Deepening Depression in Women Balancing Work–Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Population
2.2. Context
2.3. Assessment Tools
- (a)
- Section 1 included information on the study, privacy protection, and informed consent.
- (b)
- Section 2 included the participants’ demographic backgrounds, including age, education, work, marital status, number of children, working activity, and socio-economic status. The history of life events included the impact of the COVID-19 pandemic, complex management of family life and work during the COVID-19 pandemic, and the impact produced by the 2009 L’Aquila earthquake measured on a 5-point Likert scale (0 = None; 1 = Only a little; 2 = To some extent; 3 = Considerably; 4 = Greatly). Previous contact with mental health services, mental health issues, and treatments were also assessed.
- (c)
- Section 3 included standardized questionnaires investigating quality of life, psychopathology, family functioning, and family burden.
2.4. Statistical Analyses
3. Results
3.1. Socio-Demographic and Characteristics of the Sample, Depression, Health-Related Quality of Life, and Family Functioning
3.1.1. Comparison between Female Workers and Non-Workers
3.1.2. Comparison between Female Caregivers and Non-Caregivers
3.2. Correlations between Age, Years of Education, Health-Related Quality of Life, Family Functioning, and Burden of Care
3.3. Variables Impacting Severe Depressive Symptomatology
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables Included | Workers (n = 73) | Non-Workers (n = 138) |
---|---|---|
Age, mean (SD) * | 41.8 (13.2) | 32.4 (20.1) |
Working conditions (%) | ||
Self-employed/freelancers | 23 (31.5) | |
Full-time work | 35 (47.9) | |
Part-time work | 15 (20.5) | |
Student | - | 91 (65.9) |
Housewife | - | 13 (9.4) |
Unemployed | - | 12 (8.7) |
Retired | - | 22 (15.9) |
Nationality (%) | ||
Non-EU citizens | 4 (5.5) | 4 (2.9) |
Marital status (%) * | ||
Single | 16 (21.9) | 77 (55.8) |
Married/partnership | 49 (67.1) | 50 (36.2) |
Separated/divorced | 7 (9.6) | 4 (2.9) |
Widowed | 1 (1.4) | 7 (5.1) |
Parents of children (%) * | 33 (45.2) | 32 (23.2) |
Level of education (%) * | ||
>13 years (graduated) | 24 (32.9) | 96 (69.6) |
Socio-economic status (%) | ||
High–upper middle income | 39 (53.4) | 56 (40.6) |
Middle–low income | 27 (40.2) | 57 (41.3) |
Struggling financially | 7 (9.6) | 25 (18.1) |
Variables | Workers (n = 73) | Non-Workers (n = 138) |
---|---|---|
Complex management of family life and work during COVID-19 pandemic (%) | 31 (42.5) | 77 (55.8) |
Infection with COVID-19 (%) | 9 (12.3) | 12 (8.7) |
Refusal of COVID-19 vaccination (%) | 6 (8.2) | 10 (7.2) |
Loss of someone close due to COVID-19 (%) * | 7 (9.6) | 21 (15.2) |
Subjected to the 2009 L’Aquila earthquake (%) (n = 100) * | 45 (61.6) | 55 (39.9) |
Loss of someone close during the 2009 L’Aquila earthquake (%) (n = 100) | 5 (11.1) | 10 (18.2) |
Severe impact of 2009 L’Aquila earthquake (%) (n = 100 women exposed) (intensity: severe; very severe) | ||
Family life | 21 (46.7) | 27 (49.1) |
Work | 18 (40) | 13 (23.6) |
Social life | 21 (46.7) | 22 (40) |
Severe impairment due to the L’Aquila 2009 earthquake in two out of the three domains investigated (%) (n = 43) * | 22 (30.1) | 21 (15.2) |
Previous contact with services due to mental health problems (%) (n = 94) | 38 (52.1) | 56 (40.6) |
Mental health problems reported (%) | ||
Anxiety | 20 (27.4) | 40 (29) |
Family and interpersonal problems | 13 (17.8) | 26 (18.8) |
Depression | 14 (19.2) | 23 (16.7) |
