Smoking Behavior Changes during COVID-19 among Korean Adults

Objectives: In this study, we investigated the changes in smoking behavior during the COVID-19 outbreak in Korea in 2020. We also examined the influence of general characteristics and mental health problems due to COVID-19 on changes in smoking behavior. Methods: We collected data from August to October 2020 from adults aged 19 years and older from the Korea Community Health Survey (N=229,269). Results: Among current smokers (N=39,534), 11.0% reported an increase in smoking, and 12.8% reported a decrease in smoking. Overall, 33.3% reported perceived stress and 3.7% reported depression. Participants reported COVID-related anxiety about infecting family (83.0%), economic damage (76.3%), blame or harm from others (66.5%), infection (60.6%), and death (31.3%). Lower education level, living alone, and poor subjective health status were associated with increased smoking. Being a woman and being of older age were associated with decreased smoking. Stress, depression, and anxiety about economic damage due to COVID-19 were more likely to result in increased smoking. Anxiety related to death due to COVID-19 was more likely to result in decreased smoking. Conclusion: These findings provide insight into the changes in smoking behavior caused by COVID-19.

Measurement of Barriers, Attitudes, and Expectations for Sitting Less in Pregnancy

Objective: Our objective was to develop, validate, and describe findings from an instrument to measure barriers, attitudes, and outcome expectations of sitting less in pregnant women. Methods: This validation (sub-study 1) and descriptive study (sub-study 2) evaluated a new questionnaire measuring sedentary time in pregnant women (N=131) in each trimester. Results: In sub-study 1, construct validity was supported by associations between device-measured sedentary time and questionnaire scores. An optimized questionnaire removed infrequently reported and non-correlated items. The original and optimized questionnaires with scoring instructions are provided. In sub-study 2, physical symptoms and work were most commonly reported as major reasons for sitting in pregnancy, followed by leisure, family, and social activities. Some women reported limiting sitting due to boredom/restlessness, to improve energy or health, and to control weight. In the third trimester, some women reported sitting more/less due to pain and encouragement from family, friends, and co-workers. Few women reported household chores or pregnancy risks as reasons to sit, felt sitting was healthy or necessary during pregnancy, or were encouraged to sit by healthcare providers. Conclusions: The developed questionnaire demonstrated validity and identified barriers to and expectations of sitting less during pregnancy. Prenatal interventions to reduce sitting should address general and pregnancy-specific barriers.

Individual and Family Factors in Disordered Eating Patterns of Mexican-American Women

Objective: In this study, we examined the contribution of individual- (acculturation, body mass index, and body size satisfaction) and family- (maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. Methods: We recruited adult Mexican- American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. Results: Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r = -.34, p < .01) or dieting behavior (r = -.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r = -.43, p < .01) or dieting behavior (r = -.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the strongest predictor of daughters' dieting behavior (ß = -.372, p = .008) in adjusted models. Conclusion: Mexican-American women who are less satisfied with their body size and have mothers with elevated symptoms of bulimic behavior are at risk for disordered eating patterns. Intervening at the individual level on body image and family level on maternal modeling of eating behavior may help support healthy weight management behaviors.

Factors Influencing Intention to Work while Ill: A Systematic Review

Objectives: The aim of this systematic review was to identify factors influencing workers' intention to work while ill, using the Theory of Planned Behavior (TPB) as a theoretical framework. Methods: A systematic search of articles was carried out from PubMed, Scopus, and Web of Science databases. Eligibility of each article was assessed using PRISMA guidelines. Overall, 22 articles met the inclusion criteria after the selection process and were included in this review. Results: The factors fit into 3 constructs: (1) attitude (good and bad consequences of working while ill), (2) subjective norms (descriptive and injunctive norms on working while ill), and (3) perceived behavioral control (facilitators and barriers of working while ill). Conclusions: The TPB is a practical theory to conceptualize and understand the factors influencing workers' intention to work while ill. These findings provide initial knowledge on the development of a framework to measure workers' intention to work while ill and to propose appropriate interventions for workers with chronic illness.

