COVID-19 and the repercussions on pregnant women's mental health: integrative review / COVID-19 e as repercussões na saúde mental de gestantes: revisão integrativa / COVID-19 y las repercusiones en la salud mental de mujeres embarazadas: revisión integradora

Resumo Objetivo Identificar, a partir das evidências presentes na literatura, os impactos da COVID-19 na saúde mental de mulheres grávidas. Métodos Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados/biblioteca eletrônica MEDLINE, CINAHL, PUBCOVID19 e MEDRXIV. A busca aconteceu de forma pareada no mês de dezembro de 2020, com artigos disponíveis na íntegra abordando a saúde mental das grávidas na pandemia. Resultados Os estudos que compuseram a amostra foram publicados entre os meses de abril e dezembro de 2020 e nos 10 estudos incluídos, a depressão e a ansiedade são apontados como fatores impactantes na saúde das gestantes, tendo como elementos contribuintes o medo da COVID-19, estresse e preocupações associadas à pandemia. Conclusão Houve impacto na saúde mental das gestantes na pandemia com repercussões de ordem psicossocial, socioeconômica e de assistência à saúde. Nesse contexto, a abordagem do componente psicológico na consulta de enfermagem pode fazer a diferença na atenção à gestação.

Resumen Objetivo Identificar, a partir de evidencias presentes en la literatura, los impactos del COVID-19 en la salud mental de mujeres embarazadas. Métodos Se trata de una revisión integradora de la literatura, realizada en las bases de datos/biblioteca electrónica MEDLINE, CINAHL, PUBCOVID19 y MEDRXIV. La búsqueda se realizó de forma pareada en el mes de diciembre de 2020, con artículos con texto completo disponible que abordaban la salud mental de embarazadas en la pandemia. Resultados Los estudios que formaron la muestra fueron publicados entre los meses de abril y diciembre de 2020. En los diez estudios incluidos, la depresión y la ansiedad son señaladas como factores impactantes en la salud de las mujeres embarazadas, donde los elementos contribuyentes son el miedo al COVID-19, el estrés y las preocupaciones relacionadas con la pandemia. Conclusión Hubo impacto en la salud mental de las mujeres embarazadas en la pandemia, con repercusiones de orden psicosocial, socioeconómica y de atención a la salud. En este contexto, el enfoque del componente psicológico en la consulta de enfermería puede marcar una diferencia en la atención al embarazo.

Abstract Objective To identify the impacts of COVID-19 on pregnant women's mental health from evidence in the literature. Methods This is an integrative literature review performed in MEDLINE, CINAHL, PUBCOVID19 and MEDRXIV databases/electronic libraries. The search took place in pairs in December 2020, with articles available in full addressing pregnant women's mental health in the pandemic. Results The studies that made up the sample were published between April and December 2020 and in the ten studies included, depression and anxiety were identified as factors exerting impact on pregnant women's health, and the fear of COVID-19, stress and worries associated with the pandemic as contributing elements. Conclusion There was an impact on pregnant women's mental health in the pandemic with psychosocial, socioeconomic and health care repercussions. In this context, the approach to the psychological component in the nursing consultation can make a difference in pregnancy care.

Trade-off Between Quarantine Length and Compliance to Optimize COVID-19 Control.

BACKGROUND: Guidance on COVID-19 quarantine duration is often based on the maximum observed incubation periods assuming perfect compliance. However, the impact of longer quarantines may be subject to diminishing returns; the largest benefits of quarantine occur over the first few days. Additionally, the financial and psychological burdens of quarantine may motivate increases in noncompliance behavior. METHODS: We use a deterministic transmission model to identify the optimal length of quarantine to minimize transmission. We modeled the relation between noncompliance behavior and disease risk using a time-varying function of leaving quarantine based on studies from the literature. RESULTS: The first few days in quarantine were more crucial to control the spread of COVID-19; even when compliance is high, a 10-day quarantine was as effective in lowering transmission as a 14-day quarantine; under certain noncompliance scenarios a 5-day quarantine may become nearly protective as 14-day quarantine. CONCLUSION: Data to characterize compliance dynamics will help select optimal quarantine strategies that balance the trade-offs between social forces governing behavior and transmission dynamics.

