: 1.42, 95% CI:1.19-1.68) and experiencing economic stress (PR: 1.48, 95% CI: 1.31-1.67) had a higher prevalence of healthcare avoidance. The pattern shown in this study can be useful for planning future pandemic responses, which should address healthcare avoidance, particularly among the identified vulnerable groups, including the active participation of the Sámi themselves.
| S-EPMC10208175 | biostudies-literature
Project description:The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.
| S-EPMC8051812 | biostudies-literature
Project description:BackgroundCOVID-19 has put extraordinary stress on healthcare workers. Few studies have evaluated stress by worker role, or focused on experiences of women and people of color.MethodsThe "Coping with COVID" survey assessed US healthcare worker stress. A stress summary score (SSS) incorporated stress, fear of exposure, anxiety/depression and workload (Omega 0.78). Differences from mean were expressed as Cohen's d Effect Sizes (ESs). Regression analyses tested associations with stress and burnout.FindingsBetween May 28 and October 1, 2020, 20,947 healthcare workers responded from 42 organizations (median response rate 20%, Interquartile range 7% to 35%). Sixty one percent reported fear of exposure or transmission, 38% reported anxiety/depression, 43% suffered work overload, and 49% had burnout. Stress scores were highest among nursing assistants, medical assistants, and social workers (small to moderate ESs, p < 0.001), inpatient vs outpatient workers (small ES, p < 0.001), women vs men (small ES, p < 0.001), and in Black and Latinx workers vs Whites (small ESs, p < 0.001). Fear of exposure was prevalent among nursing assistants and Black and Latinx workers, while housekeepers and Black and Latinx workers most often experienced enhanced meaning and purpose. In multilevel models, odds of burnout were 40% lower in those feeling valued by their organizations (odds ratio 0.60, 95% CIs [0.58, 0.63], p< 0.001).InterpretationStress is higher among nursing assistants, medical assistants, social workers, inpatient workers, women and persons of color, is related to workload and mental health, and is lower when feeling valued.
| S-EPMC8141518 | biostudies-literature
Project description:ObjectiveThis study evaluated job burnout among primary healthcare workers (PHCWs) in China during the COVID-19 pandemic, explored its influencing factors, and examined PHCWs' preferences for reducing job burnout.MethodWe conducted a multicenter cross-sectional study in Heilongjiang, Sichuan, Anhui, Gansu, and Shandong Provinces. An electronic questionnaire survey was conducted through convenience sampling in communities from May to July 2022. We collected sociodemographic characteristics, job burnout level, job satisfaction, and preferred ways to reduce job burnout among PHCWs.ResultsThe job burnout rate among PHCWs in China was 59.87% (937/1565). Scores for each dimension of job burnout were lower among PHCWs who had a better work environment (emotional exhaustion OR: 0.60; depersonalization OR: 0.73; personal accomplishment OR: 0.76) and higher professional pride (emotional exhaustion OR: 0.63; depersonalization OR: 0.70; personal accomplishment OR: 0.44). PHCWs with higher work intensity (emotional exhaustion OR: 2.37; depersonalization OR: 1.34; personal accomplishment OR: 1.19) had higher scores in all job burnout dimensions. Improving work environments and raising salaries were the preferred ways for PHCWs to reduce job burnout.ConclusionStrategies should be developed to improve job satisfaction among PHCWs, enhance their professional identity, and alleviate burnout to ensure the effective operation of the healthcare system, especially during periods of overwork.