Effects of Breathing Meditation Training on Sustained Attention Level, Mindfulness Attention Awareness Level, and Mental State of Operating Room Nurses

Objectives: In this paper, we explore the effects of breathing meditation training on the sustained attention level, mindfulness attention awareness level, and mental state of nurses in the operating room. Methods: We enrolled 40 nurses from September 2019 to December 2019, and divided them into a control group (N=20) and an observation group (N=20) using a random number table. The control group received routine training, based on which the observation group received breathing meditation training. We compared their sustained attention index, fatigue score, mindfulness attention awareness score, mental state score, work stress score, career satisfaction score, and career happiness index. Results: After training, the sustained attention response time was shorter at 8:00 and 18:00 in the observation group than in the control group (p < .05). The physical fatigue score, mental fatigue score, reduced activity score, reduced motivation score, and overall fatigue score of the observation group were lower than those of the control group (p < .05). The observation group had a higher mindfulness attention awareness score than did the control group (p < .05). The SAS and SDS scores of the observation group were lower than those of the control group (p < .05). The work stress score of the observation group was lower than that of the control group, whereas the career satisfaction score and career happiness index were higher (p < .05). Conclusion: Breathing meditation training can improve the sustained attention level and mindfulness attention awareness level, reduce the feeling of fatigue and work stress, help adjust the mental state, and enhance the career satisfaction and career happiness of nurses in the operating room.

Quarantine Hotels: Integration between Hospitality and Healthcare Services to Promote Health Behavior and Quality of Life

Objectives: COVID-19 has spread globally and infected millions of people, thereby restricting their movement. Quarantine hotels play an important role in protecting people from COVID-19 and contribute to a better quality of life. The objective of this study was to examine the role of quarantine hotels in providing improved quality of life through both medical and hospitality services under one roof to address the COVID-19 situation in Saudi Arabia. Methods: This study used a quantitative, cross-sectional research design. Data were collected from quarantine hotels in Saudi Arabia using a survey, and analyzed through Partial Least Square (PLS)-Structural Equation Modeling (SEM). Results: Medical service quality, financial savings and convenience had a positive effect on people's attitudes and intention to use quarantine hotels. Similarly, attitude, intention, and hospitality products had a positive effect on health behavior, which favorably affected quality of life. Conclusions: Medical service quality, financial savings, and convenience, as well as hospitality provided by quarantine hotels, have a positive role in promoting health behavior and quality of life.

Tracking Changes of Social Distancing in the United States of America after Outbreak of Coronavirus Disease (COVID-19) at the Early Stage

Objectives: This research examines social distancing changes over time, and by region of the United States after the COVID-19 pandemic began. Methods: We utilized information on social distancing from the Google Community Mobility Reports. We performed one-way repeated-measure analysis of variance (RM-ANOVA) to examine the overall changes in the 6 types of social distancing from baseline to the 12-week follow-up (March 1 to May 24, 2020). We applied a 2-way RM-ANOVA to evaluate the effects of time and 4 regions on social distancing. Results: According to one-way RM-ANOVA results, social distancing tended to increase until Time 3 (March 30 to April 12) and 4 (April 13 to April 26), before decreasing again, regardless of the area. The 2-way RM-ANOVA results revealed that the social distancing variations in the 6 area types over time were statistically significant in each region, along with the interaction of regions and time. Compared to other regions, social distancing was the highest in the Northeast area, except in park areas. Conclusions: We found that social distancing can be influenced not only by contagion changes, but also by regional differences. Understanding the features of social distancing can play a significant role in helping society build a promising COVID-19 prevention model.