Behavioral and psychosocial factors and their effects on insomnia among people undergoing entry quarantine in hotels during COVID-19 pandemic: a cross-sectional study in Guangzhou, China.

BACKGROUND: The COVID-19 pandemic continues to impact global health and China requires a 14-day quarantine for individuals on flights with positive COVID-19 cases. This quarantine can impact mental well-being, including sleep. This study aims to examine the impact of psychosocial and behavioral factors on insomnia among individuals undergoing quarantine in hotels. METHODS: This study was a cross-sectional survey carried out in Guangzhou, China. The data was gathered through online questionnaires distributed to international passengers who arrived in Guangzhou on flights and were required to undergo a 14-day quarantine in hotels arranged by the local government. The questionnaires were sent to the participants through the government health hotline "12,320." RESULTS: Of the 1003 passengers who were quarantined, 6.7% reported significant anxiety and 25.0% had varying degrees of insomnia. Anxiety was positively associated with insomnia (ß = 0.92, P < 0.001), while collectivism (ß = -0.07, P = 0.036), indoor exercise (ß = -0.50, P < 0.001), and the perceived people orientation of the public health service (ß = -0.20, P = 0.001) were negatively associated with insomnia. The study also identified moderating effects, such that a higher sense of collectivism, a greater frequency of indoor exercise, and a higher perception of the people-oriented of the public health service were associated with a lower impact of anxiety on insomnia. These moderating effects were also observed in participants with varying degrees of insomnia. CONCLUSIONS: This study reveals that a proportion of people undergoing entry quarantine experience insomnia and confirms how psychosocial and behavioral factors can alleviate insomnia in this population.

The Psychological and Wellbeing Impacts of Quarantine on Frontline Workers during COVID-19 and Beyond.

OBJECTIVE: The current study investigated the experiences, wellbeing impacts, and coping strategies of frontline workers who participated in "Hotels for Heroes", an Australian voluntary hotel quarantine program during the COVID-19 pandemic. The program was open to those who were COVID-19 positive or exposed to COVID-19 as part of their profession. METHODS: Frontline workers who had stayed in voluntary quarantine between April 2020 and March 2021 were invited to participate in a voluntary, anonymous, cross-sectional online survey including both quantitative and qualitative responses. Complete responses were collected from 106 participants, which included data on sociodemographic and occupational characteristics, experiences of the Hotels for Heroes program, and validated mental health measures. RESULTS: Mental health problems were prevalent amongst frontline workers (e.g., moderate anxiety symptoms, severe depression symptoms, and greater than usual impact of fatigue). For some, quarantine appeared to be helpful for anxiety and burnout, but quarantine also appeared to impact anxiety, depression, and PTSD negatively, and longer stays in quarantine were associated with significantly higher coronavirus anxiety and fatigue impacts. The most widely received support in quarantine was from designated program staff; however, this was reportedly accessed by less than half of the participants. CONCLUSIONS: The current study points to specific aspects of mental health care that can be applied to participants of similar voluntary quarantine programs in the future. It seems necessary to screen for psychological needs at various stages of quarantine, and to allocate appropriate care and improve its accessibility, as many participants did not utilise the routine support offered. Support should especially target disease-related anxiety, symptoms of depression and trauma, and the impacts of fatigue. Future research is needed to clarify specific phases of need throughout quarantine programs, and the barriers for participants receiving mental health supports in these contexts.

The rapid change in mental health among college students after introduction of on-campus quarantine during the 2022 Shanghai COVID-19 lockdown.

