Search Results (266)

The current paper examines how individual/personality factors are associated with the political legitimacy of government restrictions at the onset of the COVID-19 pandemic. A total of 1262 US-based participants completed an online survey comprising several scales (predictor factors), such as the Just World Scale, the Police Legitimacy Scale, and the Authoritarianism Scale measuring aggression, submission, and conventionalism. In addition, they completed scales measuring their Fear of COVID and Perceptions of Government (outcome factors). The results suggest that those who viewed the president or federal government as most responsible had lower legitimacy scores than those who reported their governor, state government, or local official or government to be responsible. Also, those who aligned with the Republican party had the lowest mean for fear of COVID, while the highest was in the “Other” political affiliation, followed by the Democrats, who had the second highest. It also turned out that whereas one’s relationships with those who have been hospitalized or died as a result of COVID and individual risk factors for COVID were not significant variables in predicting perceptions of the federal government’s handling of the pandemic, the most significant factors were Authoritarianism, Fear of COVID-19, (older) Age, Change in Federal Trust and Political Ideology. Fear of COVID-19 was the only significant factor predicting government legitimacy and individual decisions to engage in protection measures during the pandemic. Theoretical and practical implications are discussed. Full article

Coronavirus anxiety is defined as a psychological contrast characterized by excessive fear, obsessive thoughts, and reassurance-seeking behaviors associated with COVID-19. As current scales have been tested primarily in North American populations, we aimed to translate and culturally adapt three measures of dysfunctional coronavirus anxiety—the Coronavirus Anxiety Scale (CAS), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS)—for the first time in Greek-speaking populations. To translate existing scales, we followed best practices for cross-cultural comparisons using forward translation (English to Greek) and backward translation (Greek to English) with expert translation review, prior to conducting pilot testing and confirmatory factor analysis in a bespoke survey population. A total of 405 adults from Cyprus participated in this study. The results indicated that the Greek versions of these measures demonstrated adequate reliability (Cronbach’s alphas > 0.70) and strong factor structure, as supported through confirmatory factor analysis. However, only the CAS exhibited evidence of both convergent and divergent validity. Our study makes several innovative contributions which have broad implications for crisis preparedness, including providing a framework for mental health interventions in future pandemics or Black Swan events. Full article

The aim of this study was to examine the factors associated with COVID-19-related fear in older adults from Kazakhstan, and to explore its associations with sociodemographic characteristics, health status and multiple domains of quality of life in a regional context. A total of 445 individuals aged 60 and above from both urban and rural locations in Kazakhstan participated in this cross-sectional study. To assess the quality of life among older people we used the OPQoL (Older People’s Quality of Life) Scale. Further variables were evaluated: sociodemographic (age, gender, education level, marital status, and place of residence); health-related (self-reported overall health, hypertension, diabetes, cerebrovascular disease, cardiovascular disease, and chronic obstructive pulmonary disease (COPD); and COVID-19-related fear variable. Female gender (OR = 2.344; p = 0.001), present hypertension (OR = 2.106; p = 0.008), the specialized secondary educational level (OR = 2.321; p = 0.012) and at the border of significance university educational level (OR = 1.832; p = 0.051) were variables significantly associated with the COVID-19-related fear in older adults. For individuals with reported COVID-19-related fear, advanced age was significantly negatively associated with leisure and activities domain (B = −0.747; p = 0.020) of OPQoL; better self-reported overall health was significantly positively associated with life overall domain (B = 0.691; p < 0.001), health domain (B = 1.320; p < 0.001), psychological and emotional well-being domain (B = 0.395; p = 0.001), home and neighborhood domain (B = 0.249; p = 0.036), independence, control over life and freedom domain (B = 1.082; p < 0.001), financial circumstances domain (B = 1.132; p < 0.001), and leisure and activities domain (B = 0.556; p = 0.026) of OPQoL; present hypertension was significantly negatively associated with health domain (B = −0.888; p = 0.004) of OPQoL; present cardiovascular disease was significantly negatively associated with life overall domain (B = −0.588; p = 0.027), health domain (B = −0.967; p = 0.009), and independence, control over life and freedom domain (B = −0.542; p = 0.039) of OPQoL; being single was significantly negatively associated with life overall domain (B = −0.481; p = 0.033), social relations domain (B = −0.671; p = 0.014) and financial circumstances domain (B = −0.694; p = 0.036) of OPQoL; and urban place of residency was significantly positively associated with health domain (B = 0.735; p = 0.011) and psychological and emotional well-being domain (B = 0.483; p = 0.010) of OPQoL. Our findings pointed that numerous variables were associated with the COVID-19-related fear and quality of life domains regarding COVID-19-related fear in older adults from Kazakhstan during pandemics. Full article