Association of Excessive WeChat Use with Mental Disorders: A Representative Nationwide Study in China

Objectives: We examined associations between excessive WeChat use and mental disorders at the individual and contextual level. Methods: We conducted a representative nationwide survey sampling process of 11,283 medical students from 30 universities in China. Mental health status was measured by the Chinese Health Questionnaire. Both unadjusted and adjusted methods were considered in the analyses. Results: High frequency and long-time use prevalence was 19.1% and 31.2% respectively among WeChat users. The multilevel logistic regression model found that individual-level high frequency (OR = 1.26) and long-time use (OR = 1.24) were significantly associated with mental health disorders. University-level excessive WeChat use also was associated with the mental disorders (OR = 1.33 [high frequency use]; OR = 1.17 [long-time use]). Structural equation analysis showed that individual- and university-level high frequency and individual-level and university-level long-time WeChat use have a direct influence on poor mental health. The above variables, except individual-level long-time use, have an indirect influence on poor mental health through mental stress. Conclusions: This study provides new evidence that excessive WeChat use is associated with mental disorders. These findings underscore the importance of alerting people to the possible health risks of excessive social media use.

Relationship between Mindfulness and Psychological Distress in Patients with Hepatocellular Carcinoma: The Mediation Effect of Self-regulation

Objectives: In this study, we examine the relationship among mindfulness, psychological distress, and self-regulation, to determine whether self-regulation plays a mediating role in the relationship between mindfulness and psychological distress among patients with hepatocellular carcinoma (HCC). Methods:Participants completed questionnaires including the Hospital Anxiety and Depression Scale (HADS), the Five-facet Mindfulness Questionnaire (FFMQ), and the Self-regulation Scale (SRS). We used structural equation modeling to analyze the relationships among psychological distress, mindfulness, and self-regulation, with self-regulation as a mediator. Results:We found that psychological distress is negatively associated with both mindfulness (r = -0.687, p < .001) and self-regulation (r = -0.629, p < .001), and mindfulness is positively associated with self-regulation (r = 0.534, p < .001). The model indicates that mindfulness has direct impact on self-regulation (β = 0.570, p < .001) and psychological distress (β = -0.685, p < .001). Self-regulation asserts a certain mediation effect on the relationship between mindfulness and psychological distress. A bootstrap test suggests perceived stress has a mediation effect on mindfulness and psychological distress (95% CI: -0.299, -0.134, p < .001), accounting for 23.6% of total effect. Conclusions: Psychological distress is common in HCC patients. The mediation effect of self-regulation provides a reference for discussing possible correlations between mindfulness and psychological distress.

Association between Stress and Metabolic Syndrome and its Mediating Factors in University Students

Objectives: In this study, we evaluated the association between perceived stress and indicators of metabolic syndrome and how this association is mediated by sleep problems, unhealthy eating habits, and night eating syndrome, in addition to serum levels of ghrelin and cortisol in university students. Methods: We recruited 192 students from a public university in Mexico. Weight, height, waist circumference and blood pressure were taken in accordance with standard protocols. Validated questionnaires were used to assess perceived stress, sleep quality and eating habits. Fasting blood samples were taken to measure ghrelin, cortisol, triglycerides, glucose and HDL-C. Results: Path Analysis indicated direct positive effects of stress over PSQI (β = 0.341) and NES (β = 0.443); PSQI over NES (β = 0.233) and NES over glucose (β = 0.170), triglycerides over LDL-C (β = 0.215), waist circumference over SBP (β = 0.259). Likewise, standardized negative regression weights of PSQI over Diet Quality Index (β = -0.239) and ghrelin concentrations (β = -0.132), ghrelin over Diet Quality Index (β = -0.188) and waist circumference (β = -0.147). Diet Quality Index over triglycerides (β = -0.184); sleep duration over systolic blood pressure (β = -0.242); waist circumference over HDL-C (β = -0.256). Conclusion: Psychological stress leads to increased indicators of MetS via decreased sleep quality, inadequate eating habits and eating behavior in university students.