Objectives: Among the various impacts of disasters in terms of emotions, quarantine has been proven to result in significant increases in mental health problems. Studies of psychological resilience during outbreaks of epidemics tend to focus on long-term social quarantine. In contrast, insufficient studies have been conducted examining how rapidly negative mental health outcomes occur and how these outcomes change over time. We evaluated the time course of psychological resilience (over three different phases of quarantine) among students at Shanghai Jiao Tong University to investigate the influence of unexpected changes on college students. Methods: An online survey was conducted from 5 to 7 April 2022. A structured online questionnaire was administered using a retrospective cohort trial design. Before 9 March (Period 1), individuals engaged in their usual activities without restrictions. From 9 to 23 March (Period 2), the majority of students were asked to remain in their dormitories on campus. From 24 March to early April (Period 3), restrictions were relaxed, and students were gradually allowed to participate in essential activities on campus. We quantified dynamic changes in the severity of students' depressive symptoms over the course of these three periods. The survey consisted of five sets of self-reported questions: demographic information, lifestyle/activity restrictions, a brief mental health history, COVID-19-related background, and the Beck Depression Inventory, second edition. Results: A total of 274 college students aged 18-42 years (mean = 22.34; SE = 0.24) participated in the study (58.39% undergraduate students, 41.61% graduate students; 40.51% male, 59.49% female). The proportion of students with depressive symptoms was 9.1% in Period 1, 36.1% in Period 2, and 34.67% in Period 3. Depressive symptoms increased notably with the introduction of the quarantine in Periods 2 and 3. Lower satisfaction with the food supplied and a longer duration of physical exercise per day were found to be positively associated with changes in depression severity in Periods 2 and 3. Quarantine-related psychological distress was more evident in students who were in a romantic relationship than in students who were single. Conclusion: Depressive symptoms in university students rapidly increased after 2 weeks of quarantine and no perceptible reversal was observed over time. Concerning students in a relationship, ways to take physical exercise and to relax should be provided and the food supplied should be improved when young people are quarantined.

Nutrition, physical activity and psychological status during lockdown due to Covid-19

Aim of the present study was to assess physical activity, nutrition and psychological status of the population during lockdown due to covid-19. Online survey was conductedamong 534 participants within the age range of 16-78 years using convenient sampling. Participantsfrom varied regions within India and abroad were enrolled for the present study. Volunteered participants were solicited to take part in a survey that has to be carried out by filling an online questionnaire form available to them as a URL link in the invitation through WhatsApp/Messenger. The gathered data has been compiled, coded and cleaned using Microsoft Excel. Analysis has been carried out employing descriptive and inferential statistics in SPSS 17.0.Majority of participants in the studied population showed significant change in their nutrition and physical activity status due to lockdown. Covid-19 lockdown did limit their daily activities. It also had impacted their psychological status.The current investigation accentuates the need to pursue suitable life style for the maintenance of optimum metabolism and physiology. Sticking to more regular timetable of meals, effective management of stress levels and continued physical activity during the quarantine and in all the following phases of living is desirable.

[Quarantine by COVID-19 in a health professional: psychological, social and family dimensions]. / Cuarentena por COVID-19 en un profesional de la salud: dimensión psicológica, social y familiar.

OBJECTIVE: To analyze the psychological, social and family dimensions of a health professional quarantined by COVID-19. METHOD: Case report. A matrix was used as a daily log to collect information from the three dimensions analyzed. The anonymity of the person was respected at all times. RESULTS: A case study is presented with the main milestones in the daily life of a health professional during the 14 days of quarantine. In the psychological dimension, feelings of fear and uncertainty in the face of risk are highlighted, in the social dimension the importance of the accompaniment of family and friends who strengthened the adaptability to the process stands out, and in the family dimension the relevance of affective bonds and permanent communication. CONCLUSION: The aspects developed in the different dimensions should be considered by those who participate in the management and follow-up of cases in primary care, as they are the possibility of strengthening the neuronal and hormonal mechanism through family and social support. Being a health professional and having knowledge on the subject can generate a greater effect of involuntary isolation related to the risk of COVID-19. This is not only clinical, but also psychological, social and family. In this sense those who manage the cases should consider the integrality in health conditions.

Behavioral and Brain Correlates of Emotional Distress in Older Adults During COVID-19 Quarantine.

