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COVID-19: Psychol­­­ogical Distress, Fear, and Coping Strategies Among Community Members Across 17 Countries

60 Pages Posted: 14 Jun 2021

See all articles by Muhammad Aziz Rahman

Muhammad Aziz Rahman

Federation University Australia

Sheikh Mohammed Shariful Islam

Deakin University - Institute for Physical Activity and Nutrition (IPAN)

Ramy Abdelnaby

Brega General Hospital

Rayan Jafnan Alharbi

Jazan University - Department of Emergency Medical Service

Talal Ali Alharbi

King Saud University

Almajdoub Ali

Brega General Hospital

Sheikh M. Alif

Monash University

Manal Al Kloub

The Hashemite University

Nahed Al Laham

Al Azhar University-Gaza

Sondos Al-Madhoun

Al Azhar University-Gaza

Turkiya Saleh Al Maskari

Oman College of Health Sciences

Sami Almustanyir

Ministry of Health, Riyadh

Adhra Al-Mawali

Centre of Studies & Research, Directorate General Planning and Studies, Ministry of Health

Alaa Ashraf AlQurashi

King Fahad Medical City

Tamanna Bahar

National Institute of Cancer Research and Hospital

Biswajit Banik

Federation University Australia

Sek Ying Chair

The Chinese University of Hong Kong (CUHK) - The Nethersole School of Nursing

Wai Tong Chien

The Chinese University of Hong Kong (CUHK) - The Nethersole School of Nursing

Rania Dweik

Abu Dhabi University

Asmaa M. Elaidy

Al-Azhar University, Cairo - Faculty of Medicine for Girls

Nashwa El-Khazragy

Ain Shams University

Mohamed Elsayed

Ulm University - Department of Psychiatry and Psychotherapy

Deena H. Elsori

Abu Dhabi University

Nael Kamel Eltewacy

Beni Suef University

Sherief Ghozy

El-Sheikh Zayed Specialized Hospital

Tribowo Tuahta Ginting

Persahabatan General Hospital

Majeda Hammoud

Department of Communication Disorders Sciences

amr hamza

University of Aleppo - Faculty of Medicine

Suwit Inthong

Chiang Mai University

Bindu Joseph

Federation University Australia

Mohamad Ali Keblawi

University of Aleppo - Faculty of Medicine

Sabria Jihan Khan

University of Melbourne

Louisa Lam

Federation University Australia

Ilias Mahmud

Qassim University

Ahmed Suparno Bahar Moni

Universiti Sains Malaysia (USM)

Sirirat Nitayawan

Chiang Mai University

Natalia Oli

Kathmandu Medical College

Shaila Rahman

Enam Medical College and Hospital

Masudus Salehin

Federation University Australia

Carlos Schoenfeldt-Lecuona

Psychiatric University Clinic

Cattaliya Siripattarakul Sanluang

Chiang Mai University

Farhana Sultana

Dhaka Community Medical College

Agus Dwi Susanto

University of Indonesia (UI)

Feni Fitrani Taufik

University of Indonesia (UI)

Ratree Thongyu

Rangsit University

Patraporn Tungpunkom

Chiang Mai University

Mara Gerbabe Ruiz

Oman College of Health Sciences

Farhana Yasmin

Lahore Garrison University

Mimmie Claudine Watts

Federation University Australia

Amit Wazib

Enam Medical College and Hospital

Wendy M. Cross

Federation University Australia

More...

Abstract

Background: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Our study aimed to examine the extent and associated factors to psychological distress, the level of fear of COVID-19, and coping strategies amongst a diverse range of community people in multi-country settings.

Methods: A cross-sectional study across 17 countries was conducted. Psychological distress (based on the Kessler Psychological Distress Scale) was categorized into low and moderate to very high, fear of COVID-19 (based on the Fear of COVID-19 Scale) was categorized into low and high, and coping (based on the Brief Resilient Coping Scale) was categorized into low and medium to high. For country-wise comparisons, we selected the reference country based on the lowest prevalence of each outcome and examined the status for other countries. Multivariate analyses were conducted to adjust potential confounders including in-country variations; adjusted odds ratio (AOR) and 95% confidence intervals (CIs) were reported.

