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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 12117

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Prof. Dr. Mateusz Cybulski

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Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-096 Bialystok, Poland
Interests: mental health; psychogeriatrics; depression; older adults; geriatrics; COVID-19; SARS-CoV-2; fear; anxiety
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Dear Colleagues,

Mental health and emotion-related issues are now among the most important public health issues around the world. Among the reasons for this is the COVID-19 pandemic, primarily due to fear of infection or death due to the disease. Research has shown that social distancing, self-isolation, quarantine and misinformation (especially on social media) are some of the main factors causing unusual sadness, fear, frustration, helplessness, loneliness and nervousness. In extreme cases, these factors can trigger suicidal thoughts and attempts, and in some cases actually end in suicide.

We are pleased to invite clinicians and researchers to provide reviews on mental health problems occurring in various cohorts and groups, including the general population, medical staff, students, older adults, pregnant women and other vulnerable groups.

We encourage the submission of original research papers (both qualitative and quantitative), reviews, meta-analyses and case studies that contribute new knowledge in this area. Interventional studies, trials and epidemiological studies are also encouraged. The focus may include a specific population.

We look forward to receiving your contributions.

Prof. Dr. Mateusz Cybulski
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

mental health
depression
COVID-19
SARS-CoV-2
fear
anxiety

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Published Papers (9 papers)

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Research

14 pages, 339 KiB

Open AccessArticle

Difficulties in Emotion Regulation and Stress in Intensive Care Unit Nurses During COVID-19: Exploring the Mediating Role of Psychological Inflexibility and the Moderating Effect of Work Experience

by Cristian Di Gesto, Giulia Rosa Policardo, Sara Bocci Benucci, Eriada Çela and Caterina Grano

Healthcare 2025, 13(13), 1575; https://doi.org/10.3390/healthcare13131575 - 1 Jul 2025

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Abstract

Background/Objectives: The COVID-19 pandemic has placed intensive care unit (ICU) nurses under intense psychological pressure, increasing emotional and psychological stress. Two constructs—difficulties in emotion regulation and psychological inflexibility (i.e., low contact with the present moment and a lack of committed action based on personal values)—have been associated with increased perceived stress levels but remain underexplored in this population. Aims: This study investigated whether psychological inflexibility mediates the relationship between emotion regulation difficulties and perceived stress in ICU nurses. It also examined whether years of ICU work experience moderate the direct relationship between emotion regulation difficulties and perceived stress. Methods: A cross-sectional study was conducted with 210 ICU nurses (65.2% women; 34.8% men; mean age = 40.25 years ± 11.36) from Italian public hospitals. The participants completed the Difficulties in Emotion Regulation Scale, the Acceptance and Action Questionnaire-II, and the Perceived Stress Scale. A moderated mediation model was tested to examine whether psychological inflexibility mediates the relationship between emotion regulation difficulties and perceived stress and whether years of ICU work experience moderate the path between these variables. Results: Higher difficulties in emotion regulation predicted greater psychological inflexibility, which, in turn, predicted higher perceived stress. Psychological inflexibility fully mediated the relationship between emotion regulation difficulties and perceived stress. Additionally, years of ICU work experience significantly moderated the direct link between emotion regulation difficulties and perceived stress. This relationship was strongest for nurses with 1–15 years of ICU experience. The model explained 33% of the variance in perceived stress. Conclusions: This study highlights the importance of the novel construct of psychological inflexibility in the context of healthcare professionals and its role in shaping perceived stress. Addressing psychological inflexibility through targeted interventions may help mitigate stress and promote well-being among ICU nurses. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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14 pages, 429 KiB

Open AccessArticle

Living with Chronic Kidney Disease and Kidney Transplantation During COVID-19: A Study of Psychological and Behavioral Impacts

by Jasmin Jäger, Saskia Reick, Jil Beckord, Peter Weber, Adnan Halilbegovic, Rebekka Bruning, Johanna Reinold, Eva-Maria Skoda, Martin Teufel, Andreas Kribben, Oliver Witzke, Sven Benson, Anja Gäckler, Hana Rohn and Hannah Dinse

Healthcare 2025, 13(13), 1488; https://doi.org/10.3390/healthcare13131488 - 21 Jun 2025

Viewed by 211

Abstract

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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18 pages, 617 KiB

Open AccessArticle

Assessing COVID-19-Related Psychological Distress: Validation of the AMICO Scale in Spanish Nursing University Students

by Nadine Badillo-Sánchez, Cristina Morgado-Toscano, Regina Allande-Cussó, Juan Gómez-Salgado, Murat Yıldırım, Krzysztof Goniewicz, Israel Macías-Toronjo and Javier Fagundo-Rivera

Healthcare 2025, 13(9), 1058; https://doi.org/10.3390/healthcare13091058 - 4 May 2025

Viewed by 491

Abstract

Background: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. Methods: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach’s alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. Results: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach’s alpha = 0.913). Conclusions: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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10 pages, 271 KiB

