The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey

Abstract Background The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. Methods An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. Results Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). Conclusions The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health.

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Beyond PPE: a mixed qualitative–quantitative study capturing the wider issues affecting doctors’ well-being during the COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2021-050223 ◽

2021 ◽

Vol 11 (3) ◽

pp. e050223

Author(s):

Lyndsey Jayne Cubitt ◽

Yu Ri Im ◽

Ciaran James Scott ◽

Louise Claire Jeynes ◽

Paul David Molyneux

Keyword(s):

Mental Health ◽

Online Survey ◽

Negative Impact ◽

Positive Impact ◽

Working Hours ◽

Well Being ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk

The COVID-19 pandemic has brought unprecedented challenges to the medical workforce. This has put them at increased risk of burnout at a time when levels are already worryingly high in the profession, with recent studies consistently showing that around half of doctors meet the validated criteria for burnout.ObjectivesTo understand the wider factors influencing and impacting upon hospital doctors’ well-being during the COVID-19 pandemic in England.DesignCross-sectional survey and mixed quantitative–qualitative analysis.SettingAcute National Health Service (NHS) Foundation Trust in England.ParticipantsAn online survey was circulated in early June 2020 to all 449 doctors employed by the Trust. 242 doctors completed the survey (54% response rate).Primary outcome measuresQuestions assessed occupational details, self-reported changes in physical and mental health, satisfaction with working hours and patterns, availability of personal protective equipment (PPE), medication and facilities, communication and sought to identify areas seen as having a significant effect on doctors’ well-being.Results96% of respondents requiring PPE were able to access it. Nearly half of the respondents felt that their mental health had deteriorated since the start of the pandemic. Over a third stated that their physical health had also declined. Issues identified as having a negative impact on doctors included increased workload, redeployment, loss of autonomy, personal issues affecting family members, anxiety around recovery plans, inadequate access to changing and storage facilities and to rest areas that allow for social distancing. Doctors appreciated access to ‘calm rooms’ that were made available for staff, access to clinical psychology support, free drinks and free car parking on site.ConclusionThe emerging themes are suggestive of increased burnout risk among doctors during the COVID-19 pandemic and encompass factors well beyond shortage of PPE. Small organisational initiatives and the implementation of changes suggested by survey respondents can have a positive impact on doctors’ well-being.

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Resilience, well-being, depression symptoms and concussion levels in equestrian athletes

Journal of Public Mental Health ◽

10.1108/jpmh-08-2020-0110 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Annika McGivern ◽

Stephen Shannon ◽

Gavin Breslin

Keyword(s):

Mental Health ◽

Online Survey ◽

Well Being ◽

Depression Symptoms ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Content Type ◽

Mental Health Support ◽

History Of

Purpose This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being. Design/methodology/approach In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being. Findings In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores. Practical implications Findings highlight the need for mental health promotion and support in equestrian sport. Social implications Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being. Originality/value This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.

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Neighborhood Walkability and Physical and Mental Health among Older Adults Living in a Deprived Community

Innovation in Aging ◽

10.1093/geroni/igab046.2355 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 620-621

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Shailee Shah ◽

Noah Webster

Keyword(s):

Mental Health ◽

Older Adults ◽

Physical Health ◽

Negative Impact ◽

Assistive Device ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Neighborhood Walkability ◽

Walking Programs

Abstract Background Identifying the factors to improve the quality of life (QOL) is vital to decrease morbidity and mortality rates among older adults. Although unfavorable neighborhood features have a significant negative impact on QOL, few studies have investigated these relationships in a deprived community. The purpose of the study was to understand how neighborhood walkability is associated with QOL using the SF-36 among urban-dwelling older adults. Methods This is a cross-sectional survey. Participants were recruited in 2018 and 2019 at regional health clinics in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. Results Of the 132 participants, the majority were female (66%), African American (77%), single, divorced, or widowed (75%), and educated below GED level (84%). After adjusting for gender, assistive device use, medication, and the Supplemental Security Income receipt, multiple regression analysis revealed that those with better perceptions of land-mixed use and accessibility within their neighborhood were more likely to have better physical health (β = .36, p<.05). However, the perceptions of greater pedestrian safety were associated with the poor physical and mental health (PCS; β = -0.19, p <.05; MCS; β = -0.25, p < .05). Perceptions of the presence of walking hazards and crime were not significantly associated with QOL. Discussion Findings suggest that neighborhood walkability characteristics are associated with physical health. The development of walking programs with accessible neighborhoods will be urgent to improve the health-related QOL for older adults living in a targeted community.