Findings: A total of 8559 people participated in this study. Mean age (±SD) was 33 (±13) years and two-thirds (64%) were females. More than one-third (40%) self-identified as frontline or essential service workers. More than two-thirds (69%) experienced moderate to very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (AOR 1.56 [1.29-1.90]), being affected by the change of financial situation, comorbidity with mental health conditions (AOR 3.02 [1.20-7.60]), unsure contact with COVID-19 patient, and use of healthcare services in the last six months were associated with moderate to very high levels of psychological distress. Doctors had higher psychological distress (AOR 1.43 [1.04-1.97]), but low levels of fear of COVID-19 (AOR 0.55 [0.41-0.76]); nurses had medium to high resilient coping (AOR 1.30 [1.03-1.65]). Participants from 10 countries (Hong Kong, Oman, Libya, Kuwait, Saudi Arabia, UAE, Jordan, Syria, Palestine and Egypt) demonstrated significantly higher psychological stress compared to the participants from Thailand. Participants from four countries (Oman, Indonesia, Hong Kong and Pakistan) exhibited higher levels of fear of COVID-19 compared to those from Libya. Participants from 12 countries (Jordan, Egypt, Saudi Arabia, Kuwait, Hong Kong, UAE, Palestine, Thailand, Oman, Nepal, Indonesia and Syria) demonstrated statistically significant medium to high resilience coping compared to those from Australia.

Interpretation: Females and people with existing mental health issues were the most vulnerable groups of populations for adverse psychological impact of COVID-19 pandemic across 17 countries. While these two groups had ongoing challenges in a COVID-free world, the pandemic worsened their wellbeing. There is an urgent need to prioritise their needs. Adequate medical and social support along with specific health promotion policies should be considered within the strategic response to the ongoing pandemic and future crises.

Funding Information: None.

Declaration of Interests: We declare no competing interests.

Ethics Approval Statement: Ethics approval was obtained from the Human Research Ethics Committee from each participating country. The survey was voluntary in nature and it was clarified in the PLIS, so that participants got the opportunity to have informed decision to participate in the study. Privacy and confidentiality of the collected data were maintained. All responses were anonymous and there was no information about the identity of the participants.

Keywords: COVID-19, coronavirus, mental health, psychological distress, fear, coping, resilience

Suggested Citation

Rahman, Muhammad Aziz and Islam, Sheikh Mohammed Shariful and Abdelnaby, Ramy and Alharbi, Rayan Jafnan and Alharbi, Talal Ali and Ali, Almajdoub and Alif, Sheikh M. and Al Kloub, Manal and Al Laham, Nahed and Al-Madhoun, Sondos and Al Maskari, Turkiya Saleh and Almustanyir, Sami and Al-Mawali, Adhra and AlQurashi, Alaa Ashraf and Bahar, Tamanna and Banik, Biswajit and Chair, Sek Ying and Chien, Wai Tong and Dweik, Rania and Elaidy, Asmaa M. and El-Khazragy, Nashwa and Elsayed, Mohamed and Elsori, Deena H. and Eltewacy, Nael Kamel and Ghozy, Sherief and Ginting, Tribowo Tuahta and Hammoud, Majeda and hamza, amr and Inthong, Suwit and Joseph, Bindu and Keblawi, Mohamad Ali and Khan, Sabria Jihan and Lam, Louisa and Mahmud, Ilias and Bahar Moni, Ahmed Suparno and Nitayawan, Sirirat and Oli, Natalia and Rahman, Shaila and Salehin, Masudus and Schoenfeldt-Lecuona, Carlos and Sanluang, Cattaliya Siripattarakul and Sultana, Farhana and Susanto, Agus Dwi and Taufik, Feni Fitrani and Thongyu, Ratree and Tungpunkom, Patraporn and Ruiz, Mara Gerbabe and Yasmin, Farhana and Watts, Mimmie Claudine and Wazib, Amit and Cross, Wendy M., COVID-19: Psychol­­­ogical Distress, Fear, and Coping Strategies Among Community Members Across 17 Countries. Available at SSRN: https://ssrn.com/abstract=3866545 or http://dx.doi.org/10.2139/ssrn.3866545

Muhammad Aziz Rahman (Contact Author)

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Sheikh Mohammed Shariful Islam

Deakin University - Institute for Physical Activity and Nutrition (IPAN) ( email )

Geelong, Victoria
Australia

Ramy Abdelnaby

Brega General Hospital ( email )

Brega
Libya

Rayan Jafnan Alharbi

Jazan University - Department of Emergency Medical Service ( email )

Saudi Arabia

Talal Ali Alharbi

King Saud University

P.O. Box 2460
Riyadh, 11451
Saudi Arabia

Almajdoub Ali

Brega General Hospital ( email )

