Search Results (1,424)

Background/Objectives: Public healthcare workers face significant occupational stress during crisis situations, yet research on this particular population remains limited compared to other healthcare workers. The aim of this study was to investigate the impact of the COVID-19 pandemic on distress levels and the sense of coherence among public health workers by integrating psychological assessments with physiological markers of stress to identify protective factors against pandemic-related occupational stress. Methods: This longitudinal study was conducted at the Teaching Public Health Institute of Split and Dalmatia County from July 2021 to February 2022 at two time points: the latency phase (between COVID-19 waves) and hyperarousal phase (during an active wave). Fifty-four public health workers participated in the study. There were three questionnaires assessing psychological distress: Kessler Psychological Distress Scale, Impact of Events Scale—Revised and Sense of Coherence Scale-29. Salivary and blood samples were collected at both time points to measure cortisol levels, cortisol awakening response, and interleukin-6 concentrations. Results: The cortisol area under the curve with respect to ground (AUCg) was significantly elevated during the stress phase compared to the latency phase (234.8 vs. 201.8; p = 0.023), indicating heightened physiological stress responses. Epidemiologists demonstrated significantly lower sense of coherence scores compared to non-epidemiologists (117.9 ± 9.1 vs. 125.6 ± 10.5; p = 0.029). A lower sense of coherence was significantly associated with higher psychological distress and post-traumatic stress symptoms. Multiple linear regression analysis revealed that sense of coherence and interleukin-6 levels were significant independent predictors of cortisol changes. Conclusions: The findings demonstrate that public health workers experience measurable physiological stress responses during pandemic peaks, with sense of coherence emerging as a protective psychological factor. Interventions targeting sense of coherence and organizational support may possibly enhance resilience and reduce mental health morbidity in this vulnerable workforce during crisis situations. Full article

Background: The COVID-19 virus is a source of both acute and chronic stress for many people. This stress could uniquely impact children and their mental health. Research has shown that children with neurodevelopmental disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) are at an increased risk of negative mental health symptoms due to stress, but high-quality sleep may be associated with a protective role against these symptoms. We, therefore, aimed to investigate whether the impacts of COVID-19 and sleep problems were independently linked with children’s mental health and to examine whether sleep could mediate the relationship between COVID-19 impact and child mental health. Finally, we sought to compare the degree to which sleep problems could mediate this relationship in children without ADHD and in children with ADHD. Methods: In this cross-sectional study, a total of 304 parents of children were sampled from a larger study investigating the impact of the COVID-19 pandemic on Canadian families and children in the spring of 2021. Parents reported on their children’s mental health, sleep, and the impacts of COVID-19 on their child. Of the total sample, 234 children were reported as having an ADHD diagnosis, and 70 children were reported to not have ADHD. Results: We found that both the impact of COVID-19 and sleep problems independently and positively contributed to the mental health symptoms (p < 0.001) experienced by children with ADHD and without ADHD. Children with ADHD were found to have higher scores for COVID-19 child impact, sleep problems, and negative mental health. However, sleep problems had a greater impact on the mental health of children without ADHD compared to ADHD children. Additionally, the results suggest that sleep problems mediated ~20% of the relationship between COVID-19 impact and child mental health in children with ADHD and ~51% of this relationship in children without ADHD. Conclusions: The findings emphasize the significant role of sleep in mediating child mental health symptoms during periods of stress in children without ADHD and in children with ADHD. We highlight the importance of considering sleep quality and supporting healthy sleep in times of stress to improve child mental health symptoms. Full article

The COVID-19 pandemic had widespread psychological effects, prompting research into long-term impacts on mental health and identity development. This retrospective study examined how pandemic-related stress affected obsessive–compulsive symptoms (OCS) and generalized anxiety symptoms across three timepoints, prior to the pandemic (2019–February 2020), during the height of the pandemic (March 2020–2022), and the present (within the past month), and how changes in these symptoms relates to identity. The sample consisted of undergraduate students (N = 476) who completed an anonymous online survey battery. Indices of psychological “damage” and “recovery” showed although OCS levels returned to baseline in the current period, anxiety levels remained elevated. COVID-related stress predicted higher OCS and anxiety symptoms across timepoints. Greater symptom damage was associated with more identity disturbance, while recovery from anxiety was related to reduced identity disturbance. Recovery from OCS was uniquely related to higher identity consolidation. These findings suggest the psychological toll of the pandemic extends beyond clinical symptoms, impacting foundations of identity. Although some psychological recovery has occurred, lingering anxiety symptoms may continue to affect developmental outcomes. Further research is needed to understand mechanisms that support long-term recovery and identity formation in the wake of large-scale stressors like the COVID-19 pandemic. Full article