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Stressful experiences impact on pain, fatigue and mental health in people with endometriosis: a questionnaire study during the COVID-19 pandemic

10.22541/au.162500834.44230862/v1 ◽

2021 ◽

Author(s):

Lysia Demetriou ◽

Christian Becker ◽

Beatriz Martínez-Burgo ◽

Adriana Invitti ◽

Marina Kvaskoff ◽

...

Keyword(s):

Mental Health ◽

Effect Size ◽

Online Survey ◽

Current Status ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Holistic Management ◽

Stressful Experiences ◽

The Impact

Objective To explore the impact of the COVID-19 pandemic on pain and fatigue symptoms and their interactions with the impact on mental health in people with endometriosis. Design Global cross-sectional survey. Setting Online survey. Sample A total of 4717 adults with a surgical or radiological diagnosis of endometriosis. Methods An online global study collected data in 5 languages between 11th May to 8th June 2020. The survey included questions on current-status and changes of endometriosis-symptoms, mental health, demographics, and the impact of the COVID-19 pandemic on the respondents’ lives. Main Outcome Measures Self-reported changes to endometriosis-associated symptoms (pelvic pain, tiredness/fatigue, bleeding) and to mental health during the early stages of the COVID-19 pandemic. Results Respondents reported a marked worsening of their endometriosis symptoms (endo-associated pain (39.3%; 95% CI [37.7, 40.5]), tiredness/fatigue (49.9%; 95% CI [48.4, 51.2]) and bleeding (39.6%; 95% CI [38.2, 41])) and mental health (38.6%; 95% CI [37.2, 39.9]). Those with a pre-existing mental health diagnosis (38.8%) were more negatively impacted. The worsening of pain and TF were significantly correlated with worsening of mental health (p<0.001) and these relationships were found to be weakly mediated by pain catastrophising scores (pain: effect size: 0.071, LLCI= 0.060, ULCI= 0.082, TF: effect size: 0.050, LLCI= 0.040, ULCI= 0.060). Conclusions This study demonstrates that stressful experiences impact the physical and mental health of people with endometriosis. The findings highlight the need to consider psychological approaches in the holistic management of people with endometriosis.

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The Effect of the COVID-19 Pandemic Movement Restrictions on Self-Reported Physical Activity and Health in New Zealand: A Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041719 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1719

Author(s):

Rebecca M. Meiring ◽

Silmara Gusso ◽

Eloise McCullough ◽

Lynley Bradnam

Keyword(s):

Mental Health ◽

Physical Activity ◽

New Zealand ◽

Online Survey ◽

Short Form ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Physically Active ◽

Positive Effect

This study describes self-reported physical activity (PA), motivation to exercise, physical and mental health and feelings towards PA during the March-May 2020 COVID-19 lockdown in New Zealand. Adults over the age of 18 years (n = 238; 80.2% female) completed the International Physical Activity Questionnaire (IPAQ), the Behavioural Regulation in Exercise Questionnaire 3, the Short Form-36 and open-ended questions about PA through an anonymous online survey. Regular exercise was undertaken by 85% of respondents prior to lockdown, but only 49.8% were able to maintain their usual level of PA. Although respondents were considered sufficiently physically active from the IPAQ, 51.5% reported not being able to maintain their usual level of PA primarily due to the closure of their gym facilities. Sixty percent of respondents reported that PA had a positive effect on their overall wellbeing. When asked to specify which aspects of wellbeing were affected, the effect on mental health was reported the most while the effect on body image or fitness was reported the least. Strategies to increase or maintain engagement in physical activity during lockdowns should be encouraged to promote positive mental health during the COVID-19 pandemic.