COVID-19 led to unprecedented lockdowns and changes in older adults' lives, especially those with type 2 diabetes who have high risk of complications and mortality. We investigated the associations of cognitive and motor function and gray matter volumes (GMVs) with COVID-19 lockdown-related emotional distress of type 2 diabetes older adults, participating in the Israel Diabetes and Cognitive Decline Study. We administered a questionnaire to obtain information about anxiety, depression, general well-being, and optimism during a mandated lockdown. Lower grip strength before lockdown was associated with increased sadness, anxiety, and less optimism. Slower gait speed was associated with greater sadness. Lower GMV was related to greater anxiety during the lockdown when compared with anxiety levels before the COVID-19 outbreak. Yet, global cognition was not associated with any emotional distress measure. These results support the role of good motor function on emotional well-being during acute stress and GMV as a potential underlying mechanism.

Impacting factors and sources of perceived stress by home-quarantined residents in Shanghai during COVID-19 epidemic.

BACKGROUND: Home-quarantine is one of the most common measures implemented to prevent or minimize the transmission of COVID-19 among communities. This study assessed stress levels of the home-quarantined residents in Shanghai during a massive wave of COVID-19 epidemic this year, explored the stress sources perceived by the respondents, and analyzed the association between each of the sociodemographic factors and the stress level. METHODS: This online survey was launched during April 23 - 30, 2022, the early stage of a massive wave of COVID-19 in Shanghai, China. Participants were quarantined-residents negative for COVID-19. They were asked to list some situations that were their major concerns and perceived stressful, in addition to sociodemographic and COVID-19 related information. Moreover, they were asked to complete the Perceived Stress Scale-14 (PSS-14) for the assessment of stress level. RESULTS: A total of 488 valid questionnaires were collected from 192 male and 296 female respondents. Overall, 207 persons (42.42%) presented high stress level (PSS-14 score ≥43). The top three concerns perceived stressful by respondents are "not allowed to go outdoors", "uncertain duration of the epidemic", and "lack of food supply". Fewer than 50% of the respondents perceived the other situations stressful. Higher proportions of young adults (≤ 29 years old), males, unemployed, singles, and those with low income (≤ 1999 yuan/month) perceived high stress compared to their counterparts, none of COVID-19 related factors is associated with the stress level, including location of residence, result of nucleic acid test, knowledge about COVID-19, whether vaccinated, and quarantine duration. CONCLUSION: Home-quarantine applied to people negative for COVID-19 led to a lot of major concerns that may be perceived stressful, whereas the virus-related factors did not show significant impact on mental health of the respondents.

The Correlation between Social Media Addiction and Emotional Eating during the COVID-19 Quarantine Period.

This study was conducted with 458 participants. The demographic and health information of the participants along with the Social Media Addiction, Emotional Eating Scale were obtained. The level of social media addiction in adults was moderate, and women were more interested in social media than men. As the average age of participants increased, the virtual tolerance, virtual communication, social media scores decreased (p < .05). The study found that 51.6% of individuals with emotional eating tendencies happened to be obese. The social media addiction scale scores of those with emotional eating tendencies were higher than those without emotional eating tendencies (p < .05).

Investigating the psychological effects of home quarantine during the early peaks of the COVID-19 pandemic: a survey from Iran.

We assessed psychological symptoms among individuals who were quarantined during early coronavirus disease 2019 (COVID-19) peaks. This cross-sectional study was performed during April-October 2020 in Iran. We surveyed 100 individuals with COVID-19 patients in their families and 100 others with health conditions associated with a higher risk of developing critical forms of COVID-19 infection, who have completed at least 14 days of home quarantine. Validated Persian versions of the 21-item Depression, Anxiety, and Stress and 22-item Impact of Event Scale-Revised were used to measure the symptoms of depression, anxiety, stress and distress. The rates of stress, anxiety, depression and quarantine-related distress were 46.5, 48.5, 57.0 and 80.5%, respectively; however, they were not significantly different between the contact and no-contact groups. Female sex and being unemployed were significantly associated with quarantine-related distress, P = 0.007 and P = 0.018, respectively. Independent risk factors for anxiety were a history of medical comorbidity ( P = 0.025) and contact with COVID-19 patients ( P = 0.007). Findings show high prevalence rates of psychological symptoms among quarantined individuals, regardless of whether they had contact with COVID-19 patients or not. Female sex and unemployment were risk factors for quarantine-related distress.