The COVID-19 pandemic (2020–2023) profoundly disrupted healthcare systems and imposed sustained psychological burdens on healthcare professionals and trainees. Reliable instruments are essential for assessing these impacts. This study evaluated the construct validity and reliability of the Fear of COVID-19 Scale (FCV-19S) in a convenience sample of 1761 healthcare professionals, trainees, and academic staff at a single U.S. academic health sciences center (the University of Oklahoma Health Campus). Participants completed the FCV-19S; confirmatory factor analysis (CFA) examined its dimensional structure; and internal consistency was assessed using Cronbach’s α and McDonald’s ω. The one-factor model demonstrated good internal consistency (α = 0.89; ω = 0.89) but exhibited sub-optimal model fit (CFI = 0.89; TLI = 0.83; SRMR = 0.06; RMSEA = 0.18). The two-factor model, distinguishing emotional and somatic fear, showed substantially improved fit (CFI = 0.97; TLI = 0.96; SRMR = 0.03; RMSEA = 0.09) and acceptable internal consistency for both factors (α = 0.85 and 0.86; ω = 0.85 and 0.87), although RMSEA remained above conventional thresholds for close fit. Overall, findings support a two-factor structure as a comparatively superior and more nuanced representation of fear responses among an academic health workforce. The validated FCV-19S offers a reliable tool for assessing COVID-19-related distress in clinical and educational health settings, informing targeted interventions to strengthen workforce resilience. Full article

Background/Objectives: Professional quality of life influences patient care, staff well-being, and organizational efficacy. The COVID-19 pandemic placed pressure on healthcare professionals, disrupting their professional quality of life and imposing a psychological burden. In Greece, these issues were intensified by a decade of economic crisis, marked by constrained healthcare budget, personnel shortages, and insufficient resources. This study investigates the pandemic’s impact on the professional quality of life of Greek healthcare professionals to support targeted interventions. Methods: A cross-sectional study was conducted using descriptive statistics. The participants were a convenience sample of 246 healthcare professionals from a Greek regional university hospital with at least one year of experience and who had worked with COVID-19-positive or potentially exposed but asymptomatic patients. Data were collected between March and June 2021 using the Professional Quality of Life Scale (version 5). Results: Of the 246 participants, 81.3% were women and 33.8% were aged 50 or older. Moderate concern and fear regarding COVID-19 were reported, with 34.6% extremely afraid of transmitting the virus to family or friends and 22.8% to patients or their families. Overall professional quality of life was moderate: compassion satisfaction was moderate to high, while burnout and secondary traumatic stress were moderate to low. Higher compassion satisfaction was linked to holding a position of responsibility. Burnout was associated with having children, permanent employment, years of experience, and increased pandemic-related fear. Higher secondary traumatic stress was associated with older age, more years of experience, and greater pandemic-related fear. Conclusions: These findings support international research and highlight that the moderate levels observed indicate intrinsic motivation based on professionalism in patient care, providing evidence of resilience and coping mechanisms that reduce psychological consequences on well-being due to the pandemic. Full article