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Psychological Stress among Students in Health-Related Fields during the COVID-19 Pandemic: Results of a Cross-Sectional Study at Selected Munich Universities

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126611 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6611

Author(s):

Kristina Schröpfer ◽

Nicole Schmidt ◽

Sandra Kus ◽

Clemens Koob ◽

Michaela Coenen

Keyword(s):

Mental Health ◽

Psychological Stress ◽

Negative Impact ◽

Well Being ◽

Cross Sectional Study ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Health Related

The COVID-19 pandemic has been a challenging period of upheaval for higher education students. This study aims to assess the factors associated with psychological stress during the COVID-19 pandemic among a sample of students in health-related fields at Munich universities in Germany. Students (n = 623) from KSH Munich and LMU Munich completed an online cross-sectional survey. Information on demographics and academic and everyday difficulties due to the COVID-19 pandemic as well as data on physical and mental health were collected. Multivariable logistic regression analyses were performed to identify factors associated with the outcome. The prevalence for higher psychological stress was 44% among the study population. Factors associated with higher psychological stress were: lower overall life satisfaction (p < 0.0001), worsened health situation (p < 0.0001), lack of social support (p = 0.0301) and social interaction (p = 0.0115), worries about financial difficulties due to loss of income (p = 0.0134), stressful thoughts about a second wave (p < 0.0001), feeling unable to positively influence the situation (p = 0.0262) and study-related effects, such as perceived study burden (p = 0.0003) and likely delay in studies (p = 0.0178)). The COVID-19 pandemic is having a significant negative impact on the mental health of students in health-related fields. Proactive efforts to support the mental health and well-being of students are needed.

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Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample

Healthcare ◽

10.3390/healthcare9060735 ◽

2021 ◽

Vol 9 (6) ◽

pp. 735

Author(s):

Schoultz Mariyana ◽

Leung Janni ◽

Bonsaksen Tore ◽

Ruffolo Mary ◽

Thygesen Hilde ◽

...

Keyword(s):

Mental Health ◽

Social Media ◽

Health Information ◽

Online Survey ◽

Negative Impact ◽

National Study ◽

Free Text ◽

Cross Sectional ◽

Mental Health Information ◽

The Uk

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

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The Perceived Impact of The First UK Covid-19 Lockdown on Companion Animal Welfare and Behaviour: A Mixed-Method Study of Associations with Owner Mental Health

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116171 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6171

Author(s):

Emily Shoesmith ◽

Luciana Santos de Assis ◽

Lion Shahab ◽

Elena Ratschen ◽

Paul Toner ◽

...

Keyword(s):

Mental Health ◽

Animal Welfare ◽

Online Survey ◽

Negative Impact ◽

Companion Animals ◽

Principal Component ◽

Companion Animal ◽

Free Text ◽

Cross Sectional ◽

Human Animal

Background: Companion animals may be a positive presence for their owners during the Covid-19 pandemic. However, the welfare of a companion animal is strongly influenced by the behaviour of their owners, as well as their physical and social environment. We aimed to investigate the reported changes in companion animal welfare and behaviour and to examine the association between these changes and companion animal owners’ mental health. Methods: A cross-sectional online survey of UK residents over 18 years of age was conducted between April and June 2020 (n = 5926). The questionnaire included validated, bespoke items measuring outcomes related to mental health, human-animal bonds and reported changes in animal welfare and behaviour. The final item of the survey invited open-ended free-text responses, allowing participants to describe experiences associated with human-animal relationships during the first UK lockdown phase. Results: Animal owners made up 89.8% of the sample (n = 5323), of whom 67.3% reported changes in their animal’s welfare and behaviour during the first lockdown phase (n = 3583). These reported changes were reduced to a positive (0–7) and negative (0–5) welfare scale, following principal component analysis (PCA) of 17 items. Participants reported more positive changes for cats, whereas more negative changes were reported for dogs. Thematic analysis identified three main themes relating to the positive and negative impact on companion animals of the Covid-19 pandemic. Generalised linear models indicated that companion animal owners with poorer mental health scores pre-lockdown reported fewer negative changes in animal welfare and behaviour. However, companion animal owners with poorer mental health scores since lockdown reported more changes, both positive and negative, in animal welfare and behaviour. Conclusion: Our findings extend previous insights into perceived welfare and behaviour changes on a very limited range of species to a wider a range of companion animals. Owner mental health status has a clear, albeit small, effect on companion animal welfare and behaviour.

