Role of self-esteem and personal mastery on the association between social support and resilience among COVID-19 long haulers.

Although the COVID-19 mortality rate is declining, the number of individuals dealing with persistent COVID-19 symptoms is increasing worldwide, making long COVID a global public health concern. People with long COVID (long haulers) often deal with physical and mental stressors. Long haulers' psychological resilience could play a key role in coping with these stressors in intercorrelation with psychosocial resources. The current study aims to test a hypothesized relationship between social support and its functions (i.e., instrumental and emotional) and the resilience of long haulers through serial mediation by personal mastery and self-esteem. A cross-sectional and self-administered online survey was conducted among 460 individuals with long COVID recruited from COVID-19 Facebook support groups in the United States. Analyzing data indicated a positive correlation between social support and the resilience of long haulers. Structural equation modeling suggested that self-esteem and personal mastery fully mediated the association between social (instrumental) support and resilience. Personal mastery also mediated the association between self-esteem and resilience in social (instrumental) support models. However, in the emotional support model, the indirect effect was non-significant for the mediation by personal mastery and self-esteem. Findings suggest that social support, mainly instrumental support, may protect long haulers by promoting their resilience through self-esteem and personal mastery. This study emphasizes the importance of including social support services in designing programs for COVID-19 long haulers.

The Role of Social Media in the Experiences of COVID-19 Among Long-Hauler Women: Qualitative Study.

BACKGROUND: The extant literature suggests that women are more vulnerable to COVID-19 infection and at higher risk for developing long COVID. Due to pandemic mitigation recommendations, social media was relied upon for various aspects of daily life, likely with differences of usage between genders. OBJECTIVE: This study aimed to explore the role and functions of social media in the lives of long-hauler women. METHODS: Participants were purposively snowball-sampled from an online health promotion intervention for long-hauler women with COVID-19 from March to June 2021. During this time, one-on-one, semistructured interviews were conducted online until data saturation was agreed to have been achieved (ie, 15 interviews). Interview transcripts and field notes were analyzed using an emergent, inductive approach. RESULTS: In total, 15 women were enrolled. The main roles of social media included facilitating support group participation, experience sharing, interpersonal connections, and media consumption. Emergent themes demonstrated that participants rely on social media to fulfill needs of emotional support, social engagement, spirituality, health planning, information gathering, professional support, and recreationally for relaxation. As long-hauler women turn to social media to discuss symptom and health management as well as the intention to vaccinate, this study demonstrates both the associated benefits (ie, decreased isolation) and challenges (ie, misinformation, rumination, resentment, jealousy). CONCLUSIONS: The public health implications of these findings support the development of gender-tailored health promotion interventions that leverage the benefits of social media, while mitigating the negative impacts, for women with long COVID.

Lived experiences of neurofibromatosis type 1 patients: Social life, stigma, and intervention strategies.

Neurofibromatosis type 1 (NF1) is a neurogenetic disorder associated with visual-spatial problems, executive dysfunction, and language deficits, making patients experience social isolation, stigma, anxiety, and depression. Here, we explored NF1 patients' lived experiences by conducting semi-structured, in-depth interviews with 21 NF1 patients and 16 care providers. The thematic analysis uncovered dimensions of NF1 patients' social lives at different ecological levels, including their relationships with family, friends, teachers, coworkers, providers, and society. Positive dimensions of NF1 patients' social life (e.g. familial support and sacrifice, responsibility, and self-sufficiency, supportive friends, and professors) counter negative dimensions (e.g. the vulnerability in sexual relationships, social interactions, discriminatory professors, misconceptions about abilities, appearance bias, internalized and social stigma, violence, and low self-esteem). Adaptive strategies used or suggested by NF1 patients at personal (e.g. supportive network, positive reframing, acceptance of their bodies) and social levels (e.g. psychological support, group therapy, public awareness, and governmental support) were identified.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model.

BACKGROUND: Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS: In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS: In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (ßs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (ßs = -0.61 to -0.43, ps < 0.001). CONCLUSION: Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Impact of Mass Media on HIV/AIDS Stigma Reduction: A Systematic Review and Meta-analysis.