| S-EPMC10731250 | biostudies-literature
Project description:BackgroundMaintaining the physical and psychological well-being of healthcare workers (HCWs) is crucial for health system resilience. In sub-Saharan Africa, particularly Uganda, HCWs faced significant challenges during the coronavirus disease 2019 (COVID-19) pandemic, compounded by pre-existing resource constraints. This study investigated challenges faced by HCWs at a designated COVID-19 hospital ('the Hospital') and explored determinants of maintaining healthcare personnel's motivation during the COVID-19 pandemic in Uganda.MethodsA facility-based cross-sectional study was conducted at the Hospital from May to July 2023, with 120 HCWs categorised by profession. Data were collected using a structured questionnaire. Descriptive and logistic regression analyses were performed to identify motivation-related factors. The questionnaire assessed sociodemographic data, COVID-19 knowledge, medical history, support received, and pandemic-related challenges. Psychological impact was measured using a four-point Likert scale.ResultsAmong respondents, 61.7% worked during the first lockdown and 93.3% during the second. COVID-19 knowledge was high, with over 70% answering questions correctly, although vaccine effectiveness had a slightly lower accuracy rate. The study revealed that 32.5% of HCWs tested positive for COVID-19 and 25% displayed vaccine hesitancy. Key challenges included fear of infection, transportation disruptions, income reduction, and social isolation. Notably, 92.5% reported significant anxiety related to infection. Factors positively associated with remaining motivated were age (≤ 30 versus > 30 years; adjusted odds ratio [AOR]: 10.34, 95% CI; 1.92-55.74), profession (co-medical/non-medical staff versus medical doctors/medical officers; AOR: 11.66, 95% CI: 1.03-132.22), receiving mentoring/tutoring (AOR: 18.87, 95% CI: 2.55-139.72), and information from supervisors/management (AOR: 12.5, 95% CI: 2.60-60.42). In contrast, psychological impact was negatively affected by isolation from family and friends (AOR: 0.61, 95% CI: 0.41-0.92).ConclusionsDespite challenges, most HCWs at the Hospital remained motivated. These findings emphasised the importance of technical and psychological support, such as mentoring and effective communication from upper-level supervisors, rather than financial incentives, in maintaining motivation among the HCWs. Comprehensive support systems are essential for sustaining HCWs' motivation during the pandemic, especially in resource-limited settings. Further research should address the long-term mental health effects and enhance HCWs' resilience in future health crises.
| S-EPMC11772877 | biostudies-literature
Project description:BackgroundThe COVID-19 outbreak and consequent physical distance measures implemented worldwide have caused significant stress, anxiety, and mental health implications among the general population. Unemployment, working from home, and day-to-day changes may lead to a greater risk of poor mental health outcomes.ObjectiveThis paper describes the protocol for a web-based cross-sectional study that aims to address the impact of the COVID-19 pandemic on mental health.MethodsIndividuals from the general population aged 18 years or more and living in Portugal were included in this study. Data collection took place between November 10, 2020, and February 10, 2021. An exponential, nondiscriminative, snowball sampling method was applied to recruit participants. A web-based survey was developed and shared on social media platforms (eg, Facebook, Instagram, Twitter, LinkedIn, and WhatsApp groups) and through e-mail lists for recruitment of the seeds.ResultsData analysis will be performed in accordance with the different variables and outcomes of interest by using quantitative methods, qualitative methods, or mixed methods, as applicable. A total of 929 individuals had completed the web-based survey during the 3-month period; thus, our final sample comprised 929 participants. Results of the survey will be disseminated in national and international scientific journals in 2021-2022.ConclusionsWe believe that the findings of this study will have broad implications for understanding the psychological impact of the COVID-19 pandemic on Portuguese residents, as well as aspects related to the informal economy. We also hope that the findings of this study are able to provide insights and guidelines for the Portuguese government to implement action. Finally, we expect this protocol to provide a roadmap for other countries and researchers that would like to implement a similar questionnaire considering the related conclusions.International registered report identifier (irrid)DERR1-10.2196/28071.
