Levels, Predictors, and Distribution of Interpersonal Solidarity during the COVID-19 Pandemic

Since introducing the first non-pharmaceutical interventions (NPIs) to decelerate the spread of the virus, European governments have highlighted the role of “solidarity”. However, the role and levels of solidarity, especially during the past lockdowns, is uncertain. The present study thus explores the levels, the role, and the distribution of received and demonstrated interpersonal solidarity during the COVID-19 pandemic. This pooled cross-sectional study was conducted from March 2020 to March 2021 in Germany, including 19,977 participants. Levels of solidarity between the first and the second lockdowns in Germany were compared, possible predictors were examined, and three clusters were defined to unveil distributional patterns of solidarity reception and/or demonstration. To compare solidarity levels between the first and the second lockdowns in Germany, a dummy-coded lockdown variable was introduced and regressed on the two solidarity items. To identify predictors of received and demonstrated solidarity, two multiple linear regression models were computed, testing several demographic and psychological factors. For further exploratory analyses, clusters of “helpers”, “non-helpers”, and “help-receivers and helpers” were computed based on a k-means cluster analysis. Results revealed a lower level of solidarity during the second lockdown compared with the first one. Demonstrated solidarity was positively predicted by adherent safety behavior to avoid COVID-19 infection and by middle age, and negatively by depression symptoms, male gender, and high age. Received solidarity was positively predicted by higher age, by both adherent and dysfunctional safety behavior in avoidance of COVID-19 infection, and by lower educational level. “Helpers” reported little received solidarity but demonstrated high solidarity, “non-helpers” showed both little demonstrated and received solidarity, and “help-receivers and helpers” showed middle–high received and demonstrated solidarity. The three clusters differed the most regarding the variables of age, adherent and dysfunctional safety behavior, fear of COVID-19, subjective risk perceptions regarding contraction of COVID-19 and the respective consequences, and trust in governmental interventions in response to COVID-19. The decrease in interpersonal solidarity over the course of the COVID-19 pandemic, as well as its predictors, should be considered regarding prospective impositions. Furthermore, as depressive symptoms were identified to negatively predict interpersonal solidarity, the adequate provision of mental health services, especially during the COVID-19 pandemic, becomes even more important

Acceptance, drivers, and barriers to use eHealth interventions in patients with post-COVID-19 syndrome for management of post-COVID-19 symptoms: a cross-sectional study

Background: Post-COVID-19 syndrome is a new and debilitating disease without adequate treatment options. eHealth could be a reasonable approach for symptom management. Objectives: This study aims to evaluate the acceptance for eHealth interventions for symptom management in individuals with post-COVID-19 syndrome, as well as drivers and barriers influencing acceptance. Design: Cross-sectional study. Methods: This study was conducted from January 19 until 24 May 2022. Recruitment took place with a web-based survey. Acceptance and predictors of eHealth interventions were measured by the extended UTAUT model. Included in the model were the core predictor performance expectancy, social influence, and effort expectancy. Previously diagnosed mental illness was estimated and mental health by using the well-established Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire Depression Scale. The effect of sociodemographic and medical data was assessed. Multiple hierarchical regression analyses as well as group comparisons were performed. Results: 342 individuals with post-COVID-19 syndrome were examined. The acceptance of eHealth interventions for symptom management was moderate to high (M = 3.60, SD = 0.89). Acceptance was significantly higher in individuals with lower/other education, patients with moderate to severe symptoms during initial COVID-19 infection, still significantly impaired patients, and individuals with a mental illness. Identified predictors of acceptance were age (β = .24, p  < .001), current condition including moderate (β = .49, p  = .002) and still significantly impaired (β = .67, p  < .001), digital confidence (β = .19, p  < .001), effort expectancy (β = .26, p  < .001), performance expectancy (β = .33, p  < .001), and social influence (β = .26, p  < .001). Conclusion: Patients with post-COVID-19 syndrome reported a satisfying level of acceptance and drivers and barriers could be identified. These factors need to be considered for the implementation and future use of eHealth interventions

Mental health burden of patients with diabetes before and after the initial outbreak of COVID-19: predictors of mental health impairment