Social Isolation Affects the Mimicry Response in the Use of Smartphones : An Ethological Experiment during the COVID-19 Pandemic.

Humans are social animals that rely on different ways to interact with each other. The COVID-19 pandemic strongly changed our communication strategies. Because of the importance of direct contact for our species, we predict that immediately after the forced social isolation, people were more prone to engage in direct rather than in virtual interactions, thus showing a lower mimicry response in the use of smartphones. In a non-longitudinal study, we collected behavioral data under naturalistic contexts and directly compared the data of the mimicry response gathered immediately following the Italian lockdown (May-September 2020) with those gathered one year later (May-October 2021). Contrary to our expectations, the mimicry response in the use of smartphones was higher immediately after the lockdown than a year later. Probably the large use of these devices during the lockdown translated into a greater sensitivity to be affected by others' smartphone manipulation. Indeed, social isolation modified, at least in the short term, the ways we interact with others by making us more prone to engage in "virtual" social interactions. The bright side of the coin unveiled by our findings is that the effect seems to diminish over time. The large behavioral dataset analyzed here (1,608 events; 248 people) also revealed that the mimicry response in the use of smartphones was higher between familiar subjects than between strangers. In this view, mimicry in manipulating smartphones can be considered an example of joint action that fosters behavioral synchrony between individuals that, in the long-term, can translate into the formation of social bonding.

[Narratives on changes in health-related behaviours during lockdown in Spain according to gender]. / Narrativas sobre cambios de conductas en salud durante el confinamiento en España según género.

OBJECTIVE: To explore experiences related to health-oriented behaviours during lockdown in the Spanish resident population from a gender perspective. METHOD: Qualitative research with a critical and feminist approach. Twenty-nine semi-structured interviews (17 women and 12 men) were conducted between June and July 2020 via telephone with people who had previously answered an online survey. The interviews were transcribed and a thematic content analysis was carried out, differentiating between the experiences of women and men. The data were triangulated by the research team. RESULTS: Among women, greater diversity emerged in terms of health behaviours. Among them, the difficult experiences related to COVID-19, the complexity of living together and doing unpaid care work, as well as the importance of support networks, stood out. Among men, there were different attitudes towards sport, self-care and having time for healthy eating were positively valued, and there was a good assessment of coexistence and organisation in household chores. In both men and women, work overload and economic problems were related to emotional distress and difficulties in carrying out healthy activities. CONCLUSIONS: Health-oriented behaviours during lockdown differed according to gender. They were mostly limited to COVID-19 experiences, socio-economic conditions and burden of care. It is essential to tailor public health and primary care programmes according to people's life moments, taking into account their social context and questioning traditional gender roles.

Analysis of psychological status and effect of psychological intervention in quarantined population during the epidemic of SARS-CoV-2.

ABSTRACT: During outbreaks of the coronavirus disease 2019 (COVID-19), many countries adopted quarantine to slow the spread of the virus of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Quarantine will cause isolation from families, friends, and the public, which consequently leads to serious psychological pressure with potentially long-lasting effects on the quarantined population. Experience of specific practices to improve the psychological status of the mandatory quarantined population was limited. The aim of this study was to investigate the psychological impact of mandatory quarantine, and evaluate the effect of psychological intervention on the quarantined population.We conducted a prospective cohort study to assess and manage the psychological status of a mandatory quarantined population in Beijing, China. A total of 638 individuals completed 2 questionnaires and were enrolled in this study, of which 372 participants accepted designed psychological intervention while other 266 participants refused it. The SCL-90 questionnaire was used to evaluate the psychological status and its change before and after the intervention. The differences of SCL-90 factor scores between participants and the national norm group were assessed by 2 samples t test. While the SCL-90 factor scores before and after intervention were compared with 2 paired samples t test.Compared with the Chinese norms of SCL-90, the participants had higher SCL-90 factor scores in most items of the SCL-90 inventory. The SCL-90 factor scores of participants with psychological intervention significantly decreased in somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism. In contrast, most factor scores of the SCL-90 inventory changed little without statistical significance in participants without psychological intervention.Psychological problems should be emphasized in the quarantined individuals and professional psychological intervention was a feasible approach to improve the psychological status of the mandatory quarantined population in the epidemic of SARS-CoV-2.