| S-EPMC8528386 | biostudies-literature
Project description:BackgroundGrowing evidence suggests that severe acute COVID-19 illness increases the risk of long COVID (also known as post-COVID-19 condition). However, few studies have examined associations between acute symptoms and long COVID onset.ObjectiveThis study aimed to examine associations between acute COVID-19 symptom profiles and long COVID prevalence using a population-based sample.MethodsWe used a dual mode (phone and web-based) population-based probability survey of adults with polymerase chain reaction-confirmed SARS-CoV-2 between June 2020 and May 2022 in the Michigan Disease Surveillance System to examine (1) how acute COVID-19 symptoms cluster together using latent class analysis, (2) sociodemographic and clinical predictors of symptom clusters using multinomial logistic regression accounting for classification uncertainties, and (3) associations between symptom clusters and long COVID prevalence using modified Poisson regression.ResultsIn our sample (n=4169), 15.9% (n=693) had long COVID, defined as new or worsening symptoms at least 90 days post SARS-CoV-2 infection. We identified 6 acute COVID-19 symptom clusters resulting from the latent class analysis, with flu-like symptoms (24.7%) and fever (23.6%) being the most prevalent in our sample, followed by nasal congestion (16.4%), multi-symptomatic (14.5%), predominance of fatigue (10.8%), and predominance of shortness of breath (10%) clusters. Long COVID prevalence was highest in the multi-symptomatic (39.7%) and predominance of shortness of breath (22.4%) clusters, followed by the flu-like symptom (15.8%), predominance of fatigue (14.5%), fever (6.4%), and nasal congestion (5.6%) clusters. After adjustment, females (vs males) had greater odds of membership in the multi-symptomatic, flu-like symptom, and predominance of fatigue clusters, while adults who were Hispanic or another race or ethnicity (vs non-Hispanic White) had greater odds of membership in the multi-symptomatic cluster. Compared with the nasal congestion cluster, the multi-symptomatic cluster had the highest prevalence of long COVID (adjusted prevalence ratio [aPR] 6.1, 95% CI 4.3-8.7), followed by the predominance of shortness of breath (aPR 3.7, 95% CI 2.5-5.5), flu-like symptom (aPR 2.8, 95% CI 1.9-4.0), and predominance of fatigue (aPR 2.2, 95% CI 1.5-3.3) clusters.ConclusionsResearchers and clinicians should consider acute COVID-19 symptom profiles when evaluating subsequent risk of long COVID, including potential mechanistic pathways in a research context, and proactively screen high-risk patients during the provision of clinical care.
| S-EPMC11460306 | biostudies-literature
Project description:The COVID-19 pandemic has exposed healthcare staff to mental distress. Given the importance of applying effective strategies to cope with stress caused by COVID-19, this study aimed to assess the stress-coping strategies of Iranian healthcare providers. This cross-sectional study was performed through a web-based survey. Data collection was done online using a demographic data questionnaire and the short form of Endler and Parker's coping inventory. The mean scores of task-oriented strategies (27.06 ± 5.13) were higher than avoidance-oriented (19.42 ± 5.77) and emotion-oriented strategies (18.45 ± 5.76), and the healthcare workers mainly used task-oriented styles to cope with COVID-19-related stress. There was a significant difference between the score of task-oriented strategy in terms of age groups (P < 0.001), work experience (P = 0.018), level of education (P < 0.001), having children (P = 0.002), and type of hospital (P = 0.028). The score of task-oriented strategies was lower in employees who were in the age group of 20-30 years and had less than 10 years of work experience, and it was higher in employees who had children, worked in private hospitals, and had a master's degree or higher. The score of emotion-oriented strategies in the age group of 51-60 years was significantly lower than other age groups (P < 0.01) and was significantly higher in employees with a bachelor's degree than those with a master's degree or higher (P = 0.017). There was no significant difference between the scores of avoidance-oriented strategies and any socio-demographic variables. According to the findings of this study, young and less experienced employees were more inclined to utilize emotion-oriented coping styles. Therefore, considering appropriate training programs for these employees to apply effective coping strategies is extremely important.
| S-EPMC10257513 | biostudies-literature