Associations Between Eating, Mobility, and Toileting Functional Dependence and COVID-19 Symptoms.

OBJECTIVES: The first goal of this study was to explore associations between functional dependence levels during activities of daily living (eg, functional mobility, eating, and toileting) before COVID-19 and presence of COVID-19 symptoms (eg, fever, dehydration, lethargy, and shortness of breath) during illness. The second goal of this study was to explore associations between presence of specific COVID-19 symptoms and level of functional decline from before to after illness. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: A total of 375 residents at a single skilled nursing facility in New York City. METHODS: Data were extracted from the Minimum Data Set 3.0 and chart reviews. Multiple linear regressions analyzed relationships between baseline functional dependence in eating, functional mobility, and toileting and presence of dehydration, lethargy, shortness of breath, and fever. Ordinal linear regressions analyzed associations between COVID-19 symptom presence and changes in functional dependence from before to after illness. RESULTS: Pre-COVID-19 eating dependence was significantly associated with dehydration during COVID-19. Dehydration during COVID-19 was significantly associated with greater functional declines in functional mobility from before to after illness. Shortness of breath was significantly associated with increased functional declines in eating and functional mobility. CONCLUSIONS AND IMPLICATIONS: Patients with COVID-19 should be monitored for shortness of breath and dehydration, as these symptoms are associated with functional decline. Individuals experiencing functional decline before COVID-19 onset are especially vulnerable to these symptoms. Future research should further explore the relationship between functional status and COVID-19 symptoms.

Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing.

AIM: The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions. METHODS: This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (n = 38,679) and data collected in 2020 were used for Study 2 (n = 50,307). RESULTS: Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity. CONCLUSION: Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.