Background: The integration of artificial intelligence (AI) into mobile health (mHealth) applications has been accelerated by the widespread adoption of smartphones and recent technological advances, particularly in the wake of the COVID-19 pandemic. This experience has expanded the role of AI-powered apps in real-time health monitoring, early detection, and personalized treatment pathways. Aim: This review aims to summarize recent evidence on the use of AI in healthcare-related mobile applications, with a focus on clinical trends, practical implications, and future directions. Methods: Studies were prioritized based on methodological rigor, with systematic reviews forming the core of the analysis. Additional literature was considered to capture emerging trends and applications where a relevant rigorous screening and scoring procedure was applied to ensure methodological quality and relevance. Only studies addressing healthcare applications, rather than computational or computer science frameworks, were included to reflect the journal’s clinical scope. Results and Discussion: Fifty-six secondary studies were analyzed in detail. Thematic synthesis revealed a post-pandemic shift toward applications targeting mental health, chronic care management, and preventive services. Additional screening showed that, despite their increasing use in clinical contexts, few AI-based apps were formally classified as medical devices. This highlights a gap between technological innovation and regulatory oversight. Ethical concerns—including algorithm transparency, clinical responsibility, and data protection—were frequently reported across studies. Conclusions: This review underscores the growing impact of AI in mobile health, while drawing attention to unresolved challenges related to regulation, safety, and clinical accountability. A more robust integration into health systems will require clearer governance frameworks, validation standards, and interdisciplinary dialogue between developers, clinicians, and regulators. Full article

Older individuals primarily belong to the group with an increased risk of SARS-CoV-2 infection. Social distancing and other strategies to mitigate the COVID-19 pandemic may negatively impact the psychophysical parameters of seniors. Objective: The main aim of this study is to analyze the changes in psychophysical parameters among seniors in the context of the COVID-19 pandemic over a one-year observation. Materials and methods: The observation involved 54 respondents aged 60 and above. The study was conducted three times from March 2020 to April 2021. The selected research method was a diagnostic survey based on a questionnaire. Results: The level of general physical activity in the study groups during the pandemic was determined to be moderate with an upward trend. A downward trend in self-assessment of quality of life was observed, particularly in the area of mental health, along with an increase in symptoms of anxiety, aggression, and insomnia. Conclusions: The pandemic period did not significantly affect the level of physical activity among the surveyed seniors, but an intensification of mental symptoms was noticeable. Full article

Background: Prehospital emergency professionals are exposed to high psychosocial demands that may impact their mental health, but pre-COVID-19 baseline data from Spanish services are scarce. This study aimed to assess the general health and psychosocial risk factors in a regional prehospital emergency service before the COVID-19 pandemic. Methods: We conducted a cross-sectional descriptive study (September–December 2019) including 51 physicians, nurses, and emergency medical technicians working at the 061 Health Emergency Center in Granada (Andalusia, Spain). General health and chronic problems were assessed with the Goldberg General Health Questionnaire (GHQ-28/CGHQ-28), and work-related psychosocial risks were evaluated using the COPSOQ-ISTAS21 questionnaire. Descriptive statistics, group comparisons, and exploratory Spearman correlations between health indicators and psychosocial dimensions were performed. Results: Most participants reported good self-perceived general health, but the chronic coding of the GHQ (CGHQ-28) indicated long-term difficulties mainly related to social dysfunction, somatic symptoms, and anxiety/insomnia. Exposure to unfavorable psychosocial risk was frequent, particularly in psychological demands, double presence (work–family conflict), and low esteem, with intermediate–unfavorable patterns in active job/development, insecurity, and social support/leadership. Exploratory correlations suggested that double presence was the psychosocial factor most consistently associated with chronic distress. Conclusions: In this pre-COVID-19 cohort of prehospital emergency professionals, good perceived general health coexisted with chronic psychological strain and high exposure to adverse psychosocial work factors. These findings support the need for organizational measures to reduce psychological demands and work–family conflict and to strengthen social support and leadership in prehospital emergency teams. Full article

