COVID-19: prevalence of job-demands, stress, work–life difficulties and work–life balance among international business travelers

PurposeInternational business travelers (IBTs) face daily challenges pertaining to the frequency and duration of travel. Following the outbreak of coronavirus disease (COVID-19), the study aims to draw upon the job demands-resources (JD-R) model and the literature on work–life balance (WLB) to examine how this crisis have disrupted IBTs routines and the implications for their WLB.Design/methodology/approachData were collected in April 2020 with an online survey answered by 141 IBTs from different locations. The first set of analyses examined the perceived change in job-demands (i.e. business travel and workload) including stress and work–life difficulties following the outbreak of COVID-19. The second set of analyses tested the hypotheses that the perceived change in workload and stress predict IBTs' work–life difficulties, which, in turn, affect their WLB.FindingsThe results show that the decline in job-demands (i.e. business travel and workload) after the outbreak of COVID-19 was not enough to reduce IBTs' stress and ameliorate their work–life difficulties and WLB. Only respondents who experienced a decrease in workload, including less relational difficulties, reported a superior WLB.Originality/valueThe study widens the scope and relevance of global mobility studies in crisis settings by timely reporting the changes in job-demands, stress and work–life difficulties among IBTs following the outbreak of COVID-19. Additionally, the research extends the use of the JD-R model in the international context by advancing our knowledge of the interplay between contextual demands and job-demands in affecting IBTs' stress, work–life difficulties and WLB.

Change of Health and Change of Preferences on Life-Sustaining Treatment: Evidence From a Longitudinal Study

Background Decision-making for end-of-life (EoL) care is not a one-off choice. Older adults may change their preferences for life-sustaining treatments along their health continuum. Guided by prospect theory, we hypothesize that perceived change in health status is a driver behind preference changes. Method: Health and Retirement Study Wave 2012 to 2018 data. Sample is limited to 5,646 older adults who reported whether they requested to limit treatment in living will during two waves of data. Two possible preference changes were tested: from limited to default care and from default to limited care. Change in health status was indicated by changes (1=same, 2=improve, 3=decline) in physical pain, general health, activities of daily living, instrumental activities of daily living (IADL), and number of diagnoses. Multilevel logistic regression models were used to understand how change of health status was related to changes in EoL preferences. Results 700 older adults changed their preferences some time in 8 years. Those who changed their preferences are more likely to be older and not married, and to have lower socioeconomic background. Older adults who experienced deteriorated pain levels were more likely to change their preferences from default to limited care (OR=3.77, p<.05) and less likely to change from limited to default care (OR=0.63, p<.05). Change in IADL is also a significant predictor of change of preferences. Implication: The findings highlight the importance of periodic reassessment of EoL care preferences with older adults. We discuss policy and practice implications regarding health changes as underlying mechanisms of preference changes.

Retrospective Perceptions of Changes in Well-Being: The Impact of Age, Culture, and Aging Attitudes on Accuracy

Aging attitudes have important consequences on functioning in later-life. A critical question concerns whether such attitudes may bias perceptions of one’s own aging, with potentially negative effects on important outcomes. Using data from adults aged 30 – 85 in the US (n=315), Hong Kong (n=317), and Germany (n=623), we examined the impact of age and aging attitudes on accuracy of perceptions of change in well-being over five years in different domains of functioning. Across contexts, comparisons revealed good correspondence between retrospective reports and actual change. However, older adults and those with negative attitudes retrospectively reported less positive change over this period. Accuracy of perceived change was affected by aging attitudes, with positive attitudes being associated with greater accuracy across most domains, although culture moderated these effects. The results highlight the complex relationship between culture and perceptions of well-being, as well as the potentially insidious effects of attitudes on their accuracy.

Perceived Change in Tobacco Use and Its Associated Factors among Older Adults Residing in Rohingya Refugee Camps during the COVID-19 Pandemic in Bangladesh

This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06–0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06–1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03–1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period.

Flourishing Through Music Creation: A Qualitative Investigation of the Lullaby Project Among Refugee and Incarcerated Communities

The Lullaby Project is an innovative model developed to support with vulnerable groups through community-based music creation. It pairs expectant and new mothers with professional musicians, to create a lullaby for their children. This paper presents an investigation of the project’s pilot implementation in the United Kingdom, bringing together musicians from the Royal Philharmonic Orchestra, refugee mothers and inmate fathers from a central London prison. The research aimed to understand how the Lullaby Project was experienced, focusing on the potential areas of perceived change linked with the concept of mental health as flourishing. Participants (N=12) took part in semi-structured interviews and kept daily notes to aid recollection of the sessions in the interviews. Interpretative phenomenological analysis was adopted as the research approach. Participants considered the project to carry significance for them in three key areas: (1) wellbeing, through a strong sense of accomplishment, meaning and connectedness, and the experience of positive emotions; (2) proactivity, promoting initiative, both musical and relational; and (3) reflectiveness, stimulating perspective-taking and positive coping mechanisms. The Lullaby Project offers an effective model towards promotion of flourishing among vulnerable groups, and the results make a strong case for its implementation.

Minimal important change and responsiveness of the Migraine Disability Assessment Score (MIDAS) questionnaire

Background The MIDAS is the most used questionnaire to evaluate migraine-related disability, but its utility to assess treatment response remains unclear. Our aim was to estimate the MIDAS’ minimal important change (MIC) value and its responsiveness. Methods A total of 103 patients were enrolled in a non-pharmacological, preference-based clinical trial. MIDAS and global rating of self-perceived change (GRoC) scores were collected at baseline, after 5 weeks of treatment, 4-weeks and 3-months follow-up after treatment. Anchor-based approaches were used to establish MIC values and responsiveness. Findings In all 3 timepoint comparisons, MIDAS presented a MIC of 4.5 points. A moderate positive correlation was identified between the MIDAS change and GRoC scores. The area under the curve ranged from 0.63 to 0.68. Conclusions This study showed that MIDAS has a limited responsiveness to change. A change of 4.5 points or more represents a clinically important change for patients with high frequent migraine and chronic migraine receiving non-pharmacological treatment.