Open AccessArticle

Physical Activity Levels and Women’s Mental Health After COVID-19 Infection

by Miloš Stamenković, Saša Pantelić, Saša Bubanj, Emilija Petković, Nikola Aksović, Adem Preljević, Bojan Bjelica, Tatiana Dobrescu and Adina-Camelia Şlicaru

Healthcare 2024, 12(23), 2346; https://doi.org/10.3390/healthcare12232346 - 24 Nov 2024

Viewed by 1760

Abstract

Background: The aim of this research is to investigate the associations between physical activity and mental health parameters (depression, anxiety, and stress) among women who have recovered from COVID-19; Methods: This research involved two measurements: the initial test, conducted 2-to-4 weeks post-COVID infection, and the final test, performed 14-to-16 weeks after the virus’s activity. The sample consisted of women (n = 190) aged 20 to 60 (47.60 ± 11.1, 47.60 ± 11.1, mean ± Std.Dev.) who were infected with COVID-19. To assess the level of physical activity, a longer version of the IPAQ questionnaire was used. Self-assessment of mental health was determined by a longer version of the DASS questionnaire; Results: The t-test analysis revealed significant differences in mental health and physical activity levels between the initial and final measurements. After three months, subjects showed lower mental health scores (indicating improvement) and higher Metabolic Equivalent of Task (MET) values across all physical activity domains, with moderate physical activity showing the greatest increase. The regression analysis showed that at the initial measurement, there was no statistically significant association of physical activity with mental health parameters. Three months after the initial measurement, regression analysis showed that there was a statistically significant association of physical activity with anxiety (F = 3.97; p = 0.000) and depression (F = 3.34; p = 0.001) but not with stress (F = 1.67; p = 0.106); Conclusions: This research revealed that higher levels of physical activity improved mental health in post-COVID-19 women, with varying effects on anxiety and depression depending on the activity domain. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

12 pages, 982 KiB

Open AccessArticle

Balance and Health-Related Quality of Life After 1 Year of COVID-19 Social Restriction Measures: A Cross-Sectional Study in Two Samples from Spain

by Elisabet Huertas-Hoyas, Cristina Rodríguez-Rivas, Mª Pilar Rodríguez-Pérez, María García-de-Miguel, Nuria Trugeda-Pedrajo, Laura Delgado-Lobete, Gemma Fernández-Gómez and Lucía Rocío Camacho-Montaño

Healthcare 2024, 12(21), 2164; https://doi.org/10.3390/healthcare12212164 - 30 Oct 2024

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Abstract

Background: The COVID-19 pandemic significantly impacted the well-being of the general population. However, more information is needed regarding the relationship between participation-related outcomes. This study aimed to analyze the impact of the pandemic on occupational balance (OB) and health-related quality of life (HRQoL) before and after social restrictions and to explore their relationship with COVID-19 diagnosis. Methods: We conducted a study among individuals diagnosed with COVID-19, assigning a healthy control group with the same sociodemographic characteristics using the EQ-5D-5L and the Occupational Balance Questionnaire (OBQ). Results: The final sample size consisted of 61 participants in the COVID-19 diagnosis group (50.8% male; mean age 34.6 ± 14.17 years) and 57 healthy participants (50.8% male; mean age 33.7 ± 13.77 years). There were no differences in the sociodemographic variables between the groups. Significant differences were found between groups both before the pandemic and 1 year after confinement measures in HRQoL and OBQ (p < 0.005). The regression model indicated significant associations (p < 0.001) between HRQoL and both current OB and COVID-19 diagnosis. However, the OBQ scores from before the pandemic did not show a significant association with HRQoL (p = 0.336). Conclusions: In conclusion, social restrictions from the COVID-19 pandemic negatively impacted HRQoL in our sample even 1 year after confinement, with COVID-19 diagnosis and occupational imbalance predicting worse outcomes, highlighting the need for targeted interventions not only for the current situation but also for possible future public health crises. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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11 pages, 227 KiB

Open AccessArticle

An Assessment of Mental Health Challenges of Lesbian, Gay, Bisexual, and Transgender College Students during the COVID-19 Pandemic

by Lei Xu, H. Daniel Xu, Wenhua Lu and Divya Talwar

Healthcare 2024, 12(20), 2047; https://doi.org/10.3390/healthcare12202047 - 16 Oct 2024