Sleep disorders | 9 (12.3) | 15 (10.9) |
Eating disorders | 10 (13.7) | 12 (8.7) |
Substance abuse | -- | 3 (2.2) |
Other problems | 5 (6.8) | 14 (10.1) |
Treatments | ||
Admission to a psychiatric ward | -- | 2 (3.5) |
Psychopharmacological treatment (n = 39) | 11 | 28 |
Type of drug | ||
Anxiolytic drugs | 4 (36.4) | 8 (28.6) |
Antidepressant drugs | 6 (54.5) | 14 (50) |
Antipsychotic drugs | 1 (9.1) | 6 (21.4) |
Variables | Total Sample (n = 211) | Workers (n = 73) | Non-Workers (n = 138) |
---|---|---|---|
PHQ-9 total mean score (SD) * | 9.5 (6.17) | 7.82 (5.7) | 10.30 (6.2) |
PHQ-9 total score > 10 (%) * | 82 (40.2) | 19 (26) | 63 (45.7) |
PHQ-9 score 1–5—absent–mild depression (%) | 64 (30.3) | 28 (38.4) | 36 (26.1) |
PHQ-9 score 6–10—moderate depression (%) | 65 (30.8) | 26 (35.6) | 39 (28.3) |
PHQ-9 score 11–15—moderately severe depression (%) | 44 (20.9) | 9 (20.5) | 35 (25.4) |
PHQ-9 score > 15—severe depression (%) | 38 (18) | 10 (26.3) | 28 (20.3) |
Family Functioning Questionnaire (SD) | |||
Communication * | 23.3 (4.8) | 24.9 (4.7) | 22.5 (4.6) |
Problem solving * | 21.0 (6.7) | 23.6 (6.0) | 19.7 (6.7) |
Personal goals * | 23.8 (3.9) | 22.3 (3.8) | 24.5 (3.8) |
Variables Included | Non-Caregivers (n = 164) | Caregivers (n = 47) |
---|---|---|
Age, mean (SD) | 35.3 (18.5) | 37.0 (18.8) |
Range age | ||
Young adults (18–35 years) (%) | 100 (61) | 26 (55.3) |
Adults (%) | 51 (31.1) | 18 (38.3) |
Over 65 (%) | 13 (7.9) | 3 (6.4) |
Nationality (%) | ||
Non-EU citizens | 7 (4.3) | 1 (2.1) |
Marital status (%) | ||
Single | 72 (43.9) | 21 (44.7) |
Married/partnership | 76 (46.3) | 23 (48.9) |
Separated/ divorced | 8 (4.9) | 3 (6.4) |
Widowed | 8 (4.9) | -- |
Parents of children (%) | ||
No children | 118 (71.3) | 29 (61.7) |
1 child | 15 (9.2) | 8 (17.0) |
2 children | 23 (14.1) | 6 (12.7) |
3 children | 8 (4.2) | 4 (10.6) |
Level of education (%) | ||
>13 years (graduated) | 70 (42.3) | 21 (44.7) |
Working conditions (%) | ||
Self-employed/freelancers | 15 (9.1) | 8 (17.0) |
Full-time work | 32 (19.5) | 3 (6.4) |
Part-time work | 11 (6.7) | 4 (8.5) |
Student | 72 (43.9) | 19 (40.4) |
Housewife | 9 (5.5) | 4 (8.5) |
Unemployed | 9 (5.5) | 3 (6.4) |
Retired | 16 (9.8) | 6 (12.8) |
Socio-economic status (%) | ||
High–upper middle income | 75 (45.7) | 20 (42.6) |
Middle–low income | 66 (40.2) | 18 (38.3) |
Struggling financially | 23 (14.0) | 9 (19.1) |
Variables | Non-Caregivers (n = 164) | Caregivers (n = 47) |
---|---|---|
Complex management of family life and work during COVID-19 pandemic (%) | 86 (52.4) | 22 (46.8) |
COVID-19 infection (%) | 16 (9.8) | 5 (10.6) |
Refusal of COVID-19 vaccination (%) | 11 (6.7) | 5 (10.6) |
Loss of someone close due to COVID-19 (%) * | 17 (10.4) | 11 (23.4) |
Subjected to 2009 L’Aquila earthquake (%) (n = 100) | 77 (47) | 23 (48.9) |
Loss of someone close during the 2009 L’Aquila earthquake (%) | 12 (15.5) | 3 (13) |
Severe impact of 2009 L’Aquila earthquake (%) (n = 100 women exposed) (intensity: severe; very severe) | ||
Family life | 37 (48) | 11 (47.8) |
Work | 25 (32.4) | 6 (26.1) |
Social life | 32 (41.5) | 11 (47.8) |
Severe impairment due to the 2009 L’Aquila earthquake in two out of the three domains investigated (%) (n = 43) | 33 (42.9) | 10 (43.5) |
Previous contact with services due to mental health problems (%) (n = 94) | 71 (43.3) | 23 (48.9) |
Mental health problems reported (%) | ||
Anxiety | 42 (25.6) | 18 (38.3) |
Family and interpersonal problems | 28 (17.1) | 11 (23.4) |
Depression | 27 (16.5) | 10 (21.3) |