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Public Concerns during the COVID-19 Lockdown: A Multicultural Cross-Sectional Study among Internet Survey Respondents in Three Countries

Journal of Clinical Medicine ◽

10.3390/jcm10081577 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1577

Author(s):

Alona Emodi-Perlman ◽

Ilana Eli ◽

Nir Uziel ◽

Joanna Smardz ◽

Anahat Khehra ◽

...

Keyword(s):

Mental Health ◽

Online Survey ◽

Middle Eastern ◽

Well Being ◽

Cross Sectional Study ◽

Internet Survey ◽

Physical And Mental Health ◽

Cross Sectional ◽

Culturally Different ◽

Patient Health

(1) Background: this study aimed to evaluate the worries, anxiety, and depression in the public during the initial coronavirus disease 2019 (COVID-19) pandemic lockdown in three culturally different groups of internet survey respondents: Middle Eastern (Israel), European (Poland), and North American (Canada). (2) Methods: a cross-sectional online survey was conducted in the mentioned countries during the lockdown periods. The survey included a demographic questionnaire, a questionnaire on personal concerns, and the Patient Health Questionnaire-4 (PHQ-4). A total of 2207 people successfully completed the survey. (3) Results: Polish respondents were the most concerned about being infected. Canadian respondents worried the most about their finances, relations with relatives and friends, and both physical and mental health. Polish respondents worried the least about their physical health, and Israeli respondents worried the least about their mental health and relations with relatives and friends. Canadian respondents obtained the highest score in the PHQ-4, while the scores of Israeli respondents were the lowest. (4) Conclusions: various factors should be considered while formulating appropriate solutions in emergency circumstances such as a pandemic. Understanding these factors will aid in the development of strategies to mitigate the adverse effects of stress, social isolation, and uncertainty on the well-being and mental health of culturally different societies.

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Aftermath of anti-police protests in Nigeria: Burden and predictors of psychiatric morbidity among protesters and non-protesters

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211049332 ◽

2021 ◽

pp. 000486742110493

Author(s):

Olatunde Olayinka Ayinde ◽

Oluwasemiloore Peace Atere ◽

Ugonna Ibeawuchi ◽

Toyin Bello ◽

Abiola Ogunkoya ◽

...

Keyword(s):

Mental Health ◽

Odds Ratio ◽

Online Survey ◽

Negative Impact ◽

Psychiatric Morbidity ◽

Northern Nigeria ◽

Willingness To Participate ◽

Post Traumatic Stress ◽

Cross Sectional ◽

Ratio Range

Objectives: Anti-police (#EndSARS) protests took place in October 2020 across several Nigerian cities, resulting in deaths, injuries and loss of property, but the psychological sequelae of these protests have not been studied. Method: In a cross-sectional online survey, we collected data on psychiatric morbidity and potential risk factors from 426 Nigerian social media users, who self-identified as participants or non-participants in a recent anti-police protest. Results: We found elevated rates of psychiatric morbidity, with worse outcomes for protesters compared to non-protesters (psychological distress [44.2% vs 29.8%], depression [26.0% vs 14.9%], anxiety [51.0% vs 29.8%], post-traumatic stress disorder [7.4% vs 1.8%], current substance use [11.2% vs 4.5%] and suicidal ideation [7.1% vs 4.4%], respectively). After adjusting for the effects of COVID-19 pandemic and previous mental health diagnosis, the predictors of poor mental health among non-protesters were being unmarried (odds ratio = 7.4, p = 0.01) and low resilience (odds ratio range = 4.1–5.4, p < 0.03) while for the protesters, the predictors were low resilience (odds ratio range = 2.9–4.7, p < 0.01), being from Northern Nigeria (odds ratio = 4.7, p < 0.01) or residing in Northern Nigeria (odds ratio = 2.8, p = 0.03), being under-/unemployed (odds ratio range = 2.1–2.5, p < 0.04), holding the view that the protest was caused by the state of the economy (odds ratio = 2.0, p = 0.01), belief that the protest had a direct negative impact on the protester (odds ratio = 2.3, p = 0.04) and willingness to participate in future protests (odds ratio = 4.13, p = 0.02). Conclusion: We conclude that participating in the #EndSARS protest was associated with significant psychiatric morbidity. There is need to recognise and address the mental health sequelae of collective actions, and invest in programmes that build resilience and address socio-political determinants of mental health, especially with a focus on youth.

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