Cited by 1 | Viewed by 1772

Abstract

Introduction: Collegiate mental health continues to be a worrisome public health concern among college students in the U.S. The unprecedented COVID-19 pandemic has caused an upward trend of mental health crises, especially among lesbian, gay, bisexual, and transgender (LGBTQ+) college students. The objective of this study was to assess the mental health statuses, attitudes towards disease control and mitigation measures, and coping strategies among this vulnerable group. Methods: A web-based survey was conducted at a medium-sized public university in the mid-Atlantic region during the summer and fall of 2021 when COVID-19 was still a major public health concern. The survey was distributed through the listservs of the college and was advertised through campus-wide social media. Descriptive and inferential statistics including a t-test for the differences in group means and a logit regression model for comparing the groups were used. Results: Our final sample is composed of 611 students with 79% of the respondents identifying as straight, and 20% in the LGBTQ+ group. Our results showed that LGBTQ+ students exhibited higher levels of anxiety and fear compared to the non-LGBTQ+ groups. Also, a large proportion of LGBTQ+ students were negatively impacted by the pandemic as compared to the non-LGBTQ+ groups (p = 0.05), while they generally have more positive views on the public health measures to alleviate the adverse impacts from COVID-19 (p = 0.001). Conclusions: Public health emergency management should adopt appropriate strategies and adapt their services to support the mental health needs of LGBTQ+ students. Our study highlighted the need to design tailored health promotion programs and enhance support systems for LGBTQ+ college students during similar emergencies. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

17 pages, 340 KiB

Open AccessArticle

Factors Associated with Older People’s Anxiety Symptom Positioning after COVID-19: Cross-Sectional Findings from a Canadian Sample

by Gail Low, Anila Naz AliSher, Juceli Morero, Zhiwei Gao, Gloria Gutman, Alex Franca and Sofia von Humboldt

Healthcare 2024, 12(18), 1837; https://doi.org/10.3390/healthcare12181837 - 13 Sep 2024

Viewed by 1477

Abstract

This study sheds light on the personal characteristics of older Canadians self-identifying as severely anxious and the coping strategies that they gravitated to mitigate their anxiety. Our studied sample consisted of 606 Canadians aged 60 and above who took part in an e-survey across all 10 of Canada’s provinces, launched in July 2022, when social distancing was lifted across the country. Participants completed a personal characteristics questionnaire, the Geriatric Anxiety Scale or GAS-10, and a checklist of everyday coping strategies for mitigating anxiety. A seemingly greater number of severely anxious Canadians were born female, self-identified as a cisgender woman, and were in their 60s and in poor to fair health. A univariate logistic regression analysis revealed that all such personal characteristics were associated with statistically significantly greater odds of experiencing severe anxiety. In our multivariate logistic regression analysis, no significant differences were observed between the sexes (AOR = 0.590, p = 0.404), and non-binary and cisgender men (AOR = 0.689, p = 0.441) and women (AOR = 0.657, p = 0.397). Nor were there statistically significant differences in the odds of experiencing severe anxiety for those living with versus without a life partner and chronic illnesses. Older Canadians experiencing severe anxiety were far more likely to normalize their fear and anxiety (AOR = 4.76, p < 0.001), challenge their worries (AOR = 5.21, p < 0.001), and to relax or meditate (AOR = 2.36, p = < 0.001). They were less inclined to decrease other sources of stress in their lives, to stay active, and to get enough sleep. We offer anticipatory guidance for mental health program planners and practitioners, and fruitful avenues of inquiry for researchers. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

17 pages, 2045 KiB

Open AccessArticle

What Chinese Women Seek in Mental Health Apps: Insights from Analyzing Xiaohongshu User Posts during the COVID-19 Pandemic

by Zhenzhen Qin, Sandy Ng, Wenqing Wu and Suxin Zhang

Healthcare 2024, 12(13), 1297; https://doi.org/10.3390/healthcare12131297 - 28 Jun 2024

Cited by 1 | Viewed by 3009

Abstract

Gender disparity poses a prominent obstacle to achieving effective mental health outcomes in digital healthcare. Despite women being more inclined to use mental health apps and seeking designs tailored to their specific needs, there is limited research on the factors influencing female users’ engagement with these apps. The COVID-19 pandemic has further exacerbated its disproportionate impact on women’s mental health. This study investigates female users’ posts (n = 5538) about mental health apps during the pandemic, using data collected via a Python web crawler from Xiaohongshu, a popular female-centric social media platform in China. A mixed-methods approach used qualitative thematic analysis and quantitative descriptive statistics. Among these posts, therapeutic functionality emerged as the highest priority, followed by credibility and user experience, with specific design elements highlighted as particularly significant. These findings provide valuable insights for mental health researchers and developers, including you, aiming to create gender-tailored mobile solutions to address the mental health challenges faced by women, especially during future pandemics. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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14 pages, 280 KiB

Open AccessArticle

From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists’ Experiences and Post-Pandemic Perspectives

by Marianne Saragosa, Farwa Goraya, Frances Serrano, Behdin Nowrouzi-Kia, Sara Guilcher, Yasmin Abdul Aziz and Basem Gohar

Healthcare 2024, 12(10), 1050; https://doi.org/10.3390/healthcare12101050 - 20 May 2024

Cited by 2 | Viewed by 1609

Abstract

Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health Across Diverse Populations)

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