Sleep disorders | 16 (9.8) | 8 (17) |
Eating disorders | 17 (10.4) | 5 (10.6) |
Substance abuse | 1 (0.6) | 2 (4.3) |
Other problems | 16 (9.8) | 3 (6.4) |
Treatments | ||
Admission to a psychiatric ward | 1 | 1 |
Integrated treatment (drug prescription + psychotherapy) | 14 (8.5) | 7 (14.8) |
Psychopharmacological treatment (n = 39) | 29 | 10 |
Type of drug | ||
Anxiolytic drugs | 10 (34.5) | 2 (20) |
Antidepressant drugs | 16 (55.2) | 4 (40) |
Antipsychotic drugs | 3 (10.3) | 4 (40) |
Variables | Non-Caregivers (n = 164) | Caregivers (n = 47) |
---|---|---|
PHQ-9 total mean score (SD) | 9.07 (5.8) | 11 (7.1) |
PHQ-9 total score > 10 (%) | 59 (37.1) | 23 (51.1) |
PHQ-9 score 1–5—absent–mild depression (%) | 51 (31.1) | 13 (27.7) |
PHQ-9 score 6–10—moderate depression (%) | 54 (32.9) | 11 (23.4) |
PHQ-9 score 11–15—moderately severe depression | 35 (21.3) | 9 (19.1) |
PHQ-9 score > 15—severe depression (%) | 24 (14.6) | 14 (29.8) |
Family Functioning Questionnaire (SD) | ||
Communication | 23.5 (4.4) | 22.7 (5.7) |
Problem solving | 21.4 (6.6) | 19.8 (7.1) |
Personal goals | 24.0 (3.8) | 23.0 (4.3) |
Physical Disability Caregivers (n = 23) | Mental Disability Caregivers (n = 24) | |
---|---|---|
Family Functioning | ||
Communication | 22.6 (6.5) | 22.8 (5.1) |
Problem solving | 20.6 (4.3) | 19.0 (6.5) |
Personal goals | 22.9 (4.6) | 23.0 (4.1) |
Burden of care | ||
Objective burden | 1.79 (0.50) | 1.86 (0.41) |
Subjective burden * | 2.00 (0.54) | 2.64 (0.70) |
Support received from professionals | 2.43 (0.92) | 2.51 (0.68) |
Support received from relatives and friends * | 2.24 (0.98) | 2.80 (0.69) |
Measures | Age | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Education, years | 0.304 ** | -- | ||||||||||||
2. SF-36 GH | 0.245 ** | 0.143 * | -- | |||||||||||
3. SF-36 MH | 0.413 ** | 0.202 ** | 0.512 ** | -- | ||||||||||
4. SF-36 RE | 0.380 ** | 0.322 ** | 0.451 ** | 0.628 ** | -- | |||||||||
5. SF-36 VT | 0.419 ** | 0.204 ** | 0.590 ** | 0.835 ** | 0.646 ** | -- | ||||||||
6. SF-36 SF | 0.412 ** | 0.214 ** | 0.542 ** | 0.755 ** | 0.611 ** | 0.697 ** | -- | |||||||
7. PHQ9 total score | 0.452 ** | −0.310 ** | −0.560 ** | −0.836 ** | −0.681 ** | −0.799 ** | −0.738 ** | -- | ||||||
8. FPQ, objective burden of care | −0.171 | −0.0151 | −0.384 ** | −0.207 | −0.354 * | −0.337 * | −0.300 * | 0.332 * | -- | |||||
9. FPQ, subjective burden of care | −0.076 | −0.011 | −0.292 * | −0.545 ** | −0.391 ** | −0.631 ** | −0.550 ** | 0.501 ** | 0.563 ** | -- | ||||
10. FPQ, (lack of) support from relatives and friends | 0.020 | −0.179 | −0.207 | −0.342 * | −0.155 | −0.412 ** | −0.231 | 0.303 * | 0.232 | 0.304 * | -- | |||
11. FPQ, (lack of) professional support | −0.031 | −0.186 | −0.236 | −0.200 | −0.139 | −0.336 * | −0.199 | 0.301 * | 0.007 | 0.155 | 0.580 ** | -- | ||
12. FFQ, problem solving | 0.434 ** | 0.291 ** | 0.422 ** | 0.519 ** | 0.399 * | 0.556 ** | 0.529 ** | −0.569 ** | −0.130 | −0.110 | −0.465 ** | −0.453 ** | -- | |
13. FFQ, communication | 0.382 ** | 0.214 ** | 0.404 ** | 0.442 ** | 0.324 ** | 0.460 ** | 0.433 ** | −0.472 ** | −0.290 * | −0.291 * | −0.373 ** | −0.309 * | 0.733 ** | -- |
14. FFQ, personal Goals | −0.147 * | −0.167 * | 0.350 ** | 0.208 ** | 0.131 | 0.233 ** | 0.277 ** | −0.209 ** | −0.261 | −0.300 * | −0.403 ** | −0.315 * | 0.171 * | 0.165 * |
Variables | Categories | B | p | Exp(B) | 95% Confidence Interval for Exp(B) | |
---|---|---|---|---|---|---|
Lower Bound | Upper Bound | |||||
Age | Moderate depression | −0.036 | 0.010 | 0.964 | 0.938 | 0.991 |