Background/Objectives: Long COVID (LC) is characterized by persistent symptoms such as fatigue, pain, and reduced quality of life, often lasting months after acute infection. Exercise-based interventions have shown promise, but evidence for non-aerobic programs remains limited. This study aimed to evaluate the effects of a 12-week motor control exercise program on body composition and fatigue in women with LC and to explore associations with physical activity and psychosocial factors. Methods: An exploratory pre–post non-controlled intervention study was conducted in 17 women with LC symptoms persisting for over one year. Participants completed 24 individualized sessions of a non-aerobic therapeutic exercise program focused on trunk stabilization. Outcomes included body composition (bioimpedance analysis), fatigue (Modified Fatigue Impact Scale), health-related quality of life (EQ-5D-5L), physical activity (IPAQ), and kinesiophobia (TSK-11). Paired t-tests, effect sizes, correlations, and regression models were applied. Results: The intervention significantly reduced total body fat (37.09% to 35.41%, p < 0.001) and trunk fat (35.82% to 33.82%, p < 0.001), with large effect sizes. Physical and psychosocial fatigue improved markedly (MFIS physical: 29.71 to 21.06, p < 0.001; psychosocial: 6.00 to 4.29, p = 0.001), while cognitive fatigue showed non-significant change. Pain/discomfort scores decreased substantially (2.86 to 1.79, p < 0.001). Vigorous activity and walking time increased, and sedentary time decreased. No significant changes were observed in muscle mass or kinesiophobia. Conclusions: A structured, non-aerobic exercise program can effectively reduce body fat, alleviate fatigue, and improve pain perception in women with LC, supporting its role in rehabilitation. Multimodal strategies may be required to address cognitive symptoms and fear of movement. Full article

Contemporary Chinese society has undergone enormous socio-economic transformations over the past four decades. The Confucian principle of so-called filial piety (xiao) has shaped Chinese culture for centuries, laying the foundation for family and social life. However, the current Chinese reality, with widespread consumerism and economization of thinking, requires young Chinese people to redefine their role in relation to their aging parents. The process of individualization in a strongly group-oriented society undergoing intense transformation, coupled with the strong cultural pressure to implement the Confucian xiao principle, provides material for interesting research questions. This paper studies caregivers’ coping strategies in the context of the principle of filial piety and the form of its practice during the pandemic and lockdown. It aims to capture the impact of the unique experience of isolation, exacerbated by the fear and uncertainty about the fate and health of parents. At the methodological level, it uses quantitative and qualitative analysis, adapting well-known scales and customized queries to capture the social challenges of the COVID-19 pandemic. Full article

Background: Tinnitus has been increasingly reported during the COVID-19 pandemic, following both infection and vaccination. While these reports suggest that pandemic-related factors may influence the onset or worsening of tinnitus, the perceptual characteristics and functional consequences of such cases remain poorly understood. This study examined the nature, severity, and communication-related impact of self-reported tinnitus following COVID-19 vaccination. Methods: A total of 770 adults who self-reported new or worsened tinnitus after vaccination completed a structured online survey between August 2021 and May 2023. Standardized instruments included the Tinnitus Functional Index (TFI), the Speech, Spatial and Qualities of Hearing Scale (SSQ), and visual analog scales assessing loudness discomfort and hyperacusis-related symptoms. Analyses included descriptive statistics, chi-square tests, t-tests, and correlation matrices. Results: Respondents reported moderate to severe tinnitus-related distress, with the greatest impacts on emotional control, sleep, and relaxation. Many described communication difficulties in noisy or multi-talker environments, despite relatively preserved spatial hearing and sound quality. A substantial subset endorsed hyperacusis symptoms, including sound-induced annoyance, fear, and intolerance. Correlation analyses revealed strong associations between emotional, cognitive, and auditory domains, underscoring the multidimensional burden of tinnitus in this population. Conclusions: Self-reported tinnitus after COVID-19 vaccination was associated with distress, sleep disruption, and communication difficulties, mirroring patterns commonly observed in tinnitus more broadly. Although causality cannot be determined, these findings highlight the importance of comprehensive audiological and psychological assessment for individuals reporting auditory complaints after vaccination and support the inclusion of functional hearing outcomes in tinnitus evaluation protocols. Full article