Background/Objective: The COVID-19 pandemic resulted in unprecedented societal changes globally and negatively impacted the psychosocial health of pregnant women. This study aimed to explore how direct, indirect, and unrelated factors associated with the COVID-19 pandemic influenced stress levels among pregnant women. Methods: This interpretivist qualitative study employed open-ended survey questions to capture the lived experiences of 313 pregnant women in the third trimester residing in Florida between January and March 2022, during the Omicron surge. Thematic analysis was conducted, guided by the Stress and Coping Theory and the Stress Buffering Theory. Results: Participants described a range of stressors directly and indirectly related to the COVID-19 pandemic that affected pregnant women. Themes related to increased stress were (1) fear, worry, and anxiety related to COVID-19 infection, (2) fear, worry, and anxiety related to preparedness for birth/baby due to pandemic restrictions, (3) prevention concerns associated with COVID-19, (4) lack of social support, (5) return to normalcy, (6) health-related social needs, (7) physical health issues, and (8) navigating conflict and grief. Conversely, stress-reducing factors were (1) preventive measures during the pandemic, (2) coping strategies, (3) not having to work, and (4) social support. Conclusions: Pregnant women experienced heightened stress due to a complex interplay of factors related directly or indirectly to the COVID-19 pandemic. It is important that maternity care, mental health and health-related social needs screenings and referrals, and tailored interventions are integrated into public health crises preparedness plans to limit the stress that pregnant women experience and support their well-being. Full article

Introduction: The impact of the COVID-19 pandemic on suicide risk has been documented during the acute phase, but less is known about people who attempted suicide during the post-acute period. This study investigates how adults who attempted suicide during the post-acute pandemic period (2021–2023) understood COVID-19’s role in their attempt. Method: We analyzed interview data from 329 adults (59% female; 41% male), enrolled following a recent suicide attempt between 2021 and 2023. Participants were asked about the general impact of COVID-19 on their lives and then specifically about whether stress related to COVID-19 was a primary reason for their attempt or contributed to their suicidal thoughts. Results: When asked about their recent attempt, 11% of participants identified stress related to COVID-19 as the primary reason for their attempt, and an additional 23% indicated it contributed to their suicidal thoughts. When describing general impacts, participants reported effects across multiple domains: social isolation, physical health concerns, mental health impacts, and economic effects. Discussion: The attribution of suicide attempts to COVID-19-related stress during the post-acute period highlights the extended impact of public health crises on vulnerable individuals. These findings emphasize the need for sustained, integrated medical and mental healthcare following such crises. Full article

Purpose: Remote work continues to transform both organizational structures and individual work experiences, introducing new dynamics that can simultaneously enhance or undermine employees’ mental health and overall well-being. These evolving conditions influence levels of stress, resilience and burnout within increasingly digital and flexible work environments. The present study aimed to provide a comprehensive understanding of how remote work affects occupational stress, mental health, burnout and employee well-being through a bibliometric analysis of Scopus-indexed literature complemented by a narrative synthesis of emerging research themes. Methods: A total of 185 peer-reviewed documents were retrieved from the Scopus database and analyzed using the VOSviewer software, version 1.6.20 (0) (Leiden University, Leiden, The Netherlands). The study employed performance analysis techniques to assess annual publication trends, identify the most influential authors and sources and evaluate citation impact. Furthermore, science mapping methods, including co-authorship, bibliographic coupling, co-citation, and co-occurrence analyses, were used to visualize the intellectual structure and thematic evolution of the field. Results: The co-occurrence analysis identified three major thematic clusters. We first explored how the abrupt shift to teleworking redefined employee well-being, the second examined the psychological consequences of evolving work environments on mental health and occupational stress and the third investigated the prevalence, determinants and contextual factors of occupational burnout across professional domains. Conclusions: The findings demonstrated complex interrelations among remote work, occupational stress, mental health, and burnout, highlighting that the accelerated adoption of remote work—especially during and after the COVID-19 pandemic—has substantially reshaped employees’ psychological health and work experiences. Thus, remote work emerges as a double-edged phenomenon that can either foster resilience and well-being or heighten stress and burnout, depending on the availability of supportive organizational structures, psychosocial resources, and adaptive coping mechanisms. Full article