'Now you will understand what it is like to be confined': Did COVID-19 lockdowns affect perceptions about long-term psychiatric hospitalizations? A report from Argentina.

BACKGROUND: Lockdowns have been one of the government's primary measures to control COVID-19, especially during the initial waves of the pandemic, but there is concern on the impact of lockdowns on people's mental health. Confinement is still today the reality of many people with severe mental illness in many places of the world. OBJECTIVE: Given that the general population experienced confinement during the COVID-19 pandemic, we sought to explore if that affected perceptions about long-term psychiatric hospitalizations. METHODS: About 134 residents from middle-class neighborhoods in urban settings in the Province of Buenos Aires, Argentina, were surveyed. Participants were asked if they felt emotionally affected by the pandemic and lockdown, and about their perceptions of long-term psychiatric hospitalizations. Association between personal emotional impact by the pandemic or lockdown with perceptions about long-term psychiatric hospitalization were analyzed using chi-square test. Qualitative analysis of pandemic and lockdown effects was held. RESULTS: Respondents tended to overlap the emotional effects of the pandemic and the lockdown. Some responses explicitly referred to confinement. No association was observed between emotional impact by the pandemic or lockdown and perceptions about long-term psychiatric hospitalization among the sample. The general population's perceptions of long-term psychiatric hospitalization do not appear to be affected by the first-hand experience of confinement, which suggest persistence of stigma, and the need to reconsider public policies and actions that attempt to impact on it.

Understanding the Psychological Well-Being of International Arrivals in a Purpose-Designed Australian COVID-19 Quarantine Facility.

Equivocal evidence suggests that mandatory supervised quarantine can negatively affect psychological well-being in some settings. It was unclear if COVID-19 supervised quarantine was associated with psychological distress in Australia. The sociodemographic characteristics associated with distress and the lived experiences of quarantine are also poorly understood. Therefore, this study aimed to evaluate the mental well-being of international arrivals undergoing supervised COVID quarantine in a purpose designed facility in the Northern Territory, Australia. We conducted a concurrent triangulation mixed-methods study comprising of an observational cross-sectional survey (n = 117) and individual qualitative interviews (n = 26). The results revealed that several factors were associated with distress, including significantly higher levels of depression for those who smoked, drank alcohol, had pre-existing mental health conditions and had no social networks in quarantine. Levels of psychological distress were also related to waiting time for re-entry (the time between applying to repatriate and returning to Australia) and flight origin. Qualitative data showed that despite quarantine being viewed as necessary, unclear communication and a perception of lack of control were affecting emotional well-being. This information is useful to inform the further development of models to identify those at most risk and support psychological well-being in quarantine settings.

Morocco's National Response to the COVID-19 Pandemic: Public Health Challenges and Lessons Learned.

This report aimed to provide an overview of the epidemiological situation of COVID-19 in Morocco and to review the actions carried out as part of the national response to this pandemic. The methodology adopted was based on literature review, interviews with officials and actors in the field, and remote discussion workshops with a multidisciplinary and multisectoral working group. Morocco took advantage of the capacities already strengthened within the framework of the application of the provisions of the International Health Regulations (IHR) of 2005. A SWOT analysis made it possible to note that an unprecedented political commitment enabled all the necessary means to face the pandemic and carry out all the response activities, including a campaign of relentless communication. Nevertheless, and despite the efforts made, the shortage of human resources, especially those qualified in intensive care and resuscitation, has been the main drawback to be addressed. The main lesson learned is a need to further strengthen national capacities to prepare for and respond to possible public health emergencies and to embark on a process overhaul of the health system, including research into innovative tools to ensure the continuity of the various disease prevention and control activities. In addition, response to a health crisis is not only the responsibility of the health sector but also intersectoral collaboration is needed to guarantee an optimal coordinated fight. Community-oriented approaches in public health have to be strengthened through more participation and involvement of nongovernmental organizations (NGOs) and civil society in operational and strategic planning.