Background!#!The COVID-19 pandemic is affecting people's mental health worldwide. Patients with diabetes are at risk for a severe course of illness when infected with SARS-CoV-2. The present study aims to retrospectively examine mental health changes in patients with diabetes in Germany before and after the initial COVID-19 outbreak, and to furthermore explore potential predictors of such changes.!##!Methods!#!Over the course of eight weeks from April to June 2020, 253 individuals diagnosed with diabetes participated in an online cross-sectional study. Participants completed an anonymous survey including demographics, depression (PHQ-2) and generalized anxiety symptoms (GAD-2), distress (DT), and health status (EQ-5D-3L). In addition, all instruments used were modified to retrospectively ask participants to recall their mental health and health status before the outbreak had started. Additionally examined factors were COVID-19-related fear, trust in governmental actions to face the pandemic, and the subjective level of information about COVID-19.!##!Results!#!This study shows a significant increase in prevalence of depression symptoms, generalized anxiety symptoms and distress, as well as significantly decreased health statuses in diabetes patients after the initial COVID-19 outbreak. Increased depression symptoms, generalized anxiety symptoms and distress were predicted by COVID-19-related fear, whereas trust in governmental actions to face COVID-19 predicted higher depression symptoms.!##!Conclusions!#!The results indicate a negative impact of the initial COVID-19 outbreak on mental health and health status in patients with diabetes. In order to improve the efficacy of psychological support strategies for diabetes patients during the pandemic, possible predictors of mental health impairment such as the aforementioned should be examined more thoroughly and addressed more openly

Increased Safety Behavior and COVID-19-Related Fear in Adults with Cystic Fibrosis during the Pandemic

People with cystic fibrosis (pwCF) face great challenges during the ongoing COVID-19 pandemic. Recent research found equal levels of distress in pwCF and healthy controls (HC). The current study aimed to investigate the mental health burden and safety behavior in pwCF. Sixty-nine adult pwCF and sixty-nine propensity-score-matched HC participated in this study. Participants completed an anonymous online questionnaire assessing distress, generalized anxiety, depressive symptoms, COVID-19-related variables, self-reported adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). PwCF showed equal amounts of distress (W = 2481.0, p = 0.669), depressive symptoms (W = 2632.5, p = 0.268), and generalized anxiety symptoms (W = 2515.5, p = 0.565) compared to the HC. COVID-19-related fear (W = 1872.0, p = 0.028), ASB (W = 1630.0, p = 0.001), and DSB (W = 1498.5, p &lt; 0.001) were significantly elevated in pwCF. The pwCF estimated that the probability of suffering from symptoms (W = 954.5, p &lt; 0.001), experiencing a severe course (W = 806.5, p &lt; 0.001), or dying (W = 1079.0, p &lt; 0.001) from COVID-19 is significantly higher than that of the HC. ASB was associated with a CF diagnosis, COVID-19-related fear, and a subjective level of information (R2 = 0.414, F(13, 124) = 6.936, p &le; 0.001). DSB was associated with a diagnosis of CF and COVID-19-related fear (R2 = 0.196, F(13, 124) = 3.169, p &le; 0.001). The data suggest that pwCF show functional and adequate behaviors towards the risk caused by the pandemic. Therefore, functional coping behaviors may provide advantages in addressing pandemic challenges

Fear of Death during COVID-19 Does Not Explain Post-Infection Depression Symptoms beyond Reported Symptoms during the Infection in COVID-19 Survivors

The COVID-19 pandemic poses an unprecedented global burden to the general population and, in particular, to individuals who have been infected with SARS-CoV-2. In the context of the discussion about &ldquo;post COVID-19&rdquo;, the aim of the study was to advance research on mental health and long-term consequences after COVID-19. In total, 214 COVID-19 survivors (female: 54.2%; hospitalized: 36.7%) participated in the repeated cross-sectional assessment. In addition to demographic data, mental and somatic symptoms, fear of death at the time of infection, and depressive (PHQ-8) and generalized anxiety symptoms (GAD-7) were assessed. Results showed an increased prevalence of depressive symptoms and symptoms of generalized anxiety compared to observations in the general population prior to the COVID-19 pandemic. Psychological symptoms of depression and reported levels of fear of death during the SARS-CoV-2 infection showed a negative association with the time interval since COVID-19 diagnosis. Furthermore, although fear of death during the acute COVID-19 was related to depression and generalized anxiety, this association was predominantly explained by the presence of mental and somatic symptoms. In conclusion, initial fear of death does not impact mental health beyond the overall symptom burden. Furthermore, depressive symptoms appear to vanish across time since infection