Brega
Libya

Sheikh M. Alif

Monash University

23 Innovation Walk
Wellington Road
Clayton, Victoria 3800
Australia

Manal Al Kloub

The Hashemite University ( email )

Nahed Al Laham

Al Azhar University-Gaza ( email )

Jamal Abdl Naser St.
Gaza P.O Box 1277
Gaza, Gaza Strip P.O. Box 1
Palestine

Sondos Al-Madhoun

Al Azhar University-Gaza ( email )

Jamal Abdl Naser St.
Gaza P.O Box 1277
Gaza, Gaza Strip P.O. Box 1
Palestine

Turkiya Saleh Al Maskari

Oman College of Health Sciences ( email )

Sur
Oman

Sami Almustanyir

Ministry of Health, Riyadh ( email )

Saudi Arabia

Adhra Al-Mawali

Centre of Studies & Research, Directorate General Planning and Studies, Ministry of Health ( email )

Alaa Ashraf AlQurashi

King Fahad Medical City

Riyadh
Saudi Arabia

Tamanna Bahar

National Institute of Cancer Research and Hospital

Bangladesh

Biswajit Banik

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Sek Ying Chair

The Chinese University of Hong Kong (CUHK) - The Nethersole School of Nursing ( email )

Shatin
Hong Kong

Wai Tong Chien

The Chinese University of Hong Kong (CUHK) - The Nethersole School of Nursing ( email )

Shatin
Hong Kong

Rania Dweik

Abu Dhabi University

Abu Dhabi
United Arab Emirates

Asmaa M. Elaidy

Al-Azhar University, Cairo - Faculty of Medicine for Girls ( email )

Egypt

Nashwa El-Khazragy

Ain Shams University

Cairo
Egypt

Mohamed Elsayed

Ulm University - Department of Psychiatry and Psychotherapy ( email )

Germany

Deena H. Elsori

Abu Dhabi University

Abu Dhabi
United Arab Emirates

Nael Kamel Eltewacy

Beni Suef University

Bani Sweif
Egypt

Sherief Ghozy

El-Sheikh Zayed Specialized Hospital ( email )

Giza
Egypt

Tribowo Tuahta Ginting

Persahabatan General Hospital

Majeda Hammoud

Department of Communication Disorders Sciences

Safat, 13060
Kuwait

Amr Hamza

University of Aleppo - Faculty of Medicine ( email )

Syria

Suwit Inthong

Chiang Mai University

Huay Kaew Road
Chiang Mai, 50100
Thailand

Bindu Joseph

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Mohamad Ali Keblawi

University of Aleppo - Faculty of Medicine ( email )

Syria

Sabria Jihan Khan

University of Melbourne ( email )

185 Pelham Street
Carlton, Victoria 3053
Australia

Louisa Lam

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Ilias Mahmud

Qassim University

Qassim University, Saudi Arabia
College of Sciences and Arts
Buraydah, 52571
Saudi Arabia

Ahmed Suparno Bahar Moni

Universiti Sains Malaysia (USM)

Minden, 11800
Malaysia

Sirirat Nitayawan

Chiang Mai University

Huay Kaew Road
Chiang Mai, 50100
Thailand

Natalia Oli

Kathmandu Medical College

PO Box 21266
Sinamangal
Kathmandu
Nepal

Shaila Rahman

Enam Medical College and Hospital

Bangladesh

Masudus Salehin

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Carlos Schoenfeldt-Lecuona

Psychiatric University Clinic ( email )

Ulm
Germany

Cattaliya Siripattarakul Sanluang

Chiang Mai University

Huay Kaew Road
Chiang Mai, 50100
Thailand

Farhana Sultana

Dhaka Community Medical College ( email )

Agus Dwi Susanto

University of Indonesia (UI)

Feni Fitrani Taufik

University of Indonesia (UI)

Kampus Baru UI Depok
Jawa Barat, 16424
Indonesia

Ratree Thongyu

Rangsit University

52/347 Colonel Thaksin Lak Hok
Pathum Thani
Thailand

Patraporn Tungpunkom

Chiang Mai University

Huay Kaew Road
Chiang Mai, 50100
Thailand

Mara Gerbabe Ruiz

Oman College of Health Sciences ( email )

Sur
Oman

Farhana Yasmin

Lahore Garrison University ( email )

Lahore, Punjan 54000
Pakistan

Mimmie Claudine Watts

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

Amit Wazib

Enam Medical College and Hospital

Bangladesh

Wendy M. Cross

Federation University Australia

University Dr.
Mt Helen, 3350
Australia

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