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College-student clients using mental health services contend with increased anxiety and depressive symptoms, and their vulnerability to infectious respiratory diseases and severe clinical outcomes rises. To mitigate severe outcomes, health behaviors serve as essential protective tools to reduce the risk of infectious diseases, including COVID-19. Considering the escalating prevalence of anxiety and depression among college-student clients, little is known about how anxiety and depressive symptoms could potentially attenuate the protective effects of COVID-19 health behaviors (i.e., masking, social distancing, and hygiene practice). This study aims to examine the interactive effects of anxiety/depression and health behaviors in predicting COVID-19 infection. Methods: We analyzed data from the 2020-2021 Healthy Mind Study including a random sample of 9884 college-student clients in mental health services across 140 higher education institutions in the United States. We performed multivariable logistic regression to assess whether and to what extent the associations between COVID-19 health behaviors and infection depended on severity of anxiety or depressive symptoms. Results: Anxiety symptom severity negatively moderated the protective effects of social distancing against infection after adjusting for demographic characteristics and pre-existing chronic health conditions. Depressive symptom severity negatively moderated the protective effects of masking, social distancing, or hygiene practices against infection. Conclusion: The associations between certain COVID-19 health behaviors and infection were conditional on anxiety and depressive symptom severity. Findings suggest a potential public health benefit of mental health clinicians' efforts in assessing and treating clients' anxiety and depressive symptoms, namely reducing their vulnerability to COVID-19 infection and perhaps other infectious respiratory diseases.
RESUMO
INTRODUCTION: Anxiety, depression, and sleep disturbances among accident and emergency nurses not only harm their well-being but also affect patient care and organizational outcomes. This study examines anxiety, depression, and sleep prevalence and associations among accident and emergency nurses. METHODS: We conducted a cross-sectional correlational survey with 331 accident and emergency nurses in 12 Omani governmental hospitals. RESULTS: Results showed that 28.7% of accident and emergency nurses reported symptoms indicative of anxiety, with 13.6% experiencing symptoms of depression, 16.6% reporting mild sleep disturbances, and 1.5% experiencing moderate disturbance. Those with symptoms of anxiety (r = 0.183, P = .001) or depression (r = 0.152, P = .005) were more likely to experience sleep disturbances. Being single (t [170.7] = 2.5, P = .015), childless (t [169.7] = -2.807, P = .008), Omani (t [215] = 7.201, P < .001), younger (r = -0.375, P < .001) and having less clinical experience (t [329] = 4.6, P < .001) were associated with a higher anxiety score. For depression, being of Omani nationality (t [215] = 7.201, P < .001), having less than 10 years of experience (t [329] = 3.2, P =.002), and being of younger age (r = -0.285, P < .001) were associated with a higher score. DISCUSSION: Accident and emergency nurses commonly experience anxiety, depression, and sleep disturbances. Implementing interventions to promote their mental well-being or manage these issues is crucial. Organizational support is vital for ensuring their mental health, and individual-level interventions may also prove beneficial.