The outbreak of the COVID-19 pandemic and the control measures implemented by governments have caused serious harm to the physical and mental health of many, including professionals working in the construction industry. As one of the largest industries globally, it is important to examine the psychosocial hazards that occurred during the pandemic and their impacts on the mental health outcomes of construction professionals, especially those working for construction enterprises, as their work tends to be site-based and has been influenced more seriously during the pandemic. This research used a questionnaire to gather data from 531 professionals working in China’s construction industry. Descriptive analysis, Spearman’s correlation analysis, and partial least-squares structural equation modeling (PLS-SEM) were employed to analyze the data. The findings indicate that work–family-related factors were critical psychosocial hazards. Their prevalence rates of depression, anxiety, and stress symptoms are 32.96%, 32.58%, and 16.95%, respectively. Personal factors are the strongest predictors of poor mental health outcomes, especially anxiety, while work–family-related factors are influential on the development of depression symptoms. The findings are unique, as they reveal critical psychosocial hazards that affect the mental health of construction professionals during the pandemic. They provide important theoretical references for governments or construction enterprises to develop disaster management plans in cases of similar public health emergencies in the future. Full article

Background/Objectives: The COVID-19 pandemic accelerated the shift toward community- and home-based care models. Within this transformation, Family and Community Nurses (FCNs) have become key in bridging hospital and primary care, supporting continuity, self-care, and quality of life (QoL). Despite increasing recognition, evidence on FCN-led interventions remains fragmented. This systematic review and meta-analysis aimed to synthesize evidence on the impact of FCN interventions on QoL and clinical outcomes in post-COVID and people living with chronic conditions managed in community and home settings. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, CINAHL, PsycINFO, Embase, and Cochrane Library (January 2020–November 2024). Eligible studies were randomized controlled trials evaluating FCN-led interventions. Primary outcomes were QoL (measured with validated tools) and glycemic control (HbA1c). Secondary outcomes included hospital readmissions, anxiety, depression, and self-care abilities. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials. Random-effects meta-analyses were performed, with heterogeneity evaluated by I². The protocol was prospectively registered in PROSPERO (CRD42024567890) before data extraction. Results: Seventy-one studies (n = 19,390) were included. Interventions comprised home visits, telehealth, patient education, and case management. Pooled analyses demonstrated significant improvement in QoL (SMD 0.34, 95% CI 0.18–0.50) and reduction in HbA1c (−0.47%, 95% CI −0.69 to −0.25). FCN interventions also reduced hospital readmissions (RR 0.74, 95% CI 0.62–0.89) and improved mental health outcomes. Most studies were judged at low to moderate risk of bias. Conclusions: FCN-led interventions significantly enhance QoL, mental health, and clinical outcomes while reducing hospital readmissions. These findings highlight the strategic importance of integrating FCNs into community-based healthcare models. Full article

Background/Objectives: Implicit theories of thoughts, emotions, and behavior (TEB) describe beliefs that these attributes are either changeable (growth mindset) or unchangeable (fixed mindset). While the impact of mindsets on negative mental health indicators, such as psychopathological symptoms, is well-documented, their relations with positive indicators such as life satisfaction, particularly in the context of stress, remain underexplored. This study aimed to address this gap by testing whether the association between adolescents’ implicit theories of TEB and life satisfaction is mediated by cognitive reappraisal and whether stressful life events moderated two paths within the mediation model. Methods: Participants were 620 high school students (49.5% female, 43.5% male, 5.8% gender-nonconforming, 1.1% undisclosed) aged 14 to 19 years (M = 17.51, SD = 1.23), who completed an online survey in Spring 2022, while the COVID-19 pandemic still significantly affected daily life. Mediation and moderated mediation models were tested using PROCESS macro in SPSS. Results: Mediation analysis revealed that growth mindset positively influenced life satisfaction both directly and indirectly through cognitive reappraisal. Stressful life events significantly moderated the direct effect of growth mindset on life satisfaction, with the positive direct effect diminishing as stress increased. Conclusions: The positive link between growth mindset and life satisfaction was strongest under lower stress and transmitted through cognitive reappraisal across stress levels. Given the cross-sectional design, findings should be interpreted as correlational, not causal. Future longitudinal research should clarify temporal directionality and reciprocal links among mindset, coping, and well-being to inform interventions that strengthen adaptive beliefs and regulation skills. Full article