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-COVID Syndrome (PCS) are chronic conditions that share relevant pathophysiological mechanisms. Conventional rehabilitation programs have often been associated with patient dissatisfaction and frequent adverse events (AEs), highlighting the need for safer and more effective clinical approaches. This study aims to compare the effects of a telerehabilitation program based on conscious movement with those of conventional low-intensity exercise in individuals with ME/CFS or PCS. Methods: This is a prospective, single-blind, three-arm, parallel, superiority randomized clinical trial. A total of 147 participants (aged 18–70) with ME/CFS or PCS will be recruited and randomly assigned to one of three groups: (a) conscious movement; (b) low-intensity exercise; or c) usual care. All interventions will be delivered via telehealth over 12 weeks, with weekly 45-min sessions combining health education and individually tailored exercises. Participants will be encouraged to practice daily using the provided materials. Adherence rates and potential AEs will be recorded. The primary outcome is the total score on the 14-item Chalder Fatigue Scale at 12 weeks (post-intervention). Secondary outcomes include heart rate variability, functional performance, pain intensity and interference, mental health, interoceptive awareness, quality of life, sleep quality and fear of movement. Measurements will be collected at baseline, post-intervention, and at 3-month follow-up. Discussion: Recent evidence suggests that both autonomic and cognitive activity modulate immune function. Conscious movement, which integrates exercise with interoception and mindfulness-based strategies, may provide greater benefits than low-intensity exercise alone. Study limitations should be considered when interpreting the results. Trial registration: Registered at ClinicalTrials.gov on 15 May 2025 (NCT06978582). Protocol version 4 (29 September 2025). Ethics Committee code: 2025-0180. Full article

Background: Fear of COVID-19 has been associated with adverse mental and physical health outcomes, yet evidence from The Netherlands is limited. This study investigated associations between fear of COVID-19, mood, quality of life, immune fitness, and related health variables during the first Dutch national lockdown and identified key predictors of fear. Methods: In June–July 2020, n = 1020 Dutch adults completed an online survey assessing demographics, personality, mental resilience, pain sensitivity, pain catastrophizing, alcohol use, immune fitness, and mood. Retrospective ratings were provided for the pre-pandemic period (January–March 2020) and the first lockdown (March–May 2020). Fear of COVID-19 was measured using a modified Fear of COVID-19 Scale. Results: Overall, 13.2% of participants reported significant fear of COVID-19, which was associated with poorer mood, reduced quality of life, lower immune fitness, more severe COVID-19 symptoms, greater pain sensitivity, and higher levels of pain catastrophizing. Regression analysis explained 19.6% of the variance, with pre-pandemic anxiety (8.7%) and poorer immune fitness (3.4%) as the strongest predictors of fear of COVID-19, followed by lower psychoticism, lower mental resilience, older age, greater helplessness, and greater extraversion. Discussion: These findings suggest that a minority experienced high levels of fear of COVID-19 with substantial consequences, including negative effects on mood, immune fitness, and quality of life. The strong association with pre-existing anxiety and immune fitness highlights the need for early identification and targeted interventions for vulnerable groups to reduce psychological and physical health impacts in future public health crises. Full article