Associations of physical activity and sedentary behaviors with child mental well-being during the COVID-19 pandemic

Background The COVID-19 pandemic resulted in public health and policy measures to reduce in-person contact and the transmission of the virus. These measures impacted daily life and mental well-being (MWB). The aims of this study were to explore the MWB impacts of COVID-19 on children and assess the associations among perceived changes in physical activity (PA) and sedentary behaviors (SB), with perceived MWB changes, using a mixed-methods approach. Methods A convergent parallel mixed-methods design consisting of an online survey with a convenience sample and interviews was conducted from May through July 2020 with parents/caregivers of kindergarten through 5th graders in the St. Louis region. Survey domains assessed included child MWB, PA, and SB. Interviews were recorded, transcribed, and qualitatively analyzed using a code book developed to elicit themes. Survey data was analyzed with chi-squared tests and logistic regressions. The dependent variable was perceived change in child MWB due to the impact of COVID-19. Independent variables included perceived changes in PA, SB, and child concerns about COVID-19. Results Sample size consisted of 144 surveys and 16 interviews. Most parents reported a perceived decrease in child MWB (74%), a decrease in child PA (61%), and an increase in child SB (91%). Discontentment with stay-at-home orders and concern about COVID-19 were associated with a perceived decrease in MWB. Children whose PA decreased were 53% less likely to have the same or better MWB (OR 0.47) and children whose outside PA decreased were 72% less likely to have the same or better MWB (OR 0.28). Common qualitative themes included difficulty in adjusting to COVID-19 restrictions due to school closures and lack of socializing, child concerns about family getting sick, and PA benefits for improving MWB. Conclusions Based on parent perceptions, MWB decreased with COVID-19. Maintained or increased child PA improved the chances MWB would remain the same or improve. Parent interviews provide context to these findings by showing how COVID-19 impacted MWB and the associations between PA and MWB. Understanding protective factors for child MWB during COVID-19 is important to offset negative long-term health outcomes from this ongoing pandemic.

Family Structure, Economic Outcomes and Perceived Change in Economic Well-being in India

As demographic, economic and cultural shifts continue to diversify family structure, researchers need to explore new ways of conceptualizing and measuring family characteristics and economic outcomes. There are hardly any quantitative studies in India to understand the families from a demographic perspective and relate them to economic outcomes. Thus, we explore the plausible association between the family structure and economic outcomes and perceived change in economic well-being in India. This study conceptualized and adopted a demographic approach to derive family typologies that suit a developing country like India and its cultural context. The study uses the latest information based on India Human Development Survey, 2011-12 and applies robust statistical methods. The findings suggest that family structure makes a huge difference in their economic outcomes. Mostly the families with single residents (adult or older) and families with female children or older adults have a huge economic disadvantage compared to their counterparts.

Change in physical activity and stress during COVID-19 in a sample of older adults with exercise habits

BACKGROUNDː The COVID-19 outbreak forced many states to introduce public health and social measures (PHSM), which may pose an obstacle to performing physical activity (PA).METHODS: This study investigated PA levels and their changes and perceived stress in a sample of 193 participants (aged 71.21 ± 4.87 years) engaged in exercise lessons prior to PSHM. Data were collected via an online survey distributed directly to the participants. The survey included two instruments: the International Physical Activity Questionnaire and the Perceived Stress Scale.RESULTS: The results indicate that sports habits may be a protective factor in staying active and meting PA recommendations. Nevertheless, there were no associations between the number of exercise lessons in the pre-COVID-19 period and PA level or the perceived change in PA during PSHM. Ability to replace the cancelled exercise lesson with PA of similar duration and intensity was negatively associated with PA levels and its change. The PSS-10 score suggests that the sample did not experience a significant increase in perceived stress, but the relationship of this outcome to PA is unclear.CONCLUSIONS: The promotion of alternative PA that could be performed during PHSM and building long-term exercise habits in older adults should be considered.

Positive mental health and perceived change in mental health among adults in Canada during the second wave of the COVID-19 pandemic

Introduction Canadian surveys from spring/summer 2020 suggest the prevalence of some positive mental health (PMH) outcomes have declined compared to pre-pandemic levels. However, less is known about the state of PMH during the second wave of the COVID-19 pandemic. Methods We compared adults’ self-rated mental health (SRMH), community belonging and life satisfaction in Fall 2020 versus 2019 in the overall population and across sociodemographic characteristics using cross-sectional data from the Survey on COVID-19 and Mental Health (September–December, 2020) and the 2019 Canadian Community Health Survey. We also conducted regression analyses to examine which sociodemographic factors were associated with reporting in Fall 2020 that one’s mental health was about the same or better compared to before the pandemic. Results Fewer adults reported high SRMH in Fall 2020 (59.95%) than in 2019 (66.71%) and fewer reported high community belonging in Fall 2020 (63.64%) than in 2019 (68.42%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in Fall 2020 (7.19) than in 2019 (8.08). Females, those aged under 65 years, those living in a population centre, and those absent from work due to COVID-19 had lower odds of reporting that their mental health was about the same or better in Fall 2020. Conclusion The PMH of adults was lower during the pandemic’s second wave. However, the majority of individuals still reported high SRMH and community belonging. The findings identify certain sociodemographic groups whose mental health appears to have been more negatively impacted by the pandemic. Continued surveillance is important in ensuring mental health builds back better and stronger in Canada after the pandemic.