Moderately severe depression | −0.095 | 0.000 | 0.909 | 0.868 | 0.952 | |
Severe depression | −0.068 | 0.008 | 0.934 | 0.888 | 0.983 | |
Lack of a stable romantic partnership | Moderate depression | 0.124 | 0.784 | 1132 | 0.465 | 2.756 |
Moderately severe depression | 1.101 | 0.053 | 3.006 | 0.988 | 9.148 | |
Severe depression | 1.113 | 0.098 | 3.044 | 0.813 | 11.399 | |
Less than 13 years of education | Moderate depression | 0.0362 | 0.411 | 1.436 | 0.605 | 3.408 |
Moderately severe depression | 0.306 | 0.591 | 1.358 | 0.444 | 4.152 | |
Severe depression | 1.688 | 0.021 | 5.410 | 1.288 | 22.714 | |
Struggling financially | Moderate depression | −0.427 | 0.579 | 0.652 | 0.144 | 2.952 |
Moderately severe depression | 0.870 | 0.260 | 2.387 | 0.525 | 10.852 | |
Severe depression | 1.224 | 0.145 | 3.402 | 0.654 | 17.687 | |
Previous access to mental health services | Moderate depression | 0.634 | 0.155 | 1.885 | 0.787 | 4.514 |
Moderately severe depression | 1.956 | 0.001 | 7.070 | 2.288 | 21.842 | |
Severe depression | 2.391 | 0.000 | 10.923 | 2.908 | 41.020 | |
Traumatic experience with the 2009 L’Aquila earthquake | Moderate depression | 1.369 | 0.013 | 3.932 | 1.332 | 11.612 |
Moderately severe depression | 2.242 | 0.004 | 9.416 | 2.077 | 42.691 | |
Severe depression | 1.705 | 0.077 | 5.502 | 0.829 | 36.527 | |
COVID-19 infection | Moderate depression | 0.239 | 0.742 | 1.270 | 0.307 | 5.248 |
Moderately severe depression | −0.073 | 0.939 | 0.930 | 0.143 | 6.039 | |
Severe depression | −0.483 | 0.651 | 0.617 | 0.076 | 5.008 | |
Complex life management during the COVID-19 pandemic | Moderate depression | 0.533 | 0.221 | 1.705 | 0.726 | 4.003 |
Moderately severe depression | 1.086 | 0.046 | 2.964 | 1.018 | 8.628 | |
Severe depression | 1.280 | 0.045 | 3.598 | 1.026 | 12.616 | |
Caregiving for a loved one | Moderate depression | −0.129 | 0.821 | 0.879 | 0.287 | 2.693 |
Moderately severe depression | 0.304 | 0.652 | 1.355 | 0.362 | 5.075 | |
Severe depression | 1.058 | 0.150 | 2.880 | 0.683 | 12.147 | |
Problem solving | Moderate depression | −0.093 | 0.096 | 0.912 | 0.817 | 1.017 |
Moderately severe depression | −0.164 | 0.010 | 0.849 | 0.750 | 0.961 | |
Severe depression | −0.234 | 0.001 | 0.791 | 0.686 | 0.912 | |
Communication | Moderate depression | −0.095 | 0.192 | 0.909 | 0.788 | 1.049 |
Moderately severe depression | −0.029 | 0.726 | 0.971 | 0.824 | 1.145 | |
Severe depression | −0.124 | 0.189 | 0.883 | 0.734 | 1.063 | |
Personal goals | Moderate depression | −0.100 | 0.100. | 0.905 | 0.803 | 1.019 |
Moderately severe depression | −0.127 | 0.105 | 0.881 | 0.756 | 1.027 | |
Severe depression | −0.222 | 0.012 | 0.801 | 0.674 | 0.952 |
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Giusti, L.; Mammarella, S.; Del Vecchio, S.; Salza, A.; Casacchia, M.; Roncone, R. Deepening Depression in Women Balancing Work–Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy. Behav. Sci. 2023, 13, 892. https://doi.org/10.3390/bs13110892
Giusti L, Mammarella S, Del Vecchio S, Salza A, Casacchia M, Roncone R. Deepening Depression in Women Balancing Work–Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy. Behavioral Sciences. 2023; 13(11):892. https://doi.org/10.3390/bs13110892
Chicago/Turabian StyleGiusti, Laura, Silvia Mammarella, Sasha Del Vecchio, Anna Salza, Massimo Casacchia, and Rita Roncone. 2023. "Deepening Depression in Women Balancing Work–Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy" Behavioral Sciences 13, no. 11: 892. https://doi.org/10.3390/bs13110892