Background: The COVID-19 pandemic, declared to be over by the World Health Organization (WHO) on 5 May 2023, significantly impacted global physical, mental, economic, social, and political conditions. Since the onset of the pandemic, conspiracy theories have surged globally, facilitated by the Internet and social media. Conspiracy thinking is associated with mistrust in traditional sources of information, such as newspapers and news/TV programs, and lower adherence to public health guidance. However, there is limited understanding of how these beliefs are reflected in specific health-related behaviors and the mediating variables involved. Objective: The study aims to analyze the relationship between the belief in conspiracy theories, perceived personal control, and psychological well-being during the COVID-19 pandemic in Italy to understand how belief in conspiracy theories may contribute to less adherence to government guidelines and the role of factors such as personal control, trust in social media, and traditional sources of information in this relationship. Methods: In total, 437 Italian adults (296 women, 140 men, 1 non-binary; M_age = 31.41, SD = 13.32) completed measures of well-being, perceived control, use/trust of traditional vs. social-media sources, conspiracy beliefs, and adherence. Results: Well-being correlated positively with perceived control and social-media trust. Perceived control correlated positively with social-media trust and negatively with traditional-source trust. Adherence correlated positively with traditional-source trust and negatively with all conspiracy measures. Mediation showed an indirect effect of conspiracy beliefs on lower adherence only via reduced trust in traditional sources. In contrast, no indirect effects were found via social-media trust or perceived control. Conclusions: Conspiracy beliefs undermine adherence primarily by eroding trust in traditional information. Risk communication should rebuild institutional trust and tailor messaging across both social and traditional channels, taking into account psychological factors. Full article

Background: This cross-sectional observational study examined the relationship between caregivers’ adverse childhood experiences (ACEs), their perceived COVID-19-related burden, child psychopathology, and changes in family relationships during the pandemic. Methods: The final sample included 285 children (M = 10.19, SD = 3.36) from clinical settings and their caregivers. Caregivers reported their own ACEs and their children’s psychopathology. Perceived caregiver COVID-19 burden and changes in family relationships were also assessed. Correlational analyses, regressions, and mediation models were conducted to test direct and indirect associations. Results: Caregivers reported an average of 1.63 ACEs, with 18.4% reporting four or more. Children of caregivers who reported four or more ACEs exhibited significantly elevated psychopathology scores. However, caregiver ACEs did not directly predict the perceived COVID-19 burden. A mediation analysis revealed that child psychopathology mediated the association between caregiver ACEs and caregiver COVID-19 burden. Unexpectedly, higher caregiver ACEs were associated with less negative perceived changes in family relationships, particularly in 2023, indicating heterogeneous family adjustment trajectories. Conclusions: These findings highlight that child psychopathology is a key mechanism in the intergenerational transmission of caregiver burden linked to childhood adversity. They also suggest that support systems, resilience, or differing expectations among high-ACE caregivers may help buffer changes in family relationship. Early identification and trauma-informed, family-centered interventions beyond acute crisis are essential. However, limitations include the reliance on caregiver self-report and cross-sectional design. Further, longitudinal, multi-informant research is needed to clarify these dynamics and inform targeted support strategies. Full article

Background/Objectives: To report patients’ perspectives on the impact of adult-onset Still’s disease (AOSD) on their health-related quality of life (HRQoL), work productivity and the effect of coronavirus (COVID)-19, using data from the PRO-AOSD (patient-reported outcomes adult-onset Still’s disease) survey in Germany. Methods: The PRO-AOSD survey comprised blinded patient and physician surveys. An additional post-hoc analysis was performed to determine the relationship between HRQoL and disease activity (defined per C-reactive protein and Physician’s Global Assessment data). The following outcomes were reported: patients’ perspectives on the impact of AOSD on their physical and mental HRQoL and work productivity, outcomes for patients with active versus inactive disease, and the effect of COVID-19 on their general health and work productivity. Results: Adult patients with AOSD were recruited from 19 centers in Germany. A total of 124 patients were included: 59.7% (74/124) were female, and the mean age of diagnosis was 38.2 years. Reported HRQoL was impaired in almost all domains, especially physical health. For the 58 patients whose data enabled categorization into active (31.0%, 18/58) versus inactive disease (69.0%, 40/58), patients with active disease reported significantly worse outcomes in the following (p < 0.001): likelihood of perceiving their health as excellent or similar to other people’s health, severity of pain in the past month, and the ability to complete strenuous activities. Although all patients were of working age, not all were employed (60.5%, 75/124). Many patients felt that compared to their peers, they were more burdened by the COVID-19 pandemic (33.9%) and were more afraid of contracting COVID-19 (49.2%). Conclusions: Patients with AOSD suffered from impaired HRQoL, which was worsened by active disease and the COVID-19 pandemic. Full article