Background and Objectives: The COVID-19 pandemic has caused profound disruptions in socioeconomic, and health domains, with significant implications for mental well-being. The aim of this study was to evaluate the impact of the pandemic on stress, anxiety, and depression, alongside perceived social support, coping flexibility and related factors, and to examine how these issues vary across different age groups. Materials and Methods: A cross-sectional analytical study was conducted in Türkiye between August and December 2020. Data were collected through an online questionnaire including sociodemographic characteristics, pandemic-related concerns, and validated scales: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Coping Flexibility Scale (CFS), and Multidimensional Scale of Perceived Social Support (MSPSS). Statistical analyses included descriptive and comparative tests, correlation analysis, multiple linear regression models, and correspondence analysis. Results: Among 1699 participants, 58.0% were female; 24.5% and 42.1% reported anxiety and depressive symptoms above thresholds, respectively. Younger age correlated negatively with stress, anxiety, and depression scores (p < 0.001). Feelings of loneliness, loss of control, ostracism, and sleep or concentration problems were positively associated with anxiety, depression, and stress, but negatively associated with coping flexibility and social support (p < 0.001). The 15–20 age group had the highest anxiety and depression levels and the lowest social support; the 15–30 group showed the highest stress, while the 61–75 group exhibited the lowest coping flexibility. Regression models explained 62.7% of anxiety and 56.6% of depressive symptom variances. Major predictors of anxiety included depressive symptoms, stress, and fear of dying from COVID-19, while depressive symptoms were predicted by age, stress, coping flexibility, social support, and anxiety. Conclusions: The findings highlight the considerable psychological burden and distinct vulnerabilities among age groups. Mental health interventions should be tailored according to age, emphasising the enhancement of social support and coping flexibility to strengthen resilience in future pandemics. Full article

Introduction: Pregnancy is a period of many challenges and changes that women face. These challenges include being pregnant during the COVID-19 pandemic, as well as preparing for childbirth. Personal resources, such as hardiness, may help to adapt to these difficult life events. Objective: The aim of this study was to determine the relationship between fear of COVID-19, stress, fear of childbirth, hardiness, and life satisfaction in pregnant women and identify two predictors, fear of childbirth and life satisfaction, in pregnant women during the pandemic. Method: This study involved 247 pregnant women aged 18 to 39. Five tools were used: the Labour Anxiety Questionnaire (KLP II), the Health-Related Hardiness Scale (HRHS), the Pandemic-Related Pregnancy Stress Scale (PREPS), the Satisfaction with Life Scale (SWLS), and the Fear of COVID-19 Questionnaire (FOC-6). Results: Significant positive correlations were observed between fear of COVID-19 and perinatal infection stress (r = 0.74, p < 0.001), preparedness stress (r = 0.51, p < 0.001), and fear of childbirth (r = 0.32, p < 0.001). Perinatal infection stress was positively associated with preparedness stress (r = 0.53, p < 0.001) and fear of childbirth (r = 0.33, p < 0.001). Preparedness stress was positively correlated with fear of childbirth (r = 0.47, p < 0.001). Fear of childbirth was negatively correlated with hardiness (r = −0.22, p < 0.001) and life satisfaction (r = −0.29, p < 0.001). The predictors of fear of childbirth are preparedness stress associated with the organization of childbirth (β = 0.38, t = 5.60, p < 0.001) and hardiness (β = −0.16, t = −2.84, p = 0.00, p < 0.01), while the predictor of satisfaction with life is fear of childbirth (β = −0.31, t = −4.28, p = 0.00, p < 0.001). Conclusions: Epidemics of infectious diseases may have a negative emotional impact on pregnant women, causing fear and stress and contributing to an increased level of fear of childbirth, which can lead to complications for the health of the mother and child. Therefore, it is particularly important to support women preparing for childbirth during subsequent pandemics or other crisis situations. Personal resources, such as hardiness, are important for experiencing fear of childbirth, which is why pregnant women who experience increased fear and stress should have their resources strengthened. Full article