HIV-related stigma is a major barrier to HIV testing and care engagement. Despite efforts to use mass media to address HIV-related stigma, their impact on reducing HIV-related stigma remains unclear. Thus, we conducted a systematic review and meta-analysis of peer-reviewed publications quantitatively examining the impact of mass media exposure on HIV-related stigma reduction and published from January 1990 to December 2020. Of 388 articles found in the initial screening from scientific databases, 19 met the inclusion criteria and were included in the systematic review. Sixteen articles reported the quantitative effect of mass media exposure on HIV-related stigma and were included in the meta-analysis. Systematic review results showed considerable heterogeneity in studied populations with a few interventions and longitudinal studies. Results suggested a higher interest in utilizing mass media by health policymakers in developing countries with greater HIV prevalence to reduce HIV-related stigma. Meta-analysis results showed a modest impact of mass media use on HIV-related stigma reduction. Despite heterogeneity in the impact of mass media on HIV-related stigma, Egger's regression test and funnel graph indicated no evidence for publication bias. Results demonstrated an increase in the impact of mass media on reducing HIV-related stigma over time and no correlation between the HIV prevalence in countries and the impact of mass media. In summary, mass media exposure has a modest and context-specific impact on HIV-related stigma reduction. More large-scale mass media interventions and studies addressing the impact of mass media on different forms of stigma are required to inform policies.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model.

Background: Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. Methods: In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. Results: In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( ß s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( ß s = -.61 to -.43, p s < .001). Conclusion: Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Resilience resources and coping strategies of COVID-19 female long haulers: A qualitative study.

Background: Female long haulers deal with persistent post-acute COVID-19 symptoms that have serious health implications. This study aimed to identify resilience resources at multiple socio-ecological levels for female long haulers and describe how resilience resources affect their responses to long COVID. Methods: Purposive sampling was adopted to recruit participants through social media from April to June 2021 followed by 15 semi-structured interviews. An inductive analytical approach was adopted to categorize themes by open and axial coding that were verified by peer review. Results: Female long haulers relied on resources at various socio-ecological levels to foster their resilience in response to long COVID. At the individual level, they utilized cognitive and emotional resources to increase knowledge, learn new skills, set goals, and manage emotions; behavioral resources (e.g., internal motivation and executive functioning) to perform physical, creative, and recreational activities, and adopt healthier eating habits; and spiritual resources to perform spiritual rituals and connect with God. At the social level, the support from existing relationships and/or online social support groups enhanced their social identity and provided material and informational resources. At the health systems level, the guidance from counselors and physicians and availability of clinics, medicines, and health equipment assisted them in symptom management and medication adherence. Conclusion: The resilience of female long haulers can be enhanced through (1) offering financial and health-related resources, (2) developing online social-support groups, (3) counseling and care service training for healthcare professionals, and (4) implementing more psychosocial interventions by labor organizations.

Social Life of Females with Persistent COVID-19 Symptoms: A Qualitative Study.

Persistent COVID-19 symptoms (long COVID) may bring challenges to long haulers' social lives. Females may endure more profound impacts given their special social roles and existing structural inequality. This study explores the effects of long COVID on the social life of female long haulers. We conducted semi-structured interviews via Zoom between April and June 2021 with 15 female long haulers in the United States, purposely recruited from Facebook and Slack groups and organization websites related to long COVID. Interviews were audio-recorded and transcribed verbatim with consent. The interview data were managed using MAXQDA and examined by thematic analysis. Long COVID negatively affected female long haulers' social lives by causing physical limitations, economic issues, altered social relationships, social roles' conflicts, and social stigma. Long COVID prevented female long haulers' recovery process. Physical limitations altered their perceptions on body, and family-work conflicts caused tremendous stress. They also experienced internalized stigma and job insecurities. This study provides insights into challenges that COVID-19 female long haulers could face in their return to normal social life, underscoring the vulnerability of females affected by long COVID due to significant alterations in their social lives. Shifting to new methods of communication, especially social media, diminished the adverse effects of long COVID (e.g., social isolation).

Impact of COVID-19 symptoms on social aspects of life among female long haulers: A qualitative study.

Introduction: Persistent COVID-19 symptoms (long COVID) may bring numerous challenges to long haulers' social lives. Women may have to endure more profound impacts given their social roles and existing structural inequality. This study aims to explore the impacts of long COVID on various aspects of social life among female long haulers. Methods: We conducted 15 semi-structured interviews with female long haulers in the United States purposely recruited from Facebook groups, Slack group, and organization websites. The interviews were audio recorded after appropriate consent and transcribed verbatim. Inductive approach was applied in thematic analysis, which consists of six stages: becoming familiar with data, developing initial codes, extracting themes, refining themes, labeling themes, and reporting. The MAXQDA software was used in data analysis. Results: Participants reported persistent symptoms that negatively affected their social lives in many ways. The main impacts included physical limitation, financial hardship, social relationship, conflict of social roles, and social stigma. Negative effects of long COVID hindered female long haulers' recovery process. Social isolation, COVID-19 associated stigma, and conflicts of social roles cause tremendous stress. Employers' support and social media usage may play positive role in their coping with impacts of long COVID on their social life. Conclusion: Existing policies and intervention programs need to be adapted to address the challenges and barriers that long haulers face in returning to normal social life, especially for females. Tailored social life-related recommendations and social support are needed for female long haulers.