Perceptions of the COVID-19 pandemic and government response among Turkish-speaking immigrants in Germany during the initial lockdown period.

Understanding the socioeconomic and health impacts of the pandemic and their consequences on immigrants necessitates consideration of how they have perceived the global threat. By applying agenda-setting theory to Turkish-speaking immigrants in Germany as a case study, I investigated what issues created a sense of urgency for them during the initial lockdown and how they approached the government's COVID-19-related agenda. I used purposeful sampling and video comments on COVID-19-related news created by three journalists on YouTube channels and applied qualitative content analysis to interpret the comments. Analysis of 118 comments and 68 replies showed that social media played an important role in immigrants' awareness of COVID-19, especially about authorities' responses, pandemic-related measures, and economic aid packages. Immigrants perceived the information as cause for concern and reactions varied by socioeconomic status. Comments not only supported authorities pandemic strategies but also indicated doubts caused by lack of transparency, certain recommendations, regulations, and aid.

Pictorial Assessment of Health-Related Quality of Life. Development and Pre-Test of the PictoQOL Questionnaire.

The aim of the present study was to develop a pictorial questionnaire for the assessment of health-related quality of life (PictoQOL) and to examine its content validity and usability across three exemplary population groups of different origin residing in Germany (non-migrants, Turkish migrants and Arabic-speaking migrants). A mixed-methods design combining qualitative and quantitative methods was used, comprising 6 focus group discussions with a total of 17 participants, 37 cognitive interviews and a quantitative pretest with 15 individuals. The PictoQOL consists of a pictorial representation of a total of 15 different situations. Using a visual Likert scale, respondents indicate how much each situation applies to them. Some representations proved to be culturally sensitive and were adapted. Respondents found the use of an additional graphic layer in the form of symbols in addition to pictures helpful for interpretation. The PictoQOL is considered to allow a more accessible assessment and better comparability of HRQOL across different population groups regardless of their literacy level. It is therefore considered to be superior to existing instruments for routine use in health research and practice. Future studies need to examine its convergent and factorial validity.

"We are taking every precaution to do our part ": a comparative analysis of nursing, palliative and hospice care facilities' websites during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has a significant impact on health care processes. Precautions such as restrictions imposed on visitors and social distancing have led to multiple challenges, particularly in terms of communication. Using the case of nursing, palliative and hospice care facilities in Germany and drawing on agenda-setting theory, the present study aims to shed light on how health care facilities use their websites to inform (potential) health care users about changes in regulations, new protective measures implemented and about recommendations in the context of the COVID-19 pandemic. METHODS: The websites of nursing, palliative and hospice care facilities in Germany were examined using qualitative document analysis and qualitative content analysis. A total of 138 websites was analysed in the study. The data gathered includes all information about COVID-19 on these websites published from the beginning of March until August 15, 2020. RESULTS: Facilities show similarities in adhering to the measures taken by the authorities to restrict the spread of SARS-CoV-2 and to protect vulnerable patients and employees. All facilities urged the public to avoid paying visits to patients in facilities unless there was an emergency; however, visiting procedures in practice varied by types of facilities. For optimal communication, telephone and especially video calls were the options preferred by health care providers and health care users. Facilities made great efforts to prevent emotional stress and to strengthen resilience among all stakeholders. Transparency was adopted by many facilities in order to build the public's trust. CONCLUSIONS: The agenda of health care facilities has been seriously affected by the COVID-19 pandemic. The study sheds light on the strategies developed by facilities, their efforts to increase emotional resilience among health care staff and health care users, the ethical guidelines they have adopted regarding privacy policies as well as how these themes are communicated via the facilities' websites. The results can inform other health care facilities about how websites can be used as essential communication tools in times of public health crises.

[Reasons for rejecting official recommendations and measures concerning protection against SARS-CoV-2-a qualitative study of social media posts]. / Gründe für die Ablehnung behördlicher Empfehlungen und Maßnahmen zum Schutz vor SARS-CoV-2 ­ eine qualitative Studie auf Basis von Beiträgen in sozialen Medien.

BACKGROUND: In order to slow down the spread of SARS-CoV­2 (severe acute respiratory syndrome coronavirus type 2) the federal states and the government in Germany have implemented protective measures with far-reaching consequences for the population and the economy. Amongst others, these measures include the temporary restriction of the operation of leisure facilities as well as contact and travel restrictions. These government regulations and recommendations have provoked mixed reactions, with some parts of the population not complying accordingly. OBJECTIVES: The aim of the present study is to explore reasons for the noncompliance with protective measures on the basis of social media posts. MATERIALS AND METHODS: Three social networks (Facebook, Twitter, and YouTube comments) were systematically investigated for the period 2 March to 18 April 2020 with regard to attitudes and beliefs about "social distancing" and other protective measures by means of qualitative document and content analysis. A total of 119 postings were included in the analysis and interpreted. RESULTS: Six main categories and four subcategories were identified in terms of the rejection of protective measures: misinformation of social media (trivialization and doubts about the effectiveness of protective measures), mistrust of the established public media, knowledge deficits and uncertainty, restriction of basic rights, the role of authorities (population control and poor trust in the Robert Koch Institute), and economic consequences of the pandemic. CONCLUSION: Misinformation in social media and knowledge deficits may contribute to underestimating the pandemic. In addition, economic pressures may contribute to rejecting protective measures. To increase the acceptance of implemented protective measures, health education and transparent and evidence-based communication represent relevant determinants.

Lay perspectives on social distancing and other official recommendations and regulations in the time of COVID-19: a qualitative study of social media posts.

BACKGROUND: COVID-19 caused by a new form of coronavirus (SARS-CoV-2) first appeared in China end of 2019 and quickly spread to all counties of the world. To slow down the spread of the virus and to limit the pressure on the health care systems, different regulations and recommendations have been implemented by authorities, comprising amongst others the closure of all entertainment venues and social distancing. These measures have received mixed reactions, particularly from young individuals, with many not following available advice. Drawing on the information in social media discussion forums, the present study explores the reasons why people ignore the orders and recommendations of the authorities and why the authorities are unable to produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak. METHODS: Three open-access social media forums (Reddit, Twitter, and YouTube comments) were systematically searched with respect to COVID-19-related beliefs, attitudes, and behaviours of individuals. The data was retrieved in the first 3 weeks of March 2020. Qualitative document analysis and qualitative content analysis were used as the methodical approach. The data was reviewed by all authors and jointly interpreted to minimise inconsistencies. RESULTS: The study reveals that reasons such as information pollution on social media, the persistence of uncertainty about the rapidly spreading virus, the impact of the social environment on the individual, and fear of unemployment associated with inequality in the distribution of income lead people to ignore the orders and recommendations of the authorities. The findings suggest that government representatives and politicians could not produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak, due to not building trust among the public and taking concrete economic steps to satisfy them. CONCLUSION: In uncertain crises, transparency in the presentation of information and government policies emerge as influential determinants in creating social susceptibility and solidarity. The differences between social classes constitute one of the important factors that affect the decision-making mechanisms of individuals in determining the necessary steps to be undertaken in times of crisis.