Background: Key populations (KPs), particularly female sex workers (FSWs), continue to face significant barriers in accessing HIV-related healthcare services in South Africa. Structural challenges have historically hindered equitable HIV treatment access, worsened by the COVID-19 pandemic. Overburdened clinics, staff shortages, and travel constraints disrupted HIV services and ART adherence. In response, the Differentiated Service Delivery (DSD) model was rapidly scaled up to decentralise care and improve treatment continuity. Objective: To solicit the views of stakeholders regarding their interests, roles and experiences in the implementation of the HIV treatment DSD model among FSWs in South Africa, as well as associated successes and barriers thereof. Methods: We purposively selected and interviewed eight stakeholders, comprising government officials, implementers and sex workers’ advocacy organizations. Thematic analysis was used to explore the perceived impact of DSD models and associated successes and barriers in the current service delivery landscape. Results: The study found that decentralization of DSD models improved access to services for FSWs. However, the criminalization of sex work perpetuates fear and marginalization, while stigma and discrimination within healthcare settings remain significant deterrents to HIV treatment uptake. High mobility among FSWs also disrupts continuity of care, contributing to treatment interruptions and lack of data on loss to follow-up. Participants highlighted the need for legal reform, increased healthcare provider sensitization, and the integration of mental health and psychosocial support in HIV services. Peer-led interventions and digital health innovations, such as biometric systems and electronic medical records, emerged as promising strategies for enhancing patient tracking and retention. Nonetheless, the sustainability of DSD models is threatened by an overreliance on external donor funding and insufficient government ownership. Conclusions: To achieve equitable healthcare access and improved HIV outcomes for KPs, especially FSWs, a multi-pronged, rights-based approach is essential. This must include community engagement, structural and legal reforms, integrated support services, and sustainable financing mechanisms to ensure the long-term impact and scalability of DSD models. Full article

The COVID-19 pandemic significantly impacted multiple aspects of human life, including the psychological and physical health of college students. This study explores how students in Virginia’s Shenandoah Valley, a region within the larger Appalachian area, experienced anxiety, depression, and fear of COVID-19. An online survey was conducted at a large public university in the US, yielding responses from 680 undergraduate and graduate students. Linear regression was applied to continuous outcomes, specifically the Fear of COVID-19 Scale (FCV-19S) and depression scores. For dichotomous outcomes such as anxiety and depression (when categorized), separate logistic regression models were employed. The majority of respondents were female (78.0%), White (81.9%), and undergraduates (80.4%), with approximately 41.4% majoring in health-related disciplines. Results indicated that female students reported higher levels of anxiety, depression, and fear of infection compared to their male counterparts. Additionally, undergraduate students exhibited greater depressive symptoms than graduate students. Students who perceived less institutional support from their university during the pandemic also reported significantly higher psychological distress. These findings underscore the pressing need for universities and policymakers to collaborate in enhancing mental health resources and communication strategies for students during times of crisis. Full article

Background: Due to the new COVID-19 vaccine types used in the COVID-19 vaccination program, significant levels of uncertainty and vaccine hesitancy arose due to fears about anaphylactic reactions, especially in patients with allergies. This study aimed to analyze how patients with significant allergies receiving specific immunotherapy (SIT) reacted to COVID-19 vaccines in real life. Methods: We assessed 57 patient charts of individuals with allergies receiving SIT for documented allergies, for their comorbidities, total IgE and tryptase levels, and Hospital Anxiety and Depression Scale (HADS) scores. Questionnaires regarding COVID-19 vaccination status and reported adverse reactions were analyzed. Results: Patients were more frequently male (58%) and had a mean age of 43 years, and the majority (60%) had already experienced an anaphylactic reaction in the past, most commonly to the allergen of the current SIT. In total, 93% received COVID-19 vaccinations. More than half of the patients (57%) reported at least one adverse reaction after COVID-19 vaccination. Out of these patients, 97% reacted in an unspecific way, with symptoms of general illness. One potential allergic reaction, classified as a grade 1 anaphylactic reaction, was documented. The patient with the potential allergic reaction was significantly more concerned before receiving the vaccination and had experienced possible allergic reactions to other vaccinations in the past. The remaining patients with unspecific reactions after vaccination had also experienced such adverse reactions in the past to other vaccinations. Antihistamine premedication was associated with fewer unspecific reactions after COVID-19 vaccination. Conclusions: Vaccinations in patients with significant allergies and prior anaphylactic reactions are, overall, safe. Prior allergic reactions after other vaccinations could be a potential risk for reaction after COVID-19 vaccinations, whereas antihistamine intake could be beneficial in reducing side effects after COVID-19 vaccinations in patients with allergies. Prospective studies on this topic are needed. Full article